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Silveira FM, Schuch LF, Pereira-Prado V, Sicco E, Almeda-Ojeda O, Molina-Frechero N, Paparella ML, Villarroel-Dorrego M, Hernadez M, Bologna-Molina R. Frequency of BRAF V600E immunoexpression in ameloblastomas: a multi-institutional analysis of 86 cases in Latin America and comprehensive review of the literature. Med Oral Patol Oral Cir Bucal 2024:26493. [PMID: 38615253 DOI: 10.4317/medoral.26493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 03/18/2024] [Indexed: 04/15/2024] Open
Abstract
BACKGROUND The initiation of odontogenic tumorigenesis often involves the activation of the MAP-kinase pathway, with a pivotal role played by the BRAF V600E mutation. This study aimed to investigate the frequency of BRAF V600E immunoexpresion in ameloblastomas diagnosed in four Latin American centers and correlate this finding with the histological types and subtypes of the analyzed cases. MATERIAL AND METHODS A total of 86 samples of ameloblastomas were examined for immunohistochemistry using anti-BRAF V600E antibody. The histopathological features of each case were analyzed. RESULTS Positivity for anti-BRAF V600E antibody was detected in 65/86 cases (75.6%). BRAF V600E was positive in 38/56 cases (67.9%) of conventional ameloblastomas and in 27/30 cases (90.0%) of unicystic ameloblastomas. A statistically significant difference in BRAF V600E positivity was observed when comparing unicystic ameloblastomas to conventional ameloblastomas (p=0.03). No statistically significant difference in BRAF V600E positivity was observed when comparing histological variants, both for conventional ameloblastomas and unicystic ameloblastomas. CONCLUSIONS This study highlights a high frequency of BRAF V600E immunoreactivity in ameloblastomas among Latin American cases. The prevalence of the BRAF V600E immunoexpresion may suggest the feasibility of utilizing BRAF-targeted therapy for ameloblastomas with this mutation.
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Affiliation(s)
- F-M Silveira
- Department of Diagnostics in Pathology and Oral Medicine Universidad de la República, Montevideo, 16400, Uruguay
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2
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Prieto-Correa JR, Bologna-Molina R, González-González R, Molina-Frechero N, Soto-Ávila JJ, Isiordia-Espinoza M, Márquez MC, Verdín SL. DNA oxidative damage in oral cancer: 8-hydroxy-2´-deoxyguanosine immunoexpression assessment. Med Oral Patol Oral Cir Bucal 2023; 28:e530-e538. [PMID: 37471300 PMCID: PMC10635627 DOI: 10.4317/medoral.25924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 06/22/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND The development and establishment of oral squamous cell carcinoma are confined to carcinogenesis, which involves oxidative stress via oxygen-free radical production as a hydroxyl radical (HO•), considered the most important cause of oxidative damage to basic biomolecules since it targets DNA strands. 8-Hydroxy-2´-deoxyguanosine (8-OHdG) is considered a free radical with a promutagenic capacity due to its ability to pair with adenosine instead of cytosine during replication. MATERIAL AND METHODS We collected 30 paraffin-embedded tissue samples of OSCC from patients treated between 2013 and 2018. We recorded risk habits, disease stage, disease free survival and death with at least 3 years of follow-up. 8-Hydroxyguanosine was evaluated by immunohistochemistry and subsequently classified as weak-moderate or strong positive expression. Additionally, we noted whether it was expressed in the cytoplasm and/or nucleus. RESULTS Most of the cases expressed 8-OHdG with a strong intensity (80%). All neoplastic cells were preferentially stained in only the cytoplasm (70.0%), but nuclear positivity was found in 30%, independent of the intensity. Based on the location in the cytoplasm and/or nucleus, tumors >4 cm showed a high frequency (95.5%) of 8-OHdG expression in only the cytoplasm, with a significant difference (p value 0.001). Additionally, overall survival was affected when immunoexpression was present in the cytoplasm and nucleus because all deaths were in this group were statistically significant (p value = 0.001). CONCLUSIONS All tumors showed DNA oxidative damage, and 8-OHdG was preferentially expressed in the cytoplasm. This finding was associated with tumor size and, when present in the nucleus, might also be related to death.
