Benign Tumors Research Articles

Epidemiología de los tumores musculoesqueléticos en una unidad de referencia

ObjectiveThe objective of this study was to perform an epidemiological analysis of patients presented to the Musculoskeletal Tumors Committee of a reference hospital. Material and methodA retrospective analysis of patients with sarcomas treated in a reference Sarcoma Unit between 2009 and 2022 was carried out. ResultsA total of 1978 patients were analyzed, of which 1477 (74.67%) were diagnosed as sarcomas. They were divided into 446 (30.20%) bone tumors and 1.031 (69.80%) soft tissue tumors. The most common benign bone tumor was enchondroma (27.23%), giant cell tumor (59.21%) was the most common tumor of intermediate malignancy and the malignant one was osteosarcoma (24.78%). The most frequently observed benign soft tissue tumor was lipoma (50.74%), the atypical lipomatous tumor (53.25%) was the most frequent tumor of intermediate malignancy and the malignant one was sarcoma of uncertain differentiation (38.10%). ConclusionOur study represents the first work on the epidemiology of sarcomas and other musculoskeletal tumors in our country, being very useful to adapt the resources destined for their diagnosis and treatment.

Nondysraphic Intramedullary Spinal Cord Lipomas in the Adult Population

ObjectiveIntramedullary spinal cord lipomas without spinal dysraphism are rare. Although they are benign tumors, they can cause significant neurological deficits. Their tight adherence to the spinal cord presents a challenge for resection. Therefore, we review our institutional experience treating adult patients with intramedullary lipomas in the absence of dysraphism and report long-term outcomes after resection. MethodsAll adult patients undergoing resection of intramedullary spinal cord lipomas at a comprehensive cancer center between June 2011 and June 2023 were retrospectively identified. Patients with spinal dysraphism or extramedullary lipomas were excluded. Patients were included if they had microscopic surgical debulking with tissue sampling confirming the diagnosis. ResultsSix patients were identified with a mean age of 35.0±11.5 years and 67% were female. Four cases localized to the thoracic spine. Symptoms included pain, numbness, and lower extremity motor weakness; only one patient reported bowel and bladder dysfunction. All patients experienced transient neurological decline in the immediate post-operative period. Five recovered to independent ambulation at long-term follow-up, including one recovering to full strength. One patient required a repeat resection after four years due to tumor progression and functional decline. Tumor progression was not recorded in the other patients. ConclusionsSubtotal resection is a safe and effective treatment. Detethering of the spinal cord, resection of exophytic components, and tumor debulking can improve symptoms and prevent further deterioration in most cases. The resection can be assisted using a laser to vaporize the fatty tissue of the lipoma without physical manipulation of the spinal cord.

Additional value of CMR parametric mapping in tissue characterization of common benign pediatric cardiac tumors.

Cardiac Magnetic Resonance (CMR) parametric mapping is underexplored in cardiac tumors. To evaluate the contribution of mapping sequences on the characterization of pediatric tumors. All pediatric patients referred for cardiac tumors at Bambino Gesù Children's Hospital from June 2017 to November 2023, who underwent CMR with mapping sequences, were included. The diagnosis of tumor type was performed according to signal characteristics on different sequences. Mass parametric mapping for each subtype and interobserver variability was assessed. Sixteen patients were enrolled. The mean age at CMR was 7 ± 5 years. "Traditional" mass-type assessment diagnosed hemangioma (Group A) in 3 patients (19%), fibroma (Group B) in 4 patients (25%), rhabdomyoma (Group C) in 6 patients (37%), and lipoma (Group D) in 3 patients (19%). The ANOVA analysis revealed significant differences in mass native T1 and mass extracellular volume (ECV) values among the four subgroups (p<0.001 for both comparisons). The mean native T1 and ECV values were respectively 1465 ± 158 msec and 54 ± 4% for Group A, 860 ± 118 msec and 93 ± 4% for Group B, 1007 ± 57 msec and 23 ± 5% for Group C, and 215 ± 13 msec and 0 ± 0% for Group D. Mass mapping analysis is feasible and reproducible in children. ECV values provide the most accurate differentiation. Mass ECV consistently resembles normal myocardium in rhabdomyoma, is extremely high (approaching 100%) in fibroma, equals to zero in lipoma, and matches blood pool ECV (1-Hct) in hemangioma.

