Benign Tumors Research Articles

Role of Fine Needle Aspiration Cytology in Paratesticular Neoplasms-A Case Reports-Based Systematic Review.

The cytology features of neoplastic paratesticular lesions are mostly documented as case reports. Thus, we conducted a case report-based literature review to identify the characteristics of paratesticular neoplasms and tried to determine the significance of FNAC in these tumors. The studies were searched using PubMed and Scopus. The quality assessment was done using the JBI critical appraisal checklist for case reports. The articles that received an overall rating of "Include" underwent data extraction. The data were extracted from the articles and analyzed. We included 34 case reports from 33 published articles. The mean age of patients was 44.74 (13-85) years, and the most common clinical manifestation was scrotal swelling (70.59%, 24/34). Lesions were commonly observed on the right side (65.63%, 21/32), and the most common tumor site was epididymis (35.29%, 12/34). A total of 38.24% (13/34) cases were nonmalignant, and 61.76% (21/34) were malignant on the cytological diagnosis. The adenomatoid tumor (53.85, 7/13) was the most common nonmalignant tumor. Other entities were schwannoma, benign spindle cell neoplasm with atypia, nerve sheath tumor, lipoma, undifferentiated pleomorphic sarcoma, rhabdomyosarcoma, epithelioid sarcoma, liposarcoma, malignant rhabdoid tumor, pigmented neuroectodermal tumor of infancy and mesothelioma. Considering the malignant and nonmalignant groups, the sensitivity, specificity, and diagnostic accuracy of cytology were 95.00%, 84.62%, and 90.91%, respectively. Cytopathologists should be familiar with the cytological features of various malignant and nonmalignant paratesticular tumors to prevent unnecessarily invasive surgical management. The current systematic review emphasizes usefulness of FNAC in the preoperative cytological identification of paratesticular tumors.

Unicystic Ameloblastoma Masquerading as Vascular Lesion

Ameloblastoma is a benign epithelial tumor of odontogenic origin which shows variations in its presentation that intrigue the authors. Authors report a case of unicystic ameloblastoma which presented, clinically and radiographically mimicking features of a vascular lesion. Patient reported with the chief complaint of pain and swelling in the left lower-third of the face. The investigations performed gave a diagnosis dilemma and hence deciding on appropriate investigations played a pivotal role to enable precise diagnosis of the lesion and facilitated surgeons to decide on the treatment plan.

Effect of Different Glucose Levels and Glycation on Meningioma Cell Migration and Invasion.

Meningiomas are predominantly benign tumors, but there are also malignant forms that are associated with a poor prognosis. Like almost all tumors, meningiomas metabolize glucose as part of aerobic glycolysis (Warburg effect) for energy supply, so there are attempts to influence the prognosis of tumor diseases using a glucose-reduced diet. This altered metabolism leads to so called hallmarks of cancer, such as glycation and glycosylation. In this study, we investigated the influence of low (3 mM), normal (5.5 mM) and high glucose (15 mM) on a malignant meningioma cell line (IOMM-Lee, WHO grade 3). In addition, the influence of methylglyoxal, a by-product of glycolysis and a precursor for glycation, was investigated. Impedance-based methods (ECIS and RTCA) were used to study migration and invasion, and immunoblotting was used to analyze the expression of proteins relevant to these processes, such as focal adhesion kinase (FAK), merlin or integrin ß1. We were able to show that low glucose reduced the invasive potential of the cells, which was associated with a reduced amount of sialic acid. Under high glucose, barrier function was impaired and adhesion decreased, which correlated with a decreased expression of FAK.

