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Background: Lateral neck swellings in ENT have various causes, commonly found in the anterior triangle of the neck. Accurate diagnosis through imaging, FNAC, and biopsy is crucial for appropriate treatment, ranging from conservative management to surgery. Understanding incidence, etiology, pathology, and clinical behaviour is important for effective management and follow-up. Materials and Methods: Institutional Ethical committee approval was obtained and informed consent was taken from the study subjects. Patients with lateral neck swellings underwent clinical examination and FNAC, followed by further investigations based on FNAC reports. Lymph node biopsies were taken for histopathological examination. Management was based on the final diagnosis, and patients were followed up for six months. Results were analyzed and tabulated. Results: In our study of 96 patients, lateral neck masses were most common in individuals aged 46-59, with an equal male-to-female ratio. The majority of cases (82.29%) were from low socioeconomic status. Metastasis in cervical lymph nodes was the most frequent cause of lateral neck swellings, primarily in males aged over 45, and tubercular lymphadenitis was the second most common cause in females aged 18-30. The clinical diagnosis had high sensitivity (87.18%) and specificity (92.98%) for detecting malignant lesions, and these values increased when the histopathological examination was used as the gold standard. Conclusion: To evaluate and manage lateral neck swellings, a multidisciplinary approach is necessary, including medical history, clinical examination, imaging, and pathological investigations like FNAC and HPE. Prompt and accurate diagnosis is critical to prevent morbidity and mortality, and management depends on the underlying cause. Effective management requires close communication between the clinician and the pathologist. [ABSTRACT FROM AUTHOR]

Simple Summary: Pheochromocytomas and paragangliomas are rare neuroendocrine tumours that originate from the adrenal medulla or extra-adrenal sympathetic or parasympathetic ganglia. They have the potential to secrete catecholamines, leading to e.g., hypertension. The only curative treatment modality is radical surgery. In disseminated diseases, limited data are available to guide proper medical treatment. Peptide receptor radionuclide therapy (PRRT) represents a rather novel treatment modality for these tumours. In the present nation-wide study, including all patients (n = 28) treated with PPRT in Denmark, we show a median overall survival of 72 and a median progression-free survival of 30 months with low toxicity. In conclusion, PRRT seems to represent an effective treatment option. The sequence of PRRT in treatment algorithms for pheochromocytomas and paragangliomas remains to be clarified. Introduction: Pheochromocytomas and paragangliomas are rare neuroendocrine tumours that originate from chromaffin cells within the adrenal medulla or extra-adrenal sympathetic ganglia. Management of disseminated or metastatic pheochromocytomas and paragangliomas continues to pose challenges and relies on limited evidence. Method: In this study, we report retrospective data on median overall survival (OS) and median progression-free survival (PFS) for all Danish patients treated with peptide receptor radionuclide therapy (PRRT) with 177Lu-Dotatate or 90Y-Dotatate over the past 15 years. One standard treatment of PRRT consisted of 4 consecutive cycles with 8–14-week intervals. Results: We included 28 patients; 10 were diagnosed with pheochromocytoma and 18 with paraganglioma. Median age at first PRRT was 47 (IQR 15–76) years. The median follow-up time was 31 (IQR 17–37) months. Eight patients died during follow-up. Median OS was 72 months, and 5-year survival was 65% with no difference between pheochromocytoma and paraganglioma. Patients with germline mutations had better survival than patients without mutations (p = 0.041). Median PFS after the first cycle of PRRT was 30 months. For patients who previously received systemic treatment, the median PFS was 19 months, compared with 32 months for patients with no previous systemic treatment (p = 0.083). Conclusions: The median OS of around 6 years and median PFS of around 2.5 years found in this study are comparable to those reported in previous studies employing PRRT. Based on historical data, the efficacy of PRRT may be superior to 131I-MIBG therapy, and targeted therapy with sunitinib and PRRT might therefore be considered as first-line treatment in this patient group. [ABSTRACT FROM AUTHOR]

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Objective: To identify imaging features that help distinguish between HCCs and non-HCC malignancies assigned to LI-RADS M (LR-M) and evaluate the diagnostic performance of a LI-RADS with targetoid criteria using thin-rim arterial phase hyperenhancement (APHE). Materials and Methods: This retrospective study included 381 patients (387 observations) at high-risk for HCC who underwent enhanced-MRI before surgery. Three radiologists reviewed images for LI-RADS categorization of hepatic observations. Univariate and multivariate analysis was conducted to determine reliable features to differentiate between HCC and non-HCC malignancies among the LR-M lesions. The thin-rim (<30%) APHE was defined based on the thickest thickness of rim APHE compared with the tumor radius, and a modified LI-RADS emphasizing thin-rim APHE as a specific feature of LR-M was established. We compared the diagnostic performance of modified LR-M and LI-RADS 5 (LR-5) with the conventional one. Results: Thin-rim APHE and targetoid diffusion-weighted imaging (DWI) were found as independent predictive factors of non-HCC malignancies, while enhancing capsule, thick-rim APHE and peripheral washout were noted as independent variables significantly associated with HCC of LR-M (P<0.05). The noticeable diagnostic performance of thin-rim APHE in distinguishing non-HCC malignancies from HCCs using the ROC curve. Emphasizing thin-rim APHE on targetoid features, the modified LR-M revealed significantly superior specificity and accuracy (89.4% vs 81.1%, P=0.004; and 87.9% vs 82.2%, P=0.027, respectively) while maintaining high sensitivity (82.2% vs 86.0%; P=0.529) compared with the LR-M. Meanwhile, the modified LR-5 achieved greater sensitivity and accuracy (88.6% vs 79.7%, P=0.004; and 85.8% vs 80.1%, P=0.036, respectively) for diagnosing HCC, without compromising specificity (78.3% vs.81.1%; P=0.608) compared with the LR-5. Conclusion: Thin-rim APHE may be the specific imaging feature for differentiating non-HCC malignancies from HCCs within LRM. The modified targetoid criteria emphasizing thin-rim APHE can improve the diagnostic performance of LI-RADS for hepatic malignancies. [ABSTRACT FROM AUTHOR]

Objective: To study the outcomes of endoscopic ultrasound-guided gastroenterostomy (EUS-GE) using lumenapposing metal stent (LAMS) in patients with benign and malignant gastric outlet obstruction (GOO). Materials and Methods: This single-center study retrospectively reviewed the medical records of benign and malignant GOO patients who underwent EUS-GE between May 2019 and September 2023. We evaluated the technical success, adverse events related to the techniques used, clinical success, and recurrence and reintervention rates. Results: A total of twelve patients who underwent three different EUS-GE techniques were included in this study. The first method was the direct over-the-guidewire technique, the second was the wireless-freehand method, and the third was modified endoscopic ultrasound-guided double-balloon occluded gastroenterostomy bypass (M-EPASS). All 3 techniques used preloaded oroenteral catheters in combination. Technical success was achieved in 83.3% (10/12) of patients, and there were 16.6% (2/12) failures due to misdeployment. One (8.3%) severe adverse event occurred resulting in peritonitis during the direct over-the-guidewire method. The second failure, which ensued after use of the wireless-freehand technique, achieved successful stent deployment at the second attempt without any complications. Clinical success was 100% (11/11), and mean follow up was 6.2 months. There was one (9.1 %) incidence of recurrence at 12-month follow up. Conclusion: EUS-GE is effective in the management of GOO, and the wireless-freehand and M-EPASS techniques in combination with oroenteral catheters should be the technique of choice in term of safety and efficacy. [ABSTRACT FROM AUTHOR]

