Distinguishing infiltrative basal cell carcinoma (BCC) from poorly differentiated cutaneous squamous cell carcinoma (cSCC) remains a significant histopathological challenge. Automated deep learning approaches hold promise for improving diagnostic reliability, yet robust external validation is essential. In this study, we developed a weakly supervised deep learning model to classify these diagnostically challenging subtypes and evaluated its generalizability across internal and external cohorts, as well as in comparison to a dermatopathology foundation model (HistoGPT). The model employed a multiple-instance learning framework (CLAM) using the histopathology-specific transformer Phikon for feature extraction from whole-slide images. Slide-level ground-truth diagnoses from the collected images (n = 335, University Hospital Erlangen) were derived from routine clinical practice and re-evaluated by two board-certified dermatopathologists. Performance was assessed on an internal test set of 84 whole-slide images (27 cSCC and 57 BCC) and two external datasets: Queensland cohort (n = 10, curated in-distribution cases) and the COBRA cohort (n = 200, broad, partly out-of-distribution cases). Model discrimination was quantified using ROC curves, while accuracy, sensitivity, and specificity were reported alongside 95% Wilson confidence intervals (CIs). On the internal test set, the model achieved perfect classification [area under the receiver operating characteristic (AUC) = 1.0; 100% accuracy, sensitivity, and specificity]. Similarly, strong performance was observed in the Queensland cohort (AUC = 1.0), although limited by sample size. In the more heterogeneous COBRA cohort, discrimination remained high (AUC = 0.923, 95% CI 0.885-0.961), requiring threshold adjustment to correct for marked calibration shift (balanced accuracy 86.5% at Youden's J). Attention heatmaps highlighted histologically meaningful regions. In zero-shot evaluation on the internal test set, HistoGPT achieved an overall accuracy of 77%, with high class-wise sensitivity for BCC (98%, 95% CI 91-100) but markedly reduced sensitivity for cSCC (33%, 95% CI 19-52). Fine-tuning a task-specific classifier on the HistoGPT backbone substantially improved performance, achieving near-perfect discrimination and 98% balanced accuracy. These findings demonstrate that weakly supervised deep learning enables highly accurate classification of diagnostically challenging BCC and cutaneous squamous cell carcinoma subtypes. However, reliable deployment across institutions necessitates careful calibration and domain adaptation, and even powerful foundation models such as HistoGPT benefit from targeted fine-tuning to ensure robust performance in dermatopathology.

Infiltrative hepatocellular carcinoma Resistance: Integrating Microenvironment, Host Factors, and Therapy.

Marjolin's ulcer (MU) is a rare but aggressive squamous cell carcinoma arising from chronic cutaneous injury and has been only exceptionally reported in domestic animals. Chronic skin wounds are common in small ruminants raised under semi-arid conditions and may predispose to malignant transformation; however, MU has not previously been documented in sheep. Here, we report five cases in Santa Inês ewes from a confined flock in the semi-arid region of Northeastern Brazil. The affected 36-month-old ewes developed chronic dorsal wounds after repeatedly crawling under galvanised wire fencing, resulting in persistent mechanical lacerations over a two-year period. These non-healing hypertrophic wounds enlarged rapidly during the three months preceding clinical evaluation. The lesions were multinodular, ulcerated, friable, and malodorous, with extensive scarring consistent with prolonged secondary-intention healing. Histopathology revealed a moderately differentiated infiltrative squamous cell carcinoma (SCC) arising from ulcerated epidermis and characterised by marked keratinocyte atypia, keratin pearl formation, fibrosis, and chronic fibrinosuppurative dermatitis. Immunohistochemistry demonstrated diffuse pancytokeratin immunolabelling, confirming the epithelial origin of the neoplasm. Complete necropsies of all five affected ewes revealed no evidence of lymphatic or visceral metastases. This investigation represents the first documented report of traumatic MU in sheep associated with chronic dorsal fence-wire injury and underscores the importance of distinguishing this entity from solar radiation-induced SCC, which typically affects non-pigmented, sun-exposed anatomical sites. Early recognition and prompt management of chronic wounds are essential to prevent malignant transformation and improve outcomes in small ruminants.

Giant breast masses, defined as lesions over 5 cm, present diagnostic challenges due to their size and varied pathology. This prospective study evaluated 50 women with palpable giant breast lumps using mammography, ultrasonography, and image-guided biopsy. Imaging findings were compared with histopathology to assess diagnostic agreement. Infiltrative carcinoma was the most common malignancy, while benign phyllodes tumours were the largest benign group. A strong correlation was observed between higher BI-RADS categories and malignancy. These findings highlight the usefulness of a combined clinical, imaging, and biopsy approach for accurate diagnosis and informed treatment of large breast masses.

