Diagnosis Of Tumors Research Articles

Childhood Heart Tumors: Detection, Diagnosis, and Treatments

: Childhood cardiac tumors are rare but challenging conditions that can have a significant impact on a child’s health and even be fatal if not detected and diagnosed timely. While various types of tumors can occur in the heart, the most common among children are benign tumors, such as rhabdomyomas. Diagnosis of pediatric cardiac tumors is often challenging and requires a combination of clinical examination, imaging studies and biopsy. In some cases, the tumors may be asymptomatic and discovered incidentally, while in others, they can cause symptoms, such as shortness of breath, chest pain, arrhythmias and congestive heart failure. Treatment options for pediatric cardiac tumors vary depending on the type, size and location of the tumor and may include surgical resection, watchful waiting or a combination of both. The prognosis for children with cardiac tumors is generally good, with a high rate of complete cure in many cases. However, long-term follow-up and monitoring are important to detect and manage any potential complications or recurrence of the tumors.

Accuracy of clinical diagnosis, imaging methods, and biopsy in tumours and pseudo-tumours of the hand

Accuracy of clinical diagnosis, imaging methods, and biopsy in tumours and pseudo-tumours of the hand

A Comparative Study on BRAFV600E Mutation, Sonographic Findings, and Pathologic Characteristics in Non-invasive Follicular Thyroid Neoplasm with Papillary-like Nuclear Features (NIFTP) and Invasive Follicular Variant of Papillary Thyroid Carcinoma (IFVPTC)

Objective: Noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) comprise a new subgroup of thyroid tumors of follicular origin with borderline histologic features that lack evidence of either capsular or vascular invasion. In contrast to the invasive follicular variant of papillary thyroid carcinoma (IFVPTC), adverse events such as cancer-related death, distant or regional metastases, and structural or biochemical recurrence do not occur in patients with NIFTP. Many studies have been done to elucidate these two specific types of papillary thyroid cancer (PTC) and reduce aggressive therapeutic actions. This study compares molecular, cytological, and radiologic features of NIFTP and IFVPTC. Materials and Methods: Two groups of patients with NIFTP and IFVPTC (n = 18 in each group) who were referred to the endocrine clinic, at Imam Reza Hospital, were enrolled in this crosssectional study. Molecular analysis for BRAFV600E mutation of thyroid tissue was evaluated for all cases. Patient data included: age, sex, type of surgery, thyroid sonographic findings, and prior cytological diagnosis with the Bethesda system for reporting thyroid cytopathology. Results: Only two cases in the IFVPTC group were positive for BRAFV600E mutation. The majority of NIFTP cases were diagnosed as benign lesions (8/18). In contrast, the majority of IFVPTC cases were diagnosed as suspicious for malignancy on cytology (7/18). The mean nodule size in ultrasound in the NIFTP group (41.81 ± 20.43 mm) was larger than the IFVPTC group (36.72 ± 20.73 mm) (p =0.47). Most cases in the IFVPTC group had significantly multiple nodules (72.2%), while most cases in the NIFTP group (81.3%) had solitary nodules. Nodule composition in both groups was solid and complex; however, no cystic nodules were detected in ultrasound examinations. Furthermore, no calcification or lymphadenopathy was seen in the majority of cases in ultrasound. In the IFVPTC group, 47.1% and 35.3% of nodules were hyperechoic and hypoechoic, respectively, while 23.1%, 38.5%, and 23.1% of nodules in the NIFTP group were heterogenic, hyperechoic, and hypoechoic, respectively. Conclusion: According to our findings, only 11.1% of IFVPTC cases were BRAFV600E-positive, while none of the patients in the NIFTP group showed this mutation. However, IFVPTC was predominantly associated with a preceding diagnosis of PTC on FNA, and NIFTP was associated with the preceding diagnosis of benign lesions and follicular neoplasm. Sonographic findings failed to distinguish NIFTP from IFVPTC.

Ultrasonographic liver nodules are more often benign lesions in dogs with hemoperitoneum secondary to splenic tumor rupture.

