Higher Tumor Incidence Research Articles

Bibliometric Analysis to Improve Combined Treatment Strategies for Glioblastoma in America

Introduction: Bibliometric analysis quantitatively examines scientific literature to extract insights. This article has conducted such analysis on glioblastoma multiforme (GBM) treatment articles. GBM, a prevalent brain tumor, is typically treated with surgery, radiation, and chemotherapy. Objectives: The article aimed to bibliometrically analyze articles discussing combined GBM treatment to identify impactful research areas and encourage collaboration. Materials and Methods: The study encompassed a comprehensive search in the Scopus database, spanning articles published from 1974 to 2022. Inclusion criteria encompassed research conducted in the Americas, both clinical and experimental. A total of 772 articles were collected and categorized based on their primary focus on combined treatment approaches. Results: Clinical studies constituted 52% of articles, suggesting a slight dominance. The analysis unveiled key research moments, including a 1998 focus shift and a pivotal 2005 study on temozolomide- radiation combination. Top journals, trends, and authors were identified, with the USA leading in contributions. Discussions: Despite high brain tumor incidence, research distribution discrepancy is concerning. Regional epidemiological studies have been endorsed. The dominance of US and German authors in GBM collaboration has raised equity issues due to budget and GDP disparities limiting Latin American representation. Conclusion: GBM research in the region is dominated by the USA, while contributions from Latin American countries remain limited. The absence of comprehensive epidemiological studies on GBM in Latin America is concerning, considering the evident impact of the disease in the region. This underscores the urgent need for increased research participation and collaboration to advance the understanding and treatment of GBM across Latin American nations.

Role of Magnetic Resonance Spectroscopy and Diffusion-weighted Imaging in the Evaluation of Supratentorial Brain Tumours with Histopathology Correlation at a Tertiary Care Hospital: An Observational Study

Abstract Background: Traditional magnetic resonance imaging (MRI) may face challenges in accurately discerning supratentorial malignancies. However, advanced techniques such as diffusion-weighted imaging (DWI) and magnetic resonance spectroscopy (MRS) have significantly enhanced diagnostic accuracy. Thus, the study aimed to evaluate the effectiveness of these non-invasive diagnostic methods in patients with suspected intracranial lesions. Materials and Methods: In this prospective observational study at Osmania General and Allied Hospitals, 40 eligible patients were enrolled. After applying the inclusion and exclusion criteria, MRI examinations were conducted at two hospitals utilising GE 1.5T and PHILIPS 1.5T 32-channel machines. Standardised brain sequences, encompassing T1- and T2-weighted scans, DWI, gradient-recalled echo and fluid-attenuated inversion recovery imaging, were systematically performed. In addition, post-contrast administration and contrast-enhanced MRS were employed. Results: In this study, a higher tumour incidence was observed in males (52%) compared to females (48%). The choline/creatine (CHO/Cr) ratio revealed more cases below 1.5 and fewer at the 3.1–3.5 level. Perilesional CHO/Cr ratio had the highest cases (21) at 1.1–2.0 and the lowest (2) at 3.1–4.0. Further analysis revealed significant differences in the mean CHO/Cr ratio amongst primary low-grade (1.8), primary high-grade (3.91) and metastatic tumours (7.23). The mean choline/N-acetyl aspartate (NAA) ratio also differed significantly amongst these tumour types, with choline/NAA and CHO/Cr ratios indicating statistical significance in distinguishing primary low-grade tumours. In addition, mean apparent diffusion coefficient values showed significant differences between primary low-grade tumours (1.1), primary high-grade tumours (0.87) and metastasis (0.855). Conclusion: This study underscores gender-related differences in supratentorial tumour susceptibility and highlights distinct tumour distributions based on grades. These findings emphasise the significance of considering gender, age and histopathological attributes when evaluating supratentorial tumours.

Bringing the Genomic Revolution to Comparative Oncology: Human and Dog Cancers.