Clinical Profile and Histopathological Pattern of Major Salivary Gland Tumors in a Nigerian Tertiary Hospital

Abstract Background: Varieties of tumors can arise from major salivary glands primarily or secondarily. Over 30 histological subtypes have been documented by the World Health Organization, serving as a guide in diagnosis and management. Objectives: To evaluate the clinical and histological pattern of presentation of major salivary gland tumors. Materials and Methods: This is a clinical retrospective study, done at the University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria, assessing records of patients with major salivary gland tumors seen between January 2018 and December 2022. Data obtained were analyzed using Statistical Package for Social Sciences version 26. The results were presented in tables and charts and comparisons were made using the Chi-squared test. Results: Out of the 57 patients with major salivary gland tumors studied, 30 (52.6%) were benign tumors, and 27 (47.4%) were malignant tumors. About 63.2% of patients were predominantly females, whereas 36.8% were males with a male-to-female ratio of 1:1.7. The most common presenting symptom was swelling. The average duration of symptoms before presentation was 24 and 12 months for benign and malignant tumors, respectively. The parotid gland (61.4% total) was the most common site of tumor presentation for both benign and malignant tumors followed by the submandibular and sublingual the least. The most common histological variant was pleomorphic adenoma (40.4%) for benign and mucoepidermoid carcinoma (28.1%) for malignant. Surgery was the first line of treatment given. Conclusion: The observed pattern of clinical and histological presentation of major salivary gland tumors will guide clinicians on the approach for the management.

Intratumoral calcification on CT assists in distinguishing benign and malignant upper abdomen neoplasm.

The significance of calcification and microcalcification in diagnosing malignant tumors is well established, but their role in the upper abdomen is less explored in routine radiology. To assess the effectiveness of computed tomography (CT) imaging in detecting intratumoral calcification within upper abdominal tumors. This study retrospectively enrolled patients with upper abdominal tumors featuring intratumoral calcifications who underwent plain and contrast-enhanced CT scans between January 2016 and December 2019. We examined the imaging characteristics of calcifications, including location, edges, shape, CT values, and association with necrosis. The diagnostic utility of calcification for distinguishing benign and malignant tumors was assessed using receiver operating characteristic curves. Univariate and multivariate logistic regression analyses were conducted to identify independent predictive factors for the diagnosis of malignancy characterized by intratumoral calcification. This study included 153 patients (median age 49 ± 21years; 83 men) with pathologically confirmed tumors of the upper abdomen (including liver, pancreas, and gastrointestinal tract) with intratumoral calcifications. Significant differences in CT values between benign and malignant tumors were observed (P < .001), with high diagnostic accuracy of calcification in CT imaging (receiver operating characteristic area = 0.884, sensitivity = 0.815, specificity = 0.976). The characteristics of calcification, including its edge and shape, were significantly correlated with tumor differentiation (P < .01). Multivariate logistic regression analysis revealed that the presence of adjacent necrosis around intracalcification is an independent predictor of malignancy (odds ratio = 5.48; 95% confidence interval: 1.55, 19.41; P = .008). Intratumoral calcification in CT imaging is a key marker for distinguishing between benign and malignant epigastric tumors, offering high specificity. Key message • What is already known on this topic - Intratumoral calcification, as a highly sensitive radiological marker, has shown potential in differentiating between benign and malignant tumors in thyroid and breast cancers. However, its discriminatory role in upper abdominal tumors is often overlooked. Therefore, assessing the diagnostic accuracy of intratumoral calcification on CT scans is crucial for improving diagnostic efficiency and avoiding unnecessary examinations. • What this study adds - Intratumoral calcification on CT exhibits high specificity in differentiating between benign and malignant upper abdominal tumors, providing a simple and reliable criterion for improving diagnostic accuracy. • How this study might affect research, practice or policy - This study highlights the significance of intratumoral calcification characteristics observed on CT in determining whether upper abdominal tumors are benign or malignant. The findings could pave the way for the development of a CT-based calcification scoring system, which would facilitate rapid and accurate diagnostics in clinical practice, thereby optimizing treatment strategies and enhancing patient prognosis.

Parametric optimization and comparative study of machine learning and deep learning algorithms for breast cancer diagnosis.