To evaluate the reliability of preoperative abdominal ultrasonography as a staging tool for dogs with hemoperitoneum due to presumed splenic tumor rupture, focusing on the detection of metastatic lesions in the liver. 99 dogs from 20 emergency and specialty hospitals across the US. Dogs with nontraumatic hemoperitoneum secondary to splenic tumor rupture were included. A post hoc analysis was conducted on data from a nationwide prospective trial investigating novel treatments for canine hemangiosarcoma. The accuracy of preoperative staging was assessed by comparing ultrasonographic findings with intraoperative observations and histologic findings. On preoperative ultrasonography, there was a 20% incidence of liver lesions identified, with no association to liver lesions seen during operation. Notably, 22% of liver lesions observed during operation were missed on preoperative ultrasonography. The presence of liver lesions on preoperative ultrasonography was associated with a higher likelihood of a benign splenic tumor diagnosis. There was no association between the identification of liver lesions on preoperative ultrasonography and the presence of metastatic disease on liver biopsy, with a sensitivity and specificity of 19% and 82%, respectively. Additionally, ultrasound had low sensitivity in detecting intra-abdominal lesions beyond the liver and spleen, with 82% of these lesions missed preoperatively. This study challenges conventional perceptions around the approach to staging in dogs with hemoperitoneum. These findings advocate for a reevaluation of the staging approach, with more comprehensive modalities like whole-body CT or MRI potentially being more warranted.

Brain Tumor Detection and Classification Using MRI Images

Abstract: Brain tumors pose a serious health risk, and prompt and precise identification is essential for successful treatment. This article describes an automated method employing convolutional neural networks (CNNs) to identify and categorize brain cancers in MRI images. The dataset that was used consists of 7,023 MRI scans that were obtained from three different sources: the Br35H dataset, the SARTAJ dataset, and the fig share repository. Four classes are identified from the images: pituitary tumors, gliomas, meningioma’s, and no tumor. With the use of this improved dataset, the CNN model was created and trained, ultimately attaining a 97.5% test accuracy. Moreover, class-wise analysis showed that the precision values for pituitary tumors were 96.1%, 98.8%, 96.1%, and 98.6%, respectively, with equivalent recall rates of 94.7%, 95.4%, 100%, and 99% for gliomas, meningioma’s, and no tumors. With values of 0.966 for gliomas, 0.957 for meningioma’s, 0.994 for no tumor, and 0.975 for pituitary tumors, the F1-scores demonstrate the general resilience of the model. These findings show that the suggested CNNbased method is effective in assisting with brain tumor diagnosis from MRI scans, providing radiologists and other medical practitioners with a useful tool. In order to improve diagnostic accuracy, future study may entail enhancing the model even further and investigating the integration of other imaging modalities

MTOR inhibitor in the treatment of TFE-positive advanced maligmnant PEComa of the uterus: a case report and literature review.

The pre- and intra-operative diagnoses of malignant uterine vascular perivascular epithelioid cell tumors (PEComas) can be challenging, for which the literature is limited. Some cases have been shown to have TSC gene mutations or rearrangements of the MiT factor family, resulting in variable responses to mTOR inhibitors. We report a case of a TFE-positive malignant PEComa of the uterus with pulmonary metastases that responded favorably to the mTOR inhibitor, everolimus. A 52-year-old female underwent a total hysterectomy 5 years ago for suspected sub-serosal or broad ligament fibroids. The intraoperative pathologic diagnosis was leiomyosarcoma of the uterus and the postoperative diagnosis was malignant PEComa of the uterus. The patient declined genetic testing and further treatment. In December 2020 the patient presented with a pelvic mass and underwent open abdominal mass resection and pelvic adhesiolysis. The pathologic findings confirmed recurrent malignant PEComa of the uterus. The pulmonary lesions gradually progressed during the follow-up period, so treatment with everolimus was initiated. Close follow-up evaluation for nearly 3 years showed disease remission without recurrence or progression. The patient described herein had a TFE-positive uterine malignant PEComa with lung metastasis and responded well to the mTOR inhibitor, everolimus. Close follow-up in the last 3 years showed remission without recurrence or progression.