Dogs are humanity's oldest friend, the first species we domesticated 20,000-40,000years ago. In this unequaled collaboration, dogs have inadvertently but serendipitously been molded into a potent human cancer model. Unlike many common model species, dogs are raised in the same environment as humans and present with spontaneous tumors with human-like comorbidities, immunocompetency, and heterogeneity. In breast, bladder, blood, and several pediatric cancers, in-depth profiling of dog and human tumors has established the benefits of the dog model. In addition to this clinical and molecular similarity, veterinary studies indicate that domestic dogs have relatively high tumor incidence rates. As a result, there are a plethora of data for analysis, the statistical power of which is bolstered by substantial breed-specific variability. As such, dog tumors provide a unique opportunity to interrogate the molecular factors underpinning cancer and facilitate the modeling of new therapeutic targets. This review discusses the emerging field of comparative oncology, how it complements human and rodent cancer studies, and where challenges remain, given the rapid proliferation of genomic resources. Increasingly, it appears that human's best friend is becoming an irreplaceable component of oncology research.

Establishment of a histiocytic sarcoma cell line and anti-tumor effect of bortezomib in the African pygmy hedgehog (Atelerix albiventris).

The African pygmy hedgehog (Atelerix albiventris) is known to have a high incidence of tumor. However, investigating the tumors of this species has been constrained by the limited availability of research materials such as cell lines and genome information. In this study, we successfully established a novel cell line from a histiocytic sarcoma (HS) of an African pygmy hedgehog, allowing us to conduct a drug screening. We investigated using FDA-approved drug library screening to determine which anticancer drug this tumor cell line is sensitive to, and as a result of apoptosis experiments, bortezomib among the three proteasome inhibitors was found to induce cell death of cancer cells by significantly increasing caspase-3 cleavage (P<0.01). Thus, we elucidated that the proteasome inhibitors, particularly bortezomib, exhibit anti-tumor effects on a cell line derived from an HS in an African pygmy hedgehog through a mechanism comparable to that described in human tumors. This study reports the first characterized cell line from the African pygmy hedgehog and also highlights the potential utility of bortezomib as an anti-tumor treatment for HS in this species.

NFS-28. CLINICAL CHARACTERISTICS AND THERAPEUTIC INTERVENTIONS IN A CASE SERIES OF PEDIATRIC PATIENTS WITH VESTIBULAR SCHWANNOMAS AND NEUROFIBROMATOSIS TYPE 2

Abstract BACKGROUND Pediatric neurofibromatosis type 2 (NF2) is an understudied genetic disorder with high incidence of tumors including vestibular schwannomas (VS) and meningiomas. Although predominately recognized as an adult disease, there is a shortage of comprehensive studies in pediatric NF2. This case series describes a large cohort of pediatric NF2 patients with VS and their disease management. METHODS Our study included 24 patients with initial symptoms of NF2 before age 19. The patients were treated at the Neurofibromatosis Clinic of The University of Texas MD Anderson Cancer Center between 1/1/2005-12/31/2023. Our analysis incorporated data from clinic notes, surgical reports, audiology reports, electromyography reports, pathology reports, and imaging studies. RESULTS Patients presented with NF2 at an age range from 18 months to 18 years (mean age 8.1 ± 5.2 years). Among the patients, 67% underwent surgical interventions, including auditory brainstem implants, cochlear implants, ventriculoperitoneal shunts, and/or craniotomies for tumor resection. Additionally, treatment in 21% of cases involved radiotherapy, employing stereotactic radiosurgery, intensity-modulated radiotherapy, and proton beam irradiation. Targeted therapies, including bevacizumab, lapatinib, everolimus, temsirolimus, brigatinib, or a combination thereof, were administered to eleven patients. The best exhibited response by most patients was stable disease for a median duration of 10 months, and clinical improvement/stabilization of the hearing loss. Most reported toxicities related to bevacizumab or temsirolimus. Overall, limited clinical improvement was observed within this cohort after interventions. CONCLUSION This study discusses the clinical presentation of pediatric NF2 with VS and highlights the need for effective therapeutic options to manage tumors and symptoms in this patient population. A notable research gap exists in pediatric NF2, compounded by the lack of preclinical models to study the disease. The absence of approved drugs underscores the necessity for more comprehensive studies to guide therapeutic strategies. Combination therapies may advance treatment approaches and achieve improved outcomes.

