Benign Solid Tumors Research Articles

Aneuploidy in neoplasia: Single-cell data on 83,862 tumors.

Chromosomal aneuploidy, that is, numerical chromosome aberrations, is one of the molecular hallmarks of cancer. However, when neoplasms are studied with sequencing- and array-based approaches, chromosome numbers and ploidy states are typically inferred from bulk DNA data. Furthermore, published molecular estimates of neoplasia-associated aneuploidy often also include genomic imbalances resulting from various types of structural rearrangement, which likely result from other mechanisms than numerical chromosome aberrations. We thus analyzed chromosome numbers using single-cell cytogenetic data from 83,862 tumors, and show that both benign and malignant tumors are highly heterogeneous with regard to deviations from the normal, diploid state. Focusing on the chromosome numbers in 112 specific tumor types, defined by both exact morphologic diagnosis and organ location and from which data from ≥50 cases were available, we found two major clusters: one predominated by near-diploid neoplasms and one by neoplasms with extensive aneuploidy and one or more whole genome doublings. The former cluster included most benign solid tumors, myeloid neoplasms, and malignant gene fusion-associated solid tumors, whereas the latter was predominated by malignant solid tumors and lymphomas. For 16 malignant tumor types, the distribution of chromosome numbers could be compared to TCGA ploidy level data. Cytogenetic and molecular data correlated well, but the former indicates a higher level of clonal heterogeneity. The results presented here suggest shared pathogenetic mechanisms in certain tumor types and provide a reference for molecular analyses.

Value of elastography in characterization of solid renal masses

BackgroundSolid renal masses often come to light as incidental findings during abdominal ultrasound examinations. Once detected, determining whether a renal mass is benign or malignant becomes imperative for informed decision-making regarding management and treatment strategies. In this investigation, the aim was to explore the diagnostic efficacy of real-time strain sonoelastography in assessing solid renal masses.MethodsThis prospective research was steered on 26 individuals diagnosed with a solid renal mass, as endorsed by pathological analysis after surgical removal or biopsy. Elastography was performed on all patients. The measurement of strain index values for tissues was achieved by placing regions of interest of equal or near-equal size on both the tumor (A) and the adjacent normal renal cortex (B).ResultsStrain elastography showed no correlation with patient’s age, size of mass and probe to mass distance with p > 0.05 all. Sensitivity analysis showed that strain index can significantly predict malignant renal masses (P = 0.003) using a cut-off point 2, with 92.9% area under curve, 95.2% sensitivity, 80% specificity, 80% negative predictive value, 95.2% positive predictive value, and overall diagnostic accuracy 92.3%. Strain index > 2 was an independent predictor for malignant renal masses (P = 0.025), odds ratio 7.29 when adjusting for other risk factors. Malignant renal masses were significantly higher strain index compared to benign lesions with (P = 0.001).ConclusionsStrain elastography is a valuable technique for distinguishing between malignant and benign solid renal tumors. Benign lesions have lower strain index values compared to malignant ones, making the strain index a useful screening tool for distinguishing between benign and malignant renal masses using cut-off point 2.

“Sex Cord Stromal Tumor Masquerading as Broad Ligament Fibroid in a Postmenopausal Woman: Lessons Learned from a Case Report”

Background:: Ovarian fibromas are sex cord-stromal tumors accounting for 4% of all ovarian tumors. They are benign, solid ovarian tumors commonly encountered in perimenopausal and postmenopausal women. They are usually asymptomatic or present with vague symptoms like abdominal pain. This makes their pre-operative diagnosis difficult. Case Report:: The present case report briefs the finding of ovarian fibroma in a 59-year-old postmenopausal woman presenting with dull aching lower abdominal pain, misdiagnosed as broad ligament fibroid on ultrasonography and malignant ovarian mass on MRI. She underwent exploratory laparotomy with total abdominal hysterectomy and bilateral salpingo-oophorectomy. Intraoperative findings included a right-sided smooth, solid, freely mobile ovarian mass of size 4x5 cm, uterus and left ovary were atrophic, with healthy bilateral fallopian tubes. Her histopathology report revealed ovarian fibroma with minimal nuclear atypia. Conclusion:: Ovarian fibromas are common benign solid ovarian tumors, that are difficult to diagnose pre-operatively, and often confused with uterine or broad ligament fibroids due to their similar clinical and radiological presentations. Hence, the clinician should keep ovarian fibromas as one of the differentials in the diagnosis of solid adnexal masses mimicking broad ligament fibroids.

