Damage of the internal carotid artery (ICA) is very rare but can be a dramatic complication of endonasal sinus surgery. In the literature only a few cases are reported, some of them with fatal ...results.
We present two cases with massive bleeding of the ICA caused by endonasal sinus surgery.
In both cases bleeding could be stopped sufficiently by implanting a stentgraft.
The lumen of the artery could be preserved and no neurological deficits were observed.
-activating mutations are the most frequent driver mutations in papillary thyroid cancer (PTC). Targeted inhibitors such as dabrafenib have been used in advanced
-mutated PTC; however, acquired ...resistance to the drug is common and little is known about other effectors that may play integral roles in this resistance. In addition, the induction of PTC dedifferentiation into highly aggressive
-driven anaplastic thyroid cancer (ATC) has been reported. We detected a novel
(P34R) mutation acquired during dabrafenib treatment in a progressive metastatic lesion with ATC phenotype. To identify a potential functional link between this novel mutation and tumor dedifferentiation, we developed a cell line derived from the metastatic lesion and compared its behavior to isogenic cell lines and primary tumor samples. Our data demonstrated that
mutations induce changes in cell morphology, reorganization of F-actin almost exclusively at the cell cortex, and changes in cell adhesion properties. We also established that
amplification, with or without mutation, is sufficient to drive cell proliferation and resistance to
inhibition. Further, we identified polyploidy of chromosome 7, which harbors
, in both the metastatic lesion and its derived cell line. Copy number amplification and overexpression of other genes located on this chromosome, such as
,
, and
were also detected, which might also lead to dabrafenib resistance. Our study suggests that polyploidy leading to increased expression of specific genes, particularly those located on chromosome 7, should be considered when analyzing aggressive thyroid tumor samples and in further treatments.
PDF