Penile cancer is a rare but relevant tumor entity. Due to the low case numbers in individual hospitals deviations from treatment standards and delayed treatment repeatedly occur. This is all the more serious as only an early and consistent treatment management can ensure a curative approach. For this reason, in several European countries penile cancer is only treated in a few special centers. This article provides a current overview of the epidemiology and etiology as well as diagnostic recommendations and treatment options for this malignant neoplasm. The early diagnosis is decisive for the subsequent approach. A consistent primary management with an organ-preserving complete resection of the primary tumor and all lymph nodes infested by the tumor whenever possible is a basic prerequisite for a curative treatment of penile cancer. In a metastatic situation a multimodal treatment concept is often necessary. A good psycho-oncological accompaniment of the patient and a consistent follow-up care also appear to be crucial.

Fluorescence imaging is widely applied in oncology owing to its cost-effectiveness, noninvasiveness, and real-time imaging capability. Many activatable fluorescent probes targeting tumor biomarkers, such as β-galactosidase (β-gal) and viscosity, have been developed. However, the reliance on a single-response mechanism limits their ability to capture the dynamic alterations within tumors during cancer progression and chemotherapy. In this study, we rationally designed and developed ZW-gal, a dual-locked near-infrared (NIR) probe activated by both β-gal activity and viscosity. ZW-gal exhibited favorable photophysical properties, such as a large Stokes shift (125 nm), rapid enzymatic activation (within 2 min), and a strong viscosity-dependent fluorescence enhancement (up to 24.6-fold). Leveraging this dual-responsiveness, ZW-gal successfully distinguished cancer from normal cells, visualized doxorubicin-induced cancer cell senescence, and monitored cell death. In a mouse model of liver cancer, ZW-gal enabled precise tumor localization and identified senescent tumors. Moreover, through in situ spraying, ZW-gal provided real-time surgical navigation, facilitating complete tumor resection. Building on these advantages, ZW-gal represents a powerful tool with broad potential to advance both basic cancer research and personalized clinical applications.

The objective of this study was to explore the clinical diagnostic indicators and treatment approaches for intravenous leiomyomatosis (IVL), particularly when it extends into the inferior vena cava and the right heart system. Nine patients with IVL admitted to our hospital were enrolled in this study. The ultrasonographic, CT, MRI, pathological findings and surgical details of these patients were comprehensively analysed. All patients underwent surgical procedures. Postoperative pathological examination confirmed the presence of IVL, along with intramural leiomyoma of the uterus. Immunohistochemical results demonstrated that smooth muscle actin, smooth muscle myosin heavy chain, Desmin, Caldesmon, oestrogen receptor and progesterone receptor were highly positive. The Ki-67 index of most specimens was <3%, except for case 4. In case 4, which invaded the right atrium, the Ki-67 index ranged from 2% to 5%. Through molecular testing, this case with extension to the right atrium and inferior vena cava was identified as intraventricular smooth muscle neoplasia with fumarate hydratase deficiency. No copy number variation mutations were detected in all cases. Although IVL is a rare histologically benign tumour, it exhibits the capacity to infiltrate cardiac chambers and pulmonary vasculature. Therefore, early diagnosis via imaging techniques, precise assessment of the extent of intravenous leiomyoma involvement, complete lesion resection and perioperative administration of anti-oestrogen medications are pivotal for enhancing patient prognosis. Additionally, for cases with atypical nuclei or high Ki-67 levels, multidisciplinary collaboration is required to personalised treatment.

While the role minimally invasive surgery (MIS) is established for primary endometrial carcinoma (EC), its feasibility in recurrent cases remains underexplored. To systematically review the literature about MIS for EC recurrence. A systematic literature search was conducted across six electronic databases, targeting studies published until October 31, 2024. Inclusion criteria encompassed all peer-reviewed studies reporting MIS for recurrent EC. Data extraction focused on surgical outcomes and survival metrics, following PRISMA guidelines. Out of 9652 results, 15 studies with 17 cases of patients with EC recurrence met the inclusion criteria. All patients underwent successful MIS, with no intraoperative complications reported. Complete resection (when reported) was achieved in 100% of cases, and adjuvant treatment was administered in 64.7% of patients. The mean follow-up duration was 23.6 months, with a disease-free survival rate of 63.6%. Risk of bias assessment indicated a predominance of low to medium risk of bias within studies. MIS might be feasible and safe in cases of abdominal recurrence of EC when the number of recurrence localizations is less than three. MIS might be a management option independently from EC histology, grade and stage (except for stage IV), previous adjuvant therapy and group of risk. The endoscopic approach could be both laparoscopic and robotic, without any apparent difference in terms of feasibility, safety and survival outcomes. However, data on this topic are limited and our findings need to be confirmed by additional studies.