Immunohistochemical expression of Beclin-1 and LC3B in benign and borderline ovarian tumors

Background Epithelial ovarian tumors account for ⁓90% of ovarian cancers. Recently conducted studies have demonstrated autophagy role in tumor development and progression. Autophagic markers include Beclin-1, essential for autophagosome formation and LC3B, required for the elongation step during autophagy. Aim To investigate Beclin-1 and LC3B expression in benign and borderline epithelial ovarian tumors along with its relation to clinicopathologic parameters. Materials and methods Thirty-six cases of epithelial ovarian neoplasms were subjected to hematoxylin and eosin staining and immunohistochemical staining with Beclin-1 and LC3B. Results Beclin-1 was expressed in the nucleus and/or the cytoplasm of tumor cells. The cytoplasmic expression of Beclin-1 was significantly more frequent in borderline cases compared with benign tumors. High Beclin-1 cytoplasmic expression was significantly associated with tumor size, gross appearance, and tumor histological type. Benign Brenner tumors were the only benign tumors expressing cytoplasmic Beclin-1 localization. Regarding LC3B expression, nuclear and cytoplasmic subcellular localizations were also detected. Cytoplasmic LC3B localization was significantly more frequent in the borderline groups. A significant relation was observed between high cytoplasmic LC3B expression and tumor size, tumor gross appearance, and histological type. The majority of benign Brenner tumors showed a high cytoplasmic LC3B expression. Conclusions The expression of Beclin-1 and LC3B varies in benign versus borderline epithelial ovarian tumors. Cytoplasmic expression is predominant in borderline tumors. Beclin-1 and LC3B cytoplasmic expression is significantly high in small-sized and solid benign tumors. Benign Brenner tumors are the only benign tumors showing cytoplasmic Beclin-1 and LC3B localization.

Perilous myoma in the puerperium: A case report

Leiomyoma, a benign solid tumour found in the female genital tract, affects 3%-13% of pregnancies. These growths occur as sub serosal, intramural, or submucosal tumours. Approximately 10%–30% of pregnant women experience fibroid-related complications, such as spontaneous abortion, preterm labour, soft tissue dystocia, uterine inertia, feto pelvic disproportion, fetal malposition, and postpartum hemorrhage and a higher risk of caesarean delivery. This case report aims to shed light on the complexities arising in the postpartum period for women previously diagnosed with large fibroids during pregnancy. By exploring a specific case, this report emphasizes the importance of understanding and addressing these complications comprehensively. A 27-year-old primigravida sought antenatal care at 8 weeks of gestation with a 6cm intramural fibroid. Her pregnancy progressed smoothly, leading to a healthy vaginal delivery. However, at 7 weeks postpartum, she experienced pelvic discomfort, heavy lochia, and bleeding. Imaging revealed a submucosal fibroid protruding into the endometrial cavity with degenerating component Myomectomy performed. This case underscores the necessity of a comprehensive understanding of complications associated with large fibroids, spanning both the antenatal and postpartum periods. Heightened awareness and timely intervention are crucial to ensuring optimal outcomes for both maternal and foetal health.

A Rare Case of Virilizing Ovarian Fibrothecoma in A Teenage Girl

Ovarian fibrothecomas comprise tumors in the spectrum of ovarian sex cord / stromal tumors where there are components of both an ovarian fibroma and an ovarian thecoma. They account for 3-4% of all ovarian tumors. Most occur in adult women, with 65% in postmenopausal women. However, it represents only 2% of pediatric ovarian tumors. They are the most common benign solid ovarian tumor. The tumors are usually hormonally inactive but can be estrogenic or sometimes androgenic. Here we are reporting a rare case of a 15-year-old girl presenting with primary amenorrhea, severe hirsutism and finally diagnosed with ovarian fibrothecoma. After surgical removal of the tumor, a dramatic response was observed as the patient developed menarche. She was relieved of her hirsutism by laser therapy later, but her deep voice remained the same. CBMJ 2024 January: vol. 13 no. 01 P: 95-97

Huge renal angiomyolipoma

Renal angiomyolipoma (AML) is a rare solid benign tumor composed of varying amounts of mature adipose tissue, smooth muscle, and thick-walled vessels. This article presents a clinical observation and immediate results of a two-stage treatment of giant renal AML (preliminary superselective embolization with further partial nephrectomy) in a 58-year-old woman.

Gene amplification in neoplasia: A cytogenetic survey of 80 131 cases.

