Non-epithelial Malignant Tumors Research Articles

Clinical Case of Successful Surgical Treatment for Giant Cell Metastatic Lung Sarcoma

Introduction. Sarcomas refer to a group of heterogeneous non-epithelial malignant tumors originating from connective tissue. These tumors are characterized by extremely aggressive local growth, relatively low incidence of lymphogenic metastases, predominant and early hematogenic generalization. These tumors most oft en metastasize to the lungs.Materials and methods. The paper describes a case of successful surgical treatment for a giant retroperitoneal fibrosarcoma metastasis to the lung.Results. Successful treatment for sarcoma depends primarily on a global understanding by oncologists of the complex pathogenesis, histological forms and principles of comprehensive treatment for this complex, polymorphic group of malignant pathologies. The earlier the primary site is diagnosed, the sooner and more definitely the surgical treatment is performed, and the more correctly the drug therapy is carried out, the better the result of the complex treatment approach. Similarly, sarcoma secondary sites should be treated proactively – without waiting until their size and local spread contraindicate surgical treatment. Conclusion. Neglected sarcoma cases indicate the need for combined and extended surgical interventions, one successful example of which is described in this paper.

Lacrimal sac lymphoma: a case series and literature review

To study the clinical and pathological characteristics of the lacrimal sac lymphoma, which is rare but it is the major type of non-epithelial malignant tumor in the lacrimal sac region. Sixty-four cases of malignant lacrimal sac tumors in our hospital from 1986 to 2020 were retrospectively reviewed. Eight cases of lacrimal sac lymphoma were carefully reviewed. There were five mucosal-associated lymphoid tissue (MALT) lymphomas, one diffused large B-cell lymphoma, one NK/T cell lymphoma, and one mantle cell lymphoma. All eight patients represented symptoms of epiphora with swelling in the lacrimal sac for a certain period of time and showed no signs of systemic involvement at the first time of clinical visits. They had received either chemotherapy or radiotherapy after surgery. Long-term follow-up (from 11 to 220mo) showed that, except one patient with MALT lymphoma died for unknown reasons at 104mo after surgery, the other 7 patients were all alive with no signs of local recurrence, neither in other organs. Non-epithelial malignant tumors of the lacrimal sac are rare and lymphoma is the major subtype.

Ultrasonographic diagnosis and surgical outcomes of adnexal masses in children and adolescents

This study aimed to evaluate the incidence, clinical diagnosis, surgical treatment, and histopathological findings of adnexal masses in children and adolescents. This retrospective study included patients aged < 20 years who were diagnosed with adnexal masses between January 2005 and December 2018 at the Konkuk University Medical Center. Adnexal masses were diagnosed in 406 patients. The mean age of patients was 17.3 years at the time of diagnosis. The primary presenting symptoms and signs were abdominal pain (81.4%), mass per abdomen (13.7%), dysmenorrhea (3.4%), incidental finding (2%), and abdominal distention (0.5%). In total, 204 patients underwent surgery for adnexal masses, and 202 patients were observed without surgery. Histopathological examination revealed 110 benign neoplasms, 72 non-neoplastic lesions, 3 ectopic pregnancies, 3 tubo-ovarian abscesses, 7 borderline malignant tumors, and 9 non-epithelial ovarian malignant tumors. Abdominal pain was the most common reason for hospital visits and surgery in adolescents and young women with adnexal masses. The ultrasonographic diagnosis was consistent with the histopathological diagnosis. In recent years, the use of minimally invasive surgery such as laparoscopy and robotic, has increased in young patients with adnexal masses.

Clinical and pathological patterns of non-epithelial malignant ovarian tumours in Western Saudi Arabia.