Breast Cancer is the leading form of cancer found in women and a major cause of increased mortality rates among them. However, manual diagnosis of the disease is time-consuming and often limited by the availability of screening systems. Thus, there is a pressing need for an automatic diagnosis system that can quickly detect cancer in its early stages. Data mining and machine learning techniques have emerged as valuable tools in developing such a system. In this study we investigated the performance of several machine learning models on the Wisconsin Breast Cancer (original) dataset with a particular emphasis on finding which models perform the best for breast cancer diagnosis. The study also explores the contrast between the proposed ANN methodology and conventional machine learning techniques. The comparison between the methods employed in the current study and those utilized in earlier research on the Wisconsin Breast Cancer dataset is also compared. The findings of this study are in line with those of previous studies which also highlighted the efficacy of SVM, Decision Tree, CART, ANN, and ELM ANN for breast cancer detection. Several classifiers achieved high accuracy, precision and F1 scores for benign and malignant tumours, respectively. It is also found that models with hyperparameter adjustment performed better than those without and boosting methods like as XGBoost, Adaboost, and Gradient Boost consistently performed well across benign and malignant tumours. The study emphasizes the significance of hyperparameter tuning and the efficacy of boosting algorithms in addressing the complexity and nonlinearity of data. Using the Wisconsin Breast Cancer (original) dataset, a detailed summary of the current status of research on breast cancer diagnosis is provided.

Identifying Potential Diagnostic and Therapeutic Targets for Infantile Hemangioma Using WGCNA and Machine Learning Algorithms.

Infantile hemangioma (IH) is the most common benign vascular tumor during infancy and childhood and is characterized by abnormal vascular development. It is the most common vascular tumor and its related mechanisms and treatments remain a problem. IH-related biomarkers have been identified using transcriptome analysis and can be used to predict clinical outcomes. This study aimed to identify the key target genes for IH treatment and explore their possible roles in the IH pathophysiology. Gene records were acquired from the Gene Expression Omnibus database. Utilizing integrated weighted gene co-expression network examination, gene clusters were determined. Single-sample gene set enrichment analysis was performed to gauge immune infiltration. Essential genes were identified via Random Forest and Least Absolute Selection and Shrinkage Operator analyses. Ultimately, a set of five pivotal genes associated with the ailment was identified (NETO2, IDO1, KDR, MEG3, and TMSB15A). A nomogram for predicting IH diagnosis was constructed based on hub genes. The calibration curve showed valid agreement between the prediction and conclusion that the key genes in the model were clinically significant. Neuropilin and Tolloid-like 2 (NETO2) are closely associated with tumor development. The role value of NETO2 expression levels increased in hemangioma-derived endothelial cells (HemECs). After silencing NETO2, the growth and migration of cancer cells were significantly restrained. This study revealed the critical role of NETO2 in IH development, suggesting that targeting NETO2 may be effective in improving the therapeutic outcome of IH.

Our Single Center Experience in Osteoid Osteoma Patients Treated with CT-Guided Percutaneous Radiofrequency Ablation Treatment and Follow-up.

Introduction Osteoid osteoma (OO) is a painful benign bone tumor. Typically, it causes pain that is most noticeable during the night, which is improved by nonsteroidal anti-inflammatory drugs. In the treatment of symptomatic lesions, open surgery for nidus removal is the gold standard. However, surgical technical difficulties and morbidities vary by location. Percutaneous radiofrequency ablation (RFA) therapy guided by computed tomography (CT) is now a popular treatment option for OO. This study aims to assess our single-center experience with the technique, complications, and procedure effectiveness. Materials and Methods The study included fifteen patients who were treated between 2017 and 2021. A retrospective analysis was carried out on archive images and file records. The lesions' location, nidus width, and affected area (cortical, medullary) were all recorded. The procedure and technical success, as well as postoperative complications and the need for repeat ablation, were all documented. Results A total of 20 patients, 18 men, and 2 women, were included in the study, and 12 of them were pediatric patients. The patients' mean age was 16.9±7.3 years old, and the mean nidus diameter was 7.1±8.7 mm. There were 13 cortical niduses, 2 intramedullary niduses, and 5 corticomedullary niduses. The lesions were in the femur (n=12), tibia (n=6), scapula (n=1), and vertebrae (n=1). Two recurrences (10%) were observed in our patients during the follow-up. Patient with a femoral OO, the pain started again 12 weeks after the procedure and we performed additional RFA. The patient with vertebral OO had fewer symptoms and full recovery was not achieved. Therefore, the vertebral OO was ablated again 4 months later, and clinical success was achieved. One patient had a minor burn at the entry site that went away on its own after a short period of time. Except for the patient who was scheduled for a repeat RFA, no recurrence has been observed so far. The primary and secondary success rates are, respectively, 90% (18/20) and 100% (20/20). Conclusion RFA has a high success rate in treating OO. The procedure failure and recurrence rates are low. There are possibilities for posttreatment pain relief, early discharge, and a quick return to daily life. For inappropriate lesion localization, the RFA process replaces surgical treatment. The procedure-related complication rate is low. On the other hand, the burn during the procedure can be a serious problem.