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Affiliation(s)
- J-R Prieto-Correa
- Instituto de Investigación en Odontología Centro Universitario de Ciencias de la Salud Universidad de Guadalajara, Sierra Mojada # 950 Colonia Independencia, Guadalajara, Jalisco, C.P. 44340, Mexico
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3
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Derderian N, Pereira-Prado V, Hernandez M, Isiordia-Espinoza M, Arocena M, González-González R, Tremillo-Maldonado O, Meleti M, Molina-Frechero N, Bologna-Molina R. Ep-CAM (MOC-31) expression in tooth germ and ameloblastoma. Med Oral Patol Oral Cir Bucal 2022; 27:e403-e409. [PMID: 35975801 PMCID: PMC9445613 DOI: 10.4317/medoral.25145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 07/16/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Ep-CAM, a transmembrane glycoprotein expressed in most epithelium in normal conditions, has diverse roles in these tissues, including in cell adhesion, proliferation, differentiation, cell cycle regulation, migration and intracellular signaling. It is also over-expressed in most malignant neoplasia, participating in the initiation, progression, and metastatic dissemination of the tumor. The expression and roles of this protein in oral neoplasia, particularly in odontogenic tumors, remain unestablished. The objective of this study consisted in analyzing the expression of this protein in ameloblastoma and tooth germ. MATERIAL AND METHODS Ep-CAM (MOC-31) expression was evaluated by immunohistochemistry in tooth germs (TG) (n = 16) ameloblastomas (AM) (n = 60) and 2 ameloblastic carcinomas. Sections were visualized in their totality with an optical microscope, and positivity observed in cell membrane and cytoplasm was graded according to the following semi-quantitative scale: Neg, "essentially unstained", for negative sections or staining <5% of cells; + for staining of 5-50% of cells; ++ for staining >50% of cells. RESULTS Most tooth germs expressed MOC-31 (81.3%), strong staining was observed both in the inner epithelium of the enamel organ and in the adjacent stellate reticulum. 16.7% of the AM cases showed MOC-31 expression, the immunoexpression expression was diffuse at the cytoplasmic and membrane level. The only two cases of ameloblastic carcinoma included were strong positive to MOC-31. No correlation was observed between protein expression and gender, age, clinical variants, or histological subtypes. CONCLUSIONS Overexpression was found in TG and ameloblastic carcinoma compared to AM; further studies with different experimental strategies are suggested to clarify the biological significance of this finding.
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Affiliation(s)
- N Derderian
- Molecular Pathology, School of Dentistry Universidad de la República (UDELAR) Las Heras 1925, Montevideo 14600, Uruguay
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4
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Pereira-Prado V, Vigil-Bastitta G, Sánchez-Romero C, Arocena M, Molina-Frechero N, González-González R, Meleti M, Bologna-Molina R. Immunoexpression of galectin-3 and its potential relation to hypoxia-inducible factor-1α in ameloblastomas. Biotech Histochem 2021; 96:296-301. [PMID: 32744463 DOI: 10.1080/10520295.2020.1800819] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
In tumor biology, hypoxia triggers signaling pathways that induce transcription of genes related to angiogenesis, metastasis, glucose metabolism and apoptosis. We investigated the expression of hypoxia related proteins, galectin-3 (Gal-3) and hypoxia-inducible factor-1α (HIF-1α), in conventional (CA) and unicystic ameloblastomas (UA). We applied immunohistochemistry for Gal-3 and HIF-1α to 72 cases of ameloblastoma: 59 cases of CA and 13 cases of unicystic UA. Immunoexpression was evaluated semiquantitatively. Gal-3 expression was observed in 40% of the cases: 23/59 CA and 6/13 UA. HIF-1α immunostaining was observed in 55% of cases: 36/59 CA and 4/13 UA. 19 CA and 2 UA were positive for both markers. Immunostaining was evident in the center of the tumor islands, which exhibited squamous metaplasia or cystic degeneration. The expression of Gal-3 and HIF-1α in ameloblastomas could be interpreted as a response to hypoxic stress. Co-expression of both proteins in CA may suggest a potential interaction that participates in the biological behavior of this ameloblastoma variant.