Simple Summary: Neoplasm registries are not a common feature of veterinary oncology practice in Africa. Therefore, this study was conducted by obtaining data for specific breeds, age groups or gender with regards to neoplasm occurrence in Nigeria for 17 years (2000–2017). The institutions included in the study were Ahmadu Bello University, Zaria; Federal University of Agriculture Abeokuta; Federal University of Agriculture, Makurdi; Michael Okpara University of Agriculture, Umudike; University of Abuja; University of Ibadan; University of Nigeria, Nsukka; and Usmanu Dan Fodio University, Sokoto. The highest prevalence was reported in the avian species, with Marek's disease the most prevalently diagnosed neoplastic disease. Females were more affected compared to males, and tumours from the digestive location prevailed. Little emphasis is given to the appropriate diagnosis and recording of neoplastic cases, therefore, an estimation of the neoplastic cases noted in VTHs in Nigeria was done. In addition to the use of mapping tools, the distribution and the prevalence of specific neoplasms, in different geographical zones of Nigeria, were presented. This study will be beneficial to veterinary clinicians, pathologists and epidemiologists and could form a foundation for subsequent work in veterinary oncology and epidemiology in Nigeria and Africa. Incidence data from 17-year veterinary neoplasm surveillance and registration were reviewed. Most of the neoplastic cases diagnosed in Nigerian veterinary teaching hospitals (VTHs) were in the avian (49%) and canine species (44%). Fewer cases were recorded in the equine (3.2%), bovine (2.4%), ovine (1.5%), caprine (0.3%) and porcine (0.15%) species. Marek's disease was the most prevalently diagnosed neoplastic disease of domestic animals in Nigerian VTHs from 2000–2017. Also, the Nigerian local breed had a higher mean distribution than any other dog breed and this was statistically significant (p < 0.05). Nearly all of the neoplastic cases diagnosed, were found in females (60.4%) and so the mean distribution of sex was statistically significant (p < 0.05). The digestive system, with 296 (46.25%) cases, was the anatomic location where the majority of the neoplastic cases were found. However, the mean distribution of different neoplastic anatomic sites was not statistically significant (p > 0.05). In conclusion, little emphasis is given to the appropriate diagnosis and recording of neoplastic cases that are diagnosed. The study provides information regarding the prevalence and distribution of tumours in different animal species consulted in Nigeria veterinary teaching hospitals. To illustrate all of this, ArcGIS software was used. Veterinary clinicians, pathologists and epidemiologists from Nigeria may benefit from the results of this study by freely accessing some specific data regarding the breed, the age group or the gender of some animal species diagnosed with different tumours. [ABSTRACT FROM AUTHOR]

In terms of frequency and mortality, lung cancer ranks second among all cancers worldwide for both men and women. It is suggested that pattern classification and machine learning be applied to the identification and categorization of lung cancer. Convolution neural network (CNN) techniques divide the input data into groups according to the distinctive characteristics of the input. Using a standard approach to analyze a large number of computed tomography images, early detection of lung cancer can save lives. The suggested effort is centered on identifying the precise type of cancer and making predictions about whether it is benign or aggressive. The deployment of proposed model is an attempt to improve the accuracy of the system. The proposed work showed an overall accuracy of 98.4% during the detection of lung cancer and 98.8% accuracy towards the prediction of specific type in the lung cancer. Mean average precision score of 97.17% and 98.75% test and validation respectively. 0.96, 0.93, and 0.95 for malignant test data. [ABSTRACT FROM AUTHOR]

Rationale and objectives: To construct a predictive model for benign and malignant peripheral pulmonary lesions (PPLs) using a random forest algorithm based on grayscale ultrasound and ultrasound contrast, and to evaluate its diagnostic value. Materials and methods: We selected 254 patients with PPLs detected using chest lung computed tomography between October 2021 and July 2023, including 161 malignant and 93 benign lesions. Relevant variables for judging benign and malignant PPLs were screened using logistic regression analysis. A model was constructed using the random forest algorithm, and the test set was verified. Correlations between these relevant variables and the diagnosis of benign and malignant PPLs were evaluated. Results: Age, lesion shape, size, angle between the lesion border and chest wall, boundary clarity, edge regularity, air bronchogram, vascular signs, enhancement patterns, enhancement intensity, homogeneity of enhancement, number of non-enhancing regions, non-enhancing region type, arrival time (AT) of the lesion, lesion-lung AT difference, AT difference ratio, and time to peak were the relevant variables for judging benign and malignant PPLs. Consequently, a model and receiver operating characteristic curve were constructed with an AUC of 0.92 and an accuracy of 88.2%. The test set results showed that the model had good predictive ability. The index with the highest correlation for judging benign and malignant PPLs was the AT difference ratio. Other important factors were lesion size, patient age, and lesion morphology. Conclusion: The random forest algorithm model constructed based on clinical data and ultrasound imaging features has clinical application value for predicting benign and malignant PPLs. [ABSTRACT FROM AUTHOR]

Simple Summary: Malignant Brenner tumors are rare ovarian neoplasms. Our aim is to provide insights concerning this rare entity. We reviewed 115 cases reported in the English literature until 15 September 2023, and analyzed the available demographic, clinical, and pathologic data. We also described the treatment modalities. A comparison of the available data showed that patients treated with lymph node dissection had a better disease-related survival rate. Disease recurrence was associated with tumor stage with marginal statistical significance and was more frequent in patients with ascites and those with abnormal CA-125 levels. Larger series with treatment details and long term follow-up data are needed to define the optimal management for this uncommon entity. Background: Malignant Brenner tumors are rare ovarian tumors, accounting for less than 1% of malignant ovarian neoplasms. The aim of this manuscript is to systematically review the current literature concerning malignant Brenner tumors. Methods: We searched three medical databases (PubMed, Scopus, and Web of Science) for relevant articles published until 15 September 2023. Results: After applying inclusion and exclusion criteria, 48 manuscripts describing 115 cases were included in this study from the English literature. Conclusions: We analyzed the demographic, clinical, pathological, and oncological characteristics of 115 patients with malignant Brenner tumors. The statistical analysis showed that recurrence was marginally statistically significantly related to tumor stage and was more common in patients with ascites and in women with abnormal CA-125 levels; patients that were treated with lymphadenectomy had better disease-specific survival. [ABSTRACT FROM AUTHOR]

Objective: To determine the diagnostic accuracy of Diffusion Weighted MRI in differentiating malignant from benign liver lesions taking histopathology as gold standard. Methods: This Cross-sectional study was conducted at Departments of Radiology and Medicine, JPMC, Karachi from February 23, 2019 till September 25, 2019. Data was prospectively collected from patients after taking consent. One hundred twenty five patients presenting with hepatic mass who met the inclusion criteria were included. Quantitative data was presented as simple descriptive statistics giving mean and standard deviation and qualitative variables as frequency and percentages. Sensitivity, specificity, positive and negative predictive values and diagnostic accuracy were calculated. P-value of ≤0.05 was considered as significant. Results: Mean age in our study was 59.75±8.57 years. Total 71 (56.8%) were male and 54 (43.2%) were female. Out of 125 patients, sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of DW MRI for the diagnosis of malignant focal liver lesion by taking histopathology as gold standard was found to be 92.3%, 93.6%, 96%, 88% and 92.8% respectively. Conclusion: DW MRI scan has high diagnostic accuracy and being accurate in making a diagnosis and differentiation of benign from malignant focal liver lesion would decrease need of invasive modality of histopathology. [ABSTRACT FROM AUTHOR]