Retroperitoneal lymphangioma in a tertiary care hospital of North India

Less than 200 cases of retroperitoneal lymphangiomas (RL), a rare type of benign cystic tumour of the lymphatic system that makes about 1% of all lymphangiomas, have been documented to date. Their rarity makes preoperative diagnosis challenging. 95% of lymphangiomas are found in the head, neck, and axilla where they are most frequently found. We are presenting a 30 years old woman, who presented to outpatient department (OPD) of general surgery with symptoms of recurrent left lumbar pain, radiating towards inguinal region for one month. The contrast computed tomography (CT) scan of abdomen and pelvis defined a large thin walled homogenous non enhancing hypodense cystic lesion in left side of abdomen in retroperitoneal location from left lobe of liver till pelvis on left side craniocaudally. The patient was planned for exploratory laparotomy. Midline laparotomy was performed. A cystic lymph-filled tumour was detected in the abdominal cavity adjacent to the bowel loops. Histologically the mass contained variable-sized cystic spaces lined by flattened endothelium consistent with lymphatic vessels, which on immunostaining were positive for CD31 and negative for Pan CK. The patient was discharged satisfactorily. In conclusion, retroperitoneal lymphangioma presents vaguely as abdominal pain or mass and grown to large sizes without causing any significant symptom. Tumour markers for the excised tissue are important for diagnosis. Laparotomy or laparoscopy are the two surgical excision methods used to treat retroperitoneal cystic lymphangioma and it responds well to excision.

Chondroblastoma of the femoral head-surgical management, outcomes and clinical perspectives: a case report

Chondroblastoma is a rare benign tumor predominantly affecting the epiphyses of long bones, often presenting in the second decade of life. It is known for its potential to recur and cause joint complications despite its benign histology. This report details the case of a 12-year-old boy diagnosed with chondroblastoma of the femoral head, who underwent surgical treatment involving curettage and the use of synthetic hydroxyapatite (HA) bone substitutes. The patient presented with groin pain and limping, with imaging studies revealing an osteolytic lesion in the femoral head. A core needle biopsy confirmed the diagnosis. To manage the lesion, an anterolateral approach was used to perform extensive curettage, and the defect was filled with HA blocks. Postoperatively, the patient was managed with gradual weight-bearing and regular follow-ups. At five years, the patient exhibited normal hip function with no evidence of tumor recurrence, collapse of the femoral head, or osteoarthritis. This case demonstrates that the use of synthetic HA as a bone substitute in the treatment of chondroblastoma can effectively preserve joint integrity and function, providing a viable alternative to traditional grafting methods. The approach was successful in maintaining articular congruence and preventing complications, highlighting the potential benefits of synthetic materials in managing subchondral bone lesions.

