Sentinel lymph node (SLN) biopsy is a critical staging tool in skin and soft tissue cancers. Although technetium lymphoscintigraphy is the most common adjunct, indocyanine green (ICG) demonstrates a promising alternative in pediatric, adolescent, and young adult (AYA) skin and soft tissue cancers. Evaluate the safety and efficacy of ICG in SLN biopsy (SLNB) in diverse pediatric and AYA solid cancers in a multi-institutional environment. This is a prospective, observational study conducted at 13 member institutions in the Pediatric Surgical Oncology Research Collaborative between 2019 and 2023. Eligible patients underwent SLNB for primary or recurrent solid skin and soft tissue tumors. Peritumoral ICG was administered intraoperatively. Outcomes included SLN detection rates, histopathology of excised specimens, and surgeon-reported assessment of utility. Safety was assessed through adverse event reporting. Forty SLNB procedures yielded 84 specimens: 13 melanoma (32.5%), 12 squamous cell carcinoma (30%), 11 non-rhabdomyosarcoma soft tissue sarcoma (27.5%), two rhabdomyosarcoma (5%), one Ewing sarcoma (2.5%), and one malignant peripheral nerve sheath tumor (2.5%). Histologic evaluation identified 81 lymph nodes, 75 benign (89.3%) and six malignant (7.1%); three specimens were adipose tissue (3.6%). Of 81 lymph nodes, 76% were ICG-positive. ICG had a sensitivity of 79.5%, a specificity of 33%, and a positive predictive value of 96%. All malignant nodes were ICG-avid. There were no adverse reactions to ICG at 30 days. ICG is a safe and effective adjunct for SLNB in pediatric and AYA soft tissue and skin malignancies.

Purpose: Choroid plexus papilloma (CPP) is a rare, benign intraventricular tumor that typically has an excellent long-term survival rate after gross total resection. Nevertheless, some patients develop delayed leptomeningeal dissemination (LMD) years after the initial diagnosis, a phenomenon that remains poorly understood. The authors encountered a case of CPP with delayed LMD 14 years after resection, which prompted this systematic review to identify potential risk factors. Methods: A systematic review was conducted according to PRISMA guidelines to identify CPP reports with subsequent delayed LMD. Studies of atypical CPP, choroid plexus carcinoma, or concurrent LMD at diagnosis were excluded. Extracted variables included demographics, tumor location, extent of resection, recurrence, proliferative index, and latency to dissemination. Results: Thirty patients developed delayed LMD after initial diagnosis. Seventeen patients underwent gross total resection, ten underwent subtotal resection, and three were unreported. Delayed LMD occurred with tumor recurrence in 14 patients. Histological transformation was observed in nine patients: eight progressed to aCPP and one to CPC. The extent of resection, recurrence, and tumor transformation were not significantly associated with delayed LMD. Conclusions: The pathogenesis and optimal treatment strategy of this phenomenon remain unclear. No significant risk factors for delayed LMD development in CPP were identified. Future studies incorporating molecular characterization are needed to clarify the mechanisms of LMD in patients with CPP and to improve risk stratification, underscoring the importance of lifelong surveillance and the integration of molecular profiling in clinical management.

Low-grade serous ovarian carcinoma (LGSOC) usually presents in advanced stages and is associated with a high mortality rate. Clinical trials targeting the MAPK and cell cycle pathways in LGSOC have shown promising results for its treatment, however there is a need to improve efficacy and define predictive biomarkers to guide patient selection for treatment using these agents. We therefore evaluated cell cycle protein expression by immunohistochemistry (IHC) in 186 LGSOC cases, and evaluated the efficacy of the MEK inhibitor, trametinib, in combination with the CDK4/6 inhibitor, palbociclib, in preclinical models of LGSOC. Abnormal p16 expression was observed in 20% of primary and 46% of recurrent tumors, and it was associated with poorer survival (log-rank p = 0.005). Notably, cell lines with increased sensitivity to trametinib were more likely to harbor mutations in KRAS or NF1 and displayed low pRb levels. Palbociclib showed limited efficacy in vitro; however, the combination of palbociclib and trametinib treatment produced synergistic antiproliferative effects in KRAS/NF1-wild-type cell lines, which displayed higher pRb levels. Acquired drug resistance was linked to increased cyclin D1/E1 expression. This study confirms abnormal p16 IHC as a negative prognostic marker in LGSOC and establishes key determinants of sensitivity to CDK4/6 inhibitor-based therapy.

