Low Malignant Potential Research Articles

Solid pseudopapillary neoplasm (SPN), also called Frantz tumor, is a low-grade pancreatic neoplasm with low malignant potential and is mostly found in young women. It may be a diagnostic challenge because it is rare and often presents with nonspecific symptoms. A 22-year-old woman reported progressive pain in the left upper quadrant of her abdomen, early satiety, and slight weight loss in the last three weeks. The physical examination revealed a tender, palpable mass. Abdominal CT and MRI showed that a big, 8.5 cm, well-encapsulated, heterogeneous solid and cystic mass was present in the tail of the pancreas, which is typical of an SPN with hemorrhagic and necrotic components. This patient had a splenectomy and a distal pancreatectomy. The diagnosis was confirmed using histopathology, which revealed a neoplasm with solid and pseudopapillary structures. Immunohistochemistry was positive for β-catenin and CD10. The surgical margins were negative, and the Ki-67 index was low (2%). The patient managed to recover without issues and is still in the disease-free period 16 months after surgery. The case is a typical example of SPN presentation, emphasizing the necessity of considering typical clinical and radiological features to diagnose it properly and perform a timely surgery. Most cases can be treated by performing an entire surgical resection, which provides a good long-term prognosis.

Abstract Background Pancreatic cystic lesions (PCLs), a subset of which have the potential to develop into pancreatic cancer, are increasingly detected on cross-sectional imaging and pose challenges to clinicians due to the lack of diagnostic tools capable of accurately stratifying their malignant potential. Non-mucinous PCLs, of which there are several subtypes, have very low malignant potential and typically do not require treatment if asymptomatic. On the other hand, mucinous PCLs have variable short- and long-term risk potential and therefore require active management with surveillance or surgical resection. To this end, Amplified Sciences previously secured CLIA regulatory clearance for PanCystProTM, a tri-analyte marker panel powered by an algorithm capable of distinguishing mucinous from non-mucinous PCLs from <50 µL of cyst fluid with a high negative predictive value. The current study builds upon this work by stratifying risk for the most common and worrisome mucinous cyst subtype, Intraductal Papillary Mucinous Neoplasms (IPMNs), using a multi-dimensional analyte panel consuming ultra-low sample volume. Methods Surface-Enhanced Raman Spectroscopy (SERS) a cutting-edge optical detection platform enables clinical diagnostics using ultra-low sample volumes. A novel multi-analyte panel utilizing Amplified Sciences’ highly sensitive proprietary SERS reporter dyes was developed and tested retrospectively in a blinded cohort of 66 histopathologically confirmed surgically resected IPMN cysts. Thirty-four IPMNs had low-grade dysplasia (LGD), twelve high-grade (HGD) and twenty invasive carcinomas, with the latter two diagnoses grouped together in the analysis given the clinical need to identify more aggressive IPMNs for potential surgical resection. The 6-marker panel incorporates a combination of enzymatic activity assays and mass-based (immuno-SERS or iSERS) assays. Results The biomarker panel, which includes an iSERS assay for neutrophil elastase (Figure 1), was tested against the 66-sample IPMN cohort, and a predictive machine learning algorithm distinguishing HGD/invasive- from LGD IPMNs was developed. This approach resulted in sensitivity of 97.1% and a negative predictive value (NPV) of 96.6%, along with specificity of 87.5% and a positive predictive value (PPV) of 89.2%. Overall accuracy was 92.4%. Importantly, the iSERS method using antibody pairs is analogous to traditional sandwich-based ELISA methods but without the requirement for an enzymatic amplification step for detection; moreover, the sensitivity of antibody-SERS dye reporter conjugates enables a drastic reduction in sample volume requirements (1-2 µL per marker). Conclusion The Amplified Sciences’ platform leverages SERS to quantitate multiple low-abundance biomarkers in ultra-low sample volumes. This property is particularly advantageous for PCLs and will enable rapid refinement of the current promising HGD-LGD panel, focusing on testing of multiple biologically relevant marker classes (inflammation, hypoxia, etc.). Future work includes clinical validation in a larger training set with sufficient statistical power and incorporating complementary clinical information into a predictive algorithm.