Artificial Intelligence-based Enhanced Brain Tumor Prediction: A Comprehensive Investigation of Machine Learning and Deep Learning

Brain tumors pose a significant threat to patients’ quality of life and survival rates, with traditional diagnostic methods often falling short due to their time-consuming nature and susceptibility to high misdiagnosis rates. Recent progress in Artificial Intelligence (AI), especially in Machine Learning (ML) and Deep Learning (DL), offer promising alternatives for the prediction and diagnosis of brain tumors. AI models, including Support Vector Machine (SVM), Random Forests, Logistic Regression, Artificial Neural Network (ANN), Convolutional Neural Network (CNN), and Long Short-Term Memory (LSTM) models networks, have demonstrated superior performance in processing complex medical data, thereby enhancing predictive accuracy and aiding clinical decision-making. This review systematically evaluates the application of these AI techniques in brain tumor prediction, highlighting their strengths and limitations, as well as the challenges faced in terms of model interpretability, data applicability, and patient privacy. Furthermore, this paper explored future prospects for improving model interpretability, transfer learning and domain adaptation for enhancing model applicability, and federated learning for preserving patient privacy. By addressing these issues, Artificial Intelligence can significantly advance brain tumor diagnosis and treatment, ultimately improving patient outcomes.

Challenges in the diagnosis and management of soft tissue tumors of the oral cavity.

Soft tissue lesions are among the most prevalent forms of tumors or tumor-like alterations within the oral cavity. They exhibit a wide spectrum of characteristics, ranging from benign, noninvasive lesions to malignant tumors, which collectively present a diagnostic challenge. A 67-year-old patient presented with an incidental finding of induration on the right cheek during dental hygiene. The intraoral examination revealed a soft, non-tender swelling measuring 20 mm in diameter. The sensitivity and percussion tests for the teeth in the fourth quadrant yielded unremarkable results. Panoramic radiography (OPG) revealed tip-ping of the premolars and an unclear apical finding in region 44. Cone-beam computed tomography (CBCT) revealed a sharply defined, lobulated hypodense lesion in the right buccal area. To clarify the diagnosis and optimize perioperative management, a 3 Tesla dental magnetic resonance imaging (MRI) scan was performed. This identified a 23×6×23 mm lipoma along the right mandibular ramus, causing detachment of the buccinator and de-pressor anguli oris muscles. A cinematic rendering reconstruction derived from the MRI data facilitated enhanced visualization for preoperative planning. The surgical excision was performed under local anesthesia, resulting in the successful removal of the neoplasm while preserving the mental nerve and submandibular gland. Histo-pathology confirmed the presence of a lobulated mature cell lipoma. The patient exhibited no complications during the removal of the sutures, with complete wound healing and no recurrence observed. This article highlights the efficacy of advanced MRI diagnostics and post-processing techniques in the management of ambiguous soft tissue neoplasms.

Clinical and cytological characteristics of malignant pericardial effusion and estimation of the rate of progression until its evacuation by pericardiocentesis