To report a single-center experience in non-epithelial malignant ovarian tumours (NEMOT), by presenting different clinical and pathological characteristics, management and outcomes. We retrospectively reviewed electronic files of all female patients who underwent surgery for NEMOT at the Gynecology Department of King Abdulaziz University Hospital, Jeddah, Saudi Arabia, from July 2003 to July 2019. We collected baseline demographic, anthropomorphic and clinical data; pathological characteristics; management and follow-up data; and outcomes including residual disease, recurrence and last follow-up status (deceased or alive). Thirty-three women were included; mean (standard deviation) age = 33.24 (17.72) years, range = 4, 86 years. Granulosa cell tumor was the most frequent subtype diagnosed in 17 (51.5%) patients, followed by germ cell tumours 13 (39.4%). The majority of patients were diagnosed at FIGO Stage I (22, 66.7%) and with tumor Grade 1 (23, 69.7%), while 8 (24.2%) were diagnosed with Grade 3 tumors. Granulosa cell and Sertoli-Leydig cell tumours were diagnosed at an older age (mean age = 39.30 vs. 23.92 years) compared to germ cell tumours, respectively (P = 0.012). Two-third of the patients benefited from conservative surgery including oophorectomy + staging, and 16 (48.5%) benefited from chemotherapy with bleomycin, etoposide and platinum being the most common protocol (13, 39.4%) for germ cell tumours. Postoperatively, only 2 (6.1%) patients had residual disease. Recurrence and mortality were reported in one and four patients, respectively, resulting in recurrence rate = 3.0% (95% confidence interval [CI] = 0.01%, 15.8%) and mortality rate = 12.1% (95% CI = 3.4%, 28.2%). The present series of NEMOT was predominated by sex cord-stromal cell tumors, which were diagnosed in patients with older age, while germ cell tumours were underrepresented. Although survival rates were comparable to those reported internationally, more consideration should be given to following up patients regarding fertility outcomes to provide a more comprehensive evaluation of treatment success and quality of care.

A Case of Primary B-Cell Lymphoma of the Gallbladder

Introduction: Non-epithelial malignant tumors of the gallbladder account for only about 2% of all malignant tumors of the gallbladder, and lymphoma of the gallbladder is even rarer. We herein report a case of malignant lymphoma of the gallbladder diagnosed incidentally after cholecystectomy.

Single-cell transcriptomic landscapes of a rare human laryngeal chondrosarcoma

ProposeLaryngeal chondrosarcoma is a rare non-epithelial malignant tumor. At present, the cell type composition and molecular mechanism of laryngeal chondrosarcoma have not been systematically studied.MethodsThis study focused on the histopathological and imaging features of a rare primary laryngeal chondrosarcoma in a 74-year-old male. The tumor and its paracancerous cartilage tissue were single-cell sequenced and analyzed and a total of 5455 single cells were obtained. Immunohistochemical levels were also verified.ResultsIn total five cell types were identified, including chondrocytes, myeloid cells, fibroblasts, lymphocytes, and endothelial cells. We carried out further subgroup analysis, focusing on the classification and differentiation of chondrocytes, functional enrichment analysis, and cellular communication analysis of all cell types, and explored the tumor microenvironment (TME) of laryngeal chondrosarcoma. Immunohistochemistry revealed the SLAMF9 gene was specifically expressed in non-immune cells of chondrosarcoma, but was barely expressed in the normal cartilage tissues adjacent to chondrosarcomas.ConclusionThis single-cell sequencing approach provides clues for deciphering the potential mechanisms of tumor heterogeneity and TME composition in laryngeal chondrosarcoma, and represents an important step towards the treatment of laryngeal chondrosarcoma.

