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Pleomorphic adenoma, a common salivary gland tumor, is a rare benign breast tumor. It doesn't have specific features and its diagnosis can be made on the final histopathological examination. There have been reported few cases of malignant transformation and many recurrences, therefore it is required an adequate excision of this tumor with clear margins. We present the case of a woman of 47 years old, who was admitted in our Department for a right perimamelonar lump, with uncertain imaging features. A right mammary segmentectomy was performed and the routine histopathological and immunohistochemical examination led to the diagnosis of pleomorphic adenoma of the breast. [ABSTRACT FROM AUTHOR]

Abdominal radical trachelectomy (ART) is one of the fertility-sparing procedures in women with early-stage cervical cancer. The published results of ART, in comparison with vaginal radical trachelectomy, so far are limited.This retrospective study comprises all cases of female patients referred to ART with early-stage cervical cancer from 2 gynecologic oncology centers in Romania.A total of 29 women were referred for ART, but subsequently, fertility could not be preserved in 3 of them. Eleven women had stage IA2 disease (42.3%), 14 (53.8%) women had stage IB1 disease, and 1 (3.8%) woman had stage IB2 disease. Histologic subtypes were 15 (57.6%) squamous, 8 (30.7%) adenocarcinoma, and 3 (11.5%) adenosquamous. There were no major intraoperative complications in both hospitals. Early postoperative complications were mainly related to the type C parametrectomy—bladder dysfunction for more than 7 days (8 [30.7%] women) and prolonged constipation (6 [23.0%] women). Other complications consisted in symptomatic lymphocele in 2 (7.6%) patients, which were drained. Median follow-up time was 20 months (range, 4-43 months). Up to the present time, there has been 1 (3.8%) recurrence in our series. Most patients did not experience late postoperative complications. Three (11.5%) women are amenorrheic, and 1 (3.8%) woman developed a cervical stenosis. Of the 23 women who have normal menstruation and maintained their fertility, a total of 7 (30.4%) women have attempted pregnancy, and 3 (42.8%) of them achieved pregnancy spontaneously. These pregnancies ended in 2 first trimester miscarriages and 1 live birth at term by cesarean delivery.Our results demonstrate that ART preserves fertility and maintains excellent oncological outcomes with low complication rates. [ABSTRACT FROM AUTHOR]

Gastrointestinal cancer represents one of the most encountered oncologic pathologies and research studies are performed thoroughly in order to identify the exact causes and possible novel therapies. Obesity is a complex manifestation associated with numerous physiological and primarily molecular changes capable of tackling the behavior of tumoral cells and the nearby or faraway microenvironment. Adipose tissue has been once considered to have limited physiological roles, but in recent years it has been recognized as an active endocrine organ, secreting substances such as growth factors and adipokines. From an epidemiological perspective, obesity -- particularly morbid obesity -- is linked to an unfavorable progression of cancer. A key mechanism that may elucidate the association between obesity and cancer involves the insulin and insulin-like growth factor (IGF-1) pathway, sex hormones, and adipokines. [ABSTRACT FROM AUTHOR]

Introduction: Smooth muscle tumor of uncertain malignant potential (STUMP) still represents a medical and surgical challenge, being rare and hard to diagnose. Normally STUMP consists in a multitude of uterine tumors that do not meet the current histologic criteria for a specific malignant or benign tumor. Clinical, imagistic and laboratory investigations seem to only raise the presumptive diagnosis in these cases, the diagnosis being confirmed during histological examination of the post hysterectomy/myomectomy specimen. Case report: We present the case of a 50-year-old female patient who was examined for the first time for pelvic pain and sensation of increased pressure in the lower abdomen in June 2020. A gynecology consultation was performed, during which a large uterine mass was felt on vaginal digital examination combined with pelvic palpation. Further pelvic ultrasound examination revealed a voluminous tumor of the left ovary. Then, a magnetic resonance imaging was performed, which showed a large pelvi-abdominal tumor of probable ovarian origin with a mixt tissue type and cystic structure, the presence of pathological abdominal and pelvic lymph nodes, ascites with a suspicion of peritoneal carcinomatosis. The patient was referred to a tertiary center and the multidisciplinary team recommended surgical treatment. A total hysterectomy with bilateral oophorectomy and stadial lymphadenectomy was performed. After surgery, the patient had a favorable evolution and was discharged five days after the intervention in a good health condition. Macroscopic and histological examinations of the biopsy pieces showed morphological aspects of uterine smooth muscles tumors with uncertain malignancy potential/STUMP and multiple uterine leiomyomas. Discussion: Due to the rarity of these tumors, the scientific literature needs to be constantly updated in order to help physicians to correctly identify and treat this pathology. It is highly recommended to identify tumors with a high malignancy potential, so that the follow up will be sufficient to discover and treat recurrences before they become life-threatening. Conclusion: Smooth muscle tumor of uncertain malignant potential remains a difficult diagnosis due to uncertainty between malignancy and benign features. Treatment approaches are difficult in these cases and must always be in accordance with the patients' desire to maintain their reproductive functions and fertility. Recurrence of STUMP has been reported, therefore a close follow up of these patients must always be performed. [ABSTRACT FROM AUTHOR]