A Case of Quadrivial Pattern of Right Upper Lobe Bronchus

Abstract The knowledge of the tracheobronchial tree is fundamental for a bronchoscopist, especially for diagnostic, therapeutic, and surgical options that are under consideration. Among all lobes, the right upper lobe (RUL) has a relatively high incidence of tumor and airspace diseases. Most bronchial anomalies are on the right side. Bifurcation is the most common anatomical variation. Quadrification has a very low prevalence. We report the case of a 54-year-old male who came with complaints of hemoptysis and showed a quadrivial type of bronchial division of RUL during a bronchoscopic examination after which three-dimensional computed tomography bronchography showed a supernumerary lateral or axillary segment bronchus. Awareness of this variant may explain otherwise confusing findings and its clinical implication is important for every pulmonologist.

Dermoscopy and In Vivo Confocal Microscopy Findings of Basal Cell Carcinomas in Xeroderma Pigmentosum Patients.

Xeroderma pigmentosum (XP) is a rare inherited disorder with a high incidence of malignant tumours. Literature data on dermoscopic and in vivo reflectance confocal microscopy (RCM) findings in patients with XP are very limited. Dermoscopic findings in 32 biopsy-proven BCCs and RCM findings in 10 biopsy-proven BCCs developed in seven XP patients were reviewed. Of 32 BCCs, 28 were pigmented. On dermoscopy, BCCs exhibited multiple grey-blue globules/dots (81, 3%), short-fine telangiectasias/fine arborising vessels (65, 6%), multiple grey-blue ovoid nests (53, 1%), white structures (white-red structureless areas/shiny white areas/lines/strands) (56, 3%), arborising vessels (37, 5%), brown nests/globules/dots (28, 1%), spoke-wheel structures (9, 4%), leaf-like areas (9, 4%), ulceration (28, 1%), peripheral network (21, 9%), and multiple aggregated yellow-white globules (3, 1%). In 10 lesions in which further imaging with RCM was performed, RCM findings differentiated BCC from other tumours, including primary melanoma. Although the dominancy of pigmented structures may imitate melanoma clinically, dermoscopy is a valuable tool in the early diagnosis of BCCs in patients with XP. For suspicious lesions, RCM can help in differentiating pigmented BCC from primary melanoma.

Copy number signatures and CCNE1 amplification reveal the involvement of replication stress in high-grade endometrial tumors oncogenesis

PurposeManaging high-grade endometrial cancer in Martinique poses significant challenges. The diversity of copy number alterations in high-grade endometrial tumors, often associated with a TP53 mutation, is a key factor complicating treatment. Due to the high incidence of high-grade tumors with poor prognosis, our study aimed to characterize the molecular signature of these tumors within a cohort of 25 high-grade endometrial cases.MethodsWe conducted a comprehensive pangenomic analysis to categorize the copy number alterations involved in these tumors. Whole-Exome Sequencing (WES) and Homologous Recombination (HR) analysis were performed. The alterations obtained from the WES were classified into various signatures using the Copy Number Signatures tool available in COSMIC.ResultsWe identified several signatures that correlated with tumor stage and disctinct prognoses. These signatures all seem to be linked to replication stress, with CCNE1 amplification identified as the primary driver of oncogenesis in over 70% of tumors analyzed.ConclusionThe identification of CCNE1 amplification, which is currently being explored as a therapeutic target in clinical trials, suggests new treatment strategies for high-grade endometrial cancer. This finding holds particular significance for Martinique, where access to care is challenging.

Familial isolated pituitary adenoma is independent of Ahr genotype in a novel mouse model of disease

Human familial isolated pituitary adenoma (FIPA) has been linked to germline heterozygous mutations in the gene encoding the aryl hydrocarbon receptor-interacting protein (AIP, also known as ARA9, XAP2, FKBP16, or FKBP37). To investigate the hypothesis that AIP is a pituitary adenoma tumor suppressor via its role in aryl hydrocarbon receptor (AHR) signaling, we have compared the pituitary phenotype of our global null Aip (AipΔC) mouse model with that of a conditional null Aip model (Aipfx/fx) carrying the same deletion, as well as pituitary phenotypes of Ahr global null and Arnt conditional null animals. We demonstrate that germline AipΔC heterozygosity results in a high incidence of pituitary tumors in both sexes, primarily somatotropinomas, at 16 months of age. Biallelic deletion of Aip in Pit-1 cells (Aipfx/fx:rGHRHRcre) increased pituitary tumor incidence and also accelerated tumor progression, supporting a loss-of-function/loss-of-heterozygosity model of tumorigenesis. Tumor development exhibited sexual dimorphism in wildtype and Aipfx/fx:rGHRHRcre animals. Despite the role of AHR as a tumor suppressor in other cancers, the observation that animals lacking AHR in all tissues, or ARNT in Pit-1 cells, do not develop somatotropinomas argues against the hypothesis that pituitary tumorigenesis in AIP-associated FIPA is related to decreased activities of either the Ahr or Arnt gene products.

