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Ewing sarcoma with renal localization is one of the rarest members of the Ewing sarcoma family with less than 200 cases reported in the Medline database. Considering the fact that the majority of data published on the Ewing sarcoma with neuroectodermal differentiation is obtained through a few case reports and case series, it becomes understandable why we currently have no universally accepted treatment regimens.

Introduction: Adrenocortical carcinoma (ACC) represents a rare endocrine malignancy being the second most aggressive endocrine cancer after anaplastic thyroid cancer. [1]. While most of them arise sporadically, up to 15% of adult ACC patients are related to germline mutations associated with familial cancer syndromes.[1,2]. Current treatment strategies include surgery as well as systemic therapy with mitotane and chemotherapy.

Introduction: Pheochromocytomas are catecholamine-secreting tumors arising from the chromaffin cells of the adrenal medulla. We describe an unusual case of pheochromocytoma located in the infrarenal area and associated with bilateral adrenal hyperplasia.

Background: Glioblastomas are the most common tumors of the central nervous system. The incidence of brain tumors is higher in developed countries and is constantly increasing.

Background: Sepsis is the leading cause of morbidity and mortality in intensive care units. This study explored the possible role of vascular endothelial growth factor-C (VEGF-C) and podoplanin (PDPN) in sepsis.

Aim: To present a rarely diagnosed case of gastric Dieulafoy lesion. Description of case: A 62-year-old male was hospitalized with hematemesis. Laparoscopic ligature of two gastric ulcers located in the antrum was performed but the upper gastrointestinal bleeding was not stopped. The patient was transferred to another surgical clinic and he underwent an emergency abdominal laparotomy with re-suture of gastric ulcers. Considering his general condition and another recurrent bleeding, he was transferred to our hospital and a total gastrectomy of necessity was performed. The patient died four days after surgery because of sepsis. At autopsy, we identified diffuse peritonitis, hypertrophic cardiomyopathy and chronic pancreatitis with expanded fibrotic areas. Histological examination of the surgical specimen showed oversized tortuous vessels in the gastric submucosal layer with expansion into mucosa. Some of the vessels presented acute and/or organized thrombi with recanalization, in the others, lipid-rich atherosclerotic plaques were observed. Based on these criteria, the 'caliber-persistent artery', also known as 'Dieulafoy's lesion', was diagnosed. Conclusion: Dieulafoy's lesion should be suspected in every case of gastrointestinal bleeding in both adults and children. [ABSTRACT FROM AUTHOR]

Objective This study was performed to evaluate the 1-year survival rate and functional outcomes of 20 patients who underwent intersphincteric resection (ISR) for low rectal cancer. Methods Twenty patients who underwent ISR for low rectal cancer were followed up for 1 year. Complications, functional outcomes objectified by the Wexner score, and oncological outcomes were assessed. Results The short-term survival rate was 100%. The median Wexner score was ≤10 in all patients at 12 months after surgery. Signs of local recurrence were absent, and antigen levels remained within the reference ranges 1 year postoperatively. Conclusions ISR is a feasible alternative in highly selected patients who primarily refuse a colostomy bag and present with type II or III tumors. In the present study, patient-reported continence was satisfactory, and the absence of a colostomy bag increased patients’ quality of life. The oncological outcomes were satisfactory at 1 year postoperatively.

Background: We hypothesized that an ideal heart valve replacement would be acellular valve root scaffolds seeded with autologous stem cells. To test this hypothesis, we prepared porcine acellular pulmonary valves, seeded them with autologous adipose derived stem cells (ADSCs) and implanted them in sheep and compared them to acellular valves.