Uterine Angioleiomyoma: Clinical and Histopathologic Differentiation of an Underrecognized Mimicker of Uterine Leiomyoma.

Angioleiomyoma is an uncommon benign neoplasm of mesenchymal origin that arises from perivascular smooth muscle cells. This soft tissue neoplasm usually occurs in the dermal or subcutaneous tissues of the extremities, head and neck, or trunk with fewer than 40 reported angioleiomyomas arising in the uterine corpus. Herein we report a uterine angioleiomyoma in a 44-year-old G5P4 Hispanic woman with a longstanding history of recurrent abdominal pain, pelvic organ prolapse, abnormal uterine bleeding, anemia, and hypertension. The patient underwent surgical treatment with total laparoscopic hysterectomy with bilateral salpingectomy and a uterosacral ligament suspension. Uterine angioleiomyoma was diagnosed post-operatively based on gross and microscopic features. The location of the uterine angioleiomyoma within the myometrium corresponded with contrast enhancement apparent on preoperative imaging. This and other uterine angioleiomyomas have characteristic imaging, macroscopic, and microscopic features which distinguish it from leiomyoma. Enhancing awareness of this underrecognized entity will facilitate precise diagnosis and thereby enable improved understanding of the clinicopathological characteristics of uterine angioleiomyoma.

Clinicopathological Findings of Surgically Treated Nasal Cavity Schwannomas: A Case Series.

Objectives: Nasal cavity schwannomas are exceedingly rare, benign neoplasms that pose challenges in clinical differentiation from other nasal tumors. Methods: This study presents 5 cases of nasal cavity schwannoma treated surgically over a 10 year period, along with a review of the literature. Results: The most prevalent symptoms included unilateral nasal obstruction and intermittent nosebleeds. Tumors originated from various nasal sites, including the septum, middle conchae, lateral nasal wall, and alar mucosa. All surgeries were conducted transnasally, with 3 tumors excised en bloc, and the remaining two subjected to piecemeal resection. Ancient schwannoma was identified in 4 cases. No instances of recurrence were observed during the average 61 month follow-up period. Conclusions: The definitive diagnosis of schwannomas necessitates histopathological examination. An endoscopic approach to the nasal cavity, obviating the need for external intervention, proved highly effective and appropriate for both diagnosis and symptom alleviation.

ScRNA sequencing technology for PitNET studies

Pituitary neuroendocrine tumors (PitNETs) are common, most likely benign tumors with complex clinical characteristics related to hormone hypersecretion and/or growing sellar tumor mass. PitNET types are classified according to their expression of specific transcriptional factors (TFs) and hormone secretion levels. Some types show aggressive, invasive, and reoccurrence behavior. Current research is being conducted to understand the molecular mechanisms regulating these high-heterogeneous neoplasms originating from adenohypophysis, and single-cell RNA sequencing (scRNA-seq) technology is now playing an essential role in these studies due to its remarkable resolution at the single-cell level. This review describes recent studies on human PitNETs performed with scRNA-seq technology, highlighting the potential of this approach in revealing these tumor pathologies, behavior, and regulatory mechanisms.

A Retrospective Study of 290 Patients with Resectable Benign and Malignant Gastric Neoplasms to Compare Postoperative Outcomes of Endoscopic Resection with and without the Internal Traction Method Using a Spring-and-Loop with Clip (S-O Clip)

A Retrospective Study of 290 Patients with Resectable Benign and Malignant Gastric Neoplasms to Compare Postoperative Outcomes of Endoscopic Resection with and without the Internal Traction Method Using a Spring-and-Loop with Clip (S-O Clip)

Notochordal cell derived lesions: a 55-year casuistic analysis of 50 cases with radiologic-pathologic correlation in a tertiary referral hospital, and literature review.