A Case Report of Concurrent Transplant Renal Artery Stenosis, Renal Cell Carcinoma, and Papillary Thyroid Cancer After Renal Transplantation: A Literature Review

BackgroundKidney transplantation is the preferred treatment option for eligible patients with end-stage renal disease. With the advanced transplantation technology and the novel immunosuppressive agents, kidney transplant recipients survive significantly longer. But the chance of developing malignant tumors has increased, posing a serious challenge to the survival of transplanted kidneys and patients. Case presentationWe report a male patient (the patient's informed consent has been obtained) who underwent kidney transplantation 23 years ago. Subsequently appeared transplant renal artery stenosis (TRAS) , primary renal clear cell carcinoma(RCCC), and papillary thyroid cancer(TC). The narrowed blood vessels were dilated through percutaneous transluminal angioplasty (PTA), and the malignant tumor was removed surgically. Currently, anti-rejection drugs are regularly taken, and the transplanted kidney function is good. Satisfied with living conditions. ConclusionHypertension that is difficult to control after kidney transplantation should be suspected as a possibility of graft vascular stenosis. When B-ultrasound cannot accurately diagnose it, magnetic resonance angiography should be used as early as possible to clarify the diagnosis and relieve the stenosis before graft dysfunction. Transplantation patients have a high incidence of malignant tumors after surgery, and the risk increases with the prolongation of the disease course. Focus on symptomatic treatment of related diseases, and anti-rejection drugs can be reduced or not reduced as appropriate.

Clonal Origin and Lineage Ambiguity in Mixed Neuroendocrine Carcinoma of the Uterine Cervix

Small cell neuroendocrine carcinoma of the cervix (SCNEC/cervix) is a rare disease characterized by a high incidence of mixed tumors with other types of cancer. The mechanism underlying this mixed phenotype is not well understood. In this study, a panel of organoid lines from patients with SCNEC/cervix was established and focused on one line, which retained a mixed tumor phenotype, both in vitro and in vivo. Histologically, both organoids and xenograft tumors showed distinct differentiation into either SCNEC or adenocarcinoma in some regions and ambiguous differentiation in others. By tracking single cells, the existence of cells with bipotential differentiation towards SCNEC and adenocarcinomas was revealed. Single-cell transcriptional analysis identified three distinct clusters: SCNEC-like, adenocarcinoma-like, and a cluster lacking specific differentiation markers. The expression of neuroendocrine markers was enriched in the SCNEC-like cluster but not exclusively. Human papillomavirus 18 E6 was enriched in the SCNEC-like cluster, which showed higher proliferation and lower levels of the p53 pathway. After treatment with anticancer drugs, the expression of adenocarcinoma markers increased, whereas that of SCNEC decreased. Using a reporter system for KRT19 expression, changes in the differentiation of each cell were revealed to be associated with the shift in differentiation induced by drug treatment. These data suggest that mixed SCNEC/cervical tumors have a clonal origin and are characterized by an ambiguous and flexible differentiation state.

An Observational Case-Control Study on Parental Age and Childhood Renal Tumors.