Background Although p53 pathway was previously explored in human carcinogenesis, the clinical implication of this gene is still unknown. The aim of this paper was to explore the particularities of TP53gene, at molecular and protein level, in gastric cancer. Methods In 197 surgical specimens provided from patients with gastric carcinomas, consecutive cases with curative resection, without preoperative therapy, the clinicopathological parameters were correlated with immunohistochemical (IHC) expression of p53, HER-2 and the DNA mismatch repair protein MLH-1. Mutations in exons 2-11 of the TP53 were also screened using Sanger sequencing. Results The rate of TP53 mutation was 28.43% (n = 56). Although it was a widely distribution among the exons 2 and 11 (except exon 9 which did not present mutations), in half of the cases mutations were located in the exons 5 (n = 13) and 8 (n = 15). No statistical correlations were seen between TP53 mutation rate and most of the clinicopathological parameters (e.g. age and gender, tumor localization, microscopic aspect, presence of intestinal metaplasia, HER-2 expression, overall survival). Compared to the non-mutated cases, those that showed mutations, independently from the involved exon, displayed more frequent p53 protein in over 50% of tumor cells (p = 0.004). Although no correlation with pT (p = 0.63) and pN stage (p = 0.84) was seen, a direct correlation was found with the Dukes-MAC-like staging system for gastric cancer, which was proposed by our team in 2017. Based on this system, a significant high number of cases diagnosed in stage pT3N1-3 showed TP53 mutation, whereas mutations were rare in pT3N0 cases and pT1-2 stage, independently from lymph node status (p = 0.03). Another significant correlation regarded the MLH-1 protein, which was more frequently (p = 0.01) negative in non-mutated versus mutated cases (19.86% vs 7.14%). Conclusions As MLH-1 negativity is considered an indicator of microsatellite instability, the present study conclude that TP53 gene seems to not be involved in gastric cancers microsatellite instability pathway and do not iterract with HER-2 pathway. Occurrence of TP53 gene mutations induce overexpression of p53 protein in tumor cells and increases risk of lymph node metastases, especially in locally advanced cases. Legal entity responsible for the study Romanian National Authority for Scientific Research, CNCS – UEFISCDI. Funding Romanian National Authority for Scientific Research, CNCS – UEFISCDI, project number 20 PCCF/2018, code: PN-III-P4-ID-PCCF-2016-0006. Disclosure All authors have declared no conflicts of interest. [ABSTRACT FROM AUTHOR]

Background The most recent histopathological guideliness recommend evaluation of tumor buds, as an independent prognostic factor of colorectal carcinoma (CRC). In the present paper, we examined the immunoprofile of tumor buds, using three markers of epithelial mesenchymal transition (EMT): E-cadherin, β-catenin and vimentin, which were evaluated in both tumor core and buds. Methods In 157 CRCs specimens, consecutive cases with curative resection, without preoperative therapy, three molecular subtypes were defined: epithelial (positive for E-cadherin, membrane expression for β-catenin and negative for vimentin, in core and buds), mesenchymal (loss of E-cadherin staining and vimentin positivity and/or nuclear β-catenin, in core and buds) and hybrid cases (epithelial tumor core and mesenchymal tumor buds). Based on the number of buds, which were evaluated at high power field (HPF), cases were divided in two groups: group A or low grade (≤5 buds/HPF) and and group B or high-grade CRCs (>5 buds/HPF). Results It was a similar distribution between the two groups: 74 cases (47.13%) in group A and 83 cases in group B (52.87%). Most of the cases (n = 76; 48.41%) were classified as epithelial-type, followed by hybrid- (n = 63; 40.13%) and mesenchymal-type CRCs (n = 18; 11.46%). On both groups, a similar distribution was seen between epithelial- and hybrid-type cases but 14 out of the 18 mesenchymal-type CRCs belonged to group B (p = 0.01). All of the mesenchymal-type CRCs from group B showed lymph node metastases. Both lymph node status and budding degree proved to be independent prognostic factors. Conclusions In daily practice, the immunoprofile of CRC buds might have a prognostic impact. Further studies are necessary to check the prognostic role of mesenchymal-immunoprofile of tumor buds. Legal entity responsible for the study University of Medicine, Pharmacy, Sciences and Technology, Tirgu-Mures, Romania. Funding University of Medicine, Pharmacy, Sciences and Technology, Tirgu-Mures, Romania. Disclosure All authors have declared no conflicts of interest. [ABSTRACT FROM AUTHOR]