There is no doubt that brain tumors are one of the leading causes of death in the world. A biopsy is considered the most important procedure in cancer diagnosis, but it comes with drawbacks, including low sensitivity, risks during biopsy treatment, and a lengthy wait for results. Early identification provides patients with a better prognosis and reduces treatment costs. The conventional methods of identifying brain tumors are based on medical professional skills, so there is a possibility of human error. The labor-intensive nature of traditional approaches makes healthcare resources expensive. A variety of imaging methods are available to detect brain tumors, including magnetic resonance imaging (MRI) and computed tomography (CT). Medical imaging research is being advanced by computer-aided diagnostic processes that enable visualization. Using clustering, automatic tumor segmentation leads to accurate tumor detection that reduces risk and helps with effective treatment. This study proposed a better Fuzzy C-Means segmentation algorithm for MRI images. To reduce complexity, the most relevant shape, texture, and color features are selected. The improved Extreme Learning machine classifies the tumors with 98.56% accuracy, 99.14% precision, and 99.25% recall. The proposed classifier consistently demonstrates higher accuracy across all tumor classes compared to existing models. Specifically, the proposed model exhibits accuracy improvements ranging from 1.21% to 6.23% when compared to other models. This consistent enhancement in accuracy emphasizes the robust performance of the proposed classifier, suggesting its potential for more accurate and reliable brain tumor classification. The improved algorithm achieved accuracy, precision, and recall rates of 98.47%, 98.59%, and 98.74% on the Fig share dataset and 99.42%, 99.75%, and 99.28% on the Kaggle dataset, respectively, which surpasses competing algorithms, particularly in detecting glioma grades. The proposed algorithm shows an improvement in accuracy, of approximately 5.39%, in the Fig share dataset and of 6.22% in the Kaggle dataset when compared to existing models. Despite challenges, including artifacts and computational complexity, the study's commitment to refining the technique and addressing limitations positions the improved FCM model as a noteworthy advancement in the realm of precise and efficient brain tumor identification. [ABSTRACT FROM AUTHOR]

Ovarian cancer is one of the leading causes of death worldwide among the female population. Early diagnosis is crucial for patient treatment. In this work, our main objective is to accurately detect and classify ovarian cancer. To achieve this, two datasets are considered: CT scan images of patients with cancer and those without, and biomarker (clinical parameters) data from all patients. We propose an ensemble deep neural network model and an ensemble machine learning model for the automatic binary classification of ovarian CT scan images and biomarker data. The proposed model incorporates four convolutional neural network models: VGG16, ResNet 152, Inception V3, and DenseNet 101, with transformers applied for feature extraction. These extracted features are fed into our proposed ensemble multi-layer perceptron model for classification. Preprocessing and CNN tuning techniques such as hyperparameter optimization, data augmentation, and fine-tuning are utilized during model training. Our ensemble model outperforms single classifiers and machine learning algorithms, achieving a mean accuracy of 98.96%, a precision of 97.44%, and an F1-score of 98.7%. We compared these results with those obtained using features extracted by the UNet model, followed by classification with our ensemble model. The transformer demonstrated superior performance in feature extraction over the UNet, with a mean Dice score and mean Jaccard score of 0.98 and 0.97, respectively, and standard deviations of 0.04 and 0.06 for benign tumors and 0.99 and 0.98 with standard deviations of 0.01 for malignant tumors. For the biomarker data, the combination of five machine learning models—KNN, logistic regression, SVM, decision tree, and random forest—resulted in an improved accuracy of 92.8% compared to single classifiers. [ABSTRACT FROM AUTHOR]

Background: Eyelid tumors are common in the daily practice of skin tumors and are composed of benign and malignant lesions. Methods: This retrospective case series study collected histopathologic reports of eyelid tumors of patients treated between 2022 and 2023 in Razi and Farabi hospitals (Tehran, Iran). Patient data, including patient age, sex, location of the lesion, and recurrence, were collected. Descriptive and inferential statistics were used to characterize the subgroups. Results: The sample was composed of 154 eyelid tumor specimens, including 72 (47%) malignant cases, 80 (52%) benign cases, and 2 (1%) premalignant cases. Malignant tumors included 81.9% basal cell carcinomas (BCC), 15.3% basosquamous cell carcinomas (BSC), and 1.4% squamous cell carcinoma (SCC). The benign eyelid lesions were comprised of 20% intradermal melanocytic nevus, 11.3% epidermal cyst, 7.6% dermoid cyst, 10% seborrheic keratosis, 6.3% xanthelasma, 2.5% wart, 3.8% compound nevus, 5% fibroconnective tissue, 3.8% squamous papilloma, 3.8% neurofibroma, 2.5% comedone,2.5% apocrine hidrocystoma, 2.5% foreign body type granuloma, and 1.3% of others (arteriovenous hemangioma, cavernous hemangioma, cutaneous horn, etc.) The premalignant lesions were 2 cases of actinic keratosis. Benign lesions had an equal frequency of occurrence in the upper and lower lids. Malignant lesions were seen more in the lower lid. Premalignant lesions were seen in the lower lid. The mean age at diagnosis was 45.8 ± 23.06 years for patients with benign lesions and 63.5 ± 16.7 years for patients with malignant lesions. The mean age for patients with premalignant lesions was 81.5 ± 9.19 years (P < 0.001). Conclusions: In our study, benign lesions were seen predominantly in young persons and malignant lesions were mostly seen in elderly persons. There is an equal occurrence of malignant lesions in males and females, and recurrence after excision was infrequent. [ABSTRACT FROM AUTHOR]

PURPOSE OF THE STUDY Managing bone tumours is complex, relying on limited evidence, expert opinions, and retrospective reviews. Multidisciplinary approaches and early diagnosis are crucial for better outcomes, especially in young patients with growing skeletons. The aim of this systemic review and meta-analysis is to give a comprehensive review of common malignant tumors affecting long bones in children and adolescents. MATERIAL AND METHODS A PubMed/Medline search for “primary malignant long bone tumours in children” initially retrieved 1120 papers, which were subsequently narrowed down to 110 articles based on inclusion and exclusion criteria. These articles were reviewed, focusing on clinical presentation, diagnostic workup, treatment options, surgical planning, and variations in presentation, including rare tumours. The two most commonly reported tumours were osteosarcoma and Ewing sarcoma, leading to the division of studies into five groups. The inclusion criteria encompassed malignancies in patients aged 2-25 years, work-up, imaging, surgical treatment, rare tumour case reports, and surgical management principles, resulting in a heterogeneous group of articles. To enhance categorisation, it was clarified that studies with 10 or more cases were considered retrospective reviews. RESULTS Reviewing of results thus demonstrate that the two likely tumours in children under consideration were osteosarcoma and Ewing sarcoma. Their presentation fi ndings and clinical features were discussed in detail in the review. It is worth noting here that in case of differential diagnosis this should be the first on the list. DISCUSSION AND CONCLUSIONS Although focus of literature is more on the two most common tumours. However, rare tumours should be considered as they can mimic these common tumors. [ABSTRACT FROM AUTHOR]