Two-stage lamellar lower eyelid reconstruction after infiltrative basal cell carcinoma excision

Basal cell carcinoma (BCC) of the vulva accounts for less than 1% of all BCCs. Herein this report describes a case of a 25-year-old female with vulvar BCC that was presented as an ulcerated mass lesion with erythema, fissuring and bleeding in the upper region of the right labium majus. After biopsy, the histopathology results showed basal cell carcinoma, mixed nodular and infiltrative type with focal areas of squamous metaplasia confirmed by IHC staining for common BCC markers. The reasoning for this clinical case is to report the atypical presentation and unique histopathology, for future consideration as a differential diagnosis when encountering genital lesions and to contribute to an ideal treatment. Vulvar BCCs remain a rare tumor of the vulva, which has excellent prognosis if managed appropriately. Therefore, any persistent lesion in the vulvar region should be biopsied and examined histologically regardless of the age of the patient.

Ménétrier's disease (MD) is a rare, acquired premalignant condition characterized by hypertrophic gastropathy. Its defining features include giant gastric rugal folds, predominantly in the fundus and body of the stomach, foveolar hyperplasia with glandular atrophy and a protein-losing gastropathy leading to hypoalbuminemia and peripheral edema. The pathogenesis is primarily driven by the overactivation of the epidermal growth factor receptor (EGFR) signaling pathway, most commonly due to the overexpression of its ligand, transforming growth factor-alpha (TGF-α). The clinical presentation varies significantly between pediatric and adult populations. In children, the disease is often acute, self-limiting and strongly associated with cytomegalovirus (CMV) infection. In adults, it typically follows a chronic and progressive course, carrying a significant risk for the development of gastric adenocarcinoma. Diagnosis is challenging and relies on a combination of endoscopic visualization, histopathological analysis of deep or full-thickness biopsies and advanced imaging techniques such as endoscopic ultrasound (EUS) to differentiate it from its mimics, which include gastric lymphoma and infiltrative carcinoma. Management strategies have evolved from supportive care, such as high-protein diets and treatment of associated infections like Helicobacter pylori, to targeted molecular therapies. The monoclonal antibody cetuximab, which blocks EGFR, has emerged as a highly effective treatment, capable of inducing clinical and histological remission. Somatostatin analogues like octreotide and lanreotide also offer symptomatic control by inhibiting growth factor signaling. For patients with refractory symptoms, severe complications or malignant transformation, surgical intervention via partial or total gastrectomy remains the definitive treatment. This review provides a detailed examination of the current understanding of the molecular underpinnings, diverse clinical spectrum, diagnostic modalities and therapeutic landscape of MD.

Abstract Introduction/Objective Salivary duct carcinoma (SDC) is an uncommon, aggressive malignancy, comprising <10% of salivary gland tumors. It typically affects older men and may arises de-novo or as carcinoma ex-pleomorphic adenoma (PA). A mucin-rich variant of SDC (mSDC) is exceedingly rare and may closely mimic primary mucinous adenocarcinoma or metastatic carcinoma, posing diagnostic challenge. Methods/Case Report We report a case of mSDC arising from a long-standing PA in a 76-year-old man with a history of multiple resections and radiation therapy 30 years prior. He presented with a deep-lobe parotid mass. FNA revealed adenocarcinoma with mucinous features. Total parotidectomy showed a 4.1 cm infiltrative carcinoma arising from hyalinized residual PA. No lymph node metastases were found. Histologically, the entire tumor exhibited clusters of high-grade cells, including occasional signet-ring cells, floating in abundant extracellular mucin. Immunohistochemistry showed diffuse positivity for CK7 and AR, focal expression of S100, SOX10 and p63, and negativity for CD117, DOG1, p40, and SMA. The Ki-67 index was 20%. The patient is planned to receive adjuvant chemotherapy at 4-month follow-up. Results NA Conclusion This case emphasizes the diagnostic complexity of mSDC and the importance of integrating morphology, immunoprofile, and clinical history. Broader recognition of this rare variant is essential for accurate diagnosis and management.