Gene amplification is a crucial process in cancer development, leading to the overexpression of oncogenes. It manifests cytogenetically as extrachromosomal double minutes (dmin), homogeneously staining regions (hsr), or ring chromosomes (r). This study investigates the prevalence and distribution of these amplification markers in a survey of 80 131 neoplasms spanning hematologic disorders, and benign and malignant solid tumors. The study reveals distinct variations in the frequency of dmin, hsr, and r among different tumor types. Rings were the most common (3.4%) sign of amplification, followed by dmin (1.3%), and hsr (0.8%). Rings were particularly frequent in malignant mesenchymal tumors, especially liposarcomas (47.5%) and osteosarcomas (23.4%), dmin were prevalent in neuroblastoma (30.9%) and pancreatic carcinoma (21.9%), and hsr frequencies were highest in head and neck carcinoma (14.0%) and neuroblastoma (9.0%). Combining all three amplification markers (dmin/hsr/r), malignant solid tumors consistently exhibited higher frequencies than hematologic disorders and benign solid tumors. The structural characteristics of these amplification markers and their potential role in tumorigenesis and tumor progression highlight the complex interplay between cancer-initiating gene-level alterations, for example, fusion genes, and subsequent amplification dynamics. Further research integrating cytogenetic and molecular approaches is warranted to better understand the underlying mechanisms of these amplifications, in particular, the enigmatic question of why certain malignancies display certain types of amplification. Comparing the present results with molecular genetic data proved challenging because of the diversity in definitions of amplification across studies. This study underscores the need for standardized definitions in future work.

Farklı görünür diffüzyon katsayısı değerlerinin pediatrik abdomen ve pelvisin solid malign ve benign tümörlerini ayırt etmedeki yeri

Background and Aims: Diffusion-weighted magnetic resonance imaging is a non-invasive method that can be used in the characterization of tumors, by the quantification of highly cellular tumor components with the use of region of interest measurements on the generated apparent diffusion coefficient maps. The diffusion characteristics of the solid benign tumors of the abdomen and pelvis in children, and the role of apparent diffusion coefficient values in distinguishing solid malignant from solid benign tumors are not well defined. Materials and Method: This study retrospectively evaluated the role of different fractions of the measured and calculated apparent diffusion coefficient values in 49 children with a solid mass lesion of the abdomen or pelvis to determine whether those values allow for distinguishing malignant from benign solid lesions. A subgroup evaluation included the analysis of the apparent diffusion coefficient values in distinguishing Wilms tumor from neuroblastoma. Results: All fractions of apparent diffusion coefficient values were statistically significantly lower in the solid malignant tumors than in the solid benign tumors, with the mean normalized apparent diffusion coefficient values having higher sensitivity and specificity rates. The apparent diffusion coefficient values did not significantly differ between Wilms tumor and neuroblastoma. Conclusions: Apparent diffusion coefficient values can help differentiate malignant from benign solid tumors. Their role can be limited in differentiating Wilms tumor from neuroblastoma.

Efficacy and predictive factors of endoscopic ultrasound-guided ethanol ablation in benign solid pancreatic tumors

Backgrounds and ObjectivesEndoscopic ultrasound-guided ethanol ablation (EUS-EA) has recently been introduced for the management of solid pancreatic tumors, including pancreatic neuroendocrine tumors (PNETs) and solid pseudopapillary tumors (SPTs). The study aims to evaluate the efficacy and predictive factors for response of EUS-EA in solid pancreatic tumors.MethodsBetween October 2015 and July 2021, 72 patients who underwent EUS-EA for solid pancreatic tumors were included. The study outcomes were to evaluate the efficacy of EUS-EA with complete remission (CR) and objective response, and their predictive factors.ResultsDuring follow-up, 47 patients were diagnosed with PNETs and 25 with SPTs. Eight cases reached CR and 48 reached objective response. When compared with SPTs, PNETs showed similar duration to reach CR (median not reached; p = 0.319), but shorter duration to reach objective response (PNETs: median 20.6 months, 95%CI 10.26–30.88; SPTs: median 47.7 months, 95%CI 18.14–77.20; p = 0.018). Ethanol dosage > 0.35 ml/cm3 shortened the duration to reach CR (median not reached; p = 0.026) and objective response (median 42.5 months, 95%CI 25.34–59.66 vs. 19.6 months, 95%CI 10.17–29.09; p = 0.006). CR had no significant predictive factors, but PNETs showed significant predictive factors for objective response (HR 3.34, 95%CI 1.07–10.43; p = 0.038). Twenty-seven patients experienced adverse events, and there were two severe cases.ConclusionEUS-EA for pancreatic solid lesions seems feasible as a local treatment for patients who refuse or are unfit for surgery. Additionally, PNETs seem to be the better candidate for EUS-EA.