Contemporary Multimodal Management of Primary Retroperitoneal Sarcomas.

ABSTRACT Background and Aims A retrospective analysis was conducted on the clinical, pathological, and imaging features of 471 cases of pilomatrixoma, aiming to enhance clinicians' understanding of pilomatrixoma. Methods A total of 471 cases of pilomatrixoma diagnosed and surgically treated in the Affiliated Hospital of Southwest Medical University from August 1999 to July 2024 were retrospectively analyzed. Some cases were also diagnosed through preoperative fine needle aspiration, as well as ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI). Results Of these 471 patients, 224 (47.6%) were male, and 247 (52.4%) were female. Their ages ranged from 8 months to 90 years, with an average age of 18.2 years. The highest incidence of pilomatrixoma was observed in patients aged between 0 and 10 years, accounting for 46.5% (219/471). The most common site of pilomatrixoma is the face, followed by the neck. The most common area of the face is the parotid gland region, accounting for 24.8% (61/246) of facial cases. Histology and cytopathology revealed that the tumor cells usually consisted of basaloid cells and eosinophilic shadow cells, and inflammatory cells, foreign body giant cells, and calcifications were seen. Additionally, the ultrasonography showed a mass with calcification, a strong echo band, and parenchyma without calcification. The pilomatrixoma should be considered when the tumor presents as soft‐tissue density with varying degrees of calcification, well‐defined oval or circular nodules on CT, and characteristic reticular and annular hypersignal on T2WI and T2WI + FS on MRI. Conclusion Pilomatrixoma is commonly found on the face and neck of adolescent females. Cytopathology, ultrasound, and imaging features can provide clinical clues, and histopathology can make the final diagnosis. Complete surgical resection is the preferred treatment.

Microvascular invasion is a strong prognostic factor in hepatocellular carcinomas. The aim of our study was to assess the diagnostic value of mechanical parameters measured with compression MR elastography to detect microvascular invasion in hepatocellular carcinomas. In this prospective preoperative MR elastographic study, consecutive patients with hepatocellular carcinomas, scheduled for tumor surgical resection, were included. The tumor parameters assessed with MR elastography were the basal visco-elastic parameters (storage modulus, loss modulus, and phase angle, reflecting elasticity, viscosity and visco-elastic ratio) during expiration and inspiration, and the tumor stiffening slope during compression induced by respiration, reflecting non-linear elasticity. Microvascular invasion was determined with histopathological examination of resected tumors. Diagnostic performance of MR elastography was assessed with area under the receiver operating curve (AUC) analysis. The final study group consisted of 53 patients with complete surgical resection, MR elastography and histological data, including 31 patients with microvascular invasion. Compression stiffening slope and storage modulus difference between inspiration and expiration were significantly higher in hepatocellular carcinomas without than with microvascular invasion (p < 0.001 and p = 0.03, respectively). Among clinical, morphological and biomechanical imaging features, the MR elastography compression stiffening slope (p = 0.004) and histological WHO differentiation (p = 0.02-0.03) were the only independent determinants of hepatocellular carcinoma microvascular invasion. In contrast to basal biomechanical parameters, the compression stiffening slope had high diagnostic performance for detecting microvascular invasion (AUCcompression stiffening = 0.83, p < 0.001). Our results suggest that the compression stiffening slope at MR elastography is useful to diagnose microvascular invasion in patients with hepatocellular carcinomas. Question Because non-invasive imaging markers of hepatocellular microvascular invasion are lacking, the development of new MRI markers is advisable. Findings In our MR elastography study, respiration-induced tumor stiffening, in contrast to basal visco-elastic parameters, had good accuracy for diagnosing hepatocellular carcinoma microvascular invasion. Clinical relevance Our results in patients with hepatocellular carcinomas suggest that the non-invasive measurement of MR elastography tumor compression stiffening slope may assess microvascular invasion.