Diagnosis and Management of Intrascrotal Nerve Tumors: A Prospective Study

Background: Intrascrotal nerve tumors, though rare, are significant due to their potential impact on patient health and the complexities in management, especially in distinguishing benign from malignant tumors.Objective: The study aimed to evaluate the diagnosis and management of intrascrotal nerve tumors, focusing on clinical presentation, tumor characteristics, and treatment outcomes.Methods: This prospective study was conducted at the Urology Department, Institute of Kidney Diseases, HMC, Peshawar, from January to June 2023. Fifty-five male patients with confirmed intrascrotal nerve tumors were included. Data were collected from medical records, including demographic information, clinical symptoms, imaging findings, biopsy results, and treatment details. Tumor characteristics were assessed through ultrasonography and MRI. Statistical analysis was performed using SPSS version 25, with significance set at p &lt; 0.05.Results: The mean age was 45.23±2.78 years. Benign tumors accounted for 65% of cases with a mean size of 2.8 cm, while malignant tumors (MPNSTs) accounted for 35% with a mean size of 4.5 cm. Complete excision was achieved in 95% of cases; recurrence was 32% in malignant tumors (p = 0.001). The overall survival rate for malignant tumors was 58% (p = 0.002).Conclusion: Intrascrotal nerve tumors present diagnostic and management challenges, particularly MPNSTs, which require aggressive treatment and close follow-up due to high recurrence rates.

The evaluation of postoperative exocrine pancreatic insufficiency in patients with benign and low-malignant pancreatic tumor: A multicenter, prospective, observational study

Objectives: We assess the incidence of exocrine pancreatic insufficiency (EPI) at different time points after pancreatic surgery and explore pancreatic enzyme replacement therapy's (PERT) efficacy. Background: EPI is characterized by inadequate pancreatic enzymes, resulting in maldigestion and abdominal symptoms. EPI is a common postoperative complication of pancreatic surgery, yet often overlooked by surgeons. There is no clear answer to when EPI occurs after pancreatic surgery nor the duration of PERT after partial pancreatectomy. Methods: Benign or borderline pancreatic tumor patients undergoing surgeries were recruited between December 2020 and November 2021 from 10 medical centers in China. The EPI Questionnaire (EPI-Q) was performed at discharge, and 3-, 6-, 9-, and 12-month follow-ups to evaluate the occurrence of EPI. Statistical analyses were performed to identify the occurrence of EPI and explore PERT's efficacy. Results: Of the 146 patients, 105 (71.9%) were female, and the median age was 49 (range 16-78 yrs). Symptoms of EPI patients were most pronounced within 3 months post-surgery (15.7%), while most patients recovered after 1 year (96.9%). There was a negative correlation between symptom score and time since surgery. Lack of PERT in the 3-month post-surgery was associated with higher symptom scores in pancreatoduodenectomy (PD) patients, while not in distal pancreatectomy (DP) patients. Conclusions: Generally, the high-occurrence period for postoperative EPI is within 3 months after resection in patients with benign or borderline pancreatic tumors, and most will gradually recuperate with time. PERT can improve symptoms in PD patients, while reduced PERT duration may be considered for DP patients.

Surgical management of pancreatic neoplasms in children: a single-institution experience over 15 years.

Pancreatic neoplasms are rare among children and very few studies have reported on surgical outcomes for pediatric pancreatic neoplasms. Therefore, we aimed to describe patient and tumor characteristics and report on the surgical outcomes of pediatric pancreatic neoplasm. In this retrospective single-center study, we reviewed and analyzed the data of patients who underwent surgery for pediatric pancreatic neoplasms at Severance Children's Hospital between January 2007 and December 2022. Clinical data including demographics, surgical procedures, and postoperative and long-term outcomes were evaluated. A total of 28 patients underwent surgical treatment for pancreatic neoplasms with a median age of 11.7 years (range: 0.4-17.8). The most common histological diagnosis among benign tumors was solid pseudopapillary neoplasm (SPN), which occurred in 20 patients (71.4%). This was followed by a mucinous cyst, nesidioblastosis, pseudocyst, duplication cyst, and benign cyst, each occurring in one patient (3.5%). Regarding malignant tumors, pancreatoblastoma, solid pseudopapillary carcinoma, and malignant pheochromocytoma were noted in one patient each (3.5%). Tumor locations included the head in 4 patients (14.2%), the body in 7 (25%), and the tail in 16 (57.1%), and was diffuse in 1 (3.5%). The most common surgical resection range was distal pancreatectomy, found in 22 patients (78.5%), followed by pylorus-preserving pancreaticoduodenectomy, found in 2 (7.2%); duodenum-preserving pancreatic resection, central pancreatectomy, tumor enucleation, and near-total pancreatectomy were performed in one patient each (3.5%). Overall, 4 patients developed grade B or C postoperative pancreatic fistulas, and 1 experienced postoperative mortality due to uncontrollable bleeding. The mean follow-up period was 6.1 years (range: 1-15.6 years), during which no significant impact on growth after surgery was detected. Among the 20 patients with SPN, tumor rupture occurred in 4 (20%), among whom 2 experienced tumor recurrences. Histological diagnosis of benign tumors was predominant in this case series and various extents of surgical resection were performed. Surgical treatment for pediatric pancreatic neoplasms appears to be safe and effective. However, considering the long-term prognosis of these patients, it is essential to determine the appropriate extent of surgical resection based on the location of the tumor.