Abstract Introduction Pericardial effusion (PE) is a complication of neoplastic processes that worsens the prognosis and can lead to symptomatic presentations requiring pericardiocentesis (PC). There is limited literature regarding the evolution of PE from its onset to the need for PC, characteristics of these patients, progression rate of PE, and potential accelerating factors. Purpose This study aims to: i) Analyze the baseline characteristics of patients undergoing PC; ii) Evaluate the correlation between PE appearance and cytology; iii) Analyze the progression rate until PC performance. Methods This retrospective observational study includes patients with active neoplasia and significant symptomatic PE treated with PC at our hospital from 01/01/2010 to 06/30/23, with subsequent follow-up until 10/31/23. Clinical characteristics related to neoplastic processes and PE diagnosis were analyzed, including PE appearance, cytology, and computed tomography scans performed as neoplasia follow-up prior to PC. Results A total of 75 patients were included, with 6 excluded because of non-malignant conditions (2 acute pericarditis-related PE, 3 purulent PE, and 1 chylous PE). The remaining 69 patients had a median age of 59 years, with 55.1% being male. Lung neoplasm was most frequent (63.8%, with 84% adenocarcinoma), followed by lymphomas/lymphoid leukemia (7.3%), upper digestive tract (7.3%), and breast cancer (7.3%). 52.2% of PEs undergoing PC were diagnosed simultaneously with neoplasm (70.45% associated with pulmonary neoplasms); 43.5% had ECOG 1, and 89.9% had metastases (excluding PE) at PC. Cardiac tamponade was present in 27.5%, with percutaneous pericardiostomy added in 21.7%. PE appearance was sero-haematic in 49.3%, haematic in 36.2%, and serous in 14.5%. Cytology showed mostly positive results (69.2%: 50% in serous PE and 71.93% in haematic/sero-haematic PE). The median time from the last CT scan prior to PE to PC was 5 months (160 days, range: 24-943 days). PC recurrence was observed in 30.4% of cases. Follow-up mortality was 82.6%, higher in breast, renal, digestive, thymoma, and genital neoplasms (100%), with hematological neoplasms having the lowest mortality (40%), followed by pulmonary neoplasms (79.5%). Mortality was higher in patients with more lines of treatment at PC and with a higher number of metastases. The median time from PC to death was 2 months (68.5 days, range: 1 day-2007 days). Conclusions The most common neoplastic PE was associated with lung adenocarcinoma, though a variety of neoplasms were observed. Half of PEs were diagnosed concurrently with neoplasm diagnosis. Cytology sensitivity was not high, and PE appearance did not adequately predict outcomes. The median time from the last CT scan prior to PE to PC was 5 months, potentially guiding echocardiographic follow-up once PE is observed on CT. Overall mortality was high (82.6%), except for onco-hematological PE.Iconographic summary of malignant PE

Delayed Diagnosis and Misdiagnosis of Lacrimal Sac Tumors in Patients Presenting with Epiphora: Diagnosis, Treatment, and Outcomes

Background/Objectives: Epiphora, or excessive tearing, is a common symptom often attributed to benign conditions such as dry eye or nasolacrimal duct obstruction. However, it can also be an early indicator of lacrimal sac tumors, which are frequently misdiagnosed or diagnosed late due to their subtle presentation. This study aims to identify the clinical features that contribute to delays and misdiagnoses of lacrimal sac tumors in patients presenting with epiphora, with the goal of improving early detection and treatment outcomes. Methods: This retrospective study reviewed medical records from Taipei Veterans General Hospital between 2007 and 2023, focusing on patients who presented with epiphora and were later diagnosed with pathologically confirmed lacrimal sac tumors. Inclusion criteria were limited to cases that were initially misdiagnosed or had a delayed diagnosis, with imaging and clinical evaluations confirming tumor-related tear drainage obstruction. Patients with non-tumor causes of epiphora were excluded. Results: Eleven cases of lacrimal sac tumors were identified, including two benign and nine malignant tumors. The average duration from symptom onset to diagnosis was 22.4 months. Common symptoms included epiphora (100%), discharge (54.5%), and hemolacria (18.2%). Subtle clinical signs, such as asymmetry in the medial canthal region and non-tender swelling, were frequently noted. Despite receiving appropriate surgical and adjuvant treatments, the impact of delayed diagnosis was significant. Two patients succumbed to tumor-related disease; one developed lung metastasis 12 years after diagnosis, and another experienced recurrence during a six-year follow-up after undergoing extensive exenteration, adjuvant chemotherapy, and radiotherapy. Conclusions: Lacrimal sac tumors can present insidiously with symptoms often mistaken for benign conditions, leading to significant diagnostic delays. Thorough history taking, meticulous physical examination, and timely imaging are crucial for early detection. Increased clinician awareness and a high index of suspicion for lacrimal sac tumors in patients with atypical epiphora are essential to improve prognosis and reduce the risk of severe outcomes.

Metastatic Melanoma to the Small Bowel and Colon: A Systematic Review of the Global Experience and Institutional Cohort Analysis Detailing a Rare Clinical Entity.