Malignant carotid body tumors (MCBT) are rare and diagnosed after detection of nodal or distant metastases. This systematic review (SR) focuses on MCBT initially approached by surgery. Preferred Reporting Items for SR and Meta‐Analysis (MA) guided the articles search from 2000 to 2023 on PubMed, Scopus, and Web of Science. Among 3548 papers, 132 (337 patients) were considered for SR; of these, 20 (158 patients) for MA. Malignancy rate was 7.3%, succinate dehydrogenase (SDH) mutation 17%, age at diagnosis between 4th and 6th decades, with a higher prevalence of females. MCBTs were mostly Shamblin III, with nodal and distant metastasis in 79.7% and 44.7%, respectively. Malignancy should be suspected if CBT >4 cm, Shamblin III, painful or otherwise symptomatic, at the extremes of age, bilateral, with multifocal disease, and SDHx mutations. Levels II–III clearance should be performed to exclude nodal metastases and adjuvant treatments considered on a case‐by‐case basis. [ABSTRACT FROM AUTHOR]

The term dermatoglyphics was first used in 1926 by anatomist Cummins. Dermatoglyphic is a term that refers to “a skin carving.” The unique carve present on the skin surface of humans and other living beings is referred to as dermatoglyphics. This research was conducted to understand the variations in patterns and assess the usefulness of dermatoglyphics among individuals diagnosed with potentially malignant diseases and mouth cancer. Three hundred subjects were selected. The study consisted of three groups. Patients were divided into the following groups: Group I: oral submucous fibrosis (OSMF) (100), Group II: ORAL LEUKOPLAKIA (100), and Group III: Healthy Individuals (100). Our research study indicates a difference in dermatoglyphic patterns between patients and healthy individuals. Specifically, there is a lower percentage of loop patterns and an increase in arch patterns in OSMF and leukoplakia patients. These findings suggest that dermatoglyphics may have relevance in understanding or identifying certain health conditions.

Phyllodes tumours or cystosarcoma phyllodes are fibroepithelial tumours of the breast and represent 1% of breast tumours. A 20-year-old nullipara presented with an enlarging left breast mass over 6 months. Although widely excised, it was reported to be a 12 × 10 × 5.5-cm borderline phyllodes tumour with involvement of the superior and inferior margins. Seven months later, she presented with a new ipsilateral breast lump measuring 8.5 × 7.5 × 4.6 cm. She underwent a left mastectomy, a three-rib resection with titanic rods for the thoracic cage reconstruction, and a latissimus dorsi flap wound closure. Histopathology revealed a high-grade malignant phyllodes tumour with features of osteoid differentiation with the nearest deep margin measuring 3 mm. She developed metastasis to the ipsilateral axillary lymph nodes and contralateral lung 2 months postoperatively. She was given palliative radiotherapy 60 Gy in 30 fractions to the left axilla. She developed sudden lower-limb weakness due to spinal metastases. The symptoms resolved with radiotherapy to the thoracic spine (T4–T8). As the lesion continued to grow rapidly from the anterior chest wall encircling towards the back, it was deemed unresectable. She was given palliative chemotherapy (doxorubicin six cycles, followed by ifosfamide one cycle) but had disease progression. She passed away 3 months later. The mainstay of treatment for phyllodes tumour is excision with a minimal margin of 1 cm. Although margins were involved after the first surgery, she was followed up as the pathology was a borderline phyllodes. When the lump recurred and had transformed, despite extensive surgery, it returned shortly and progressed. A borderline phyllodes should be excised to obtain a minimal margin of 1 cm, even if it means performing a mastectomy, to minimise recurrence. A recurrence may undergo malignant transformation which is largely chemotherapy and radiotherapy resistant. This will result in a poor outcome and decreased survival.

Neuroleptic Malignant Syndrome (NMS) and Serotonin Syndrome (SS) are life-threatening conditions caused by adverse reactions to neuroleptics and antidepressant medications. The overlap of both syndromes is rare but has been described previously. Differentiating between both entities based on the clinical presentation can be difficult. We present a case of a young male patient with history of schizophrenia, admitted to the Medical Intensive Care Unit (MICU) for septic shock, who developed NMS and SS with oculomotor dysfunction following the abrupt cessation of clozapine while still being on an antidepressant.

PurposeGastrointestinal stromal tumor (GIST) is associated with increased risk of additional cancers. In this study, synchronous GIST, and peritoneal mesothelioma (PM) were characterized to evaluate the relationship between these two cancers.MethodsA retrospective chart review was conducted for patients diagnosed with both GIST and PM between July 2010 and June 2021. Patient demographics, past tumor history, intraoperative reports, cross-sectional imaging, peritoneal cancer index (PCI) scoring, somatic next-generation sequencing (NGS) analysis, and histology were reviewed.ResultsOf 137 patients who underwent primary GIST resection from July 2010 to June 2021, 8 (5.8%) were found to have synchronous PM, and 4 patients (50%) had additional cancers and/or benign tumors. Five (62.5%) were male, and the median age at GIST diagnosis was 57 years (range: 45-76). Seventy-five percent of GISTs originated from the stomach. Of the eight patients, one patient had synchronous malignant mesothelioma (MM), and the remaining had well-differentiated papillary mesothelioma (WDPM), which were primarily located in the region of the primary GIST (89%). The median PCI score was 2 in the WDPM patients. NGS of GIST revealed oncogenic KIT exon 11 (62.5%), PDGFRA D842V (25%), or SDH (12.5%) mutations, while NGS of the MM revealed BAP1 and PBRM1 alterations.ConclusionsOne in 17 GIST patients undergoing resection in this series have PM, which is significantly higher than expected if these two diseases were considered as independent events. Our results indicate that synchronous co-occurrence of GIST and PM is an underrecognized finding, suggesting a possible relationship that deserves further investigation.

Abstract Background The low specificity of Thyroid Imaging Reporting and Data System (TI-RADS) for preoperative benign-malignant diagnosis leads to a large number of unnecessary biopsies. This study developed and validated a predictive model based on MRI morphological features to improve the specificity. Methods A retrospective analysis was conducted on 825 thyroid nodules pathologically confirmed postoperatively. Univariate and multivariate logistic regression were used to obtain β coefficients, construct predictive models and nomogram incorporating MRI morphological features in the training cohort, and validated in the validation cohort. The discrimination, calibration, and decision curve analysis of the nomogram were performed. The diagnosis efficacy, area under the curve (AUC) and net reclassification index (NRI) were calculated and compared with TI-RADS. Results 572 thyroid nodules were included (training cohort: n = 397, validation cohort: n = 175). Age, low signal intensity on T2WI, restricted diffusion, reversed halo sign in delay phase, cystic degeneration and wash-out pattern were independent predictors of malignancy. The nomogram demonstrated good discrimination and calibration both in the training cohort (AUC = 0.972) and the validation cohort (AUC = 0.968). The accuracy, sensitivity, specificity, PPV, NPV and AUC of MRI-based prediction were 94.4%, 96.0%, 93.4%, 89.9%, 96.5% and 0.947, respectively. The MRI-based prediction model exhibited enhanced accuracy (NRI>0) in comparison to TI-RADSs. Conclusions The prediction model for diagnosis of benign and malignant thyroid nodules demonstrated a more notable diagnostic efficacy than TI-RADS. Compared with the TI-RADSs, predictive model had better specificity along with a high sensitivity and can reduce overdiagnosis and unnecessary biopsies.