Background. Ovarian carcinoid tumors are rare, representing about 0.1 % among all ovarian tumors and 0.8 to 5 % of carcinoid tumors. Strumal carcinoid is a rare type of ovarian teratoma composed of normal thyroid tissue (struma) and a carcinoid (neuroendocrine) tumor. While most cases are benign, some may exhibit malignant features, prompting treatment as a low-potential malignancy. Description of the clinical case. We report a case of giant ovarian strumal carcinoid with distant metastasis in the right atrium presenting as a free-floating thrombus. The patient underwent two-stage radical surgery. Conclusion. This case report demonstrates the importance of comprehensive preoperative clinical diagnosis, intraoperative assessment and histopathological diagnosis. With this pathology, which is often asymptomatic, various diagnostic examinations have low specificity and sensitivity, and in most cases the diagnosis is based on the results of a postoperative histology examination.

BackgroundThymomas are the most common anterior mediastinal tumours, however, overall incidence remains rare. Because of their rarity and low malignant potential, recurrence of thymomas is rarer still. Data on long-term outcomes thus remains limited. We present a single-centre review of recurrent thymoma cases over 10-years. Our objective is to assess the clinical characteristics, management, and long-term outcomes of recurrent thymoma, with a focus on recurrence patterns, histological changes, and the role of surgical intervention in recurrent disease.MethodsRetrospective review was conducted using prospectively collected data of all patients diagnosed with recurrent thymomas at our centre between January 2014 and December 2024. A total of 77 patients underwent surgical treatment for thymoma. Of these, 10 patients had recurrence. While 3/10 opted for and remain under active surveillance, 7/10 underwent further surgery for recurrence. Data including demographic characteristics, presence of paraneoplastic disorders, initial and recurrent tumour histology [World Health Organization (WHO) classification], timing and location of recurrence, and clinical outcomes were analyzed.ResultsEqual gender-distribution was noted (5 males: 5 females). Myasthenia gravis was diagnosed in 5/10. Mean age at time of recurrence was 58.3 years. The median time to recurrence was 9.8 months (but ranged up to 192 months). All recurrences were picked up on follow-up cross-sectional imaging and multidisciplinary team (MDT) discussion. Histology from original surgery showed complete macroscopic resection (R0/R1) in 8/10 patients. However, the majority of them were noted to have advanced stage (stage III/IV) thymomas on initial histology. Of 7 patients who underwent further surgery, 2 patients had different WHO grade on recurrent histology: one had a recurrence of B3 in a previously predominant B2 tumour, while another had a recurrence of B2 thymoma in a previously type A thymoma. The average length of stay following recurrence operation was 4.06 days. Despite the complexity of re-interventions, there was no peri-operative mortality. Unfortunately, 1 patient passed away from unrelated cause.ConclusionsAlthough historically we follow-up thymomas for 10 years, our experience with recurrent thymomas over a decade supports the need for lifelong surveillance, as recurrence may emerge years after initial resection in these indolent tumours. In addition, imaging follow-up allows early detection and possible further surgical intervention. Where surgical resection is feasible, we would advocate proceeding with the goal of achieving complete excision of recurrent disease. Nonetheless, MDT discussion and individualized multimodality treatment/surveillance are crucial for optimizing long-term outcomes in these rare advanced recurrent thymomas.

Franz tumor, which has been classified as solid pseudopapillary neoplasm (SPN) of the pancreas, is a rare tumor with low malignant potential that occurs mainly in young women. Its clinical manifestations are atypical or asymptomatic, diagnosis is often incidental or detected by imaging for other reasons, and little is known about their optimal treatment. This analysis aimed to increase knowledge about the occurrence and treatment strategies of SPN. A 17-year-old female who presented for 6 weeks with asymptomatic microscopic hematuria (AMH) was admitted after an outpatient ultrasound examination revealed a pancreatic mass. Abdominal enhanced computed tomography and magnetic resonance imaging revealed a solid pseudopapillary tumor of the pancreas, the large tumor involving the splenic artery and pressing on the left kidney. The patient underwent distal pancreatectomy and splenectomy, and SPN was confirmed by histopathology. She did not experience any complications and was discharged from the hospital after recovery. Postoperative reexamination and the 4-month follow-up showed that the hematuria disappeared and the tumor did not recur. The diagnosis of SPN is often incidental, as most patients are asymptomatic or have atypical symptoms. Most of the pathological manifestations were low-grade tumors. Surgical resection is still the standard of care. AMH caused by SPN is extremely rare, and the association may be attributed to exogenous tumor growth involving the kidney. As with getting an early diagnosis, surgery can be a challenge, but patients with SPN are associated with an excellent prognosis after surgery. Suspicion and proper investigation are essential to diagnose this entity in a timely manner.