Ayurvedic Intervention of Garbhashyagata Granthi (Uterine Fibroid) - A Case Report

Uterine fibroid is most common solid benign tumors in women of reproductive age. The symptoms of uterine fibroid adversely affect social and recreational activities, women's quality of life, and productivity at work. Uterine fibroid occur in 50–60% of women, rising to 70% by the age of 50 and in 30% of cases cause morbidity. A 40-year-old married woman consulted in the outpatient department (OPD) of P.G. department of Prasutitanta and Striroga with a complaint of heavy and prolong menstrual bleeding with painful menstruation since 5 years. It is associated with lower back pain, lower abdominal pain, frequent urination, mild constipation and pain in both lower extremities. Her Ultrasonography report shows bulky uterus and intramural uterine fibroid size of 19x17x25 mm. Patient was treated according to Ayurvedic management of Granthi. So the drug having properties Raktstambhak, Lekhana, Raktshodhak, Shothahara, etc. are used with advice of Pathya Aahar-Vihara.Treatment was continued for one years with a follow up once in 15days and a repeat scan revealed shrinking size of the fibroid and relief in all symptoms.

Primary Ovarian Lipoleiomyoma with Chondroid Metaplasia: an Original Case Report with Literature Review

Primary ovarian lipoleiomyoma is a rare benign tumor of the ovary predominantly consisting of smooth muscles and adipocytes. Clinically, they are asymptomatic and are diagnosed accidentally during the histopathological examination after the surgery. Herein, we report a case of unilateral, primary ovarian lipoleiomyoma in a 20-year-old primigravida who presented with complaints of abdominal distension for 4 months. The abdominal contrast-enhanced computed tomography (CECT) revealed a large, well-defined, heterogeneously enhancing mass in the right adnexa measuring 35.9 × 26.1 × 12.9 cm. A primary clinical diagnosis of teratoma was raised. Unilateral salpingo-oophorectomy was performed, and histomorphology revealed a benign smooth muscle tumor admixed with mature adipocyte and cartilage arising primarily in the ovary. The diagnosis was confirmed by immunohistochemistry. The tumor may be asymptomatic or manifest with abdominal pain or distension, like in our index case. As there are no pathognomonic clinical symptoms, tumor markers, or characteristic imaging findings, definitive diagnosis is difficult prior to surgical removal. Histomorphology and immunohistochemistry confirm the smooth muscle nature of the tumor. This common and benign solid tumor at an unusual location should be kept in the differential diagnosis of solid ovarian masses.

A heterozygous missense variant in DLX3 leads to uterine leiomyomas and pregnancy losses in a consanguineous Iranian family

Uterine leiomyomas (ULs) are benign solid tumors arising from the uterine myometrium. They are the most common pelvic tumors among females of reproductive age. Despite the universal prevalence of ULs and its huge impact on women’s lives, the exact etiology and pathophysiologic mechanisms have not been fully understood. Numerous studies indicate that genetic factors play a crucial role in ULs development. This study aims to identify the probable genetic causes of ULs in a consanguineous Iranian family. Whole-exome sequencing (WES) on five family members with ULs revealed a likely pathogenic missense variant encoding for Y88C in the transactivation (TA) domain of DLX3 gene (c.263A > G; p.Y88C). Sanger sequencing of a total of 9 affected and non-affected family members indicated a segregation with disease with autosomal dominant inheritance. Moreover, targeted Sanger sequencing on 32 additional non-related patients with ULs showed none was heterozygous for this variant. MutPred2 predicted the pathogenicity of candidate variant by both phosphorylation and sulfation loss as actionable hypotheses. Project HOPE revealed that the identified variant residue is smaller and more hydrophobic comparing to the wild-type residue. I-TASSER and UCSF Chimera were also used for modeling and visualizing the predicted variant, respectively. This WES analysis is the first to report a variant in DLX3 variation associated with ULs pathogenicity in Iranian population highlighting the effectiveness of WES as a strong diagnostic method. However, further functional studies on this variant are needed to confirm the potential pathogenicity of this mutation.

Benign solid liver tumors

Benign solid liver tumors are frequently discovered during routine sonographic examinations. As a rule, malignant tumors can be excluded using contrast medium-based sectional imaging; however, unclear cases can represent a diagnostic challenge. The category of solid benign liver tumors includes first and foremost hepatocellular adenoma (HCA), focal nodular hyperplasia (FNH) and hemangioma. Based on the most recent data, an overview of the current standards in the diagnostics and treatment is given.