Distinct lesions are derived from notochordal cells (NCDL), ranging from benign to malignant ones. This study presents fifty NCDL cases diagnosed in a tertiary hospital of reference from the past 55 years: forty-two conventional chordomas, including one chondroid chordoma subtype, four benign notochordal cell tumors (BNCT), two conventional chordomas with BNCT foci, and two dedifferentiated chordomas. All patients were adults. Three BNCT were incidentally diagnosed, and one case presented local pain. Chordomas began with local pain and/or neurological symptoms. BNCT were well-defined intraosseous lesions, hypointense on T1-weighted images (WI) and hyperintense on T2-WI, without enhancement in the contrast. Conventional chordomas, including its chondroid subtype, were lobulated masses with cortical disruption and soft tissue extension, hypointense on T1-WI and hyperintense on T2-WI, with variable contrast enhancement. BNCT were histologically composed of solid sheets of vacuolated cells with clear cytoplasm and round and central nuclei. No atypia, lobular growth pattern, myxoid matrix, or bone infiltration were seen. Conventional chordomas were histologically composed of physaliphorous cells in a myxoid stroma with lobulated and infiltrating growth patterns. Observational follow-up using radiological controls was decided on for the BNCT cases. None of these cases presented local recurrence or metastasis. En-bloc resection and adjuvant radiotherapy were selected for sacral and vertebral chordoma cases. Sixteen patients died due to tumor-related factors; twenty-eight presented local recurrence, and four developed distant metastases. New therapeutic options are being studied for chordoma cases. Clinical, radiological, and histopathological data are necessary to properly diagnose and follow up of NCDL.

Pathogenesis, diagnosis and current treatment of prolactinoma: a review of the literature

ABSTRACT: Prolactinoma is a benign tumor of the pituitary gland that leads to the overproduction of prolactin. It is the most common type of pituitary adenoma, accounting for approximately 50% of all pituitary tumors. The clinical presentation of prolactinoma varies depending on the level of prolactin elevation and the size of the tumor. In women, common symptoms include galactorrhea, amenorrhea, and infertility. Men may present with hypogonadism, decreased libido, erectile dysfunction, and gynecomastia. Large prolactinomas, known as macroadenomas, can cause mass effects such as headaches, visual disturbances due to compression of the optic chiasm, and hypopituitarism due to pressure on surrounding pituitary tissue. Understanding the pathogenesis of prolactinoma is crucial for developing effective treatments and improving patient outcomes. The development of prolactinomas involves a complex interplay of genetic, hormonal, and cellular factors. Treatment of prolactinoma aims to normalize prolactin levels, reduce tumor size, and alleviate symptoms. The first-line therapy is dopamine agonists, such as cabergoline and bromocriptine, with surgery and radiotherapy reserved for refractory cases. Furthermore, chemotherapeutic agent - temozolomide may be a treatment of choice in aggressive or malignant prolactinomas. By understanding the underlying mechanisms and different treatment methods, healthcare providers can optimize the management and outcomes for patients with prolactinoma.

A Rare Case of Solitary Neurofibroma Misdiagnosed as Diabetic Foot Ulcer in the Toe Tip Region

Neurofibromas, rare benign tumors of the peripheral nerve sheath, present diagnostic challenges, particularly in diabetic patients with toe ulcers. This case involves a 55-year-old female with type 2 diabetes mellitus who developed an enlarging ulcer on her right second toe. The initial evaluation suggested a diabetic ulcer; however, advanced imaging revealed a mass-like lesion. Partial excision and biopsy confirmed a neurofibroma with spindle cells within the myxoid stroma and S100 protein expression. One month later, total excision and Z-plasty reconstruction were performed under general anesthesia. The patient’s postoperative recovery was uneventful, and the patient was discharged without complications. Follow-up revealed successful healing with no recurrence or functional issues. This case highlights the importance of considering neurofibromas in the differential diagnosis of diabetic toe ulcers to avoid misdiagnosis and ensure appropriate management.