Multiomics Profiling Distinguishes Sebaceous Carcinoma from Benign Sebaceous Neoplasms and Provides Insight into the Genetic Evolution of Sebaceous Carcinogenesis.

Sebaceous carcinoma is the third most common nonkeratinocyte skin cancer in the United States with 1,000 cases per year. The clinicopathologic features of sebaceous carcinoma and benign sebaceous neoplasms (adenomas, sebaceomas) can overlap, highlighting the need for molecular biomarkers to improve classification. This study describes the genomic and transcriptomic landscape of sebaceous neoplasms in order to understand tumor etiology and biomarkers relevant for diagnosis and treatment. We performed whole-genome sequencing (WGS) and whole-transcriptome sequencing (WTS) of sebaceous neoplasms from six academic and two federal healthcare facilities in the United States diagnosed between January 1, 1999, and December 31, 2021. We evaluated 98 sebaceous neoplasms: 64 tumors (32 adenomas, 2 sebaceomas, 5 atypical sebaceous neoplasms, 25 carcinomas) had sufficient material for WGS, 96 tumors (42 adenomas, 11 sebaceomas, 8 atypical sebaceous neoplasms, 35 carcinomas) had sufficient material for WTS, and 62 tumors (31 adenomas, 2 sebaceomas, 5 atypical sebaceous neoplasms, 24 carcinomas) had sufficient material for combined WGS and WTS. Overall, we found decreased cholesterol biosynthesis and increased TP53 mutations, copy number gains (chromosome 6, 8q, and/or 18), and tumor mutation burden-high (>10 mutations/MB) in carcinomas compared to adenomas. Although diminished compared to adenomas, most carcinomas still had higher cholesterol biosynthesis than nonmalignant skin. Multiomics profiling also supported a precancerous model of tumor evolution with sebaceomas and atypical sebaceous neoplasms being likely intermediate lesions. The study findings highlight key diagnostic biomarkers for sebaceous carcinoma and suggest that immunotherapy and modulation of cholesterol biosynthesis could be effective treatment strategies.

The Use of Water Sac Dilation in Resecting Parapharyngeal Space Benign Tumor via Transoral Approach.

To evaluate the effectiveness of employing the water sac dilation (WSD) method during endoscopy-assisted transoral resection of parapharyngeal space benign tumor (PSBT). Between February 2017 and January 2022, a total of 32 patients diagnosed with PSBT were included in this prospective study and were randomly allocated into two groups: the WSD group and the control group. Tumors of the WSD group patients were all dissected using the WSD method. The final numbers of studied patients in WSD group and control group were 17 and 15, respectively. The basic information was comparable between these two groups of patients. All these patients successfully underwent tumor resection via transoral approach. The operation time, intraoperative blood loss, drainage volume on the first postoperative day, drainage duration, and the total drainage volume in the WSD group patients were significantly lower than those in the control group patients (all p < 0.05). No surgical complications occurred, and no residual tumor or recurrence could be identified at 6 months after surgery in both groups of patients. The application of the WSD method in endoscopy-assisted transoral resection of PSBT effectively attenuated intraoperative injury, improved surgical efficiency, and accelerated postoperative recovery. 3 Laryngoscope, 2024.