Cutaneous melanoma is among the most common solid tumors to metastasize to the gastrointestinal (GI) tract. Literature summarizing the clinical experience and features of this unique pathology is lacking. A systematic review of the available literature reporting clinically salient features of melanoma metastases to the small and large intestines was conducted. Additionally, we surveyed our institutional experience of surgically treated melanoma metastasis to the small bowel and colon. A descriptive analysis was performed. Kaplan-Meier curves with log-rank tests were used to analyze time-to-event intervals. Univariable and multivariable Cox logistic regression models were generated to identify predictors of survival. Over 100 studies including 1153 patients were included. GI metastases predominantly affected males, were in the small bowel/jejunum, equally presented as solitary and multiple lesions, and were generally not the first site of distant metastatic disease. The median time from primary lesion diagnosis to GI metastasis was 48 months. Analysis of our institutional cohort suggested that survival in patients receiving complete GI-specific surgical resection and immune checkpoint inhibitors (ICIs) was prolonged compared to palliative resection and without ICI therapy. Positive prognostic factors for survival following GI metastasis included fewer GI metastatic lesions, complete resection, and longer duration between primary tumor diagnosis and GI metastasis. GI metastases are a sign of advanced metastatic melanoma. Clinical suspicion of metastatic involvement in patients with a history of melanoma who develop any abdominal symptoms or anemia should remain high. Receipt of complete surgical resection and ICIs may prolong survival in disseminated melanoma.

Fast‐MedNeXt: Accelerating the MedNeXt Architecture to Improve Brain Tumour Segmentation Efficiency

ABSTRACTWith the rapid development of medical imaging technology, 3D image segmentation technology has gradually become a mainstream method, especially in brain tumour detection and diagnosis showing its unique advantages. The technique makes full use of 3D spatial information to locate and analyze tumours more accurately, thus playing an important role in improving diagnostic accuracy, optimising treatment planning and promoting research. However, it also suffers from significant computational expenditure and delayed processing pace. In this paper, we propose an innovative optimisation scheme to address this problem. We thoroughly investigate the MedNeXt network and propose Fast‐MedNeXt, which aims to increase the processing speed while maintaining accuracy. First, we introduce the partial convolution (PConv) technique, which replaces the deep convolutional layers in the network. This improvement effectively reduces computation and memory requirements while maintaining efficient feature extraction. Second, based on PConv, we propose PConv‐Down and PConv‐Up modules, which are applied to the up‐sampling and down‐sampling modules to further optimise the network structure and improve efficiency. To confirm the efficacy of the approach, we carried out a sequence of tests in the multimodal brain tumour segmentation challenge 2021 (BraTS2021). By comparing with the MedNeXt series network, the Fast‐MedNeXt reduced the latency by 22.1%, 20.5%, 15.8%, and 11.4% respectively, while the average accuracy also increased by 0.475% and 0.2% respectively. These significant performance improvements demonstrate the effectiveness of Fast‐MedNeXt in 3D medical image segmentation tasks and provide a new and more efficient solution for the field.

Efficient and Compressed Deep Learning Model for Brain Tumour Classification With Explainable AI for Smart Healthcare and Information Communication Systems

ABSTRACTThe detection of brain tumours presents a significant challenge in the medical domain, where prompt and precise diagnosis is crucial as patient outcomes depend on it. Conventional deep neural networks perform well in carrying out various imaging tasks within the healthcare sector; however, their effectiveness often falls short of expectations in practical applications due to the substantial computational resources required and issues with reliability. In this research, an optimised and effective deep learning model founded on the DenseNet‐169 architecture is introduced for the classification of magnetic resonance imaging brain tumours, which is particularly advantageous for smart healthcare systems and information and communication technology (ICT) settings with limited computational capabilities. The model compression methodologies, including pruning and quantization, have been employed to significantly diminish the dimensions and intricacy of the model while achieving a classification accuracy of 97.07%. Furthermore, this endeavour necessitates the enhancement of the model's interpretability through the utilisation of explainable artificial intelligence methodologies such as Gradient‐weighted Class Activation Mapping (Grad‐CAM) and SHapley Additive exPlanations (SHAP), which will aid clinicians in highlighting crucial areas of the images and validating feature importance concerning the decisions rendered by the model. A comparative performance evaluation is conducted against DenseNet‐169, ResNet‐50 and various other models to delineate the superior efficacy of our model, rendering it exceptionally adept for knowledge‐driven, real‐time brain tumour diagnosis within smart healthcare and ICT systems where resources are constrained.