Distinguishing Benign and Malignant Ovarian Tumors Preoperatively

Ovarian cancer ranks as the fifth leading cause of cancer-related mortality among women globally. In 2020, there were approximately 314,000 reported cases of new ovarian cancer patients, resulting in an estimated 207,000 deaths.1 The highest incidence rates were observed in non-Hispanic white women, with 12.0 cases per 100,000 individuals, followed by Hispanics (10.3 per 100,000), non-Hispanic blacks (9.4 per 100,000), and Asian/Pacific Islander women (9.2 per 100,000). Disparities in access to healthcare services and treatment modalities contribute to varied mortality patterns, with the highest rates recorded among African populations. In Indonesia, ovarian cancer ranks as the third most prevalent cancer, comprising 7.84% of total cancers diagnosed in women.1 The heightened mortality rate observed in ovarian cancer can be ascribed to several factors including asymptomatic tumor growth, delayed manifestation of symptoms, and inadequate screening methods, ultimately resulting in diagnoses at advanced stages. Consequently, ovarian cancer is frequently described as a “silent killer”.2 To address diagnostic delays and reduce mortality rates associated with ovarian cancer, early detection and differentiation between benign and malignant ovarian tumors are crucial. This requires a comprehensive assessment comprising patient history, physical examination, and supporting investigation.

Innovative infrared imaging approach for breast cancer screening: Integrating rotational thermography and machine learning analysis

This paper presents a novel approach to breast cancer screening using infrared (IR) imaging. This work encompasses four phases: Refining data collection, advancing analysis methods, and enhancing feature extraction with machine learning. The developed system employed a temperature-controlled chamber with rotational thermography techniques to maintain consistent temperatures and capture high-quality IR images and all possible subject views. The paper describes four key experiments to detect breast cancer using IR imaging. The experiments involved the use of dynamic temperature-based data collection and a semi-circular arc movement to ensure precise imaging, keeping the object in focus. Initial experiments involved the use of dynamic temperature-based data collection and a semi-circular arc movement to ensure precise imaging focus. The final experiment incorporated a semi-circular arc movement. For each subject, 32 thermal IR images were acquired, targeting one breast at a time while isolating the other with an IR-proof barrier. The collected datasets were used for breast abnormality detection. The analyzed results revealed that support vector machine and neural network algorithms achieved an accuracy rate of 93.18%. The system&amp;rsquo;s installation at a hospital in India allowed for real-world application and validation. The final study, which introduced a new IR imaging protocol, demonstrated improved results compared to earlier pilot studies. This method enhances the accuracy of distinguishing malignant and benign tumors, supporting early breast cancer detection and treatment. The proposed methodology addresses data collection and analysis challenges, leading to improved screening efficiency and better patient outcomes.

Esophageal large-cell neuroendocrine carcinoma mimicking benign submucosal tumor treated with endoscopic submucosal dissection

Esophageal large-cell neuroendocrine carcinoma mimicking benign submucosal tumor treated with endoscopic submucosal dissection

Sudden cardiac death due to an obstructive large right atrial myxoma.

Sudden cardiac death is a phenomenon that affects more than 200,000 individuals annually in the United States. Among sudden cardiac deaths, only a fractionally small portion is thought to be attributable to intracardiac neoplasms. Though rarely implicated as the primary cause of death, cardiac myxomas are the most common benign neoplasms of the heart and have been known to cause death due to multifactorial embolic events, fatal arrhythmias, and frank obstructive events. In this case, a healthy, asymptomatic young male was found unresponsive in his residence. Examination of the heart at autopsy revealed dilation of the right atrium and a large, hemorrhagic, irregular, and obstructing mass arising from the right atrium, consistent with cardiac myxoma. When unusual cardiac findings are discovered at autopsy, a systematic investigation of the heart, including retaining the organ for cardiac pathology consultation, is mandatory to correctly identify the cause of death.

Cardiac Tumors: Review.

Cardiac tumors are rare and encompass a variety of presentations. Clinica symptoms are usually nonspecific, but they can present as obstructive, embolic, or constitutional symptoms. Treatment options and prognosis vary highly depending on the subtype, tumor size, and location. Surgical resection is usually the first-line therapy, except for cardiac lymphomas, and provides favorable long-term prognosis in most benign tumors. Cardiac sarcomas, however, are usually diagnosed in advanced stages, and the treatment relies on a multimodal approach with chemotherapy and radiotherapy. Metastatic cardiac tumors are usually related to advanced disease and carry an overall poor prognosis.