Background: Pancreatic solid pseudopapillary neoplasms (SPNs) are rare exocrine tumours with predominance in young women. These tumours are of low malignant potential, become considerably large before causing symptoms and are associated with good prognosis. This study aimed to present and analyse clinicopathological features and surgical outcome of SPNs. Methods: A retrospective analysis of 22 patients who underwent pancreatic surgery for SPNs in a single high-volume surgical centre in 2014–2023 was performed. Results: SPN was the most frequent in females (n = 21, 95.45%) in a mean age of 34 ± 11.09 (18–55) years. Fourteen (63.64%) patients were asymptomatic, and eight (36.36%) presented with symptoms. The most common clinical symptom was abdominal pain (n = 7, 31.82%). The majority of tumours were located in the pancreatic body (n = 8, 36.36%), and most patients underwent distal pancreatectomy (n = 11, 50%). The median tumour size was 3.6 cm (IQR = 4.9; range: 1.3–14). The median duration of hospitalisation was 12.5 days, and the postoperative complication rate was 40.91%. R0 resection was achieved in 18 (81.82%) patients. Postpancreatectomy acute pancreatitis (PPAP) was the most common postoperative complication. No adjuvant therapy in any patient was needed. One-year overall survival (OS) equalled 100% and five-year OS reached 85%. None of the patients developed diabetes or signs of impaired pancreatic secretion in the follow-up period. Histopathology showed features like perineural invasion in 72.73% of cases, pseudocapsule (59.09%), haemorrhage (45.45%), vascular invasion (40.91%), mucosal metaplasia (40.91%), necrosis (31.82%), and calcification in the capsule (31.82%). Ki67 did not exceed 7%. In one case (4.55%), metastasis to a lymph node was found. Clinical suspicion agreed with histopathological results in only 10 (45.45%) cases. Conclusions: SPN most often occurs in young females. The majority of cases are asymptomatic accidental findings. The final diagnosis of SPN can be based just on analysis of histopathological examination results.

ABSTRACT Bladder cancer diagnosis is challenged by invasive monitoring and workflow inefficiencies impacting diagnostic reliability. This prospective study enrolled 150 patients (January 2020–December 2022) and evaluated a novel liquid-based immunocytochemistry platform, coupled with integrated machine learning, for detecting urothelial carcinoma in voided urine. All 150 cytology slides met the adequacy threshold of ≥2,644 urothelial cells and showed preserved cytomorphology. Eight cases of papillary urothelial neoplasm of low malignant potential (PUNLMP) were set aside a-priori, yielding an analytic cohort of 142 patients (115 urothelial-carcinoma, 27 benign) for performance analysis. hTERT (sensitivity 92.2%, specificity 66.7%), GATA-3 (67.0%, 88.9%), and CK17 (89.6%, 66.7%). In multi-marker analysis, sensitivity reached 100% (95% CI 96.8–100) when any marker was positive, whereas specificity reached 100% (95% CI 87.3–100) when all three markers were positive. The workflow-optimized platform standardizes specimen preparation and multi-marker interpretation, offering a robust foundation for urine-based bladder-cancer diagnostics. Larger, multi-center validation studies are warranted to refine specificity estimates and facilitate laboratory integration. This study demonstrates that addressing fundamental workflow challenges in bladder cancer diagnostics before implementing artificial intelligence creates more effective diagnostic tools. By prioritizing specimen integrity and standardization through a novel liquid immunocytochemistry platform, exceptional diagnostic performance was achieved with 100% sensitivity and specificity under defined marker parameters across various cancer stages. This workflow-first approach to integrating machine learning with advanced biomarker analysis offers a model for developing clinically practical diagnostic innovations that can reduce reliance on invasive monitoring procedures while improving detection accuracy.

