Abstract
This letter describes an interesting case of a 98-year-old woman with multiple head and neck squamous cell carcinoma (HNSCC) and Parkinson disease (PD). The following squamous cell cancers were discovered in this patient: (1) squamous cell carcinoma of the tongue, diagnosed and excised in 2004 with complete clinical recovery; and (2) in situ squamous cell carcinoma of the right cheek and the neck, diagnosed in 2009. She also presented difficulty in the dexterity of the right hand and a typical PD asymmetric presentation. Indeed, the patient had a rest tremor and cogwheel rigidity, bradykinesia bilaterally, stooped posture, turns en bloc, and decreased armswing on the right. These symptoms were responsive to the administration of L-DOPA. It is well known that head and neck cancer is one of the most common worldwide and that tobacco and alcohol consumptions are primary risk factors for HNSCC [1]. On the other hand, PD is one of the most common neurodegenerative disorder with a prevalence of 3% in persons over the age of 65 years [1]. PD is characterized by the presence of intracytoplasmic inclusions, named Lewy bodies (LB), and by a massive loss of dopaminergic neurons in the substantia nigra [2]. Most PD cases are sporadic, but about 15% of them are associated with genetic causes. The loss of dopaminergic afferents from the substantia nigra to the striatum and putamen results in extrapyramidal motor dysfunction, including tremor, rigidity, and bradykinesia. Another hallmark of PD is gliosis, an accumulation of activated microglia and astrocytes in the substantia nigra and striatum [2], although it remains to be clarified how gliosis is initiated and sustained in PD. The symptoms of PD can be ameliorated by medications, such as precursors of dopamines, but these remedies cannot prevent or retard the neurodegenerative progression [3]. Apoptosis is a programmed cell death process under both normal physiological and pathological conditions. Caspases, a family of cysteine-dependent aspartate-specific proteases, are important mediators of the apoptotic process [3]. Caspases cleave numerous intracellular substrates in the initiation of cell dissolution [3, 4]. Caspase 3, apoptosis-related cysteine peptidase (CASP3), maps to human chromosome 4q35 and plays important roles in the extrinsic and intrinsic apoptosis pathways (MIM 600636). Recent molecular epidemiological studies suggest that CASP3 may contribute to HNSCC susceptibility and disease progression and that increased CASP3 expression is associated with tumors of the mouth [5]. Moreover, previous studies suggested that CASP3 activation and subsequent apoptosis of dopamine neurons in the substantia nigra may be the initial step essential for the development of PD [6]. The poly (ADP-ribose) polymerase 1 (PARP1) gene, located at 1q42, is 43 Kb long and splits into 23 exons A. E. Calogero M. C. Giuffrida D. Giuffrida S. La Vignera R. Castiglione M. Salemi Section of Endocrinology, Andrology and Internal Medicine, Department of Internal Medicine and Systemic Diseases, University of Catania, Catania, Italy
Published Version
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call