Despite excellent outcomes, many open questions remain about Wilms tumor (WT). Influences and risk factors for tumorigenesis, as well as tumor aggressiveness and recurrence, are not fully understood. Parental age plays a role in various childhood diseases and is also discussed as a risk factor for childhood cancer. We analyzed both maternal and paternal age at birth as risk factors for the occurrence of Wilms and non-Wilms tumors in children and investigated whether older maternal or paternal age is associated with a higher tumor incidence. During 1990 and 2019 we collected data from 3991 patients from the multicenter studies SIOP9/GPO, SIOP 93-01/GPOH, and SIOP 2001/GPOH, of whom maternal and paternal age was available in 2277 cases. Data from the Federal Statistical Office containing live births in Germany from 1990-2019 served as a comparative database. For maternal age at birth, the control data yielded 22,451,412 cases and for paternal age yielded 19,046,314 cases. Comparing maternal and paternal ages of the study patients with those of the control data, we confirmed that higher parental age is not correlated with the incidence of renal tumors in childhood. Mean ages of fathers and mothers in patients and the control cohort increased between 1991 and 2019 (fathers: 30.28 vs. 34.04; mothers: 27.68 vs. 29.79 in the patient group and 31.29 vs. 34.23 and 28.88 vs. 32.67 in the control group, respectively) without higher numbers of patients with kidney cancer over time. No influence was found for the subtype of cancer nor for syndromes. In addition, overall survival of patients is independent of the year of diagnosis and the age of the parents but depends on histology type and stage in WT.

A Novel Mouse Model of Intrahepatic Cholangiocarcinoma Induced by Azoxymethane.

Cholangiocarcinoma is the second most common primary cancer of the liver and has a poor prognosis. Various animal models, including carcinogen-induced and genetically engineered rodent models, have been established to clarify the mechanisms underlying cholangiocarcinoma development. In the present study, we developed a novel mouse model of malignant lesions in the biliary ducts induced by the administration of the carcinogen azoxymethane to obese C57BLKS/J-db/db mice. A histopathological analysis revealed that the biliary tract lesions in the liver appeared to be an intrahepatic cholangiocarcinoma with higher tumor incidence, shorter experimental duration, and a markedly increased incidence in obese mice. Molecular markers analyzed using a microarray and a qPCR indicated that the cancerous lesions originated from the cholangiocytes and developed in the inflamed livers. These findings indicated that this is a novel mouse model of intrahepatic cholangiocarcinoma in the context of steatohepatitis. This model can be used to provide a better understanding of the pathogenic mechanisms of cholangiocarcinoma and to develop novel therapeutic strategies for this malignancy.

The Importance of Ultrasonography in the Evaluation of Mammary Tumors in Bitches.

The high incidence of mammary tumors in small animals is concerning. Patient history, clinical examination, physical evaluation, and imaging studies are important for clinical staging. Ultrasonography is commonly applied to investigate the presence of abdominal metastasis. However, it has been shown to provide important information regarding mammary tumors' architecture and advanced sonographic techniques can provide information regarding neovascularization, stiffness, and perfusion. Different techniques have been investigated to determine accuracy to predict the lesions' histological classification. This paper reviews the information regarding each sonographic technique in the evaluation of mammary tumors, describing the most common findings and their potential to accurately assess and predict malignancy. Even though the gold standard for the diagnosis of mammary lesions is the histopathological examination, some ultrasonographic features described can predict the potential of a lesion being malignant. Among the different sonographic techniques, elastography can be considered the most reliable modality to accurately differentiate benign from malignant tumors when malignant lesions present increased stiffness. However, the combination of all sonographic techniques can provide important information that can lead to a better therapeutic approach and clinical staging. Furthermore, the potential of the sonographic study, especially CEUS to monitor therapeutic progression, demonstrate the need of further studies.

Correlation between magnetic resonance images of peritumor margin enhancement and prognosis in hepatocellular carcinoma after drug-eluting bead transcatheter arterial chemoembolization.