Overall survival in elderly patients with acute complications of colorectal cancer

AIM: to assess risk factors affecting the five-year overall survival in patients ≥ 70 years old who underwent emergency surgery for complicated colorectal cancer.PATIENTS AND METHODS: a cohort retrospective study included 268 patients with complicated colorectal cancer for the period from January 10, 2010 to March 03, 2020, operated on in hospitals in Smolensk. Inclusion criteria: 1) patients underwent emergency surgery for decompensated bowel obstruction or tumor perforation with peritonitis; 2) histological type of tumor: adenocarcinoma, signet ring cell carcinoma, undifferentiated cancer; 3) age ≥ 70 years. Non-inclusion criteria: 1) subcompensated bowel obstruction, paratumoral inflammation, intestinal bleeding; 2) non-epithelial malignant tumors; 3) age &lt; 70 years.RESULTS: the significant differences were revealed in overall survival rates depending on the type of surgery. In complicated colon cancer, overall survival after one-stage surgeries was 15.35%, after tumor removal at the first stage — 21.51%, and after surgeries with tumor removal at the second stage — 46.59% (p &lt; 0.00001). For complicated rectal cancer: 1.03%, 1.6%, and 16.49%, respectively (p = 0.00402). The main factors that had an unsatisfactory effect on overall survival: surgery type — one-stage and multi-stage with tumor removal at the first stage (risk ratio (RR) 1.34; 95% coincidence interval (CI) 1.17–1.56; p &lt; 0.0001); tumor perforation (OR 1.46, 95% CI: 1.36–1.55; p &lt; 0.0001); disease stage (OR 1.61, 95% CI: 1.45–1.69; p &lt; 0.0001), tumor site (OR 1.24, 95% CI: 1.29–1.72; p = 0.004); tumor histological type — poorly differentiated adenocarcinoma (OR 1.5, 95% CI: 1.24–1.62; p &lt; 0.0001), the number of lymph nodes examined &lt; 12 (OR 0.69, 95% CI: 0.59–0.63; p &lt; 0.0001), presence of positive resection margins (R1 and/or CRM+) (OR 1.29, 95% CI: 1.14–1.47; p &lt; 0.0001); severe comorbidity (OR 1.95, 95% CI: 1.62–1.98; p = 0.003), no adjuvant treatment (OR 0.57, 95% CI: 0.49–0.63; p &lt; 0.0001).CONCLUSION: staged procedures with a minimal volume in an emergency and the second — main stage, performed in a specialized hospital, are the most appropriate in patients ≥ 70 years old.

Overall survival in elderly patients with acute complications of colorectal cancer

AIM: to assess risk factors affecting the five-year overall survival in patients ≥ 70 years old who underwent emergency surgery for complicated colorectal cancer.PATIENTS AND METHODS: a cohort retrospective study included 268 patients with complicated colorectal cancer for the period from January 10, 2010 to March 03, 2020, operated on in hospitals in Smolensk. Inclusion criteria: 1) patients underwent emergency surgery for decompensated bowel obstruction or tumor perforation with peritonitis; 2) histological type of tumor: adenocarcinoma, signet ring cell carcinoma, undifferentiated cancer; 3) age ≥ 70 years. Non-inclusion criteria: 1) subcompensated bowel obstruction, paratumoral inflammation, intestinal bleeding; 2) non-epithelial malignant tumors; 3) age &lt; 70 years.RESULTS: the significant differences were revealed in overall survival rates depending on the type of surgery. In complicated colon cancer, overall survival after one-stage surgeries was 15.35%, after tumor removal at the first stage — 21.51%, and after surgeries with tumor removal at the second stage — 46.59% (p &lt; 0.00001). For complicated rectal cancer: 1.03%, 1.6%, and 16.49%, respectively (p = 0.00402). The main factors that had an unsatisfactory effect on overall survival: surgery type — one-stage and multi-stage with tumor removal at the first stage (risk ratio (RR) 1.34; 95% coincidence interval (CI) 1.17–1.56; p &lt; 0.0001); tumor perforation (OR 1.46, 95% CI: 1.36–1.55; p &lt; 0.0001); disease stage (OR 1.61, 95% CI: 1.45–1.69; p &lt; 0.0001), tumor site (OR 1.24, 95% CI: 1.29–1.72; p = 0.004); tumor histological type — poorly differentiated adenocarcinoma (OR 1.5, 95% CI: 1.24–1.62; p &lt; 0.0001), the number of lymph nodes examined &lt; 12 (OR 0.69, 95% CI: 0.59–0.63; p &lt; 0.0001), presence of positive resection margins (R1 and/or CRM+) (OR 1.29, 95% CI: 1.14–1.47; p &lt; 0.0001); severe comorbidity (OR 1.95, 95% CI: 1.62–1.98; p = 0.003), no adjuvant treatment (OR 0.57, 95% CI: 0.49–0.63; p &lt; 0.0001).CONCLUSION: staged procedures with a minimal volume in an emergency and the second — main stage, performed in a specialized hospital, are the most appropriate in patients ≥ 70 years old.