Safety of Transaxillary Approach in Thoracic Outlet Syndrome Surgery in 484 Cases.

Impact of surgical margins on recurrence after resection of atypical lipomatous tumors: A single-center retrospective analysis.

EphA2-targeted NIR-I/II fluorescent probe for specific imaging of colorectal cancer.

Pathologic stage II non-small cell lung cancer (NSCLC) exhibits heterogeneous outcomes despite curative resection. Although adjuvant EGFR-TKI and immunotherapy have improved survival in resected NSCLC, subgroup analyses from major trials show only modest benefit in stage II disease. Given these limited gains and the variable cost-effectiveness of adjuvant therapy across regions, identifying prognostic factors is essential to guide treatment decisions and support value-based precision care. We retrospectively analyzed 115 patients with pathologic stage II NSCLC (27 IIA, 88 IIB) who underwent complete resection at a tertiary hospital in Taiwan (2016-2023). Clinicopathologic variables-including histologic subtype, spread through air spaces (STAS), and lymphovascular invasion (LVI) - were reviewed. Recurrence-free survival (RFS) and overall survival (OS) were evaluated using Kaplan-Meier and Cox proportional hazards analyses. The 5-year RFS and OS rates were 50.9% and 67.9%, respectively. Independent predictors of recurrence included tumor size >4 cm [hazard ratio (HR)=2.88, p=0.008], N1 nodal status (HR=3.20, p=0.016), and high-risk adenocarcinoma subtype (micropapillary/solid; HR=2.80, p=0.014). Adjuvant chemotherapy significantly improved OS (76.4% vs. 37.2%, p=0.002). Tumor size, nodal involvement, and histologic subtype are key prognostic determinants in stage II NSCLC. Identifying high-risk patients is crucial to optimize selection for adjuvant immunotherapy or targeted therapy and to ensure clinical and economic benefit.

PIK3R1 acts as a prominent biomarker for tumor immune microenvironment modulation in intravenous leiomyomatosis.

Brain connectivity predict surgical outcomes of low-grade epilepsy-associated neuroepithelial tumors.

Inflammatory myofibroblastic tumors of the skin and mucosal sites: A clinicopathological and molecular analysis of 3 cases with emphasis on differential diagnosis.

Background: The survival of Wilms’ tumor patients with favorable histology has improved dramatically in response to the introduction and use of current multimodal therapy. Though the SIOP and COG approaches produce nearly identical clinical outcomes, a valid debate about the relative merits of each approach continues. Objective: To Compare the intra operative difficulties in management of Wilms’ tumor by SIOP and COG protocol. Methods: This cross-sectional observational study was carried out in the Department of Pediatric Surgery in Dhaka Medical College Hospital, Dhaka from January, 2021 to July, 2022 over a period of 19 months to compare the intra operative difficulties in the management of Wilms’ tumor by SIOP and COG protocol. A total of 20 patients with Wilms' tumor scheduled for surgery at the Department of Pediatric Surgery, Dhaka Medical College Hospital, Dhaka and Bangladesh Shishu (Children) Hospital and Institute, Dhaka were enrolled in this study as per selection criteria. Two protocols were compared on the basis of per operative tumor spillage, complete resection, operative time, per operative blood loss, tumor weight and lymph node sampling. Statistical Package of Social Science (SPSS) 23 was used for data analysis. Results: More than half of the children were ≤2.5 years old. Tumor spillage was observed significantly lower in SIOP group (10.0%) than in COG group (70.0%) in this study (p0.05). Regarding tumor stages, stage I and II were 40.0% each and stage III was 20.0% in SIOP group. In COG group, Stage I, stage II and stage III were 20.0%, 10.0% and 70.0% respectively (p&gt;0.05). Lymph node sampling could be done in 80.0% cases in SIOP group and 50.0% cases in COG group (p&gt;0.05). Median operative time was 80 min in SIOP group and 120 min in COG group but the difference was not statistically significant (p&gt;0.05). Blood loss was smaller in SIOP group (median: 60 ml) than COG group (median: 65 ml), but the difference was not statistically significant (p&gt;0.05). Tumor weight was lighter in SIOP group (median: 550gm) than COG group (median: 675gm) (p&gt;0.05). Conclusion: According to this study findings, SIOP protocol showed less operative difficulties than COG protocol in the management of Wilms' tumor. Journal of Paediatric Surgeons of Bangladesh (2022) Vol. 13 (1 &amp; 2): 44-48