Comparison of miRNA Profiles of Primary Tumors and Metastatic Tumors of Salivary Gland Tumors and their Role in Prognosis: A Systematic Review

Background: MicroRNAs (miRNAs) are implicated in several biological processes, such as control of tissue homeostasis, cell signaling, differentiation, proliferation, neoplastic transformation, and activation/inhibition of apoptotic mechanisms. In this systematic review, we evaluated the changes in the expression pattern of miRNAs in salivary gland tumors (SGTs). Methods: A comprehensive search was conducted in PubMed, and Scopus with no language and date restrictions in Feb 2023. All the studies on SGTs that evaluated miRNA profiling were included. Relevant data regarding the overexpression and down-regulation of the miRNAs were extracted. The quality of the included studies was evaluated with Newcastle–Ottawa checklist. The altered expression of miRNAs was evaluated between SGTs and normal cases, benign and malignant tumors, and primary and high-grade tumors. Results: Thirteen studies were included in this systematic review. There were considerable differences between malignant and benign tumors regarding the miRNAs expression level. In the five studies, the miRNA profile of the primary tumors was compared with metastatic tumors to reveal the involvement of the miRNA in the prognosis of the salivary tumors. The miRNAs expression changes were correlated with tumor size, stage, recurrence, and occurrence of solid components. Perineural invasion and lymph node metastasis were also reported in ACC-LM cell line and recurrence of adenoid cystic carcinoma (ACC) tissues. Conclusion: The miRNA profiling confirms their prognostic value in salivary gland tumors. Significant alternations of the miRNAs expression are useful for distinguishing different types of salivary tumors and malignant tumors from benign types. The miRNA expression changes also affect the prognosis of salivary tumors.

Intravenous leiomyomatosis: A rare case report

Introduction: Intravascular leiomyomatosis (IVL) is a rare histological benign tumor without invading the tissue of the venous vessels themselves. It is characterized by continuous intraluminal growth of benign smooth muscle tumor cells along with the uterine vein to the pelvic and abdominal venous systems, including the iliac vein and inferior vena cava, and even to the right atrium of the heart and pulmonary artery, leading to life-threatening complications. This case report describes a 43-year-old female patient with IVL who underwent four myomectomy surgeries. Case Report: A 43-year-old female patient with rare IVL was admitted after four myomectomy surgeries. After preoperative evaluation by color Doppler ultrasound, cardiac ultrasound, chest and abdominal computed tomography (CT) scans, this patient underwent total hysterectomy, bilateral salpingectomy, and complete resection of the entire intravascular leiomyoma. This article discusses the characteristics, diagnosis, treatment, and especially surgical precautions of IVL. In addition to surgical resection, this article also discusses other treatment options for IVL. Conclusion: Intravascular leiomyomatosis has unique biological characteristics and clinical manifestations. Through accurate diagnosis and timely complete tumor resection, as well as regular follow-up after surgery, most IVL patients can achieve good long-term prognosis and quality of life. However, further research is needed on the etiology and pathogenesis of IVL.

Safety and Efficacy of Balloon-Assisted Kyphoplasty Followed by Stereotactic Body Radiation Therapy for Pathological Fractures.

