Collecting duct carcinoma (CDC), or Bellini duct carcinoma, is a rare and aggressive subtype of renal cell carcinoma, accounting for 0.2% - 1% of cases. It often presents at an advanced stage with nonspecific symptoms, requiring histopathology for diagnosis. Surgery remains the standard of care for localized disease, serving both diagnostic and therapeutic purposes, though adjuvant chemotherapy has shown limited efficacy. In metastatic CDC, the gemcitabine-cisplatin regimen is commonly used due to its resemblance to urothelial cancer and supportive data from prospective studies. Newer therapies offer promise in advanced cases. Immune checkpoint inhibitors, such as nivolumab alone or with ipilimumab, have shown benefits in patients with high PD-L1 expression. Targeted therapies like cabozantinib demonstrated efficacy and safety as first-line treatments in phase II trials, while sunitinib and sorafenib have shown responses in various case reports and cohorts. However, combining chemotherapy with bevacizumab did not improve outcomes in phase II trials. Despite therapeutic advances in urothelial cancers and clear cell renal tumors, the CDC entity remains a challenging malignancy, emphasizing the need for continued research to understand the true efficacy of treatment and to prolong survival in advanced disease.
BACKGROUND Gastric mixed-adenoneuroendocrine carcinoma(G-MANEC)is a subtype of gastric cancer.Building upon prior research findings,we propose that tumours containing both neuroendocrine carcinoma(NEC)and adenocarcinoma(AC)components,with each component ranging from 1%to 99%of the tumour,be classified as a distinct entity.We hereby term this adenoneuroendocrine mixed gastric cancer(G-ANEC).Research on lymph node(LN)involvement in GMANEC has focused mainly on metastasis status,with limited studies on metastatic composition.AIM To investigate the LN metastasis patterns of G-ANEC,the clinicopathological features associated with these metastasis patterns,and to explore adjuvant chemotherapy regimens for G-ANEC.METHODS We analyzed 68 G-ANEC cases treated with radical surgery and confirmed LN metastasis at Peking University Cancer Hospital between August 2012 and June 2022.Utilizingχ2 tests in IBM statistical product and service solutions statistics and R software.RESULTS We identified three distinct LN metastasis patterns in G-ANEC that were significantly associated with the NEC proportion,tumour invasion depth,Lauren classification,and tumour location(P values:0.008,0.015,0.01,and 0.004,respectively).When the SOX/XELOX regimen was applied for adjuvant chemotherapy,patients with LN metastasis comprising only AC exhibited better overall survival(OS)(94.25±11.07 months vs 54.36±11.36 months)than did those with NEC.When LN metastasis components contained NEC,there was a trend towards improved OS(64±10.77 months vs 54.35±11.36 months)and disease-free survival(71.28±9.92 months vs 66.28±11.93 months)in patients treated with the etoposide and cisplatin compared to those receiving the SOX/XELOX regimen.CONCLUSION We found a significant correlation between the NEC percentage,tumour invasion depth,Lauren classification,and tumour location and LN metastasis patterns in G-ANEC.For G-ANEC,a lower proportion of NEC or AC in the primary lesion does not preclude the possibility of these components metastasizing to the LNs.Dif
Kai ZhouZhong-Wu LiYan WuZhi-Jie WangLing-Qian WangLi-Xin ZhouLing JiaKe JiXue-Song YangJi ZhangXiao-Jiang WuAn-Qiang WangZhao-De Bu
According to the International Cancer Research Institute of the World Health Organization data,nasopharyngeal carcinoma(NPC)remains a significant health concern,particularly in regions such as Southeast Asia and southern China.Recently,substantial progress has been made in the field of basic and translational research on NPC,enhancing our understanding of the molecular mechanisms underlying the disease and paving the way for precise therapeutic approaches.This review summarizes the advances in NPC research,focusing on key areas that include radiotherapy and chemotherapy resistance and tumor metastasis,microenvironment,metabolism,microbiome,and biomarkers.Additionally,future research directions in NPC are discussed to provide valuable insights to advance the field further.
Background: Primary pulmonary lymphoepithelioma-like carcinoma (LELC) is a rare subtype of non-small cell lung cancer (NSCLC). Nevertheless, no universally acknowledged standards of care have been reported to be effective and productive for the treatment of this tumor. Materials and Methods: A patient with advanced primary pulmonary LELC was treated by employing a combination of tislelizumab and chemotherapy. Results: The patient displayed a favorable response to the combination therapy. The tumor size exhibited conspicuous abatement in contrast to the pre-treatment baseline, and the tumor markers normalized. Conclusion: The combination of immunotherapy with chemotherapy appears to be more effective than therapy alone for managing advanced primary pulmonary LELC. On that account, further clinical trials are imperative to establish this combination regimen as a potential first-line treatment option for advanced cases.