ALDH1: A potential therapeutic target for cancer stem cells in solid tumors

Solid tumors can be divided into benign solid tumors and solid malignant tumors in the academic community, among which malignant solid tumors are called cancers. Cancer is the second leading cause of death in the world, and the global incidence of cancer is increasing yearly New cancer patients in China are always the first. After the concept of stem cells was introduced in the tumor community, the CSC markers represented by ALDH1 have been widely studied due to their strong CSC cell characteristics and potential to be the driving force of tumor metastasis. In the research results in the past five years, it has been found that ALDH1 is highly expressed in various solid cancers such as breast cancer, lung cancer, colorectal cancer, liver cancer, gastric cancer, cervical cancer, esophageal cancer, ovarian cancer, head,and neck cancer. ALDH1 can activate and transform various pathways (such as the USP28/MYC signaling pathway, ALDH1A1/HIF-1α/VEGF axis, wnt/β-catenin signaling pathway), as well as change the intracellular pH value to promote formation and maintenance, resulting in drug resistance in tumors. By targeting and inhibiting ALDH1 in tumor stem cells, it can enhance the sensitivity of drugs and inhibit the proliferation, differentiation, and metastasis of solid tumor stem cells to some extent. This review discusses the relationship and pathway of ALDH1 with various solid tumors. It proposes that ALDH1 may serve as a diagnosis and therapeutic target for CSC, providing new insights and new strategies for reliable tumor treatment.

MYOEPITHELIOMA OF THE UPPER LIP: A CASE REPORT

An 82-year-old female patient complained of a slow growing painless nodule on her upper lip with a 2-year history. Extraoral examination showed swelling in the left upper lip causing facial asymmetry. Intraoral examination revealed a mobile nodule of firm consistency covered by an intact mucosa with a light purplish color, measuring approximately 2 × 1 cm. The clinical differential diagnosis included mesenchymal tumor and salivary gland tumor. Excisional biopsy was performed, and microscopic examination showed well-circumscribed benign solid tumor characterized by island and cords of cells with myoepithelial differentiation showing spindle, plasmacytoid, and ephitelioid features. The cells were immunopositive for cytokeratin 14, S-100, and α-smooth muscle actin. The diagnosis of myoepithelioma was established. After 4 months of follow-up, satisfactory wound healing and no recurrences were detected.

The Role of Endoscopic Ultrasound in the Interventional Management of Mediastinal Collections: A Narrative Review.

The numerous causes underlying mediastinal lesions require different diagnostic and therapeutic approaches, including conservative, minimally invasive, and surgical interventions. Solid lesions of a malignant nature, mostly located in the anterior mediastinum, are properly treated with surgical resection either with or without adjuvant schemes. In contrast, a surveillance program is usually recommended with solid benign tumors, depending on their size and related symptomatology. In the management of mediastinal collections, when a drainage intervention is required (suspicion of infection and symptomatology), a minimally invasive nonsurgical procedure or thoracic surgery is considered. The minimally invasive nonsurgical procedures that can be available are percutaneous radiology-guided imaging (abdominal ultrasound (US) or computed tomography (CT) scan), complete single-aspiration guided by endoscopic ultrasound (EUS) or endobronchial ultrasound (EBUS), and transmural drainage guided by EUS. Surgical debridement is feasible to treat collections, but as this entails considerable risk of postoperative complications, it is chosen only when other minimally invasive therapies are not possible. The published literature related to the interventional endoscopic approach to mediastinal lesions is scarce. Nevertheless, reports in this field reveal that interventional EUS may have a role in both the diagnosis of and therapeutic approach to mediastinal lesions, mainly in the management of mediastinal collections.

Architects of Pituitary Tumour Growth.