Pathology-Based Animal Cancer Registry of Abruzzo and Molise Regions (Central Italy): A Ten-Year Retrospective Study (2014–2023)

Pets have a crucial role in cancer research. Specifically, dogs and cats share the same environment as their owners and thus may serve as sentinels of naturally occurring tumors that are linked to the exposure to environmental hazards. Quantitative comparison of tumor types may reveal unusual cancer frequencies, providing directions for research and generation of hypotheses of cancer causation in a specific area and identification of risk factors. The aim of this study was to describe the data collected by the pathology-based animal cancer registry, managed by Istituto Zooprofilattico Sperimentale dell’Abruzzo e del Molise (IZSAM), during 10 years of activity (2014–2023) and to assess its potential epidemiological relevance. Frequencies of tumor topography and morphology in dogs and cats were described, analyzed and compared. Proportional morbidity ratios (PMRs) were calculated, taking into consideration some potential risk factors such as species, breed, sex, diet and living environment. The database comprises 5311 tumors (n = 4719 in dogs and n = 592 in cats), with a higher prevalence in females (67.3% in dogs and 61.2% in cats). The mean age at the first diagnosis of tumors was similar between sexes and slightly lower in dogs compared to cats. PMRs highlighted certain risk and “protective” factors for the development of tumors in specific topography. The risk of developing tumors of the blood and hematopoietic system (PMR = 0.44; 95% CI: 0.21–0.94), skin and subcutaneous tissues (PMR = 0.70; 95% CI: 0.61–0.80), oral cavity and pharynx (PMR = 0.60; 95% CI: 0.24–0.89), urinary organs (PMR = 0.33; 95% CI: 0.11–0.99) and bones, joints and cartilage (PMR = 0.72; 95% CI: 0.22–0.98) was lower in non-neutered male dogs than in neutered male dogs. Non-spayed female dogs had a greater risk of developing tumors of the mammary gland (PMR = 1.75; 95% CI: 1.57–1.96), female sexual organs (PMR = 2.12; 95% CI: 1.01–4.36) and respiratory system (PMR = 2.25; 95% CI: 1.55–6.74) but less risk for cutaneous and subcutaneous tissue tumors (PMR = 0.44; 95% CI: 0.38–0.51) and blood/hematopoietic system tumors (PMR = 0.47; 95% CI: 0.26–0.85) compared to spayed female dogs. Compared with mixed breed, purebred dogs had a significantly greater risk of developing mammary gland tumors (PMR = 1.36; 95% CI: 1.20–1.54) and lower risk for respiratory (PMR = 0.15; 95% CI: 0.07–0.32), gastrointestinal (PMR = 0.63; 95% CI: 0.34–0.94) and oral (PMR = 0.59; 95% CI: 0.36–0.96) neoplasia. Non-neutered male cats had a lower risk of developing skin and subcutaneous tumors (PMR = 0.68; 95% CI: 0.50–0.92) compared with neutered cats. The risk of developing skin and subcutaneous tissues tumors was higher for dogs and cats that lived mostly outdoor (PMR dogs = 1.21; 95% CI: 1.10–1.33; PMR cats = 1.18; 95% CI: 1.08–1.47), while dogs that live mainly indoor had a greater risk to develop mammary gland tumors (PMR = 0.78; 95% CI: 0.68–0.89). Results described herein highlight the fundamental role of animal cancer registration initiatives. These efforts would contribute to the possibility of conducting multicentric collaborative studies to deepen the knowledge of the epidemiology of tumors in dogs and cats from a comparative perspective, thus fulfilling the One Health approach.

Genetic profile of ferroptosis in non-small cell lung carcinoma and pharmaceutical options for ferroptosis induction.