Objective - Arterial hypertension is an important cardiovascular risk factor with destructive effects on the cardio-renal axis. Approximately 10% of the hypertensive population suffers from the secondary form of this pathology. Methods - We hereby present the case of a 47-year-old patient who was addressed to our clinic because of persistent high blood pressure values, despite medication compliance. Results - Laboratory findings revealed elevated creatinine and hypokalaemia. Transthoracic echocardiography revealed left ventricular hypertrophy, diastolic dysfunction and subclinical systolic dysfunction. The renal angiogram was normal. The aldosterone: renin ratio was elevated. The tomographic computer exam revealed the presence of two micronodules in the right adrenal gland. The diagnosis of primary hyperaldosteronism was established. After the association of an antialdosteronic agent, a better control of the tensional values was obtained. The patient was referred for the surgical treatment of the lesion. Conclusions - Primary hyperaldosteronism accounts for 5-10% of resistant hypertension cases, and unilateral adrenal adenomas are the second most common cause after bilateral idiopathic hyperplasia. When untreated, it is associated with an increased rate of arrhythmias, coronary artery disease, heart failure, stroke, proteinuria and renal dysfunction. The gold standard for the treatment of unilateral adenomas is surgical resection. [ABSTRACT FROM AUTHOR]

Purpose: No biomarker capable of improving selection and monitoring of patients with rectal cancer managed by watch-and-wait (W&W) strategy is currently available. Prognostic performance of the Immunoscore biopsy (IS B ) was recently suggested in a preliminary study., Methods: This international validation study included 249 patients with clinical complete response (cCR) managed by W&W strategy. Intratumoral CD3+ and CD8+ T cells were quantified on pretreatment rectal biopsies by digital pathology and converted to IS B . The primary end point was time to recurrence (TTR; the time from the end of neoadjuvant treatment to the date of local regrowth or distant metastasis). Associations between IS B and outcomes were analyzed by stratified Cox regression adjusted for confounders. Immune status of tumor-draining lymph nodes (n = 161) of 17 additional patients treated by neoadjuvant chemoradiotherapy and surgery was investigated by 3'RNA-Seq and immunofluorescence., Results: Recurrence-free rates at 5 years were 91.3% (82.4%-100.0%), 62.5% (53.2%-73.3%), and 53.1% (42.4%-66.5%) with IS B High, IS B Intermediate, and IS B Low, respectively (hazard ratio [HR; Low v High], 6.51; 95% CI, 1.99 to 21.28; log-rank P = .0004). IS B was also significantly associated with disease-free survival (log-rank P = .0002), and predicted both local regrowth and distant metastasis. In multivariate analysis, IS B was independent of patient age, sex, tumor location, cT stage (T, primary tumor; c, clinical), cN stage (N, regional lymph node; c, clinical), and was the strongest predictor for TTR (HR [IS B High v Low], 6.93; 95% CI, 2.08 to 23.15; P = .0017). The addition of IS B to a clinical-based model significantly improved the prediction of recurrence. Finally, B-cell proliferation and memory in draining lymph nodes was evidenced in the draining lymph nodes of patients with cCR., Conclusion: The IS B is validated as a biomarker to predict both local regrowth and distant metastasis, with a gradual scaling of the risk of pejorative outcome.

Insulinoma is a neuroendocrine tumour deriving mainly from the pancreatic islet cells that produces excessive amounts of insulin. Accurate preoperative detection and localization of insulinoma is essential for the selection of appropriate candidates for surgery. We present the case reports of three patients with benign pancreatic insulinoma. Preoperative assessment was performed by using transabdominal ultrasonography, computed tomography and magnetic resonance imaging. Their performances for the effectiveness in detecting and localizing benign insulinoma were compared. We concluded that an appropriate preoperative imaging assessment was in our case impossible, intraoperative inspection and palpation of the pancreas still being superior.