The aim of this study is to investigate the morphological characteristics and clinical significance of magnetic resonance (MR) images of peritumor margin enhancement in hepatocellular carcinoma (HCC) after drug-eluting bead transcatheter arterial chemoembolization (DEB-TACE). From January 2017 to December 2020, a total of 162 patients who received a diagnosis of HCC were included in our study. We began the follow-up with magnetic resonance imaging (MRI) for complete response assessment, and peritumor margin enhancements were classified as sharp and rough types according to morphology. During the follow-up, data such as progression or remission of the two enhancement modalities, morphological changes in terms of margin enhancements observed in MR images, and alpha-fetoprotein (AFP) levels were recorded. In the follow-up period of 36 months, 70 and 92 patients with sharp- and rough-type peritumor margins, respectively, were observed. At the end of the follow-up, patients with sharp-type margins had lower AFP levels and longer progression-free survival than those with rough-type margins (P < 0.05). Furthermore, the sharp-type margin was thinner than the rough-type margin (all P < 0.05). Moreover, the sharp-type group had a high incidence of tumors with a diameter of < 5cm, whereas the rough-type group had a high incidence of tumors with a diameter of ≥ 5cm. Continuous enhancements of peritumor margins in MRI were greater in the sharp-type group than in the rough-type group. Most of the patients with a sharp-type margin achieved disease remission (94.3%, P < 0.05), whereas most of those with a rough-type margin experienced disease progression (84.8%, P < 0.05). Patients with HCC with a sharp-type margin enhancement on MRI after DEB-TACE mostly demonstrated benign lesions with a good prognosis, whereas those with a rough-type margin mostly demonstrated malignant growth.

Assessment of proliferative activity of immature ovarian teratomas using AgNOR technology

Germ cell tumors arise from the covering stem cells on the surface of the embryonic ovary. They make up 20-30% of all types of ovarian tumors. About 95% are benign and present as mature cystic teratoma, and only 5% are malignant. Malignant germ cell tumors of the ovary represent 2.6% of all malignant tumors of the ovary, in contrast to epithelial tumors of the ovary (95%). A high incidence of ovarian malignant germ cell tumors is observed in the first two decades of life. Determining the prognosis of germ cell tumors of the ovary is a complex and problematic issue, and according to the existing literature, various methods are used to determine a more accurate classification of cases. One of them can be used AgNOR staining, which is called one of the means of proliferation assessment in the case of different tumors, as well as in the differentiation of dysplasias and benign and malignant processes. According to our research, it is used to evaluate proliferative activity during different histological differentiation of immature teratomas.

Histological Pattern of Ovarian Tumor in Reproductive age group in a Tertiary Care Hospital

Objectives: To find out the frequency of histological pattern of ovarian tumor in reproductive age group in a tertiary care Hospital. Study Design: Cross sectional study. Place &amp; duration of study: Department of Obstetrics &amp; Gynecology, Liaquat University of medical and health sciences hospital, Hyderabad from October 2021 to September 2022. Methodology: All patients with ovarian tumor in reproductive age admitted during study periods were included in study. The diagnosis of ovarian tumors was suspected form clinical features and ultrasound findings and confirmed on histopathology. Data analysis was performed on SPSS version 24. Chi-Square test of significance (chi square test) was applied to see association among categorical variables. P value ≤ 0.05 was taken as significant. Results: Similarly pattern of ovarian tumors was as followed; such as cord stromal, germ cell and epithelial ovarian 50%, 33.96% and 16.04% respectively among 106 women. High incidence of sex cord and epithelial tumors was observed in older age (above 40 years) group 25% and 68.8% respectively but germ cell tumor was observed mostly in younger age group 92.6% in 21-30 years as compared to older age women and 6.3% in above 40 years. Practical Implication: Our research establishes the basis for future studies on ovarian tumor in Pakistan, allowing for better health policy decisions to be made based on this information. Conclusion: Histopathological examination shows that epithelial and germ cell tumors collectively constitute large number of cases specifically in older age. Histological examination in early stage of life is important therapeutically and prognostically. Keywords: Ovarian tumors, Malignancies, Histological pattern, Reproductive age, Parity

Effect of tumor location on the efficacy of chemotherapy for gastrointestinal stromal tumors.