Papillary thyroid carcinoma (PTC) with blood vessel invasion (BVI) is classified as intermediate risk by the American Thyroid Association (ATA). However, no publications have adequately distinguished between encapsulated follicular variant (EFV) of PTC and infiltrative PTC with regard to BVI. Recently, the WHO classification reclassified EFV of PTC, a RAS-like tumour, as a distinct entity from PTC. In this study, we aimed to investigate the prognostic impact of BVI in infiltrative PTC. This retrospective matched case-control study included 134 cases of infiltrative PTC with BVI and at least 1 year of follow-up. A 1:1 matched control group of 134 infiltrative PTC without BVI, matched for PTC subtype and AJCC stage, was also included. CD31 and D2-40 immunohistochemistry were performed on 195 blocks to distinguish BVI from lymphatic vessel invasion (LI). BVI was defined as a CD31-positive/D2-40-negative endothelium-lined tumour embolus within a vessel wall, whereas LI was defined as a free-floating tumour plug lacking an endothelial lining within a CD31/D2-40-positive vessel. The median follow-up period was 5.3 years. Extensive BVI was the only independent adverse prognostic factor for disease-free survival (hazard ratio = 3.531) on multivariate survival analysis. On univariate analysis, infiltrative PTC with extensive BVI was associated with significantly decreased distant metastasis-free survival compared with those without BVI or with focal BVI. Using CD31 and D2-40 as gold standard ancillary tools, we established reliable histologic criteria to differentiate BVI from LI. Extensive BVI is an independent adverse prognostic factor in infiltrative BRAF V600E-like PTC and should therefore be considered in initial risk stratification for infiltrative PTC.

Background/AimsHepatocellular carcinoma (HCC) exhibits substantial morphological and biological heterogeneity. Clinical and molecular relevance of the infiltrative subtype remains poorly defined in the context of cancer immunotherapy. We aimed to evaluate the prognostic impact and molecular features of infiltrative HCC in patients treated with first-line atezolizumab plus bevacizumab (Ate/Bev).MethodsWe included 307 patients with advanced HCC treated with Ate/Bev and classified them into four gross morphological types based on imaging. Multi-omics profiling was conducted on tumor samples. Type IV infiltrative signature was derived and externally validated using five independent HCC cohorts, including IMbrave150.ResultsInfiltrative morphology, encompassing pure and mixed forms, was present in 42.7% of advanced HCC and associated with advanced disease features and compromised liver function. Patients with type IV infiltrative HCC showed lowest objective response rate (14.6%) and worst progression-free (median, 2.8 months) and overall survival (median, 7.1 months). Infiltrative morphology remained an independent predictor of poor outcomes after multivariable adjustment for confounders, including intrahepatic tumor extent. Genomic profiling revealed enriched TP53 and ATM loss-of-function mutations in type IV infiltrative HCC. Transcriptomic and proteomic analyses identified consistent activation of tumor proliferation, epithelial-mesenchymal transition, TGF-β signaling, and immunosuppressive pathways in type IV infiltrative HCC. Type IV infiltrative signature was significantly associated with poor survival across external datasets and retained independent prognostic value.ConclusionsInfiltrative HCC is a clinically aggressive and molecularly distinct subtype of advanced HCC. Morphological classification and type IV infiltrative signatures may guide risk stratification and therapeutic decision-making in advanced HCC treated with immunotherapy.

BACKGROUND: Breast cancer is the most common malignancy in females. It is routinely classified according to the WHO classification. However molecular classification can be more powerful than histopathology as a predictive factor for the different treatment strategies. Studies have shown that the triple negative breast cancer are more aggressive then others, likely to early metastasis & recur even after treatment. AIMS: This study gives insight to overall prognosis, role of molecular markers, molecular subtype and better categorisation of triple negative cancer cases. DESIGN: This was a retrospective study conducted in the Department of Pathology, Base Hospital Delhi Cantt over a period of 01 years from January 2018 to January 2019. MATERIAL AND METHODS: In this study 50 cases of breast carcinoma were included. Molecular phenotype was determined by using expression of ER, PR and HER2/neu. STATISTICAL ANALYSIS USED: Correlation of molecular subtype with histological grade, prognostic and predictive factor done by using chi square test. RESULT: Out of 50 cases, maximum 24 number of cases were Luminal A and 13 were Basal Like. Invasive ductal carcinoma is most common (88%) followed by Mucinous carcinoma (4%) and invasive mammary carcinoma. Commonest histological subtype is IDC (NOS) grade III (58%) with coexisting intraductal component with IDC was seen in 60%. Extensive intraductal component noted in 24%. Lymhovascular invasion was found in 34% of cases. Lymph node metastasis was found in 58% of cases. Incidence of ER, PR & Her2neu positivity in study population was 58%, 44% & 24%.respectively. Triple negative cases constituted 26% of total cases. On molecular classification 26% cases were basal like, luminal A were 48 %, Her2neu type were 16% and luminal B were 10% of total cases. Commonest molecular class was luminal A followed by basal like. Most common histological subtype in basal like category was infiltrating duct carcinoma grade III followed by grade II. In Her2Neu category majority of cases were IDC Grade III followed by grade II. Statistically significant association of molecular subtype was found with histological subtype, lymph node involvement and lymphovascular invasion. CONCLUSION: Molecular classification would help to determine the cases in which utilisation of chemotherapy is useful and with the help of it the prognosis in breast carcinoma can be determine. It help in the decision of requirement of the chemotherapy. In the present study significant group occurred in less than 45 years of age presenting in advanced stage of the disease. Triple negative cases were seen in 26% cases of infiltrating duct cell carcinoma indicating bad prognosis. KEY MESSAGE: In view of increasing early presentation of breast cancer at a young age, the various screening program, breast self examination and self awareness with presence of family history should be popularized to early diagnosis and prevention.