Objective To investigate the clinicopathological characteristics, treatment strategies, and prognostic outcomes of biliary neuroendocrine carcinoma (Biliary NEC), and to review the relevant literature to provide further evidence for the clinical management of this rare malignancy. Methods We retrospectively analyzed the clinical data of nine patients who underwent surgical resection and were pathologically diagnosed with biliary NEC at Shandong Provincial Hospital between May 2012 and October 2025. Clinical manifestations, imaging findings, surgical procedures, histopathological and immunohistochemical results (Syn, CgA, CD56, Ki-67), and follow-up outcomes were collected. Overall survival (OS) was estimated using the Kaplan–Meier method. Additionally, published case reports and case series from 2020 onward were reviewed for comparison. Results Among the nine patients (3 males and 6 females; median age, 65 years; range, 57–77 years), the primary tumor sites included the gallbladder (n = 4), hilar bile duct (n = 3), and distal bile duct (n = 2). The main presenting symptoms were abdominal discomfort (n = 6) and jaundice (n = 3). All tumors were poorly differentiated NECs, comprising six small-cell and two large-cell types, with Ki-67 indices ranging from 30% to 80% (median, 70%). Immunohistochemistry showed Syn (+), CgA (±), and CD56 (±), with partial expression of SSTR2. All patients underwent curative-intent resection (R0 in 8 and R1 in 1), and four received systemic chemotherapy initiated after documented tumor recurrence. The median follow-up duration was 649 days (range, 67–953 days), and the median OS was 649 days (95% CI: 85–1213 days). A review of the literature revealed that systemic chemotherapy, particularly platinum-based regimens, was associated with longer median survival (18 vs. 9 months). Conclusions Biliary NEC is a rare and highly aggressive malignancy with nonspecific clinical manifestations, and its diagnosis relies primarily on histopathological and immunohistochemical evaluation. Surgical resection remains the cornerstone of treatment, while systemic chemotherapy may provide additional survival benefit in selected patients. A high Ki-67 index and lymph node metastasis have been consistently reported as adverse prognostic indicators in biliary neuroendocrine carcinoma, primarily based on evidence from previously published studies. Given the limited sample size of the present case series, our observations should be interpreted as descriptive rather than statistically conclusive. Future multicenter studies incorporating molecular and immunologic profiling are warranted to clarify the biological behavior of biliary NEC and to optimize individualized therapeutic strategies.

Giant pedunculated submucosal leiomyoma mimicking a cervical mass in a postmenopausal woman . a rare case report

Multiple myeloma (MM) is a heterogeneous cancer that remains incurable. After treatment, the presence of residual myeloma clonal cells, or minimal residual disease (MRD), leads to tumor recurrence (relapse) and treatment failure (refractory disease). Strong clinical evidence indicates MRD is a surrogate marker of survival in patients with MM and is of important prognostic value in disease management. MRD status is dynamic and longitudinal changes in MRD status have different clinical implications. For example, sustained MRD negativity (undetectable MRD) has been associated with greatly improved survival outcomes, whereas the loss of MRD negativity is associated with disease progression. Although research on the prognostic impact of MRD dynamics in real world clinical practice is ongoing, several major concerns remain to be addressed before implementing the monitoring of MRD dynamics and MRD-guided therapeutic decision making in everyday clinical practice in the management of MM. In this review, we discuss the prognostic and clinical value of MRD dynamics, the evidence from literature for MRD-guided clinical decision making, and the challenges around implementing monitoring of MRD dynamics into clinical practice.

The heterogeneous nuclear ribonucleoprotein (HNRNP) family plays pivotal roles in multiple aspects of RNA metabolism. Recent studies suggest that HNRNP dysregulation can promote tumor development. Therefore, this study aims to systematically characterize the expression profiles, immunological associations, and prognostic significance of HNRNP family members in LUAD. Comprehensive transcriptomic and proteomic analyses were conducted using TCGA, GTEx, GEO, and CPTAC LUAD cohorts. Differential expression, immune infiltration, and survival analyses were performed using bioinformatics approaches including ssGSEA, TIDE, and Cox regression modeling. Functional enrichment and alternative splicing profiling were further applied to explore potential mechanisms, with a focus on HNRNPC. Multiple HNRNP genes were significantly overexpressed in LUAD tissues across datasets. Their expression levels positively correlated with tumor stage, metastasis, recurrence, and TP53 mutation status. High expression of several HNRNPs was associated with poor overall survival, with HNRNPC identified as an independent prognostic indicator in both TCGA and GEO cohorts. Elevated HNRNP expression was linked to reduced immune cell infiltration and lower stromal, immune, and ESTIMATE scores, alongside increased TIDE and Exclusion scores, suggesting immunosuppressive roles in the tumor microenvironment. Functionally, HNRNPC was associated with the activation of cell cycle progression and DNA damage repair. Alternative splicing analysis revealed that HNRNPC predominantly regulates exon skipping events, with enriched downstream pathways involved in chromatin remodeling and transcriptional regulation. This study highlights the critical roles of HNRNP family members in LUAD, identifying HNRNPC as a key prognostic biomarker and potential intervention candidate to improve patient outcomes.