In patients experiencing pain secondary to pathological compression fractures, balloon-assisted kyphoplasty and subsequent stereotactic body radiation therapy (SBRT) may allow for restoration of vertebral height and irradiation of the underlying malignancy to control local disease progression. The aim of this study was to evaluate the safety and efficacy of kyphoplasty treatment before SBRT in patients with spinal metastases and benign tumors. An analysis of a prospectively collected database of 70 patients and 75 metastatic and benign spinal lesions that underwent kyphoplasty before SBRT at a single institution (2002-2023) was conducted. Patient characteristics were recorded, including treatment history, dosimetry and fractionation schedule, pain outcomes, local control (LC), and overall survival. The Bilsky score and Spinal Instability Neoplastic Score were calculated to assess epidural involvement and spinal stability, respectively. The median time from kyphoplasty to SBRT was 29 days (range: 2-159). Seventy-two lesions (96%) were managed with single-fraction SBRT and 3 lesions (4%) with a multifraction regimen. The median single-fraction prescription dose was 20 Gy (range: 12-25) delivered to a median tumor volume of 35.1 cc (range: 2.2-160). After a median follow-up period of 9 months (range: 1-201), 6 lesions (8%) locally progressed. Pain was reported to improve or remain stable for most patients (88%). The LC rate was 88% at 6 months, 1 year, and 2 years. No prognostic factors were significantly associated with LC. The median overall survival was 11 months (range: 1-201) after radiosurgery. There were no reports of cement extravasation or radiation-induced neurological deficit. Two acute pain flares (3%) were reported 1 and 3 months after radiosurgery. The combined kyphoplasty and SBRT treatment paradigm can be used to treat patients with painful pathological compression fractures. Long-term LC and patient-reported improvement in pain were observed without the morbidity associated with open surgery.

Adipocyte derived exosomes promote cell invasion and challenge paclitaxel efficacy in ovarian cancer

BackgroundEpithelial ovarian cancer (EOC) is the deadliest gynaecological cancer with high mortality rates driven by the common development of resistance to chemotherapy. EOC frequently invades the omentum, an adipocyte-rich organ of the peritoneum and omental adipocytes have been implicated in promoting disease progression, metastasis and chemoresistance. The signalling mechanisms underpinning EOC omentum tropism have yet to be elucidated.MethodsThree-dimensional co-culture models were used to explore adipocyte-EOC interactions. The impact of adipocytes on EOC proliferation, response to therapy and invasive capacity was assessed. Primary adipocytes and omental tissue were isolated from patients with ovarian malignancies and benign ovarian neoplasms. Exosomes were isolated from omentum tissue conditioned media and the effect of omentum-derived exosomes on EOC evaluated. Exosomal microRNA (miRNA) sequencing was used to identify miRNAs abundant in omental exosomes and EOC cells were transfected with highly abundant miRNAs miR-21, let-7b, miR-16 and miR-92a.ResultsWe demonstrate the capacity of adipocytes to induce an invasive phenotype in EOC populations through driving epithelial-to-mesenchymal transition (EMT). Exosomes secreted by omental tissue of ovarian cancer patients, as well as patients without malignancies, induced proliferation, upregulated EMT markers and reduced response to paclitaxel therapy in EOC cell lines and HGSOC patient samples. Analysis of the omentum-derived exosomes from cancer patients revealed highly abundant miRNAs that included miR-21, let-7b, miR-16 and miR-92a that promoted cancer cell proliferation and protection from chemotherapy when transfected in ovarian cancer cells.ConclusionsThese observations highlight the capacity of omental adipocytes to generate a pro-tumorigenic and chemoprotective microenvironment in ovarian cancer and other adipose-related malignancies.

Diagnostic mistakes in assessing MRI semiotics of primary extra-axial brain tumors tumors.

Primary extra-axial brain tumors (PExT) are represented by benign and malignant tumors of the meninges and cranial nerves. Their preoperative differential diagnosis based on an analysis of the semiotics of magnetic resonance imaging. The critically important points that make it possible to classify tumors of this group are the following characteristics: tumors structure, contrast enhancements, invasion and relationship tumors with the meninges or cranial nerves. Differential diagnostic typical PExT is not difficult, because most of they heave typical MRI visual signs. With atypical MRI manifestations, reliable differentiation of tumors can be difficult. The greatest difficulty in this case is the differentiation of benign and malignant meningiomas, the distinction between solitary fibrous tumors and meningiomas, and the tumors when they localized in the cerebellopontine angles. The case series presented containing the most typical situations leading to errors in the differential diagnosis of PexT, all tumors had untypical signs. All presented tumors were histological verified. Analysis of the given clinical examples shows that consideration of the entire set of semiotic signs can reduce the number of diagnostic errors.