790 Background: Gastrointestinal stromal tumors (GISTs) arise from multiple sites within the gastrointestinal tract. Since the introduction of imatinib in 2002, patients have seen improved overall survival. However, a recent National Cancer Database (NCDB) study suggested no survival benefit to adjuvant imatinib for colorectal GIST patients. Another recent study showed that small bowel GISTs have larger median tumor size and higher incidence of tumors with at least 5 mitoses compared to gastric GISTs. These findings suggest a differential tumor biology for GISTs arising from different primary tumor sites, potentially conferring differential response to imatinib. In this NCDB study, we compare overall survival outcomes with and without chemotherapy, stratifying by primary tumor site. Methods: We queried the NCDB from 2004-2018 for patients with GIST histology. We excluded patients with age &lt;40, age&gt;80, high comorbidity score, and patients who received additional therapy other than surgery or chemotherapy. Of the 22,846 patients meeting criteria for our study, 27 patients had tumors originating from the anus, 454 from the colon, 173 from the esophagus, 15,296 from the stomach, 556 from the rectum, 32 from the rectosigmoid junction, and 6,308 from the small intestine. 8,983 (39%) received chemotherapy. Treatment with chemotherapy was used to extrapolate response to imatinib, the mainstay of treatment. Results: Cox proportional hazards analysis demonstrated increased hazard of death for chemotherapy, increasing age, and comorbidity score of 1. Positive predictive factors for survival included female sex and later year of diagnosis. For anal, esophageal, gastric, and rectosigmoid GIST patients, there was no statistically significant overall survival benefit for any treatment modality. For colonic GISTs, neoadjuvant chemotherapy combined with surgery improved overall survival. For rectal GISTs, adjuvant chemotherapy with surgery also provided survival benefit. For small intestinal GISTs, surgery alone or surgery with neoadjuvant, adjuvant, or both neoadjuvant and adjuvant chemotherapy improved overall survival. Conclusions: While our study is retrospective and limited as a NCDB study, our Kaplan-Meier survival analysis demonstrated survival benefit for chemotherapy only in patients with colon, rectal, or small intestinal GIST tumors. Our Cox proportional analysis demonstrated an overall negative survival impact for chemotherapy. These findings lend further support to the idea that differential tumor biology at each primary site may lead to differential response to imatinib. Overall, our study provides rationale for further investigating the heterogeneity of GIST tumor microenvironments, as these differences could contribute to the differential treatment outcomes.

Differential diagnosis of an osseous cranial tumor from Hellenistic Muğla, Turkey

ObjectiveThis project evaluates a cranial lesion from a Hellenistic-era individual excavated by the Muğla Archaeological Museum in Gülağzı, Turkey. MaterialsAn osseous tumor measuring 3.02 × 3.54 × 2.98 cm originating from the occipital bone of a probable young adult male. MethodsThe tumor was examined using gross morphological inspection, plain radiography (x-ray), and computed tomography (CT) imaging to identify potential differential diagnoses for the osseous cranial tumor. ResultsThe lesion in question displays features highly consistent with both osteoid osteoma and osteoblastoma. The tumor had a non-sclerotic, sharply demarcated border, a radiolucent nidus measuring less than 2 centimeters in diameter, and homogeneous sclerotic bone surrounding the nidus. ConclusionsDifferential diagnosis determined the osseous tumor to be a benign neoplasm, and in this case the features of the tumor are highly consistent with a diagnosis of either osteoblastoma or osteoid osteoma. SignificanceThe identification of novel neoplastic cases in paleopathology represents an important contribution to ongoing discussions regarding the temporality and regional variability of neoplastic conditions in the past. Additionally, a rigorous diagnostic study augmented by x-ray, CT scans, and 3D modeling provides data that can be utilized in future paleopathological studies. LimitationsDiagnostic interpretation would be aided by histological examination of the tumor, which was impossible in this case. Histological examination would provide a definitive diagnosis. Suggestions for further researchGiven the high incidence of benign tumors in the clinical literature but a paucity of reports in the paleopathological record, further research is indicated to better understand the implications of benign neoplasms in antiquity.

Equine Melanocytic Tumors: A Narrative Review.

Adult grey horses have a high incidence of melanocytic tumors. This article narratively reviews the role of some genetic features related to melanoma formation in horses, such as STX17 mutation, ASIP or MITF alterations, and the link between the graying process and the development of these tumors. A clear system of clinical and pathological classification of melanocytic tumors in naevus, dermal melanoma, dermal melanomatosis and anaplastic malignant melanoma is provided. Clinical and laboratorial methods of diagnosing are listed, with fine needle aspiration and histopathology being the most relevant. Relevance is given to immunohistochemistry, describing potentially important diagnostic biomarkers such as RACK1 and PNL2. Different therapeutical options available for equine practitioners are mentioned, with surgery, chemotherapy and electroporation being the most common. This article also elucidatesnew fields of research, perspectives, and new therapeutic targets, such as CD47, PD-1 and COX-2 biomarkers.