Lung cancer (LC) is the leading cause of cancer-related deaths and the second most commonly diagnosed malignancy worldwide. Lung adenocarcinoma (LUAD) and lung squamous cell LC (LUSCC) are the most common subtypes of non-small cell LC (NSCLC). Early diagnosis of LC can be challenging due to a lack of biomarkers. The overall survival (OS) of patients with NSCLC is still poor despite the enormous efforts that have been made to develop novel treatments. Understanding fundamental molecular and genetic mechanisms is necessary to develop new therapeutic approaches for NSCLC. A recently identified type of programmed cell death known as ferroptosis is one potential approach. Ferroptosis causes oxidative damage and the death of cancerous cells by peroxidizing unsaturated phospholipids and accumulating reactive oxygen species (ROS) in an iron-dependent manner. Ferroptosis-related gene (FRG) signatures have recently been evaluated for their ability to predict patient OS and prognosis. These analyses show FRGs are involved in cancer progression, and may serve as promising biomarkers for tumor diagnosis and therapy. Moreover, we summarize the current pharmaceutical options of ferroptosis induction and their underlying molecular mechanism in LC. Therefore, this review aims to provide a comprehensive summary of FRG-based prognostic models, their associated metabolic and signaling pathways, and promising therapeutic options for ferroptosis induction in NSCLC.

Osteosarcoma with Pathological Fracture: A Rare Case Report

Introduction: Osteosarcoma is a primary malignant bone tumor originating from stem cells and is characterized by the proliferation of tumor cells that directly form immature bone or bone-like tissue. Osteosarcoma represents only 3% to 5% of all spinal malignancies. The aim of study is to discuss the importance of diagnostic investigation for a relatively rare case of spinal osteosarcoma. Case presentation: A 49 years old female came to the Emergency Unit, with a chief complaint of bilateral weakness of lower extremities for 1 year and worsening in 2 weeks. Upon examination, the initial diagnosis was mistaken for a spinal canal stenosis because metastatic bone disease from previous history of malignant melanoma. Subsequently, a decompression with stabilization fusion and biopsy is performed. Primary osteosarcoma was confirmed from histopathology results. Further chemotherapy is planned referring to confirmed primary osteosarcoma on histopathology. Discussion: Spinal osteosarcoma is very rare. Osteosarcoma occurs most frequently in the appendicular skeleton, especially the distal femur and proximal tibial metaphysis, which account for 90% of all cases. Primary osteosarcomas of the vertebral column are uncommon and occur dominantly in the vertebral body. Biopsy remains the gold standard of care for diagnosis. Conclusion: The performance of MRI and pathologic evaluation with immunohistochemistry is particularly important for the differential diagnosis of soft tissue tumors. Histopathologic analysis also plays an important role in differentiating from metastatic bone disease. An aggressive treatment plan and long-term follow-up are mandatory in managing this case. Keywords: osteosarcoma, spinal osteosarcoma, spinal canal stenosis, malignancy, pathological fracture, rare case.

Diagnosis and Management of Malignant Epithelial Nail Unit Tumors

Background: Malignant epithelial nail unit tumors pose significant diagnostic and therapeutic challenges due to their clinical presentation often mimicking benign conditions and due to the need to preserve as much nail unit function as possible during surgery. Early detection is crucial, even if none of these tumors represent a life-threatening disease. Objectives: This review focus on squamous cell carcinoma, verrucous carcinoma, eccrine porocarcinoma, onychocytic carcinoma, basal cell carcinoma, malignant onychopapilloma, malignant onycholemmal cyst and onycholemmal carcinoma. Methods: Existing literature on the aforementioned tumors has been revised and synthesized. Results: Clinical presentation, pathology, diagnostic procedures, risk factors and the challenges associated with surgical management have been described in detail. Conclusions: Malignant epithelial tumors of the nail unit require careful evaluation and management due to their complex presentation. Early detection and an informed surgical approach are essential to improve patient outcomes and minimize complications.

High-sensitivity and spatial resolution benchtop cone beam XFCT imaging system with pixelated photon counting detectors using enhanced multipixel events correction method.