Abstract Aim The current study aims to evaluate interrater reliability of ovarian–adnexal reporting and data system (O-RADS) magnetic resonance imaging (MRI) in interpretation of adnexal and ovarian lesions. Material and methods Retrospective analysis of 131 ovarian lesions was as done for 106 consecutive female patients with adnexal and/or ovarian lesions that underwent MR imaging of the pelvis. Images interpretation was accomplished by two-blinded independent raters for cystic and solid parts of ovarian lesions. The score was 5 types classified pursuant to O-RADS. Results A perfect interrater agreement regarding overall O-RADS [Kappa: 0.874, P: 0.001]. There was a perfect interrater agreement of the solid component (Kappa: 0.979, 95% confidence interval (CI) 0.938–1.0, P: 0.001), enhancement degree relative to myometrium (Kappa: 0.876, 95% CI 0.781–0.971, P: 0.001) and entirely solid lesions (Kappa: 1.0, 95% CI 1.0–1.0, P: 0.001). A perfect interrater agreement for ORADS 1 (Kappa: 0.937, P: 0.001), ORADS 2 (Kappa: 0.983, P: 0.001), ORADS 3 (Kappa: 0.834, P: 0.001), ORADS 4 (Kappa: 0.827, P: 0.001) and ORADS 5 (Kappa: 0.963, P: 0.001) was present. Conclusions The O-RADS MRI scoring system has better characterization of adnexal masses with high interrater agreement. Overcoming limitations of this study, O-RADS, may be suggested as a basic system in assessment of adnexal masses.

Objective: To summarize the clinical and molecular pathological characteristics of malignant pulmonary nodules and improve understanding of the disease. Methods: Patients who underwent surgical resection of small pulmonary nodules in Cardiothoracic Surgery of Jiangsu Province Hospital of Chinese Medicine from March 2018 to December 2021 and were pathologically confirmed to be malignant were taken as the research objects. Retrospective analysis of clinical data and molecular pathological features of surgical specimens was conducted. Results: A total of 371 patients were enrolled, including 39 cases of carcinoma in situ (CIS), 164 cases of microinvasive adenocarcinoma (MIA) and 168 cases were invasive adenocarcinoma (IA); 69.8% were females, 30.2% were males, with a majority of females. 87.6% of patients did not smoke; The upper lobe of the right lung had the most malignant nodules (37.5%), followed by the lower lobe of the left lung (18.6%). In comparison among different pathological types, the ages of CIS, MIA and IA were (54.1±10.9), (52.2±12.6) and (59.1±9.9) years (F=16.05, P＜0.01), the smoking rates were 10.3%, 3.7% and 21.4% (X2=24.31, P＜0.01), the median tumor diameter was 0.55, 0.60 and 0.80 cm (H=76.13, P＜0.01), respectively, with IA all being the highest, and the differences were statistically significant. The mutation frequency of exons 21 of epidermal growth factor receptor (EGFR), and tumor suppressor protein p53 (TP53) in IA were higher than those in CIS and MIA (P＜0.05), while the mutation frequency of human epidermal growth factor receptor 2 (HER2) exon 20ins, mitogen-activated protein kinase (MAP2K1) and serine/threonine protein kinase (BRAF) were lower than those in CIS and MIA, and the differences were statistically significant (P＜0.05). Conclusion: Patients with malignant pulmonary nodules may have the following characteristics: more common in women, non-smoking, located in the upper lobe of the right lung. There are differences in age, smoking rate, tumor diameter and driving gene mutation frequency among the three pathological types of malignant nodules.

Primary cardiac tumours are uncommon, and approximately 90% of them, in both children and adults, are benign. Primary tumours are less prevalent than secondary malignancies that spread to the heart. The subtle and non specific nature of the clinical signs could cause a delay in diagnosis, as well as surgical treatment. Although epidemiology and multimodality imaging approaches are helpful, the definitive diagnosis often necessitates histologic evaluation, and histological characterisation continues to be the gold standard in diagnostics. Herein the authors described four (two males and two females) cases of intriguing primary cardiac tumours. All the cases were diagnosed to have a cardiac mass/clot by Echocardiography (Echo), and the cases underwent tumour excision. Histopathological analysis revealed three benign cases diagnosed as atrial myomas, and one malignant case diagnosed as high-grade spindle cell sarcoma, specifically rhabdomyosarcoma. Immunohistochemistry (IHC) was required for the definitive diagnosis of the malignant patient. All the patients were followed-up for a period of one year. All benign cases were symptom-free, while the patient who had rhabdomyosarcoma expired. The aim of the present case series was to highlight the importance of histopathological examination, as well as the prognosis of cardiac tumours.

Background: Skin disorders are common as skin is constantly exposed to various chemicals, ultraviolet rays, climate, etc., making it prone to damage leading to various diseases. The spectrum of skin disorder lesions varies according to geographical distribution, gender, and age. A large number of skin lesions can be diagnosed clinically, but histopathological examination is necessary for accurate diagnosis and proper management. Literature shows few such studies in India, but no such study could be found for the Indian Armed Forces population. The aim of our study was to understand the pattern of skin diseases in Armed Forces population. Materials and Methods: All skin biopsies received between January 2022 and December 2022 were included in the study. Two hundred skin biopsies received were examined for various skin ailments. The skin biopsies were processed, sectioned, and stained with hematoxylin and eosin and wherever required special stains like modified Ziehl–Neelsen stain. The histopathological data were retrieved and reviewed. The data were collected and entered into SPSS 20.0 for statistical analysis. Results: Out of the two hundred cases studied, the most common group of disorders were of noninfectious nonneoplastic category (55%), followed by benign neoplasms (25%) and infectious category (18%), with least cases belonging to malignant category (2%). Commonly involved site in the body was upper limbs. The most common disorder found in males was psoriasis and in females was lobular capillary hemangioma. Conclusion: Understanding spectrum of histopathological spectrum of skin disorders will aid in identifying and managing different disorders, effectively providing high-quality care to the patient.

Malignant melanoma originates from melanoma cells, which derive from the neuroectoderm of the ectodermal mucosa. The chameleonic presentation of malignant melanoma, its often asymptomatic nature, the rarity of the lesion, the grim prognosis, and the imperative for highly specialized treatment are critical factors that merit careful consideration. Herein, we report a compilation of five cases of malignant melanomas occurring at unusual anatomical locations, which were initially misdiagnosed, which on careful analysis with the use of immuno-histochemical stains were correctly diagnosed as malignant melanoma.

Background/Aim: Endometrial abnormalities represent a diagnostic challenge due to overlapping imaging features with normal endometrium. Aim of this study was to assess accuracy of dynamic contrast-enhanced and diffusion-weighted magnetic resonance imaging (MRI) in evaluation of endometrial lesions in comparison with T2 and to assess local staging validity and degree of myometrial invasion in malignancy. Methods: Forty patients with abnormal vaginal bleeding or sonographic thickened endometrial were recruited. MRI examination of pelvis was per-formed using 1.5 T scanner with a pelvic array coil. Conventional T1-and T2, dynamic contrast-enhanced (DCE) sequences and diffusion-weighted image (DWI) were performed. Results: Mean age of patients was 53.2 years and 60 % of patients COM-plained of post-menopausal bleeding. Irregular margin, type III enhancement curve, a high signal in T2WI and DWI and low signal of apparent diffusion coefficient (ADC) were significantly associated with malignancy. The optimum ADC threshold value for distinguishing benign from malignant endometrial lesions was 0.905 × 10 -3 mm 2 /S, with 95.5 % sensitivity and 92.9 % specificity. DWI was most sensitive to malignant endometrial lesions, followed by DCE (89.6 %, 98.4 %) and T2 (86.7 %, 91.4 %). DWI and DCE staging correlated with FIGO staging (p = 0.0001 and p = 0.019, respectively). DWI had the best sensitivity for myometrial invasion (95.6 %), followed by DCE (91.9 %) and T2WI (90.1 %). All three sequences had 89.7 % specificity. Conclusion: DWI and DCE MRI were superior to conventional MRI at distinguishing malignant from benign endometrial lesions and can improve myometrial invasion depth evaluation and therapy planning when COM-bined with morphological T2WI. ADC cutoff at a high b value improved MRI diagnostic sensitivity and specificity.