Molecular Characterization of the Presence of Bovine Papillomavirus in Cattle Teat Warts and a Different Treatment Approach

Background: Papillomatosis is a skin condition that is distinguished by benign proliferative tumors with a complicated etiology and epithelial proliferation. There is a need to perform a more thorough study on bovine papillomavirus and identify the virological properties of the agent in detail since a definitive treatment approach against this infection has not yet been completely identified and the suggested treatment outcomes differ. Methods: Samples were collected from warts developing on the teats of 500 cattle raised for milk production in Burdur Center and its districts. The samples were defrosted in order to extract DNA and the Dneasy Blood and Tissue Kit was used for the extraction procedure. By using a PCR assay, wart sample extracts were examined for 13 different BPV types (excluding BPV Type 7). For BPV type-specific primers, a protocol was utilized. Amplification products were demonstrated using agarose gel electrophoresis. Result: In the PCR test of 500 wart samples, BPV types (type 1-type 13) were detected in 378 (75.6%). In the general distribution of BPV types (single or mixed types) in teat warts, BPV-2 (n=85; 22.49%), BPV-8 (n=45; 11.90%), BPV-9 (n=48; 12.70%) and BPV-10 (n=52; 13.76%) were determined to be more common. In the study; it was determined that three different combined treatments provided 100% regression or complete recovery in warts developing on the teat of cattle. In conclusion; one of these three treatment combinations may be preferred for teat wart lesions in cattle.

Revealing subependymal giant cell astrocytoma with multimodal positron emission tomography: illustrative cases.

There is limited literature on the use of positron emission tomography (PET) for benign tumors originating in the brain ventricles, and the use of multiple tracers for subependymal giant cell astrocytoma (SEGA) has not been reported. The authors compared the PET findings in two SEGA cases with past reports and literature, exploring the distinctive characteristics of SEGA on PET. In a 21-year-old female with SEGA, the authors utilized 18F-fluorodeoxyglucose (18F-FDG), 11C-methionine (11C-MET), 18F-fluorothymidine (18F-FLT), 18F-fluoromisonidazole, and 18F-THK5351 tracers. Additionally, in a 6-year-old girl, the authors performed 11C-MET PET. The results indicated the accumulation of all tracers except 18F-FDG, with particularly intense accumulation noted with 18F-FLT. In particular, 18F-FLT demonstrated accumulation comparable to that observed in malignant tumors. This study suggests that multiple PET tracers can provide valuable insights into the characterization of SEGA, with 18F-FLT showing particular promise as a distinctive marker of blood-brain barrier disruption. Further research in larger cohorts may enhance our understanding of metabolic patterns in SEGA and aid in its diagnosis and treatment. https://thejns.org/doi/10.3171/CASE24111.

The impact of V-flow on preoperative diagnosis of thyroid tumors: individually and as part of multimodal sonographic imaging.

V-flow is a dynamic ultrasound technique that visualizes perfusion patterns by displaying dynamic arrows that change in response to the flow of erythrocytes. Furthermore, it provides quantitative values for the maximum and mean velocity of blood flow as well as a percentage value for turbulence. The aim was to enhance the preoperative diagnostic accuracy of thyroid lesions by combining V-flow with established ultrasound modes.B-mode, CCDS, elastography, CEUS, and V-flow were performed on 101 patients. After the ultrasound examination, every nodule was confirmed as benign or malignant via histopathology. The Kruskal-Wallis test, ROC curve, and binary logistic regression were used for the statistical analysis.93 benign regressive thyroid nodules and 8 carcinomas were included in this study. The average mean velocity value for benign lesions was measured at 19.5 cm/s and at 10.7 cm/s for malignant lesions (p = 0.039). The average turbulence percentage was 26.1% for benign nodules and 46.7% for carcinomas (p = 0.016). Carcinomas exhibited a slower and more turbulent perfusion pattern compared to benign tumors. A V-flow-centered system achieves a sensitivity of 100.0% and a specificity of 84.9% in predicting malignancy. This system could have reduced the number of unnecessary thyroid surgeries for benign lesions in our patient group by 70%.The capillary perfusion of thyroid nodules represents a significant indicator of its status. By analyzing the velocity and turbulence level of microvascular blood flow, V-flow offers promising prospects for accurately distinguishing between benign and malignant thyroid lesions. When integrated into a comprehensive multimodal sonographic imaging approach, V-flow further enhances diagnostic accuracy. · V-flow allows for qualitative and quantitative analysis of microvascular perfusion. · Malignant tumors are associated with slower and more turbulent microvascular hemodynamics. · Combining V-flow with other ultrasound modes eases the diagnosis of thyroid carcinomas. · Brandenstein MK, Zhang L, Scharf G et al. The impact of V-flow on preoperative diagnosis of thyroid tumors: individually and as part of multimodal sonographic imaging. Fortschr Röntgenstr 2024; DOI 10.1055/a-2350-0107.