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Affiliation(s)
- V Pereira-Prado
- Molecular Pathology Area, School of Dentistry, University of the Republic, Montevideo, Uruguay
| | - G Vigil-Bastitta
- Molecular Pathology Area, School of Dentistry, University of the Republic, Montevideo, Uruguay
| | - C Sánchez-Romero
- Molecular Pathology Area, School of Dentistry, University of the Republic, Montevideo, Uruguay
| | - M Arocena
- Biochemistry Area, School of Dentistry, Republic University, Montevideo, Uruguay
| | - N Molina-Frechero
- Health Care Department, Metropolitan Autonomous University, Xochimilco Unit, Mexico City, Mexico
| | - R González-González
- Department of Research, School of Dentistry, Juarez University of Durango State, Durango, Mexico
| | - M Meleti
- University Center of Dentistry, Department of Medicine and Surgery, University of Parma, Italy
| | - R Bologna-Molina
- Molecular Pathology Area, School of Dentistry, University of the Republic, Montevideo, Uruguay
- Department of Research, School of Dentistry, Juarez University of Durango State, Durango, Mexico
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Sánchez-Romero C, Pereira-Prado V, Sicco E, Suarez M, Tapia-Repetto G, Carreón-Burciaga R, Gónzalez-Gónzalez R, Villarroel-Dorrego M, Meleti M, Molina-Frechero N, Bologna-Molina R. Expression of caveolin-1 in tooth germ, ameloblastoma and ameloblastic carcinoma. Med Oral Patol Oral Cir Bucal 2021; 26:e238-e245. [PMID: 33037799 PMCID: PMC7980299 DOI: 10.4317/medoral.24151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 09/03/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The caveolin-1 protein (structural component of membrane caveolae) plays important roles in several biological functions, such as endocytosis, cell adhesion, and cell signaling. However, this protein has been associated with mechanisms of tumorigenesis in several neoplasms. The expression patterns and roles of caveolin-1 in the oral epithelium and in embryonic and odontogenic tumor tissues are still unclear. MATERIAL AND METHODS The expression of caveolin-1 was evaluated in samples of the normal gingival epithelium (n=7), human tooth germ (TG) (n=12), ameloblastoma (AM) (n=83), and ameloblastic carcinoma (AC) (n=9) by immunohistochemistry. Additionally, AM samples were analyzed by qRT-PCR and Western blot. RESULTS Most TG (91.7%), AM (73.5%) and AC (100%) samples showed diverse patterns of immunohistochemical positivity for caveolin-1, while only one gingival sample was positive. The transcript levels of cav-1 were significantly upregulated by 14.9-fold in AM tissue (P = 0.0014) compared to those in normal gingival epithelial tissue, as shown by qRT-PCR. Presence of caveolin-1 protein was confirmed by Western blot analysis. The caveolin-1 immunoexpression patterns throughout the stages of TG show its importance during odontogenesis. CONCLUSIONS The overexpression of caveolin-1 in AM and AC compared to its expression in normal gingival epithelium (adult tissue) suggests a possible role of caveolin-1 in protumoral events, but due to the similar immunoexpression observed in AM and AC, caveolin-1 may not necessarily participate in the malignant transformation process. However, future studies are needed to clarify and confirm these hypotheses.
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Affiliation(s)
- C Sánchez-Romero
- Molecular Pathology Area, Faculty of Dentistry University of the Republic, Uruguay
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6
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López-Verdín S, Martínez-Fierro ML, Garza-Veloz I, Zamora-Perez A, Grajeda-Cruz J, González-González R, Molina-Frechero N, Arocena-Sutz M, Bologna-Molina R. E-Cadherin gene expression in oral cancer: Clinical and prospective data. Med Oral Patol Oral Cir Bucal 2019; 24:e444-e451. [PMID: 31256188 PMCID: PMC6667017 DOI: 10.4317/medoral.23029] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 04/05/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Low protein expression of E-cadherin in oral squamous cell carcinoma (OSCC) has been associated with clinical and histopathological traits such as metastases, recurrence, low survival and poor tumor differentiation, and it is considered a high-risk marker of malignancy. However, it is still unknown whether low expression of E-cadherin is also present at the mRNA level in OSCC cases. OBJECTIVE The aim of this study was to compare E-cadherin mRNA expression in OSCC patients and controls and to correlate the expression with clinical and prospective characteristics. MATERIAL AND METHODS Forty patients and 40 controls were enrolled. E-cadherin mRNA expression was evaluated by quantitative real-time polymerase chain reaction using TaqMan probes. RESULTS E-cadherin mRNA expression was significantly decreased in OSCC patients compared to that of controls (p<0.001). Whereas no significant association between clinical parameters and E-cadherin expression levels was observed, we noted lower E-cadherin expression levels in patients with positive lymph node metastasis. CONCLUSIONS E-cadherin mRNA expression was markedly diminished in OSCC, in agreement with previous results that examined E-cadherin expression at the protein level. E-cadherin is downregulated in the early clinical stages of OSCC, and its mRNA levels do not change significantly in the advanced stages, suggesting that there is limited usefulness of this parameter for predicting disease progression.