Abstract Breast cancer stands as a paramount public health concern worldwide, underscoring an imperative necessity within the research sphere for precision-driven and efficacious methodologies facilitating accurate detection. The existing diagnostic approaches in breast cancer often suffer from limitations in accuracy and efficiency, leading to delayed detection and subsequent challenges in personalized treatment planning. The primary focus of this research is to overcome these shortcomings by harnessing the power of advanced deep learning techniques, thereby revolutionizing the precision and reliability of breast cancer classification. This research addresses the critical need for improved breast cancer diagnostics by introducing a novel Convolutional Neural Network (CNN) model integrated with an Early Stopping callback and ReduceLROnPlateau callback. By enhancing the precision and reliability of breast cancer classification, the study aims to overcome the limitations of existing diagnostic methods, ultimately leading to better patient outcomes and reduced mortality rates. The comprehensive methodology includes diverse datasets, meticulous image preprocessing, robust model training, and validation strategies, emphasizing the model's adaptability and reliability in varied clinical contexts. The findings showcase the CNN model's exceptional performance, achieving a 95.2% accuracy rate in distinguishing cancerous and non-cancerous breast tissue in the integrated dataset, thereby demonstrating its potential for enhancing clinical decision-making and fostering the development of AI-driven diagnostic solutions.

The escalating incidence of thyroid cancer over the past decade underscores the imperative for effective classification and early detection of thyroid nodules. An automated system for this purpose could significantly aid physicians, particularly in expediting diagnostic processes. However, attaining this objective has proven challenging, primarily attributed to the constrained dataset size for medical images and the laborious process of feature extraction. This research addresses these challenges by thoroughly exploring the importance of extracting meaningful features for tumor detection and introducing a quantum-based convolutional neural network. The proposed approach employs a quantum filter transformation for intricate feature extraction, coupled with a classical neural network for the classification of thyroid nodules in ultrasound images. The classification process involves two distinct categorizations: distinguishing between nodules that are benign or malignant, and identifying the specific suspicious class to which the nodule is attributed. The amalgamation of both classifiers yields a comprehensive characterization of thyroid nodules, showcasing notable accuracy. For tumor classification, the model achieves an accuracy of 97.63%, precision of 97.72%, and recall of 97.64% on a test dataset containing 127 images. Similarly, for suspicious level classification, the model attains an accuracy of 93.87%, precision of 94.58%, and recall of 93.88% on a test dataset containing 98 images. These results surpass the performance of existing models, marking a significant advancement in the field of thyroid nodule classification. The proposed model represents a promising and innovative methodology that could offer valuable support mechanisms in clinical settings, facilitating the rapid classification and diagnosis of thyroid cancer.

The term dermatoglyphics was first used in 1926 by anatomist Cummins. Dermatoglyphic is a term that refers to “a skin carving.” The unique carve present on the skin surface of humans and other living beings is referred to as dermatoglyphics. This research was conducted to understand the variations in patterns and assess the usefulness of dermatoglyphics among individuals diagnosed with potentially malignant diseases and mouth cancer. Three hundred subjects were selected. The study consisted of three groups. Patients were divided into the following groups: Group I: oral submucous fibrosis (OSMF) (100), Group II: ORAL LEUKOPLAKIA (100), and Group III: Healthy Individuals (100). Our research study indicates a difference in dermatoglyphic patterns between patients and healthy individuals. Specifically, there is a lower percentage of loop patterns and an increase in arch patterns in OSMF and leukoplakia patients. These findings suggest that dermatoglyphics may have relevance in understanding or identifying certain health conditions. [ABSTRACT FROM AUTHOR]

Background: Touch imprint cytology of image guided core needle biopsy implies gentle rolling of core needle biopsy obtained with the aid of imaging modality from various organs. The aim of the study was to measure the diagnostic accuracy of touch imprint cytology of image guided core needle biopsy in comparison to histopathological diagnosis. Materials and Methods: A prospective descriptive cross-sectional study was conducted among 47 touch imprint cytology of image guided core needle biopsy in the department of pathology of a tertiary care centre between 1st October 2021 to 30th September 2022 after receiving ethical approval from the institutional review committee. The Papanicolaou and Giemsa-stained slides of touch imprint smear and haematoxylin - eosin-stained slides of core needle biopsy was analysed for adequacy and categorization as non-neoplastic, benign, atypical and malignant. Convenience sampling was done. Results: The most frequent site of image guided core needle biopsy was lung (40.4%). The adequacy rate of touch imprint cytology of image guided core needle biopsy was 85.1%. Among 40 cases of adequate touch imprint smear, 28 cases (70%) were categorized as malignant. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of touch imprint cytology for categorizing a malignant lesion was 91.18%, 95.45%, 96.88%, 87.5% and 92.86% respectively. Conclusion: The touch imprint cytology of image guided core needle biopsy is a useful modality for the rapid preliminary diagnosis of lesions of various organs with decreased turnaround time for diagnostic workup and ancillary studies.

The subject matter of this study is breast tumor prediction and feature importance score finding using machine learning algorithms. The goal of this study was to develop an accurate predictive model for identifying breast tumors and determining the importance of various features in the prediction process. The tasks undertaken included collecting and preprocessing the Wisconsin Breast Cancer original dataset (WBCD). Dividing the dataset into training and testing sets, training using machine learning algorithms such as Random Forest, Decision Tree (DT), Logistic Regression, Multi-Layer Perceptron, Gradient Boosting Classifier, Gradient Boosting Classifier (GBC), and K-Nearest Neighbors, evaluating the models using performance metrics, and calculating feature importance scores. The methods used involve data collection, preprocessing, model training, and evaluation. The outcomes showed that the Random Forest model is the most reliable predictor with 98.56 % accuracy. A total of 699 instances were found, and 461 instances were reached using data optimization methods. In addition, we ranked the top features from the dataset by feature importance scores to determine how they affect the classification models. Furthermore, it was subjected to a 10-fold cross-validation process for performance analysis and comparison. The conclusions drawn from this study highlight the effectiveness of machine learning algorithms in breast tumor prediction, achieving high accuracy and robust performance metrics. In addition, the analysis of feature importance scores provides valuable insights into the key indicators of breast cancer development. These findings contribute to the field of breast cancer diagnosis and prediction by enhancing early detection and personalized treatment strategies and improving patient outcomes.