Plasma-based near-infrared spectroscopy for early diagnosis of lung cancer

Lung cancer (LC) continues to be a leading death cause in China, primarily due to late diagnosis. This study aimed to evaluate the effectiveness of using plasma-based near-infrared spectroscopy (NIRS) for LC early diagnosis. A total of 171 plasma samples were collected, including 73 healthy controls (HC), 73 LC, and 25 benign lung tumors (B). NIRS was utilized to measure the spectra of samples. Pre-processing methods, including centering and scaling, standard normal variate, multiplicative scatter correction, Savitzky-Golay smoothing, Savitzky-Golay first derivative, and baseline correction were applied. Subsequently, 4 machine learning (ML) algorithms, including partial least squares (PLS), support vector machines (SVM), gradient boosting machine, and random forest, were utilized to develop diagnostic models using train set data. Then, the predictive performance of each model was evaluated using test set samples. The study was conducted in 5 comparisons as follows: LC and HC, LC and B, B and HC, the diseased group (D) and HC, as well as LC, B and HC. Among the 5 comparisons, SVM consistently generated the best performance with a certain pre-processing method, achieving overall accuracy of 1.0 (kappa: 1.0) in the comparisons of LC and HC, B and HC, as well as D and HC. Pre-processing was identified as a crucial step in developing ML models. Interestingly, PLS demonstrated remarkable stability and relatively high predictive performance across the 5 comparisons, even though it did not achieve the top results like SVM. However, none of these algorithms were able to effectively distinguish B from LC. These findings indicate that the combination of plasma-based NIRS with ML algorithms is a rapid, non-invasive, effective, and economical method for LC early diagnosis.

Is It Possible to Prevent Nontherapeutic Laparotomies in Breast Cancer Patients With Isolated Adnexal Masses?

Introduction: The risk of ovarian malignancy is increasing in patients with a history of breast cancer. Thus, well-defined predictors of ovarian malignancy should be identified to determine surgical or conservative management of adnexal masses in women with breast cancer. This study aimed to clarify the predictors of malignant ovarian tumors in patients with breast cancer with an isolated adnexal mass. Methods: Breast cancer patients diagnosed with an adnexal mass who underwent surgery between 2010 and 2021 at a tertiary cancer center were included in the study. Patients with suspected extra ovarian metastases were excluded. Results: A total of 40 breast cancer patients who underwent surgery for ovarian masses were identified. 23 (57.5%) women had benign ovarian tumors and 17 (42.5%) had malignant ovarian tumors. Among the malignant ovarian tumors, there were three (17.6%) metastatic breast cancers in the ovary and 14 (82.4%) primary ovarian cancers. In univariate analyses, the risk of malignant ovarian tumors increased in women with age >52years (P = .012), postmenopausal status (P = .023), CA 125 ≥ 35IU/ml (P = .001), CA 15-3 ≥ 32IU/ml (P = .002), and complex ovarian masses (P < .001). Ovarian malignancies were observed in 82.4% of patients who had complex ovarian masses. Conclusion: Ovarian malignancies were diagnosed in 82.4% of the breast cancers who had complex ovarian mass on USG examination. Therefore, surgery is recommended in women with complex ovarian masses. Postmenopausal status, age >52years, CA 125 ≥ 35IU/ml, and CA 15-3 ≥ 32 were other risk factors for ovarian malignancy.