High atomic number element nanoparticles have shown potential in tumor diagnosis and therapy. X-ray fluorescence computed tomography (XFCT) technology enables quantitative imaging of high atomic number elements by specifically detecting characteristic X-ray signals. The potential for further biomedical applications of XFCT depends on balancing sensitivity, spatial resolution, and imaging speed in existing XFCT imaging systems. In this study, we utilized a high-energy resolution pixelated photon-counting detector for XFCT imaging. We tackled degradation caused by multi-pixel events in the photon-counting detector through energy and interaction position corrections. Sensitivity and spatial resolution imaging experiments were conducted using PMMA phantoms to validate the effectiveness of the multi-pixel events correction algorithm. After correction, the system's sensitivity and spatial resolution have both improved. Furthermore, XFCT/CBCT dual-modality imaging of gadolinium nanoparticles within mice subcutaneous tumor was successfully achieved. These results demonstrate the preclinical research application potential of the XFCT/CBCT dual-modality imaging system in high atomic number nanoparticle-based tumor diagnosis and therapy.

Clinical, magnetic resonance imaging, histopathological features, treatment options and outcome of spinal ependymoma in dogs: 8 cases (2011-2022).

This study aims to report on the clinical magnetic resonance imaging, histological features, treatment options and outcomes of spinal ependymomas in dogs. Retrospective evaluation of medical records from dogs histologically confirmed spinal ependymomas with clinical presentations, magnetic resonance imaging findings, histological aspects, treatment options and outcomes. Eight dogs presented with acute to subacute onset of para- or tetraparesis. Magnetic resonance imaging findings included intramedullary oval-shaped space-occupying lesions that appeared hyperintense on T2-weighted images isointense on T1-weighted images and exhibited marked homogeneous or ring contrast enhancement. A peculiar feature, previously described only in human ependymomas, was observed in three patients - a T2-weighted hypointense rim, termed hemosiderin cap sign. Haematomyelia with necrotic foci was observed in one dog. Surgery, when performed, enabling a definitive intra-vitam diagnosis. Histological examination revealed that rosettes and pseudo-rosettes as disposition of neoplastic cells were the most common features reported. Furthermore, cerebrospinal fluid metastases were identified in one case. Clinical and histopathological findings in our case series were consistent with those previously reported in the literature. Magnetic resonance imaging features were fairly typical and highly suggestive of spinal ependymomas. The hemosiderin cap sign may aid in the presumptive intra-vitam diagnosis of these rare spinal tumours. Additionally, we described cerebrospinal fluid spread of neoplastic cells and subsequent multifocal or metastasis presentations. Surgery offered a dual benefit by facilitating intra-vitam diagnosis and, in some cases, extending survival time.

Biodegradable ICG-Conjugated Germanium Nanoparticles for In Vivo Near-Infrared Dual-Modality Imaging and Photothermal Therapy.

Theranostics, by integrating diagnosis and therapy on a single platform, enables real-time monitoring of tumors during treatment. To improve the accuracy of tumor diagnosis, the fluorescence and photoacoustic imaging modalities can complement each other to achieve high resolution and a deep penetration depth. Despite the superior performance, the biodegradability of theranostic agents plays a critical role in enhancing nanoparticle excretion and reducing chronic toxicity, which is essential for clinical applications. Herein, we synthesize biocompatible and biodegradable indocyanine green (ICG)-conjugated germanium nanoparticles (GeNPs) and investigate their biodistributions in nude mice and 4T1 tumor models after intravenous injections using near-infrared (NIR) dual-modality fluorescence and photoacoustic imaging. The ICG-conjugated GeNPs have strong NIR absorption due to the NIR-absorbing ICG and Ge in combination, emit strong NIR fluorescence due to the multilayered ICG coatings, and exhibit very low in vitro and in vivo toxicity. After tail vein injections, the ICG-conjugated GeNPs mainly accumulate in the liver and spleen as well as the tumor with the help of the enhanced permeability and retention effect. The tumor's fluorescence signal is much stronger than that of the control group injected with pure ICG solution, as the GeNPs can function as biodegradable carriers for efficiently delivering the ICG molecules to the tumor. Lastly, the ICG-conjugated GeNPs accumulated in the tumor can also be utilized for photothermal treatment under NIR laser irradiation, after which the tumor volume almost diminishes after 14 days. The experimental findings in this work demonstrate that the ICG-conjugated GeNPs are promising theranostic agents with exceptional biodegradability for in vivo NIR dual-modality imaging and photothermal therapy.