Angiosarcoma of the Breast and Familial Aggregation of Cancer: Case Series of 12 Patients and Literature Review

Breast sarcomas are histologically heterogeneous non-epithelial malignant tumours derived from mesenchymal cells, arising from mammary connective tissue. They are rare, representing less than 1% of all breast cancers..

Rare primary malignant non-epithelial lung tumor: sarcoma originating from peripheral nerve sheaths

<h3></h3> Представлен случай первичной саркомы легкого у 40-летней женщины. Никаких клинических симптомов не отмечалось. Заболевание выявлено как случайная находка при рентгенологическом диспансерном обследовании органов грудной клетки в виде патологической тени в проекции нижней доли правого легкого. При компьютерной томографии органов грудной клетки, а в последующем и позитронно-эмиссионной томографии определена четко отчерченная круглая масса, максимальный диаметр 18 мм, в сегменте S_X правого легкого с повышенным гиперметаболизмом 18F-фтордезоксиглюкозы. Других очаговых образований с аномальным поглощением радиофармпрепарата в режиме сканирования всего тела не выявлено. Пациентке была выполнена нижняя лобэктомия справа с медиастинальной лимфаденэктомией видеоторакоскопическим доступом. Результаты иммуногистологического исследования позволили установить окончательный диагноз — саркома легкого из оболочек периферических нервов. Послеоперационное течение протекало без осложнений, и в течение более года после операции не выявлено признаков рецидива и метастазирования. В статье также рассмотрена эпидемиология неэпителиальных опухолей легкого, представлены обобщенные мировые данные, касающиеся случаев первичной саркомы легкого из оболочек периферических нервов, охарактеризованы результаты хирургического лечения пациентов с данной редкой первичной неоплазией легкого.

Preoperative Differentiation of Benign and Malignant Non-epithelial Ovarian Tumors: Clinical Features and Tumor Markers.

To evaluate the role of clinical features and preoperative measurement of cancer antigen 125 (CA125), human epididymis protein (HE4), and carcinoembryonic antigen (CEA) serum levels in women with benign and malignant non-epithelial ovarian tumors. One hundred and nineteen consecutive women with germ cell, sex cord-stromal, and ovarian leiomyomas were included in this study. The preoperative levels of biomarkers were measured, and then surgery and histopathological analysis were performed. Information about the treatment and disease recurrence were obtained from the medical files of patients. Our sample included 71 women with germ cell tumors (64 benign and 7 malignant), 46 with sex cord-stromal tumors (32 benign and 14 malignant), and 2 with ovarian leiomyomas. Among benign germ cell tumors, 63 were mature teratomas, and, among malignant, four were immature teratomas. The most common tumors in the sex cord-stromal group were fibromas (benign) and granulosa cell tumor (malignant). The biomarker serum levels were not different among benign and malignant non-epithelial ovarian tumors. Fertility-sparing surgeries were performed in 5 (71.4%) women with malignant germ cell tumor. Eleven (78.6%) patients with malignant sex cord-stromal tumors were treated with fertility-sparing surgeries. Five women (71.4%) with germ cell tumors and only 1 (7.1%) with sex cord-stromal tumor were treated with chemotherapy. One woman with germ cell tumor recurred and died of the disease and one woman with sex cord-stromal tumor recurred. Non-epithelial ovarian tumors were benign in the majority of cases, and the malignant cases were diagnosed at initial stages with good prognosis. The measurements of CA125, HE4, and CEA serum levels were not useful in the preoperative diagnosis of these tumors.