Glomangiopericytomas are rare spindle cell neoplasms that typically arise within the sinonasal tract and exhibit borderline to low malignant potential. While unusual, occurrences of this tumor in other regions of the head and neck have been reported, such as the deep neck spaces, larynx, tongue, and middle ear. A 44-year-old male presented with a one-year history of left infraorbital swelling, enlarging over two months and occasionally pulsating with discomfort. Cross-sectional imaging revealed a 1.5cm x 0.8cm x 1.7cm homogeneously-enhancing mass in the left medial infraorbital region eroding the adjacent maxillary sinus wall, suggestive of an infraorbital nerve schwannoma or hemangioma. The tumor was excised via a lateral rhinotomy approach with anterior maxillectomy. The final pathological diagnosis was a glomangiopericytoma. Although typically localized to the sinonasal tract, glomangiopericytomas may arise in unusual head and neck locations such as the infraorbital region. It is important to distinguish these tumors from related mesenchymal tumors such as solitary fibrous tumors and myopericytomas due to differences in their biology and malignant potential.

Borderline ovarian tumors (BOT) are neoplasms with low malignant potential, which are characterized by atypical epithelial proliferation without destructive stromal invasion. They account for 15–20 % of all epithelial ovarian tumors, with serous and mucinous BOT being the most common. The incidence of BOT ranges from 1.5 to 4.8 cases per 100,000 women, with at least one-third of patients being younger than 40 years at the time of diagnosis. Therefore, one of the most critical aspects of treatment is fertility preservation. The “gold standard” for organ-sparing treatment is resection of the affected ovary or adnexectomy, accompanied by mandatory surgical staging. Most BOT are diagnosed at early stages (FIGO I), ensuring a favorable prognosis with a 5-year survival rate of 95 % and a 10-year survival rate of 90 %. Recurrences occur in 5–34 % of cases, most often as borderline tumors and less frequently as invasive ones. Although conservative treatment is considered one of the risk factors for subsequent recurrences, its impact on overall survival has not been proven. We describe a clinical case of fertility-sparing treatment for a recurrent during second pregnancy BOT, initially diagnosed in a young woman during the first trimester of her first pregnancy.

Solid pseudopapillary tumors (SPTs) of the pancreas occur predominantly in young females and possess low malignant potential. In this study, clinicopathologic, perioperative, and long-term outcomes are compared in SPT patients that received open or minimally invasive (MIS) resection. The National Cancer Database (2010-2020) was queried to identify all patients with SPTs that underwent an open or MIS surgical resection. Propensity score matching analysis was conducted through 1:1 matching based on the nearest neighbor method. Of 835 patients, 59.7% received an open approach and 40.3% were performed MIS. Over the decade, MIS approach increased from 7.7% to 60.0% for distal pancreatectomy (DP) and 15.4% to 30.2% for pancreaticoduodenectomy (PD) (both p < 0.05). There were no differences in lymphadenectomy (>15 nodes) or resection margin positivity. Shorter length of stay was noted for MIS resections (PD: 5 vs. 8 days, p < 0.001; DP: 5 vs. 6 days, p = 0.022), and no difference was appreciated in 30-day readmission rates. There was no difference in overall survival between open and MIS approaches for PD and DP. Minimally invasive resections for SPTs have increased by ~40% over a decade and may offer a safe and feasible alternative to open resection that provides similar perioperative and long-term oncologic outcomes.

Primary pulmonary sclerosing pneumocytoma (PsP) is an unusual benign pulmonary tumor with low malignant potential. Clinical presentation may sometimes imitate more serious conditions. We described a case of newly diagnosed prostate cancer with a PSMA-avid, well-circumscribed lesion in the right lung in 68Ga PSMA PET-CT, initially mimicking a metastatic lesion. Following histopathologic examination, the case was confirmed as a rare pulmonary tumor, PsP. We declare the first reported case in the literature demonstrating PSMA expression in PsP.