The proneural-to-mesenchymal transition (PMT) is a pivotal process in glioblastoma (GBM), driving enhanced tumor aggressiveness, therapeutic resistance, and recurrence. HSPA5, a member of the heat shock protein 70 (HSP70) family, plays a crucial role in regulating and maintaining protein stability and function. Although HSPA5 is a recognized marker of poor prognosis in glioma, its underlying mechanistic function remains poorly defined. Here, we demonstrated that HSPA5 expression is highest in the mesenchymal (MES) subtype of GBM. The overexpression of HSPA5 in proneural (PN) cells induced PMT and promoted malignant phenotypes, whereas its knockdown in MES cells suppressed PMT and attenuated tumorigenicity. We further established that HSPA5 drives PMT by activating the YAP/TAZ pathway in vitro and in vivo. The expression of MES markers CD44 and c-MET was transcriptionally regulated by YAP/TAZ. Mechanistically, HSPA5 interacts directly with YAP/TAZ, disrupting their association with β-TrCP. This protective interaction inhibits the ubiquitination and proteasomal degradation of YAP/TAZ. Furthermore, HSPA5 expression was positively correlated with YAP and TAZ levels across GBM subtypes. Patients with high expression of HSPA5, YAP, and TAZ exhibited significantly poorer overall survival. Collectively, our findings suggested that HSPA5 promotes PMT through the stabilization of YAP/TAZ and identified HSPA5 as a promising therapeutic target for GBM patients.

Existing salvage therapies for recurrent glioblastoma (rGBM) have limited efficacy, with median survival of approximately 9 months. Given the complex molecular heterogeneity of GBM, single-target approaches have consistently failed as a treatment strategy. We conducted a phase 1 clinical trial to assess the feasibility, safety, and efficacy of a genomically-tailored multi-agent regimen in 30 adults with surgically-treated rGBM. Adults with IDH-wildtype glioblastoma (n=29) or grade 4 IDH-mutant astrocytoma (n=1) were consented and underwent clinically-indicated surgery for recurrent disease. Comprehensive genomic profiling was performed on the recurrent tumors, and results for each patient were discussed at an individualized molecular tumor board to determine a personalized treatment regimen combining up to 4 FDA-approved drugs, including one cytotoxic agent as backbone. A total of 12 drugs were used in 18 combinations - the most common regimen was lomustine, afatinib, and abemaciclib (n=8). The most common toxicities included cytopenias, rash, and gastrointestinal symptoms, requiring frequent dose reductions. Measured from surgery at trial enrollment, progression-free survival at 6 months (PFS-6) was 40%, overall survival at 9 months (OS-9) was 73%, and median OS was 12.7 months. After trial therapy, genomic profiling performed on subsequent recurrent tumor specimens identified genetic evolution corresponding to putative treatment resistance mechanisms. Implementation of individualized treatment regimens in a timely fashion was feasible for patients with surgically resectable rGBM. Overall efficacy was not significantly improved compared to a contemporary patient cohort treated without experimental regimens, with full dosing of most combination therapies limited by toxicities.

Background and Objectives: Glioblastoma (GBM) is the most aggressive form of primary brain tumor, characterised by high recurrence rates and poor patient prognosis. This study aimed to identify gene-expression signatures and molecular networks associated with primary and recurrent GBM to better understand the biological mechanisms underlying tumor progression. Materials and Methods: Gene expression analysis of TCGA data was conducted to identify differentially expressed genes across tumor, recurrent, and normal brain tissues. Analysis of overlapping differentially expressed gene sets revealed both common and specific gene-expression profiles across the groups, highlighting genes potentially involved in GBM recurrence. Gene network and canonical pathway analyses were performed using Ingenuity Pathway Analysis (IPA) to identify key pathways and cellular functions altered in GBM. Results: Our data identified distinct molecular signatures in tumor, recurrent, and normal brain samples, highlighting dysregulated genes associated with cellular growth, proliferation, and movement. Transcriptomic stratification revealed progressive tumor- and recurrence-adapted states, with composite Tumor Scores (TS) and Recurrence Scores (RS) classifying samples into four classes: normal-like, proliferative, transitional, and recurrence-adapted tumor states. Conclusions: These findings provide insights into the signaling networks and biological mechanisms underlying GBM recurrence and may guide the identification of potential therapeutic targets to improve the management of this malignancy.