Randomized, multicenter Phase III trial of adjuvant chemotherapy with modified FOLFIRINOX versus capecitabine or gemcitabine in patients with resected ampullary adenocarcinoma.

To summarise current understanding of and highlight recent literature on the management of paediatric head and neck teratomas. Advances in foetal ultrasonography and MRI have enhanced early detection and anatomical characterisation, allowing for birth planning. The tracheoesophageal displacement index (TEDI) offers a predictive tool for airway risk. The EXIT (ex utero intrapartum treatment) procedure remains critical for airway control in high-risk cases, with foetal endoscopic tracheal intubation (FETI) emerging as a minimally invasive alternative. While histologically immature teratomas were previously thought to carry higher malignant potential, recent studies challenge this assumption. Complete surgical resection remains the cornerstone of treatment, with increasing use of intraoperative nerve monitoring. The role of adjuvant chemotherapy remains unclear, with limited evidence of efficacy in immature tumours. Contemporary management of paediatric head and neck teratomas prioritises early identification, airway safety, and complete resection. Innovations in foetal imaging and perinatal planning have reduced morbidity, while long-term outcomes remain favourable. Ongoing research into minimally invasive foetal interventions and tumour biology is essential to further optimise care.

Salvage Surgery for Localized Recurrent Ovarian Clear Cell Carcinoma: A Retrospective Case Series.

Background The optimal surgical strategy for petroclival meningiomas (PCMs) remains debated, balancing the extent of resection against the risk of neurological morbidity. While the goal of gross total resection is widely acknowledged, its functional benefit is not uniform and may be significantly influenced by specific anatomical and pathological factors, such as cavernous sinus (CS) invasion patterns and World Health Organization (WHO) grade. This study aimed to develop and validate a quantitative, individualized surgical decision-making framework incorporating these understudied parameters. Methods We conducted a retrospective cohort analysis of 100 consecutive patients who underwent microsurgical resection for PCMs between 2013 and 2023. High-resolution MRI was used to preoperatively grade CS invasion (0–3 scale) and neurovascular encirclement (≥270° contact). Functional outcomes were assessed serially using the Karnofsky Performance Scale (KPS) preoperatively and up to 24 months postoperatively. Multivariable logistic regression and propensity score matching were employed to identify independent predictors of functional outcome (KPS improvement). Subgroup analyses informed the development of a novel Resection Utility Score (RUS). Results Complete resection predicted KPS improvement (OR = 2.34, p = 0.001), while CS invasion (OR = 0.52, p = 0.013), WHO Grade 2 (OR = 0.61, p = 0.022), and neurovascular encirclement (OR = 0.45, p = 0.002) reduced functional gains. The derived RUS guided a decision algorithm. For subgroups with RUS &amp;gt; 1 (CS 0–1, WHO Grade 1), complete resection was recommended. For RUS &amp;lt; 1 (CS 2–3, WHO Grade 2), subtotal resection was advised. Conclusion The functional benefit of resection in PCMs is modulated by CS invasion and WHO grade. The proposed RUS and decision algorithm provide a quantitative, evidence-based framework for individualized surgical planning, shifting the paradigm from a universal goal of maximal resection toward a risk-adapted strategy aimed at optimizing functional preservation without compromising oncologic control. Prospective multicenter validation is warranted.

TEM OR ESD IN EARLY RECTAL TUMORS: A CLINICAL & COST-EFFECTIVENESS ANALYSIS.