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Affiliation(s)
- S López-Verdín
- Molecular Pathology, School of Dentistry Universidad de la República (UDELAR) Las Heras 1925, Montevideo, Uruguay
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7
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Gaona E, Rivera T, Molina-Frechero N, Franco JG. Exploratory survey of initial image quality in new digital mammography units prior to use in patients in Mexico. Appl Radiat Isot 2018; 141:266-269. [PMID: 30049552 DOI: 10.1016/j.apradiso.2018.07.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2017] [Revised: 07/07/2018] [Accepted: 07/10/2018] [Indexed: 10/28/2022]
Abstract
In Mexico, previous studies performed to evaluate the image quality in 2D digital mammography facilities show a poor image quality that is not compatible with mammography screening that may modify breast cancer mortality rate. Image quality is lost due to the quality assurance programs are not implemented. We carried out an exploratory survey of thirty-six new (FFDM) units from a single manufacturer installed in several cities of the Mexican Republic with two types of target/filter combination (Mo/Mo and W/Rh). Tests were performed according to NOM-041-SSA1-2011 (Mexico), the regulation indicates that all facilities using digital mammography systems must maintain a QC program equal to the QC program recommended by the manufacturer. However, QC program recommended by the manufacturer meets with FDA and ACR Regulations. Digital mammography units evaluated exceeds quality image standards established by the ACR and FDA, even though, the W/Rh combination achieved a higher performance and reduces the average glandular dose. All mammography units met the quality control standards established by ACR, FDA and Mexican regulations. Then, the objective of this study was to evaluate the initial image quality and compliances with the manufacturer's quality control specifications before use it in patients in new full-field 2D digital mammography (FFDM) units and compares average glandular dose (AGD) with FFDM units using different anode/filter combinations (Mo/Mo and W/Rh).
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Affiliation(s)
- E Gaona
- Biological and Health Sciences Division, Metropolitan Autonomous University Xochimilco, Calz. del Hueso 1100, 04960 Mexico City, Mexico.
| | - T Rivera
- CICATA, National Polytechnic Institute, Calz. Legaria 694, 11500 Mexico City, Mexico.
| | - N Molina-Frechero
- Biological and Health Sciences Division, Metropolitan Autonomous University Xochimilco, Calz. del Hueso 1100, 04960 Mexico City, Mexico
| | - J G Franco
- Biological and Health Sciences Division, Metropolitan Autonomous University Xochimilco, Calz. del Hueso 1100, 04960 Mexico City, Mexico
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8
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Gómez-Herrera Z, Molina-Frechero N, Damián-Matsumura P, González-González R, Farfán-Morales JE, Bologna-Molina R. Expression of proteoglycans in two types of ameloblastoma: novel Immunohistochemical findings. J BIOL REG HOMEOS AG 2018; 32:479-487. [PMID: 29921372 DOI: pmid/29921372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Alterations in cellular and extracellular matrix components play an important role during tumorigenesis; proteoglycans are included among these components. Ameloblastomas are odontogenic tumors distinguished as invasive and infiltrative neoplasms and are divided into different histological types, the most common of which are the unicystic ameloblastoma and the conventional ameloblastoma. The aim of this study was to identify the presence of two proteoglycans, perlecan and biglycan, in different types of ameloblastoma. Using immunohistochemistry, we determined the presence of both proteins in 28 unicystic ameloblastomas and 23 conventional ameloblastomas. We identified the cytoplasmic and nuclear presence of perlecan and the cytoplasmic presence of biglycan in both types of ameloblastoma. The mean values of immunoexpression were higher in the conventional type compared to the unicystic type. Neither the presence of biglycan in ameloblastomas nor the nuclear presence of perlecan in any odontogenic tumor has previously been reported. The differential immunoexpression of perlecan and biglycan in these types of ameloblastomas suggests their participation in the developmental process of these tumors.