Phyllodes tumors (PTs) are rare fibroepithelial breast tumors, albeit clinically significant. This study was implemented to investigate the immunohistochemical (IHC) expression of cyclin D1 in PT subtypes and in metaplastic spindle cell carcinoma. Fifty-three resected cases of PT subtypes were analyzed. IHC analysis assessed the percentage of positive stromal tumor cells and the intensity of cyclin D1 staining. The score was classified as either negative, low, or high positive. Statistical analysis was implemented to evaluate the outcomes. Significant variations in scores were observed among various subtypes of PT, with cyclin D1 exhibiting positive nuclear expression in the stromal component of borderline and malignant tumors ( P =0.001). Malignant PTs also showed significantly different cyclin D1 expression compared with triple-negative metaplastic spindle cell carcinoma ( P =0.028). Tumor recurrence was significantly associated with high cyclin D1 expression ( P =0.013). Receiver Operating Characteristic (ROC) curve analysis demonstrated moderate discriminatory ability, with an area under the curve (AUC) of 0.701 (95% CI: 0.535-0.856, P =0.023). Univariate analysis confirmed high cyclin D1 expression as a predictor of recurrence ( P =0.035). In conclusion, cyclin D1 overexpression provides insights into tumor progression and prognosis in PTs. Notably, positive cyclin D1 expression in metastatic malignant PT could be a diagnostic challenge, if not carefully considered within clinical context. Furthermore, the significant difference in cyclin D1 expression between malignant PT and triple-negative metaplastic spindle cell carcinoma highlights its potential utility in distinguishing between them.

The epidemiological shift toward non-B non-C hepatocellular carcinoma (NBNC-HCC) highlights the need for identifying prognostic markers in this population. While microvascular invasion (MVI) has been established in hepatitis virus-related HCC (HV-HCC), its role in NBNC-HCC remains unclear. This multicenter retrospective study analyzed 3308 patients with HCC undergoing curative resection (2012-2023). Risk factors for MVI were identified using logistic regression in the overall cohort. From this cohort, 439 patients with NBNC-HCC were stratified based on the MVI status and balanced using propensity score matching (PSM). Cox regression models and Kaplan-Meier analysis with log-rank test were employed to compare recurrence-free survival (RFS) and overall survival (OS) between MVI-positive and MVI-negative subgroups. The incidence of MVI was lower in the NBNC-HCC group compared to the HV-HCC group (31.44% vs. 38.06%, P = 0.007), but viral hepatitis was not an independent risk factor for MVI (OR = 1.20, 95% CI 0.95-1.51, P = 0.118). After PSM, patients with MVI-positive NBNC-HCC had significantly worse RFS (median 30.0 vs. 47.0months) and OS (median 41.0months vs. not reached) compared to MVI-negative patients (both P < 0.01). MVI independently predicted postoperative recurrence (HR = 2.07, 95% CI 1.46-2.94) and mortality (HR = 2.17, 95% CI 1.45-3.26). MVI-positive cases also demonstrated adverse recurrence patterns, characterized by higher rates of simultaneous intrahepatic and extrahepatic recurrence (17.0% vs. 11.4%) and more frequent recurrence beyond the Milan criteria (39.8% vs. 22.9%). MVI independently predicts adverse outcomes in NBNC-HCC, associated with adverse recurrence and reduced survival. The prognostic value of MVI is independent of viral hepatitis, supporting its importance for risk stratification in this population.

In patients with ipsilateral breast tumor recurrence (IBTR) previously treated with breast-conserving surgery (BCS) followed by radiotherapy, salvage mastectomy (SM) is still considered standard of care. Currently, there is little evidence available about complication rates of repeat BCS or salvage mastectomy in patients with IBTR and possible differences. The primary aim was to report postoperative complication rates after IBTR treatment with salvage mastectomy or repeat BCS after previous BCS (± radiotherapy). Secondary, risk factors associated with complications were examined. Complication rates were reported using descriptive statistics. Complications were classified between short-term (less than 3months after surgery) and long-term (more than 3months after surgery). Logistic regression was used to evaluate possible risk factors after salvage mastectomy to report an odds ratio (OR) with a 95% confidence interval (CI). A total of 549 cases with IBTR after primary BCS were included. Short-term complications occurred in 200 (45.2%) of 442 patients treated with salvage mastectomy and in 9 (16.4%) of 55 patients treated with repeat BCS. Seroma and surgical site infection (SSI) were most common in salvage mastectomy (31.7% and 10.9%, respectively). Long-term complications were reported in 16.7% treated with salvage mastectomy and in 14.5% with repeat BCS. The risk of short-term postoperative complications after salvage mastectomy increased significantly with higher BMI. The regression analysis showed that adjuvant radiotherapy after IBTR surgery was associated with long-term postoperative complications. Salvage mastectomy in case of IBTR after primary BCS is associated with high short-term complication rates, especially seroma. The risk of short-term complications after salvage mastectomy increased with increasing BMI, while adjuvant radiotherapy after salvage mastectomy is associated with long-term complications.

