Canine cutaneous melanocytic tumours: significance of ß-catenin and survivin immunohistochemical expression.

BACKGROUND: Recent investigations have highlighted the controversial role of Wnt/ß-catenin pathway activation in human cutaneous melanoma. Survivin has been proposed as a valid prognostic marker for invasive and metastatic melanomas and lymph node melanoma metastasis in human cutaneous melanoma and is a promising therapeutic target. HYPOTHESIS/OBJECTIVES: Our aim was to investigate the immunohistochemical expression of survivin and ß-catenin in canine cutaneous melanocytic tumours, in order to understand their prognostic significance. METHODS: Twenty-one melanocytic tumours (10 melanocytomas and 11 melanomas) were investigated by immunohistochemistry using specific anti-survivin and anti-ß-catenin antibodies. A semi-quantitative method was used to analyse the results; ß-catenin immunolabelling in neoplastic cells was evaluated as cytoplasmic, membranous or nuclear. The number of survivin-positive cells was counted within ~1000 neoplastic cells. Results were related to histopathological features, evaluated in haematoxylin- and eosin-stained slides, and to the clinical data obtained through a telephone survey with referring veterinarians. RESULTS: Despite a low level of expression in the majority of cases, ß-catenin was found to be correlated strongly with malignant behaviour (P < 0.01). An overexpression of nuclear survivin was statistically related to histological features of malignancy, presence of metastasis and death related to melanoma spread (P < 0.01). CONCLUSIONS AND CLINICAL IMPORTANCE: The low nuclear ß-catenin expression, mainly found in metastatic cases, would indicate that ß-catenin activation may have only limited importance in the development or progression of canine cutaneous melanoma. The correlation of nuclear survivin expression with malignancy would indicate that survivin is possibly a useful prognostic marker and therapeutic target in canine melanoma patients.

Epithelial-to-mesenchymal transition: immunohistochemical investigation of related molecules in canine cutaneous epithelial tumours.

BACKGROUND: Epithelial-to-mesenchymal transition (EMT) is a multistep process, important in tumour invasion and metastasis, characterized by loss of epithelial markers, redistribution of ß-catenin and gain of mesenchymal markers. HYPOSTHESIS/OBJECTIVES: Our aim was to investigate the immunohistochemical aberrant expression of cytokeratin, vimentin, survivin and heat shock protein 72 (Hsp72) in canine cutaneous epithelial tumours, to understand the association of expression of these molecules with features of malignancy and their role in the EMT phenotype. METHODS: Ten canine squamous cell carcinomas (SCCs; one with lymph node metastasis), 30 canine hair follicle tumours (six pilomatricomas, eight infundibular keratinizing acanthomas, six trichoepitheliomas and 10 trichoblastomas) and five normal skin samples were investigated by immunohistochemistry using specific anti-vimentin, -cytokeratin, -survivin and -Hsp72 antibodies. A semi-quantitative method was used to analyse the results, as follows: 0 to <5%; ≥ 5 to <10%; ≥ 10 to <25%; and ≥ 25% of positive cells. Immunofluorescence was performed to investigate survivin-vimentin and survivin-Hsp72 colocalization in selected SCCs. Results - In malignant hair follicle tumours and SCCs, a reduced intensity of cytokeratin and increased survivin and Hsp72 expression were observed. In SCCs, loss of cytokeratin expression and vimentin immunolabelling, suggestive of the EMT phenotype, were evident in <5% of neoplastic cells in the front of tumour invasion. In the same areas, strong nuclear survivin and cytoplasmic Hsp72 staining was evident, often colocalizing. Only a few neoplastic cells in the front of tumour invasion showed vimentin-survivin colocalization. CONCLUSIONS AND CLINICAL IMPORTANCE: A possible simultaneous involvement of survivin and Hsp72 in tumour invasion and the multistep process of EMT of cutaneous epithelial tumours of dogs is suggested.

Intraoperative endobronchial tube displacement requiring unplanned extracorporeal circulation support.

We describe the adoption of extracorporeal circulation (ECC) as temporary pulmonary support in a patient operated on for a broncho-pleural fistula. Complex thoracic surgical procedures can require one-lung ventilation with double-lumen or selective bronchial tubes. Intraoperative tube displacement can cause severe desaturation and hypoxia, finally resulting in severe cerebral or multiorgan damages. Cardiopulmonary bypass, being able to temporarily take over the gas exchange function of the lung, is the only chance to support pulmonary function in cases such as this one. We suggest performing complex thoracic surgical procedures in centers with the availability and experience of ECC techniques.

Intrapericardial lipoma: successful resection of a giant tumor without cardiopulmonary bypass.

Cardiac lipomas are very rare neoplasms. We describe herein a case of giant intrapericardial extracavitary lipoma in a 67-year-old man who has been previously treated for prostate and kidney cancers. The patient underwent successful resection of the tumor through right anterolateral thoracotomy.