Undifferentiated pleomorphic sarcoma in the anterior mediastinum with a rapidly progressive course: A case report.

A 77-year-old woman with heart failure was admitted to our hospital. Computed tomography (CT) of the chest revealed an anterior mediastinal tumor. CT-guided biopsy revealed a malignant nonepithelial tumor of unknown origin. She was not treated with chemotherapy or radiotherapy because of her poor clinical condition. She died 33 days after admission. Following autopsy, we confirmed that the mediastinal tumor had infiltrated the large blood vessels. After final histological examination, undifferentiated pleomorphic sarcoma was diagnosed. Primary mediastinal sarcomas are very rare; clinicians should be aware of their possibility because some cases may progress rapidly as evidenced in this case.

Overview of non-epithelial ovarian tumours: Incidence and survival in the Netherlands, 1989–2015

IntroductionAbout 5% of ovarian tumours have a non-epithelial histology, including germ cell tumours (GCTs), sex cord-stromal tumours (SCSTs) and sarcomas. Because these non-epithelial ovarian tumours are rare and population-based studies are scarce, the aim of this population-based study is to describe trends in the incidence, treatment and survival of women with these tumours in the Netherlands. MethodsAll women diagnosed with non-epithelial ovarian malignant tumours in the Netherlands between 1989 and 2015 were identified from the Netherlands Cancer Registry. Data on demographics, tumour characteristics and initial treatment were collected, and overall survival was analysed. ResultsA total of 1258 non-epithelial ovarian tumours were identified comprising 752 GCTs (60%), 341 SCSTs (27%) and 165 sarcomas (13%). The European age-standardised incidence rate (ESR) was 0.4 per 100,000 persons per year for GCTs, 0.2 for SCSTs and 0.1 for sarcomas. Approximately 97% of patients underwent surgical resection for the primary tumour, 31% received systemic treatment and 3% radiotherapy. Between the late 1980s and 2015, five-year overall survival improved for all histologic subtypes: GCTs rose from 73% to 88% (p = 0.03), SCSTs from 64% to 81% (p = 0.57) and sarcomas from 20% to 29% (p = 0.14). ConclusionMalignant GCTs and SCSTs are rare, and their incidence has not significantly changed over recent decades. They have a good prognosis, which also improved slightly during this period. Primary sarcomas of the ovary are extremely rare and still have a poor prognosis.

Clinicopathological analysis of 22 cases with primary malignant tumors of the lacrimal sac

Objective To analyze the clinicopathological features sac of primary malignant tumors of lacrimal. Methods The clinical and pathologic data of 22 eyes of 22 patients with primary malignant tumors from lacrimal sac of Jan. 2014 to Dec. 2017 were analyzed retrospectively. Results All cases received pathological examination of tumors after surgical excision. Among 12 cases(54.50%) of epithelial malignant tumor: there were squamous cell carcinoma in 5 cases(41.70%), inverted papilloma with malignant transformation in 2 cases(16.70%), undifferentiated carcinoma in 2 cases(16.70%), basal cell carcinoma in 1 case(8.33%), adenocarcinoma in 1 case(8.33%) and adenoid cystic carcinoma in 1 case(8.33%). Among 10 cases(45.50%)with nonepithelial malignant tumors: there were B-cell lymphoma of mucosa-associated lymphoid tissue in 5 cases(50.00%), malignant melanoma in 3 cases(30.00%), lacrimal sac leiomyosarcoma in 1 case(10.00%) and dermatofibrosarcoma protuberans in 1 case(10.00%). Conclusion Most malignant lacrimal tumors are squamous cell carcinoma, B-cell lymphoma of mucosa-associated lymphoid tissue and malignant melanoma. Key words: Lacrimal apparatus diseases; Carcinoma, squamous cell; Carcinoma, basal cell; Lymphoma mucosa-associated lymphoid tissue

Primary pulmonary sarcoma - treatment outcomes depending on the different types of radical operation.