Abdominal multicystic peritoneal mesothelioma (MCPM) is a rare condition characterized by multiple serous cysts, predominantly affecting the pelvic peritoneum.1 There is no consensus on the clinical management of MCPM, although surgical resection remains the first-line treatment. Given its low malignant potential, the goal is complete cyst removal to alleviate symptoms and improve quality of life.2,3 In selected cases, laparoscopic surgery offers a less invasive alternative to open surgery, with several advantages, including reduced postoperative morbidity and faster recovery.4-6 However, owing to the anatomical complexity, the procedure should be performed at specialized centers to ensure optimal outcomes.7,8 PATIENTS AND METHODS: This report presents two cases of MCPM in female patients who underwent laparoscopic cytoreductive surgery (CRS). Considering the technical challenges of laparoscopic dissection in the pelvis, this series focuses on a laparoscopic peritonectomy technique guided by the dissection of the pelvic spaces. A video provides the detailed, step-by-step surgical techniques and postoperative course. The two cases illustrate tailored surgical strategies. In the first case, a uterus-sparing approach was employed to preserve the possibility of future heterologous fertility. In the second, a hysterectomy was performed owing to uterine infiltration by cystic disease, with specimen extraction via the transvaginal route, enabling scarless cytoreduction. Despite longer operative times, laparoscopy facilitated faster recovery and shorter hospital stays. Laparoscopic cytoreduction is feasible in selected patients with minimal disease burden. Owing to the surgical complexity, minimally invasive cytoreduction should only be performed after achieving technical proficiency in open cytoreductive surgery. Furthermore, a structured mentoring program and multidisciplinary support are essential for its safe implementation.

Abstract Thyroid-like follicular renal cell carcinoma is an extremely rare tumor. The tumors show a striking resemblance to well-differentiated thyroid follicular neoplasm but can be differentiated on immunohistochemistry due to lack of thyroglobulin and thyroid transcription factor 1 expression. Thyroid-like follicular renal cell carcinoma is seen in younger patients in the second to fourth decade with female preponderance. Most of the cases are asymptomatic or present with usual complaints of renal cell carcinoma such as flank pain, hematuria, or renal mass. Thyroid-like follicular renal cell carcinoma is a primary renal epithelial malignant tumor. The tumor is well encapsulated with follicular architecture comprising microfollicles and macrofollicles containing eosinophilic colloid-like material. Thyroid-like follicular renal cell carcinoma represents a rare histologic subtype of renal cell carcinoma with low malignant potential. According to the latest WHO classification 2022 of renal tumors, Thyroid like follicular renal cell carcinoma (TLFC) is put into emerging/provisional entities. These tumor types are still not part of the classification but are discussed in WHO.

The spindle cell variant of embryonal rhabdomyosarcoma is a rare variant and better differentiated from all other types of embryonal rhabdomyosarcoma variants. It usually occurs in childhood and is generally associated with a good prognosis when diagnosed early with the complete panel necessary, but it becomes a whole different story at the advanced stage, despite its low malignant potential. A 3-year-old girl with stage 4 embryonal spindle cell rhabdomyosarcoma underwent 15 cycles of chemotherapy with actynomycin-D, cyclophosphamide and vincristine, the course was marked by disease progression and death. Spindle cell embryonal rhabdomyosarcoma is a rare variety, and its prognosis depends on the stage of presentation, and rapidity of diagnosis.

The classification of mixed odontogenic tumors-specifically ameloblastic fibroma (AF), ameloblastic fibro-odontoma (AFO), and odontoma-remains controversial. The current WHO classification emphasizes the presence of dental hard tissues but overlooks the distinction between aberrant inductive activity and maturation resembling normal odontogenesis. This has led to diagnostic ambiguity and inconsistent management strategies. This study aims to propose a biologically grounded reclassification based on histological, developmental, and molecular criteria. We conducted a conceptual reassessment of AF, AFO, and odontoma, using six cases from our pathology archives. Histological slides were reviewed with focus on the type and organization of mineralized tissue (tubular dentin, osteodentine, enamel) and its epithelial-mesenchymal context. Clinical and radiological data were evaluated, and BRAF V600E mutation status was retrieved when available. A targeted literature review was performed to integrate findings on histology, genetic alterations, and malignant transformation risk. Two distinct lesion types were identified: (1) Ameloblastic fibroma with aberrant inductive activity, showing irregular osteodentine and enameloid deposits without odontoblast differentiation, harboring BRAF mutations; and (2) odontomas, characterized by mature tubular dentin and enamel formation, indicating a hamartomatous nature, despite significant clinical growth. Historical descriptions support this biological dichotomy, emphasizing the difference between aberrant inductive activity and processes resembling normal odontogenesis. We propose abandoning AFO as a distinct diagnostic entity. Instead, lesions could be classified based on the presence of organized, mature dental hard tissues. AF with aberrant inductive activity represents a benign neoplasm with low malignant potential, while odontoma is a hamartomatous lesion sometimes with large growth capacity but no malignant risk. This binary classification would align histological criteria with biological behavior, integrate molecular data, and restore diagnostic clarity. The validity of this framework should be investigated in future cohorts.