The endoscopic endonasal approach (EEA) has been the predominant surgical corridor for the craniopharyngioma in the past decade. Retrochiasmatic craniopharyngiomas pose a more difficult challenge. The narrow space between the tumor and the optic chiasm makes it difficult to have an effective and balanced protocol between aggressive therapy and reducing adverse symptoms. We have developed a meticulous method with extradural posterior clinoidectomy (EPC) and upper clivectomy (UC). Here, we present a series of such patients demonstrating its safety and efficacy. Between 2016 and 2022, we resected 35 consecutive nonelderly patients of retrochiasmatic craniopharyngiomas by using EEA with EPC and UC. We analyzed the efficacy of EPC and UC, and determinants of the extent of resection and outcomes in retrochiasmatic craniopharyngiomas. By adding EPC and UC to the standard EEA, the access route for the retrochiasmatic region has expanded from 9.7 to 19.7 mm. Gross total resection (GTR) was achieved in 28 patients, and near total resection (NTR) in 7. Anterior and posterior pituitary hormone replacement therapy was required in 33 patients at the last follow-up. Visual function status improved in 13 patients, whereas the other 22 patients remained unchanged postoperatively. Neuropsychological function status improved in 1 patient and was preserved in 34 patients. The mean duration of follow-up was 60.1 months. In the initial treatment patients (n = 20), there was no tumor recurrence in 19 GTR patients and 1 NTR patient. In retreatment patients (n = 15), tumor recurrence was detected in 5 of 9 GTR patients and in 2 of 6 NTR patients. EEA with EPC and UC for retrochiasmatic craniopharyngioma widens the surgical corridor significantly and offers the advantage to visualize the tumor origin, hypothalamus, and lower surface of the optic chiasm. EPC and UC aid in safe, maximum, and aggressive resection to decrease the tumor recurrence.

Objective To evaluate the technical feasibility, safety, and clinical outcomes of bronchial sleeve anastomosis in a pediatric case series encompassing two main etiologies (trauma and tumor). Methods A retrospective analysis was conducted on 8 pediatric patients who underwent bronchial sleeve resection at our center between May 2018 and May 2025. Preoperative diagnosis was confirmed by computed tomography, magnetic resonance imaging, and bronchoscopy. Collected data included demographic characteristics, surgical parameters, pathological results, perioperative outcomes, and follow-up information. Results All eight procedures were successfully completed without perioperative mortality. The mean operative time was 306.88 ± 127.31 min, with mean intraoperative blood loss of 51.25 ± 23.57 mL. The mean duration of mechanical ventilation was 16.06 ± 12.57 h, chest tube drainage was maintained for 234.86 ± 91.04 h, and the mean postoperative hospital stay was 25.00 ± 8.45 days. The median follow-up period was 2.7 years (range: 0.6–7.1 years). Perioperative complications included two cases of mild anastomotic stenosis, both successfully managed with bronchoscopic cryotherapy, and one case of chylothorax that resolved with conservative drainage. The trauma group required significantly longer postoperative mechanical ventilation compared to the tumor group ( P &amp;lt; 0.05). At the last follow-up, all patients were alive with patent airways, recovered pulmonary function, and had resumed normal activities. No tumor recurrence was observed in the oncology patients. Conclusion Bronchial sleeve resection represents a safe, feasible, and effective lung-preserving procedure in carefully selected pediatric patients. This technique allows complete lesion removal while maximizing pulmonary function preservation and promoting long-term quality of life, establishing it as a preferred surgical option for children with severe airway trauma or bronchial tumors.

A biomimetic nano-suspension based on orthoester designed for the inhibition of postoperative tumor recurrence.

Mimicking gingival endotoxin tolerance to modulate immune balance for tumor postoperative wound management.

Liver Transplantation in Patients With Hepatocarcinoma. Does the Donor Characteristics Influence the Risk of Tumor Recurrence and Survival?

Perspective on postoperative hormone replacement therapy and fertility preservation in Swyer syndrome with dysgerminoma: a case series and literature review.

Cryoablation as an adjunct to the excision of primary cardiac tumors.