IntroductionPrimary pulmonary sarcomas (PPS) are rare types of non-epithelial malignant tumors of the lungs (0.013–1.1% of all malignant lung tumors). The PPS can originate from mesenchymal elements of the bronchial wall, vessels or pulmonary stroma. Since the introduction of immunohistochemical and molecular diagnosis, a significant improvement in description and classification of sarcomas has been achieved. Nonetheless, sarcomas still remain a diagnostic and clinical problem.AimTo estimate factors which could have an influence on the overall survival (OS) and progression-free survival (PFS) of different types of radical operations (R0) for PPS.Material and methodsFourteen patients who underwent surgical radical treatment between 1994 and 2009 with a final diagnosis of PPS were analyzed.ResultsA group of 14 patients, treated with R0 operations (pneumonectomies, lobectomies, non-anatomical resections), were included in the analysis. Median OS of patients undergoing R0 operations was respectively: for pneumonectomy 7 months, lobectomy 20 months, non-anatomic resections 213 months. Patients subjected to non-anatomical resections had better prognosis than the others treated radically (p < 0.05); however, this group of patients had the most local recurrences (3 patients – 50%). Statistical analysis did not show the influence of prognostic factors characteristic of PPS and soft tissue sarcoma (STS) on OS in the types of surgery performed.ConclusionsThere are no unambiguous factors affecting OS and PFS of patients who have undergone anatomical and non-anatomical resections. A large number of local recurrences in non-anatomical operations may indicate that PPS spread like lung cancer.

Differential Diagnosis of Jejunum and Ileum Tumours Based on Video Capsule Endoscopy Data Using Mathematical Analysis

Aim. The aim of this study was to develop an algorithm for identifying various types of jejunum and ileum tumour lesions based on video capsule endoscopy (VCE), which can be used by physicians in the process of decision making. Materials and methods. In the study, we analysed data on the examination and treatment of 65 patients (35 men and 30 women aged 18–80 years (mean age 46 ± 28 years)), who underwent VCE in the City Clinical Hospital No. 31 and in the Clinica K+31 during the period October 2008 — April 2017. The indications for VCE were a search for a reason of gastrointestinal bleeding, the anaemia of unknown etiology and suspected tumour of the small intestine. According to the VCE results, 181 cases of various changes in the jejunum and ileum were revealed. Each tumour object had been histologically verified before our study. Capsule endoscopy was performed using equipment produced by Olympus (Japan), MicroCam Intromedic (Korea), PillCam Given Imaging (Israel), OMOM Chongqing Jinshan Science &amp; Technology (China).Results. Following expert interviews, 30 signs and their gradations were identified for assessing the type of lesion in the jejunum and ileum using video capsule endoscopy images. Among them, 8 were found to be statistically significant (affecting the division of objects into groups): patient gender, gut wall/lumen deformation, path of intestinal folds, polypoid changes, vascular pattern, mucosal regularity, mucosal lobulation and colour. Using a Bayesian heterogeneous diagnostic procedure and the calculation of diagnostic factors, a three-level algorithm has been developed for the differential diagnosis of jejunum and ileum lesions.Conclusions. The application of the proposed algorithm in clinical practice will not only allow the presence or absence of the jejunum or ileum tumour lesion to be verified, but also the type of this lesion to be determined with an accuracy of more than 86%. The developed diagnostic algorithm can support decision making by the clinician within the task of differentiating jejunum or ileum tumour lesions into three main types: benign epithelial tumours, benign non-epithelial tumours and malignant tumours. Differential diagnosis of the type of jejunum or ileum tumour lesion using the proposed diagnostic algorithm facilitates not only the development of a treatment tactic for managing such patients (dynamic observation, conservative therapy, operative treatment), but also the determination of terms (emergency, urgent, planned) and methods (endometrial luminal, laparoscopic, laparotomic) of surgical treatment.