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Affiliation(s)
- Z Gómez-Herrera
- Biological and Health Sciences Ph.D. Program, Metropolitan Autonomous University (Universidad Autónoma Metropolitana) Mexico City, Mexico
| | - N Molina-Frechero
- Health and Care Department, Metropolitan Autonomous University (Universidad Autónoma Metropolitana- Iztapalapa) Mexico City, Mexico
| | - P Damián-Matsumura
- Department of Biology of Reproduction, Metropolitan Autonomous University (Universidad Autónoma Metropolitana-Xochimilco) Mexico City, Mexico
| | - R González-González
- Research Department, Juarez University of the Durango State, Durango, Mexico
| | - J E Farfán-Morales
- Molecular Pathology Laboratory, National Institute of Pediatrics, Mexico City, Mexico
| | - R Bologna-Molina
- Molecular Pathology Area, School of Dentistry, University of the Republic (UDELAR), Montevideo, Uruguay
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9
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López-Verdín S, Soto-Avila JJ, Zamora-Perez AL, Lazalde-Ramos BP, Martínez-Fierro ML, González-González R, Molina-Frechero N, Isiordia-Espinoza MA, Bologna-Molina R. Patients with advanced oral squamous cell carcinoma have high levels of soluble E-cadherin in the saliva. Med Oral Patol Oral Cir Bucal 2017; 22:e694-e701. [PMID: 29053653 PMCID: PMC5813987 DOI: 10.4317/medoral.21907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 10/08/2017] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The objective of this study was to assess the potential clinical value of the concentration of soluble salivary E-cadherin (sE-cadherin) compared with the clinical value of the presence of membranous E-cadherin (mE-cadherin) in oral squamous cell carcinoma tumor tissues. MATERIAL AND METHODS Data regarding patient demographics, clinical stage, saliva and tumor tissue samples were collected. The saliva was analyzed for sE-cadherin protein levels and was compared to the mE-cadherin immunohistochemical expression levels in tumor tissues, which were assessed via the HercepTest® method. Patients without cancer were included in the study as a control group for comparisons of the sE-cadherin levels. RESULTS sE-cadherin levels in the saliva of patients without cancer were lower than those in patients with cancer, and the difference was statistically significant (p=0.031). Low mE-cadherin expression was statistically significantly associated with lymph node positivity (p=0.015) and advanced clinical stage (p=0.001). The inverse relationship between mE-cadherin and sE-cadherin was significant in terms of lymph node positivity (p=0.014) and advanced clinical stage (p=0.037). CONCLUSIONS The results suggest that sE-cadherin levels are significantly increased in patients with oral cancer and that its low expression within the membrane as well as the progression of the disease appear to be inversely associated with levels of sE-cadherin in the saliva.
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Affiliation(s)
- S López-Verdín
- Molecular Pathology, School of Dentistry, Universidad de la República (UDELAR), Las Heras 1925, Montevideo, Uruguay,
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10
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Jarquín-Yáñez L, Mejía-Saavedra J, Molina-Frechero N, Pozos-Guillen A, Álvarez G. Risk assessment by exposure to fluorine through water consumption, by determining susceptibility biomarkers and effect in child population of San Luis Potosi. Toxicol Lett 2016. [DOI: 10.1016/j.toxlet.2016.07.317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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11
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González-González R, Bologna-Molina R, Molina-Frechero N, Domínguez-Malagon HR. Prognostic factors and treatment strategies for adult head and neck soft tissue sarcoma. Int J Oral Maxillofac Surg 2012; 41:569-75. [PMID: 22398019 DOI: 10.1016/j.ijom.2012.02.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2011] [Revised: 10/07/2011] [Accepted: 02/02/2012] [Indexed: 02/07/2023]
Abstract
Adult head and neck soft tissue sarcomas are rare and display a variety of histological types and clinical characteristics; they are also associated with a variety of mortality risks. The purpose of this study was to examine all patients treated at the Instituto Nacional de Cancerologia for head and neck sarcoma during a 5-year period. Fifty-one adult patients were examined and treated for head and neck sarcomas from 2004 to 2009. The 51 tumours were histologically re-evaluated by expert pathologists and classified as low, intermediate or high grade sarcomas. A multivariate analysis was performed to evaluate the surgical margins, histological grades, and clinical stages as prognostic factors for the disease. Adult head and neck soft tissue tumours are rare, and they are associated with poor prognosis for patients, especially at clinical stages III and IV. The average survival rate after 2 years is 45%, and most of these patients die because of disease progression and metastases.
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Affiliation(s)
- R González-González
- Universidad Autónoma Metropolitana, Unidad Xochimilco, UAM, Mexico City, Mexico
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