Opsoclonus-myoclonus syndrome (OMS) is rarely associated with breast cancer. This paraneoplastic syndrome poses significant diagnostic and therapeutic challenges for physicians. This article discusses a case of a 58-year-old Caucasian woman with complex neurological symptoms identified as paraneoplastic OMS due to non-metastatic breast carcinoma. This autoimmune disorder is associated with onco-neural autoantibodies, precisely type II anti-Ri nuclear antibody (ANNA-2), which targets the intracellular Ri antigen (Ri-PNS) and cross-reacts with two neuron-specific antigens. A multidisciplinary approach involving neurologists played a crucial role in case management. Left breast biopsy revealed a poorly differentiated ductal infiltrating carcinoma of the left breast, with 95% positive estrogen receptors, 12% positive progesterone receptors, HER-2 1+, FISH not amplified, and Ki67 at 50%. The patient underwent quadrant surgery for breast cancer and received hormonal therapy with anastrozole. To date, the patient is cancer-free; however, OMS persists. Neurological treatment did not yield significant or durable results. In conclusion, the medical literature on OMS in patients with breast cancer is fragmentary. This report illustrates the complexity of managing breast cancer patients with OMS and reinforces the critical need for a multidisciplinary approach.

Inadvertent cervical cancer, defined as infiltrative cervical carcinoma diagnosed after a simple hysterectomy for presumed benign disease, remains clinically significant yet understudied. Despite the potential for eradication of cervical carcinoma through vaccination, screening, and early treatment, disparities in health care access continue to result in preventable cases, some of which are identified only postoperatively. This condition has long been recognized, yet its management remains undefined and is supported primarily by low- or very low-quality evidence. Diagnostic failures often stem from inadequate preoperative evaluation, missed follow-up of abnormal screening results, and insufficient re-excision with conization when indicated. Social determinants of health, including race and ethnicity, socioeconomic status, and insurance status, contribute significantly to these lapses. The identification of invasive disease only postoperatively may negatively impact prognosis, even in early stages. Treatment strategies for inadvertent cervical cancer include observation, radiotherapy with or without chemotherapy, and completion surgery, such as lymph node assessment with or without parametrectomy. While retrospective studies suggest similar oncologic outcomes across some strategies (eg, additional surgery or radiotherapy), the absence of prospective trials limits definitive conclusions. Furthermore, morbidity and quality-of-life outcomes are frequently underreported. To support clinical decision-making, we propose a risk-based classification of this condition, categorizing patients as very low, low, medium, or high risk. Until stronger evidence emerges, treatment decisions should be individualized based on tumor features, surgical approach, and patient preferences. This review summarizes current evidence, highlights gaps in knowledge, and offers a pragmatic algorithm for managing this complex clinical entity.

Nasopharyngeal carcinoma (NPC) is the most frequent malignancy arising in the nasopharynx. While cervical lymph node metastases are common at diagnosis, rare cases may occur without nodal involvement. We report the case of a 48-year-old man presenting with headache, epistaxis, and nocturnal snoring. Clinical examination revealed no palpable cervical lymphadenopathy. Imaging showed nasopharyngeal thickening with lysis of the sphenoidal floor and intracranial extension. Histological evaluation confirmed a high-grade undifferentiated infiltrating carcinoma of type UCNT. The patient responded well to chemotherapy.

Recurrent and Infiltrative Basal Cell Carcinoma of the Nose After High-Dose Rate Electronic Brachytherapy.