Background: The low specificity of Thyroid Imaging Reporting and Data System (TI-RADS) for preoperative benign-malignant diagnosis leads to a large number of unnecessary biopsies. This study developed and validated a predictive model based on MRI morphological features to improve the specificity. Methods: A retrospective analysis was conducted on 825 thyroid nodules pathologically confirmed postoperatively. Univariate and multivariate logistic regression were used to obtain β coefficients, construct predictive models and nomogram incorporating MRI morphological features in the training cohort, and validated in the validation cohort. The discrimination, calibration, and decision curve analysis of the nomogram were performed. The diagnosis efficacy, area under the curve (AUC) and net reclassification index (NRI) were calculated and compared with TI-RADS. Results: 572 thyroid nodules were included (training cohort: n = 397, validation cohort: n = 175). Age, low signal intensity on T2WI, restricted diffusion, reversed halo sign in delay phase, cystic degeneration and wash-out pattern were independent predictors of malignancy. The nomogram demonstrated good discrimination and calibration both in the training cohort (AUC = 0.972) and the validation cohort (AUC = 0.968). The accuracy, sensitivity, specificity, PPV, NPV and AUC of MRI-based prediction were 94.4%, 96.0%, 93.4%, 89.9%, 96.5% and 0.947, respectively. The MRI-based prediction model exhibited enhanced accuracy (NRI>0) in comparison to TI-RADSs. Conclusions: The prediction model for diagnosis of benign and malignant thyroid nodules demonstrated a more notable diagnostic efficacy than TI-RADS. Compared with the TI-RADSs, predictive model had better specificity along with a high sensitivity and can reduce overdiagnosis and unnecessary biopsies. Key points: MRI morphological features were predictors of malignant thyroid nodules. Prediction model achieved a high AUC, sensitivity, and specificity in predicting malignant thyroid nodules. Prediction mode outperformed TI-RADSs in diagnosing malignant thyroid nodules. [ABSTRACT FROM AUTHOR]

The higher rate of skin diseases caused by infections, allergies, lifestyle changes, increased use of chemicals, unhealthy food habits, and hereditary reactions, among other factors demand effective diagnostic mechanisms. These mechanisms should facilitate and expedite the precise diagnosis of malignant melanoma. In addition, the existing technology-assisted tests require elaborate procedures to accurately diagnose the skin disease to be treated. The deep learning-enhanced inspection involves neural networks that diagnose skin diseases by analyzing data for skin lesions such as rashes, boils, and cancer growth. This paper proposes an automated high-precision diagnostic model with the web application to identify Malignant Melanoma Cancer. The diagnostic model framework employs a convolutional neural network (CNN) with ResNet50 for data collection, preprocessing, segmentation, enhancement, feature extraction, classification, and malignant melanoma identification to improve accuracy. The proposed model eliminates unwanted noise, enhances spectral image information, and improves classification accuracy through preprocessing and mixed hybrid pooling phases. Performance analysis shows that the proposed Malignant Melanoma Cancer detection model achieves the highest accuracy of 94% and an F1-score of 93.9%. Results from a training and testing dataset of images from the International Skin Image Collaboration (ISIC) demonstrate a significant improvement over traditional methods. Further, the web application developed for this model accelerates the precise diagnosis of Malignant Melanoma Cancer with accurate information compared to other methods in practice. The potential of applying the proposed skin cancer classification model automates the malignant and benign image classification process, speeds up diagnosis and treatment, and reduces the risk of misdiagnosis. [ABSTRACT FROM AUTHOR]

Malignant melanoma originates from melanoma cells, which derive from the neuroectoderm of the ectodermal mucosa. The chameleonic presentation of malignant melanoma, its often asymptomatic nature, the rarity of the lesion, the grim prognosis, and the imperative for highly specialized treatment are critical factors that merit careful consideration. Herein, we report a compilation of five cases of malignant melanomas occurring at unusual anatomical locations, which were initially misdiagnosed, which on careful analysis with the use of immuno-histochemical stains were correctly diagnosed as malignant melanoma. [ABSTRACT FROM AUTHOR]

Background & Methods: The aim of the study is to find agreement of clinico-radiological diagnosis with pathological diagnosis and radiological diagnosis with pathological diagnosis, in distinguishing benign and malignant cystic abdominal masses in adults. A sample size of 24 subjects with 80% power to detect kappa value of 0.6 (60% agreement between clinicoradiological diagnosis with pathological diagnosis is taken on the basis of expert opinion) between clinico-radiological diagnosis with pathological diagnosis and also radiological diagnosis with pathological diagnosis. Results: Pain in the abdomen was the predominant complaint in 67.5% cases with cystic abdominal masses; the other common complaints being weight loss (20.8%), abdominal distension and anorexia (16.2 % each). In 18.9 % i.e.7/37 cases the cystic abdominal mass was an incidental finding on imaging in our study. Miscellaneous complaints seen in 6/37cases were severe headache, loss of consciousness and palpitations (1 case); breathlessness, fatigue and palpitations (1 case); giddiness and headache in 1 case; secondary infertility in 1 case and amenorrhoea in 2 cases. CA-125 levels were high in 100% malignant ovarian lesions but also found elevated in 44.4 % benign ovarian cystic lesions. CA 19.9 levels were high in 75 % malignant ovarian lesions but also found elevated in 28.5% benign ovarian cystic lesions. Conclusion: In a study comprising of 37 adults cystic abdominal masses were more commonly encountered in females i.e. 75.67 % cases and 70.0% cases were in the reproductive age group (15-44 years). Radiological diagnosis was the same as clinicoradiological diagnosis in 25/37 cases who were operated in our study. The agreement of clinico-radiological diagnosis with pathological diagnosis and radiological diagnosis with pathological diagnosis, in distinguishing benign and malignant cystic abdominal masses in adults was the same and found to be good with Kappa value of 0.690 (95% CI; 0.37-1.00) with P<0.01. [ABSTRACT FROM AUTHOR]

The United Kingdom National Health Service Breast Screening Programme proposes five B categories for reporting breast screening needle core biopsies. The system is also recommended for symptomatic patients and diagnostic vacuum-assisted biopsies. Usually over 90% of biopsies are categorised as normal (B1), benign (B2) or malignant (B5). B3 is a heterogeneous group including atypical intraductal proliferations, classical lobular neoplasia, papillary lesions, radial scars, cellular fibroepithelial lesions and some rarer lesions. It is important to comment on the presence of epithelial atypia in B3 lesions as the risk of malignancy in the excision specimen is higher if atypia is present. Recent United Kingdom guidelines propose more thorough sampling with vacuum-assisted biopsy as an alternative to diagnostic surgical excision for some B3 lesions. B4 is used for lesions suspicious of malignancy. Further investigation is usually needed for B4 lesions. B5 is subdivided into B5a for DCIS and pleomorphic LCIS, B5b for invasive carcinoma, lymphoma, sarcoma, malignant phyllodes tumour and metastases from extramammary malignancies, and B5c for carcinomas that cannot be classified as in situ or invasive. The biopsy result must be discussed at the multidisciplinary meeting in combination with the clinical and radiological findings (the triple approach) to guide patient management. [ABSTRACT FROM AUTHOR]