Cytokeratin Expression Profile Study in Malignant Ovarian Tumors

Background: Expression of cytokeratin is seen in varied ovarian tumors including primary surface epithelial tumors, Granulosa cell tumors, Sertoli – Leydig cell tumors, non dysgerminomatous germ cell tumors and metastatic carcinomas. The aim of the study is to demonstrate various patterns of cytokeratin expression in epithelial and non-epithelial malignant ovarian tumors. Methods: Materials for the present study of 39 cases of malignant ovarian tumors obtained from the patients admitted during the period of two years. For histopathological examination, 10% formalin fixed embedded representative tissue sections were studied with Haematoxylin and Eosin. Detailed microscopic examination was carried out. Application of IHC for cytokeratin expression study was carried by streptavidin – biotin complex method. The details of clinical history and relevant investigations were obtained. Results: The total number of malignant ovarian tumors studied during two year period was 39 cases. Among that, serous tumors was the most common [25 cases (64.6%)], followed by Sex cord stromal tumors [6 cases (15.3%)], metastatic tumors [4 cases (10.2%)] and Germ cell tumors [4 cases (10.2%). Cytokeratin was positive in >50% of serous epithelial cells, followed by krukenberg tumor and showed focal positivity in non-epithelial tumors. Conclusion: Evaluation for pancytokeratin (AE 1 / AE 3) in the context of ovarian tumors is useful only in specific instances including identification of epithelial differentiation in an apparently undifferentiated neoplasms and distinction of dysgerminoma from non dysgerminomatous germ cell tumors. Non dysgerminomatous germ cell tumors characteristically express cytokeratin diffusely and strongly, whereas in dysgerminoma it shows only focal and weak expression.

Nonepithelial Neoplasms of the Pancreas, Part 2: Malignant Tumors and Tumors of Uncertain Malignant Potential From the Radiologic Pathology Archives.

Almost all neoplasms of the pancreas are derived from pancreatic epithelial components, including the most common pancreatic mass, primary pancreatic ductal adenocarcinoma (PDAC). Nonepithelial neoplasms comprise only 1%-2% of all pancreatic neoplasms. Although some may arise directly from intrapancreatic elements, many originate from mesenchymal, hematopoietic, or neural elements in the retroperitoneal peripancreatic space and grow into the pancreas. Once these tumors reach a certain size, it can be challenging to identify their origin. Because these manifest at imaging as intrapancreatic masses, awareness of the existence and characteristic features of these nonepithelial neoplasms is crucial for the practicing radiologist in differentiating these tumors from primary epithelial pancreatic tumors, an important distinction given the vastly different management and prognosis. In part 1 of this article, the authors reviewed benign nonepithelial neoplasms of the pancreas. This article focuses on malignant nonepithelial neoplasms and those of uncertain malignant potential that can be seen in the pancreas. The most common malignant or potentially malignant nonepithelial pancreatic tumors are of mesenchymal origin and include soft-tissue sarcomas, solitary fibrous tumor, and inflammatory myofibroblastic tumor. These tumors commonly manifest as large heterogeneous masses, often containing areas of necrosis and hemorrhage. The clinical features associated with these tumors and the imaging characteristics including enhancement patterns and the presence of fat or calcification help distinguish these tumors from PDAC. Hematopoietic tumors, including lymphoma and extramedullary plasmacytoma, can manifest as isolated pancreatic involvement or secondarily involve the pancreas as widespread disease. Hyperenhancing paragangliomas or hypervascular metastatic disease can mimic primary pancreatic neuroendocrine tumors or vascular anomalies.