Outcomes following pre-operative MRI-guided bracketing in breast cancer patients.

Abstract Background: Triple negative breast cancer (TNBC) is defined by the absence of estrogen and progesterone receptor expression and HER2 expression. This subtype of breast cancer has the worst prognosis and the fewest therapeutic options. In recent years, there has been the advent of both immunotherapy (first in metastatic stages and then also in early breast cancer) and ADCs. Antibody-drug conjugates are used in advanced stages of the disease. In fact the ASCENT study has been shown that sacituzumab govitecan provides a significant benefit compared to single-agent chemotherpay in progression-free survival (PFS) (5.6 months vs 1.7 months) and overall survival (OS) ( 12.1 months vs 6.7 months) compared to single-agent chemotherapy). Therefore SG is currently used as a second-line treatment for metastatic TNBC. Additionally, the TROPICS-02 study demonstrated a benefit PFS and objective response rate (ORR) in patients with HR+/HER2- metastatic breast cancer (mBC) who had previously been treated with at least one line of endocrine therapy and two to four lines of chemotherapy. TROP-2 expression is elevated in HER2-negative breast tumors (HR+/HR-) and correlates with poorer survival outcomes. Sacituzumab govitecan (SG) is a pioneering TROP-2-directed antibody-drug conjugate (ADC) that combines an anti-TROP-2 antibody with SN-38, a topoisomerase inhibitor linked through a hydrolysable connector. Clinical Case: In 2021, a 57-year-old woman presented with a palpable lesion in her left breast. Diagnostic tests, including breast ultrasound and subsequent MRI, revealed a unifocal lesion measuring 4 cm and two ipsilateral axillary lymphadenopathies. A biopsy confirmed the diagnosis of ductal infiltrating carcinoma with ER expression at 9%, PgR negative, HER2 1+, and Ki67 at 40%, indicating locally advanced disease due to axillary lymph node involvement. She underwent neoadjuvant chemotherapy with epirubicin and cyclophosphamide for 4 cycles, followed by carboplatin and weekly taxol for 12 cycles. Despite the low estrogen receptor expression, carboplatin was considered due to the early triple-negative subtype. At the end of neoadjuvant chemotherapy, the patient was underwent a left mastectomy and axillary dissection, With the finding of a pathological complete response at the site of the primary tumor, but with residual disease at the axillary lymph node level. Thus, she was treated with adjuvant capecitabine and adjuvant radiotherapy. Unfortunately, in January 2023, CT scan presented multifocal recurrence (bone, lung, liver and spleen lesions). A biopsy of a liver lesion was performed, which showed triple-negative histotype. Since the disease recurrence occurred within 6 months after the completion of adjuvant chemotherapy, we considered the patient for treatment with sacituzumab govitecan plus denosumab (for bone metastasis). At the first follow-up, the CT scan showed a significant response in the liver and lung disease. The patient continued treatment with SG, with total body CT scans every 3-4 months showing maintained disease response. By February 2024, there was complete radiological response of the liver and lung lesions, with stable bone disease. The complete response is still maintained today, after 20 months the beginning of SG. As adverse events, we report: grade 3 (CTCAE) neutropenia, so it became necessary prophylaxis with G-CSF; grade 1 diarrhea and grade 1 fatigue. Conclusion: This clinical case offers significant insights. Currently, the PFS has not yet been reached at 20 months, maintaining a complete response in visceral sites and stability in bone disease, while in the ASCENT study, the mPFS was noted at 6.7 months. The fact that there is weak estrogen receptor positivity may lead to a better response to SG and should it be classified as HR+ or TN? Could it be useful to identify any new biomarkers that may have predictive value, like Trop-2? Citation Format: Elena Giontella, Elena Fiorio. Excellent and Prolonged Response to Sacituzumab-govitecan in Triple Negative mBC [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2024; 2024 Dec 10-13; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2025;31(12 Suppl):Abstract nr P4-04-39.