Irreversible electroporation is a promising non-thermal ablation method that has been shown to increase overall survival in locally advanced pancreatic cancer in some studies.However,higher quality studies with proper controls and randomization are required to establish its superiority when added with neoadjuvant chemotherapy over the current management of choice,which is chemotherapy alone.Further studies are required before establishment of any survival benefit in metastatic pancreatic carcinoma,and such evidence is lacking at present.
BACKGROUND Breast hamartomas are rare benign breast tumors,with an incidence rate of 0.8%-4.8%.Further,the coexistence of hamartomas and carcinoma is also uncommon.Our case report presents a unique instance where invasive ductal carcinoma(IDC)and ductal carcinoma in situ were found both inside and outside a breast hamartoma.This is the second case reported in the literature.CASE SUMMARY A 51-year-old woman presented with a 6.0 cm breast tumor on mammography and ultrasound,with suspicious areas indicative of malignant transformation.Biopsy of the suspicious area confirmed IDC with intraductal carcinoma.Breast magnetic resonance imaging showed typical hamartoma changes with irregular areas of abnormal enhancement both inside and outside.A breast-conserving surgery was performed,and postoperative pathology confirmed mammary hamartoma,concurrent with IDC and intraductal carcinoma occurring both inside and outside the hamartoma.Subsequently,appropriate adjuvant therapy was initiated.Currently,the patient is in good condition.Breast cancer may be located both inside and outside the ipsilateral mammary hamartoma,which is difficult to detect preoperatively,especially when there is a focus of intraductal carcinoma,requiring accurate assessment of the tumor extent by modern imaging techniques.Early detection of the coexistence of cancer is clinically important as it can alter patient management.CONCLUSION This case emphasizes the importance of modern imaging techniques in accurately evaluating mammary hamartomas associated with malignancies prior to surgery.
Lai WeiZhe TianZhi-Yong WangWei-Jia LiuHong-Bo LiYing Zhang
Primary renal cell carcinoma (RCC) with metastasis is common with an estimated 30% of patients with RCC having metastases at the time of diagnosis. Evidence of metastatic RCC without a primary renal tumor is extremely rare with only a handful of cases citing this occurrence. Occasionally an unclear patient presentation requires thoughtful consideration of all the possibilities and results in a clinician reexamining the data to expand a differential, thus arriving at a diagnosis. This is the case of a 22-year-old who presented with diffuse lymphadenopathy, fever, cough, lower abdominal pain following a trip to India where the patient was hospitalized, initially believed to be tuberculosis. After multiple needle biopsies of lymph nodes and a retroperitoneal mass that were insufficient for a diagnosis, a wide excisional biopsy was performed that led to a diagnosis in our patient. The patient was diagnosed with metastatic TFE3-rearranged (MiT translocation) renal cell carcinoma and subsequently started on pembrolizumab and Lenvatinib followed by debulking surgery.
The recent study by Chen et al,published in the World Journal of Gastroenterology,introduces a groundbreaking assessment tool-the preoperative systemic immuneinflammation index/albumin(SII/ALB)ratio-for patients with hepatocellular carcinoma(HCC)undergoing curative resection.This study not only establishes the independent prognostic significance of the SII/ALB ratio but also incorporates it into a predictive nomogram,enhancing its utility for clinical decision-making.The SII/ALB ratio,by integrating inflammatory and nutritional biomarkers,offers a novel lens through which the prognosis of HCC patients can be viewed,suggesting a more tailored approach to patient management.The development of the nomogram,validated for its accuracy in predicting patient outcomes,marks a pivotal advance,potentially guiding surgical decisions and postoperative care.However,the study's focus on a single-center cohort prompts the need for validation in a broader,more diverse patient population to ensure its applicability across various clinical settings.Moreover,longitudinal studies could elucidate the dynamic changes in SII/ALB post-surgery,offering insights into its potential as a continuous monitor for recurrence and long-term survival.This abstract aim to underscore the critical findings of Chen et al's study while calling for further research to explore the full potential of the SII/ALB ratio in the global management of hepatocellular carcinoma.