Development of effective tumor immunotherapy using a novel dendritic cell-targeting Toll-like receptor ligand.

Although dendritic cell (DC)-based immunotherapy shows little toxicity, improvements should be necessary to obtain satisfactory clinical outcome. Using interferon-gamma injection along with DCs, we previously obtained significant clinical responses against small or early stage malignant tumors in dogs. However, improvement was necessary to be effective to largely developed or metastatic tumors. To obtain effective methods applicable to those tumors, we herein used a DC-targeting Toll-like receptor ligand, h11c, and examined the therapeutic effects in murine subcutaneous and visceral tumor models and also in the clinical treatment of canine cancers. In murine experiments, most and significant inhibition of tumor growth and extended survival was observed in the group treated with the combination of h11c-activated DCs in combination with interferon-gamma and a cyclooxygenase2 inhibitor. Both monocytic and granulocytic myeloid-derived suppressor cells were significantly reduced by the combined treatment. Following the successful results in mice, the combined treatment was examined against canine cancers, which spontaneously generated like as those in human. The combined treatment elicited significant clinical responses against a nonepithelial malignant tumor and a malignant fibrous histiocytoma. The treatment was also successful against a bone-metastasis of squamous cell carcinoma. In the successful cases, the marked increase of tumor-responding T cells and decrease of myeloid-derived suppressor cells and regulatory T cells was observed in their peripheral blood. Although the combined treatment permitted the growth of lung cancer of renal carcinoma-metastasis, the marked elevated and long-term maintaining of the tumor-responding T cells was observed in the patient dog. Overall, the combined treatment gave rise to emphatic amelioration in DC-based cancer therapy.

Better Predictive Value of Cancer Antigen125 (CA125) as Biomarker in Ovary and Breast Tumors and its Correlation with the Histopathological Type/Grade of the Disease.

Both ovarian/breast cancers are the most prevalent hormone-associated gynecological-cancers, where uncontrolled cellular proliferations/genetic-errors are noticed. The cancer-antigen125 (CA125), which we assessed presently is an important biomarker in the early detection/monitoring of this disease-pathogenesis. Serum/tissue CA125 was measured by solid-phase-Enzyme-linked-immunosorbentassay in women with ovarian/breast tumors of different types (epithelial/non-epithelial; benign/ borderline/ malignant)/stages. Breast-tumor tissues were employed for histoarchitecture/DNAstability (comet) assay. Extensive protein-protein(CA125) interactions were studied by the STRING (Search-Tool-for-the-Retrieval-of-Interacting Genes/Proteins) Bioinformatics-software. Serum CA125 levels were &lt;35 U/ml in 94% of benign epithelial-cases, 35-65 U/ml in 100% of borderline-tumors and &gt;100 U/ml in the 41.17% of patients with malignant-tumors. The malignant epithelial tumor showed significantly higher (&gt;100U/ml) CA125 than the non-epithelial malignant-tumor (&lt;35-65 U/ml). Highly enhanced cellularity/histo-architectural impairment/unstable- DNA-materials/CA125 was found in advanced breast-cancers. The CA125 is highly metabolically interactive, especially with mesothelin impairing cell-cell adhesion and enhancing tissue anti-establishment. CA125 is a predictive-marker in ovarian/breast carcinoma depending on disease nature/stages. CA125, in combination with other tests like mesothelin/estradiol can be of great use in the better diagnosis of this disease. Not only as a detection-marker, has the CA125 played an interactive role in the disease processes. The Bioinformatics study revealed an important role of mesothelin and other mucin like proteins. Early detection and proper diagnosis are important determinants for the greater possibility of the relief from the disease like cancers. Selection of suitable biomarker combinations may increase the better diagnosis of the types and severity of this disease. Our present result has an impact on these aspects.