Abstract Acoording to the European Medicines Agency (EMA), Enhertu is for unresectable or metastaic Her2-positive breast cancer previously treated with antiHer2, and breast cancer with low Her2 expression that is unresectable or metastatic after chemotherapy in the metastatic or if there is recurrence during or within 6 moths after the end of adjuvant chemotherapy. Our group evaluated patients with recurrent or metastatic breast cancer treated with trastuzumab deruxtecan at the Ourense University Hospital Complex, from May 1, 2021 to May 31, 2024. 19 female patients were included, 85% with ductal infiltrant carcinoma breast. At diagnosis, 52% were postmenopausal women. Initial staging showed that 10% were in stage I, 48% in stage II, 37% in stage III, and only 5% in satge IV. Ehertu was administered most frequently in the thrid line of treatment or later in 63% of cases; 42% had previously received another ADC (TDM-1, sacituzumab govitecan, etc). 53% of the patients had a good general condition (ECOG 0) at the beginning of treatment. The most common metastases were lymph node and bone, although 32% had lung and liver metastases. The mean number cycles administered was 9 (range 1-31), and it was necessary to reduce the dose in 42% of patients to continue treatment. Thirteen patients continue with the same treatment, five changed therapeutic lines due to disease progression and one by their own decision. Of the 19 patients, 17 are still alive, indicating low mortality since the start of treatment with Enhertu. It should be noted that 6 patients (31%) were initially diagnossed as her2 negative (1+,2+/ISH -) and throughout the course of the disease they transformed into Her 2+++, wich highlights the importance of rebiopsy of patients throughout their illness, in order to provide the most appropiate treatment. 7 patients were Her2+++ patients from the debut, and 6 patients were treated in the indication of Her2 low (Her2 1+,2++/ISH-) 100% of Her2 +++ patients initially received a pertuzumab+trastuzumab+taxane regimen (Cleopata regimen). In Her2 negative patientes (1+,2++/ISH-) at diagnosis, the most common first-line treatment was cyclin inhibitors with aromatase inhibitors, given that they were hormone receptor-positive patients. Conclusions: These data undeline the effectiveness of trastuzumab deruxtecan in a heterogeneous and highly pretreated population. More follow-up is required to evaluated the impact on overwall survival, but preliminary results indicate that it is an effective treatment with tolerable toxicity in a high percentage of patients with advanced breast cancer. This drug should be considered in all who present any percentage positivity (measured by immunohistochemistry) in Her 2. Citation Format: Leticia Iglesias Rey, Paula Sampedro Domarco, Jesús García Gómez, Jesús García Mata. Real-world data on the use of trastuzumab deruxtecan in breast cancer patients at a tertiary hospital in Ourense, Spain [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2024; 2024 Dec 10-13; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2025;31(12 Suppl):Abstract nr P5-03-30.

IntroductionTumor staging (TNM) and immunohistochemistry (IHC) are established predictors of breast cancer (BC) prognosis, but there are modulations by the tumor microenvironment and serum factors. This study aims to evaluate circulating chemokines, cytokines and leukocytes in the blood of patients with BC.MethodsA prospective study involving 200 women with infiltrative breast carcinoma was conducted. Patients were stratified by TNM stage and IHC subtype for survival analysis and correlations with the Neutrophil-to-Lymphocyte Ratio (NLR) and the expression of 13 chemokines and 3 cytokines.ResultsSurvival was significantly higher in women with early-stage tumors (I/II) and in Luminal A and HER2 + subtypes. No significant differences in NLR were observed across TNM stages or IH subtypes. Among the 172 non-metastatic patients, those with NLR > 2 had shorter disease-free survival (DFS) (multivariate analysis). In the Luminal B subgroup, patients with NLR > 2 exhibited worse progression-free survival (PFS) (multivariate analysis), while in the triple-negative (TN) subgroup NLR > 3 was associated with poorer overall survival (OS) (univariate analysis). NLR was prognostic during follow-up, with lower OS observed in patients with NLR > 3 at 12 months post-diagnosis. Significant correlations were identified among 8 CC/CXC chemokines. Furthermore, leukocyte count was significantly correlated with IL-6, RANTES/CCL5, and GRO-Alpha/CXCL1; lymphocytes with MCP1/CCL2; and monocytes with IP10/CXCL10. NLR was significantly correlated with RANTES/CCL5.ConclusionRisk stratification in BC patients is grounded in tumor staging and immunohistochemistry. However, systemic inflammatory responses, including cytokine- and chemokine-mediated signaling of neutrophils and lymphocytes, play a critical role in modulating prognosis.

Basal cell carcinoma, the most common human malignancy, has a rare incidence of metastases ranging from 0.0028-0.55%. We report a case of a 74-year-old female with a 10-year history of an enlarging anterior thigh nodule. Wide resection and inguinal lymph node dissection revealed an infiltrative basal cell carcinoma with lymph node metastasis due to the presence of basaloid cells, limited peripheral palisading, loose stroma, extensive spread, perineural invasion and immunoreactivity to p40, BerEP4, and GATA3.'