Solid pseudopapillary neoplasm (SPN) of the pancreas is a rare tumor with low malignant potential, though 10-15% may show invasive or metastatic behavior. This study aimed to evaluate the safety and efficacy of endoscopic ultrasound-guided ethanol ablation (EUS-EI) in patients with SPN who were not surgical candidates. Four patients with SPN who declined or were ineligible for surgery underwent EUS-EI at Aichi Cancer Center. Technical and clinical outcomes, as well as adverse events, were assessed. Technical success was achieved in all patients (100%). Clinical success was observed in three patients (75%), including two with complete ablation and one with significant tumor reduction. No major adverse events or tumor recurrence occurred during follow-up. EUS-EI may be a safe and effective alternative for managing SPN in non-surgical candidates.

Introduction. Chronic kidney diseases are attributed to a variety of etiologies, including diabetes mellitus, hypertension, vascular diseases, cystic kidney diseases, chronic tubulo-interstitial diseases, chronic pyelonephritis, and glomerular diseases. Simple nephrectomy is indicated when the loss of renal function in a unilateral non-functional kidney is permanent in a persistently symptomatic patient. Uncommonly, a non-functional kidney may develop neoplasm unsuspected pre-operatively and be diagnosed only during histopathological examination of nephrectomy specimen. Material and methods. We examined 275 simple nephrectomies performed between 2019 and 2024 in patients with non-functional kidneys confirmed by DMSA scan. All nephrectomies done for diagnosed or even suspected tumors by pre-operative imaging were excluded from the study. Results. Chronic pyelonephritis (79.3%) was the most common histopathological diagnosis, followed by xanthogranulomatous pyelonephritis (8.7%) and granulomatous pyelonephritis (5.4%). In five (1.8%) patients, microscopy revealed non-specific chronic interstitial inflammation and interstitial fibrosis. One patient (0.4%) was diagnosed with large solitary pyelogenic cyst and renal nocardiosis. Eleven patients (4%) were diagnosed with neoplasms. Clear cell renal cell carcinoma was the most common diagnosis (27.2%), followed by urothelial carcinomas of renal pelvis (18.2%), one patient each of collecting duct carcinoma, squamous cell carcinoma of renal pelvis, and multilocular cystic renal neoplasm of low malignant potential. Three patients had papillary adenomas. Conclusion. Diligent histopathological examination of simple nephrectomy is crucial in establishing the final diagnosis with important further therapeutic implications. This is especially important in neoplastic pathologies developing in non-functional kidneys that may rarely be unsuspected by pre-operative imaging and diagnosed only during histopathological evaluation.