The pituitary is a master gland responsible for the modulation of critical endocrine functions. Pituitary neuroendocrine tumours (PitNETs) display a considerable prevalence of 1/1106, frequently observed as benign solid tumours. PitNETs still represent a cause of important morbidity, due to hormonal systemic deregulation, with surgical, radiological or chronic treatment required for illness management. The apparent scarceness, uncommon behaviour and molecular features of PitNETs have resulted in a relatively slow progress in depicting their pathogenesis. An appropriate interpretation of different phenotypes or cellular outcomes during tumour growth is desirable, since histopathological characterization still remains the main option for prognosis elucidation. Improved knowledge obtained in recent decades about pituitary tumorigenesis has revealed that this process involves several cellular routes in addition to proliferation and death, with its modulation depending on many signalling pathways rather than being the result of abnormalities of a unique proliferation pathway, as sometimes presented. PitNETs can display intrinsic heterogeneity and cell subpopulations with diverse biological, genetic and epigenetic particularities, including tumorigenic potential. Hence, to obtain a better understanding of PitNET growth new approaches are required and the systematization of the available data, with the role of cell death programs, autophagy, stem cells, cellular senescence, mitochondrial function, metabolic reprogramming still being emerging fields in pituitary research. We envisage that through the combination of molecular, genetic and epigenetic data, together with the improved morphological, biochemical, physiological and metabolically knowledge on pituitary neoplastic potential accumulated in recent decades, tumour classification schemes will become more accurate regarding tumour origin, behaviour and plausible clinical results.

Hemorrhagic renal angiomyolipoma: An analysis of 6 cases with review of the literature

Renal angiomyolipoma is the most common benign solid tumor of the kidney. It can occur sporadically or in association with tuberous sclerosis, which is an autosomal dominant inherited disease. Hemorrhagic rupture of renal angiomyolipoma with retroperitoneal hematoma is the most serious complication that can be life-threatening and requires urgent management. The aim of this study is to review, through 6 cases and by means of a review of the literature, the diagnostic criteria of renal angiomyolipoma and the particularities of management of hemorrhagic renal angiomyolipoma. We carried out a retrospective study which concerned 6 patients with hemorrhagic renal angiomyolipoma, unilateral or bilateral, during the period between January 2019 and August 2021, in the Urology Department of the Hassan II University Hospital in Fez. The average age of our patients was 53 years with an F/M sex ratio of 2. Bourneville's tuberous sclerosis was diagnosed in 3 patients. The circumstances of discovery of renal angiomyolipoma were: acute flank pain associated with anemic syndrome in 3 patients, incidental discovery in 1 patient, clot hematuria in 1 patient and abdominal mass in 1 patient. Clinical examination revealed hemodynamic instability in 1 patient, flank defense in 2 patients, lumbar mass in 1 patient and lumbar tenderness in 1 patient. The abdominal CT angiogram allowed us to retain the diagnosis of renal angiomyolipoma in all the patients, with a bilateral form in the 3 patients with tuberous sclerosis of Bourneville. Renal embolization was performed in 5 patients, while total nephrectomy was performed in 1 patient. Renal angiomyolipoma is a rare tumor in daily urological practice. Its hemorrhagic risk requires a good knowledge of diagnostic, therapeutic and monitoring methods.

Dramatic Effect of Botulinum Toxin Type A on Hypertrophic Scar: A Promising Therapeutic Drug and Its Mechanism Through the SP-NK1R Pathway in Cutaneous Neurogenic Inflammation.

BackgroundHypertrophic scar formation may be related to cutaneous neurogenic inflammation (CNI) through the substance P-neurokinin 1 receptor (SP-NK1R) signaling pathway. As a widely used drug in aesthetic clinical work, botulinum toxin type A (BTX-A) has a therapeutic effect on scars, but the actual mechanism remains unclear. This study aimed to clarify the potential mechanism by which BTX-A inhibits CNI in hypertrophic scars both in vitro and in vivo.MethodsTissue samples were obtained from surgical excisions. Immunohistological analysis was used to locate SP in human hypertrophic scars and normal skin. RT-PCR and western blot analysis were used to evaluate the expression of collagens after SP/BTX-A treatment. A rabbit ear scar model was used to explore the in vivo effect of BTX-A on scar treatment.ResultsSP and NK-1R were overexpressed in hypertrophic scars compared to normal skin tissues. Collagen secretion of hypertrophic scar-derived fibroblasts increased with increasing doses of SP. However, BTX-A may downregulate collagen expression through SP-NK1R pathway with or without the presence of SP inducing agent capsaicin. Meanwhile, SP inhibited the expression of NK-1R, and this inhibition was blocked by pretreatment with BTX-A. In vivo, intralesional BTX-A injection can also reduce the volume of scars and inhibit collagen secretion. Capsaicin may cause more severe scar manifestations, while the therapeutic effect of BTX-A remains.ConclusionOur research confirms that CNI stimulates fibroblasts during scar formation, while BTX-A can reduce collagen secretion by inhibiting the SP-NK1R signaling pathway, thus identifying a novel therapeutic target for this benign solid skin tumor.