BackgroundBorderline ovarian tumors (BOTs) are neoplasms of low malignant potential that predominantly affect women of reproductive age. Fertility preservation through fertility-sparing surgery is widely practiced; however, concerns remain regarding the risk of tumor recurrence and the reproductive outcomes following in vitro fertilization (IVF). This study aimed to evaluate IVF/ intracytoplasmic sperm injection (ICSI) outcomes in BOTs patients post-FSS and to assess the association between ovarian stimulation parameters and tumor recurrence.MethodsIn this retrospective cohort study conducted at Sixth Hospital of Sun Yat-sen University from May 2010 to May 2023, 65 women with a history of FSS for BOTs who underwent IVF/ICSI were identified. After propensity score matching, 61 BOTs patients were compared with 181 control patients without ovarian tumors. Key outcomes evaluated included ovarian stimulation parameters, live birth rates, neonatal outcomes and risk factors for tumor recurrence.ResultsThe BOTs and control groups exhibited similar outcomes regarding the number of oocytes retrieved, the quality and number of embryos, and live birth rates from the first IVF/ICSI cycles. The cumulative live birth rate over 13 years and neonatal parameters (gestational age, birth weight, and body length) were also comparable between groups. Tumor recurrence was observed in 8.62% of BOTs patients, with no significant association identified between recurrence and ovarian stimulation parameters or peak estradiol levels.ConclusionsIVF/ICSI following fertility-sparing surgery for BOTs patients yields reproductive and neonatal outcomes comparable to those in patients without BOTs and does not increase the risk of tumor recurrence. These findings support the safety and efficacy of IVF as a fertility treatment option for BOTs patients after conservative surgery. Further prospective studies with larger cohorts are warranted to validate these results and refine ovarian stimulation strategies.Clinical trial numberNot applicable.

BackgroundSolid pseudopapillary neoplasm (SPN) of the pancreas exhibits low malignant potential and is typically curable via surgical excision, with > 90% 5-year survival rates, including metastatic cases. Accurate preoperative diagnosis is crucial to minimize surgical extent. We aimed to elucidate distinctive imaging features of SPN on computed tomography (CT) and endoscopic ultrasound (EUS) with pathologic correlation, enabling radiologists to better recognize and distinguish them from other pancreatic lesions.MethodsThirty three patients (3 men, and 30 women; median age of 25 years) with pathologic diagnosis of SPN encountered between November 2019 and July 2024 were included in this study. CT images with pancreatic triphasic protocol were reviewed for tumor location, size, shape, margin, morphology, presence of capsule, calcification, hemorrhage, invasion, enlarged lymph nodes, and bile duct dilatation. Enhancement pattern was assessed and CT attenuation values were calculated. EUS was conducted in 15 patients and its sensitivity in diagnosing SPN was compared to CT alone.ResultsMost patients in our series were symptomatic young females. Dominant CT features included a well-defined encapsulated lesion with mixed solid/cystic appearance, variable degrees of hemorrhage and calcifications, heterogeneous hypo-enhancement during arterial phase with peak enhancement in portal venous phase, non-dilated bile duct, and absence of liver metastasis. Combining CT and EUS in 15 patients enhanced diagnostic sensitivity compared to CT alone.ConclusionA mixed solid/cystic pancreatic mass in a young woman with progressive enhancement and variable degrees of hemorrhage and calcifications is suggestive of SPN. Combining CT and EUS could enhance preoperative diagnostic accuracy. Despite being a descriptive study with limited scope, this institutional case series provides descriptive insights into tumor characteristics, aligning with existing literature and expanding the collective knowledge base.

Thyroid-like follicular carcinoma of the kidney (TLFC-K) is a rare primary kidney carcinoma with fewer than 60 reported cases. Current data suggest that TLFC-K has low malignant potential, with only a few reported cases of unfavorable clinical behavior. Histologically, TLFC-K is indistinguishable from kidney metastasis of well-differentiated follicular cell-derived thyroid carcinomas. Furthermore, folliculo-tubular patterns can be seen in different types of kidney lesions, making assessing follicular architecture in the kidney diagnostically challenging. We present a case of TLFC-K with a list of differential diagnoses. A hyperechoic tumor was found incidentally in the upper pole of the right kidney of a 66-year-old man. The patient underwent a radical nephrectomy. Histologically, the tumor was well-circumscribed, composed of follicular/tubular structures of different sizes filled with colloid-like material. Immunohistochemically, the absence of a positive reaction for thyroglobulin and TTF-1 excluded the secondary origin of the tumor from the thyroid. Tumor cells also showed diffuse positivity for vimentin and PAX8 and focal positivity for CK7 and CD10. The results of all other applied immunostaining tests did not align with those of different types of kidney tumors that may exhibit predominantly follicular patterns. Accordingly, TLFC-K was diagnosed. The patient shows no signs of disease relapse at the 5-month follow-up.