Objective: Our review aims to summarize the current literature on skull base infections (SBIs) and retrospectively analyze any such cases encountered at our institution. Design: A literature search was conducted using online databases PubMed, MEDLINE, and ResearchGate with the terms "skull base osteomyelitis," "temporal bone osteomyelitis," "skull base infections," "necrotizing otitis media," and "SBO". References from the resulting manuscripts were reviewed for relevant articles. A search of our electronic health records using the same key terms was also performed to identify patients with a tissue biopsy-confirmed diagnosis of skull base infections. Patients with an indeterminate diagnosis or inaccessible/poor imaging were excluded. Setting: A level one trauma and major tertiary academic medical center. Participants: All patients treated at the University of California Davis Health System with a confirmed diagnosis of skull base infections from January 2005 to November 2020. Main Outcome Measures: Imaging results, symptoms, treatment, morbidity, and mortality. Results: Our literature search yielded 59 articles ranging from 1982 to 2021. A retrospective search of our electronic health records identified two cases of skull base infections. Conclusion: Skull base infections have no pathognomonic findings. A multimodal approach with computed tomography (CT), magnetic resonance imaging (MRI), and nuclear medicine is necessary to characterize the disease process in addition to a biopsy for definitive diagnosis. Other diagnoses can mimic SBI on imaging, such as nasopharyngeal carcinoma and inflammatory pseudotumor. Culture-guided antimicrobial treatment and surgery are mainstay therapies. Other adjuvant strategies currently lack the robust evidence necessary to characterize their risks and benefits. [ABSTRACT FROM AUTHOR]

The indication for surgical resection of intraductal papillary mucinous neoplasms (IPMNs) is defined by imaging features, such as mural nodules. Although carbohydrate antigen (CA) 19-9 was selected as a parameter for worrisome features, no serum biomarkers were considered when deciding on surgical indications in the latest international consensus guideline. In this study, we assessed whether clinical factors, imaging findings, and serum biomarkers are useful in predicting malignant IPMNs. A total of 234 resected IPMN cases in Chiba University Hospital from July 2005 to December 2021 were retrospectively analyzed. Among the 234 patients with resected IPMNs diagnosed by preoperative imaging, 117 were diagnosed with malignant pathologies (high-grade dysplasia and invasive IPMNs) according to the histological classification. In the multivariate analysis, cyst diameter ≥30 mm; p = 0.035), enhancing mural nodules on multidetector computed tomography (≥5 mm; p = 0.018), and high serum elastase-1 (≥230 ng/dl; p = 0.0007) were identified as independent malignant predictors, while CA19-9 was not. Furthermore, based on the receiver operator characteristic curve analyses, elastase-1 was superior to CA19-9 for predicting malignant IPMNs. Additionally, high serum elastase-1 levels (≥230 ng/dl; p = 0.0093) were identified as independent predictors of malignant IPMNs in patients without mural nodules on multidetector computed tomography (MDCT) in multivariate analysis. The serum elastase-1 level was found to be a potentially useful biomarker for predicting malignant IPMNs. [ABSTRACT FROM AUTHOR]

Background: Solitary fibrous tumors (SFT) are the rare mesenchymal tumors originally described in the pleura. SFT of breast is even rarer and to the best of our knowledge about 35 cases are reported to date, including only six malignant SFT cases. Case presentation: We report a case of a 52-year-old lady with a large left breast mass involving all the quadrants. The tumor was diagnosed as malignant SFT in a core needle biopsy which was later confirmed on the resection specimen. Conclusion: Herein, we describe the approach and importance of optimal utilization of immunohistochemistry for diagnosing such rare tumors of the breast, particularly, when clinical presentation, radiology and fine needle aspiration cytology are incongruous. [ABSTRACT FROM AUTHOR]

The presented work suggests a robust approach for skin lesion segmentation in the state of the art of optimized active contours and level sets according to the estimation of both restriction and energy forces. The proposed system would separate accurately the interest region by defining the appropriate contour or curvature. Accordingly, the following optimizers have been utilized and tested; particle swarm optimization (PSO), genetic algorithm (GA), grey wolf optimization (GWO), whale optimization algorithm (WOA), bee colony optimization (BCO), and interior-point optimization (IPO) for optimizing the suggested trigonometric regularization functions. Experimental findings have recommended the use of the proposed Sine-IPO algorithm which targeting the best-segmentation of different types of skin lesions in dermoscopy images. In addition, different performance metrics have been utilized; true positive (TP), true negative (TN), false positive (FP), and false-negative (FN) in order to guarantee the appropriate segmentation accuracy. The results depicted the superiority of using IPO based Sine function with accuracy (about 96.23%), sensitivity (about 66.48%), specificity (about 99.45%), dice coefficient (DC) (about 67.43%), and Jaccard coefficient (JAC) (about 53.63%). [ABSTRACT FROM AUTHOR]

Biological importance in many fields, including anti-cancer activity, and advances in inorganic chemistry with biological applications have heightened the scope of interest in Schiff bases and their complexes due to the combination of an aldehyde with an amine are useful chelate to produce coordination spheres with mixed N/O donors. The discovery of Schiff base and its complexes' antitumor activity against various tumor cell lines captures the interest of researchers seeking to develop new anti-cancer drugs with no side effects. O-vanillin is a very useful aldehyde for preparing Schiff base ligands. It is found in the extract of vanilla. It is readily soluble in water. This aldehyde can combine with several different types of amine to form Schiff base which can form complexes with high stability with the majority of metals, which is caused by the azomethine group's nitrogen (N) in addition to two oxygen (O) atoms from the hydroxyl and methoxy groups. Apoptosis is a natural death process of damaged, senescent, or abnormal cells that stops cancer development. It is reduced or blocked in cancer cells and can be triggered again by anti-cancer drugs. Therefore, in anti-cancer research, inducing cancer cell apoptosis is a favourable goal to be achieved by a new molecule blocked in cancer cells and can be triggered again by anti-cancer drugs. This review focuses on recent advances in N,S,O donor Schiff base molecules for Anticancer applications. [ABSTRACT FROM AUTHOR]

Adrenal tumors in dogs are common in small animal practice and may be divided according to their origin into cortical and medullary, as the most common being adrenocortical carcinomas and adenomas, also pheochromocytomas. Breeds as Poodle, Boxer, Dachshund and Beagle over 9 years old show more risks of developing adrenal neoplasms. The aim of this study was to evaluate the possible epidemiological risks for the development of adrenal tumors in ten dogs treated at the Hospital de Clínicas Veterinárias of Universidade Federal de Pelotas (HCV/UFPel) between 2018 and 2023. Factors such as age, gender, breed, reproductive status, weight, living with other animals and comorbidities were listed for descriptive assessment. All dogs had clinical signs and ultrasound features compatible with adrenal tumors. In addition, they were all female, with mean weight of 16.4 kg, age of 11 years old and most of them had defined breed and were neutered. Thus, the profile of the dog affected by adrenal tumor was determined as female, breed defined, neutered, small to medium size and aged between 9 and 16 years. [ABSTRACT FROM AUTHOR]

Skull lesions in pediatric population are common findings on imaging and sometimes with heterogeneous manifestations, constituting a diagnostic challenge. Some lesions can be misinterpreted for their aggressiveness, as with larger lesions eroding cortical bone, containing soft tissue components, leading to excessive and, in some cases, invasive inappropriate etiological investigation. In this review, we present multiple several conditions that may present as skull lesions or pseudolesions, organized by groups (anatomic variants, congenital and development disorders, traumatic injuries, vascular issues, infectious conditions, and tumoral processes). Anatomic variants are common imaging findings that must be recognized by the neuroradiologist. Congenital malformations are rare conditions, such as aplasia cutis congenita and sinus pericranii, usually seen at earlier ages, the majority of which are benign findings. In case of trauma, cephalohematoma, growing skull fractures, and posttraumatic lytic lesions should be considered. Osteomyelitis tends to be locally aggressive and may mimic malignancy, in which cases, the clinical history can be the key to diagnosis. Vascular (sickle cell disease) and tumoral (aneurismal bone cyst, eosinophilic granuloma, metastases) lesions are relatively rare lesions but should be considered in the differential diagnosis, in the presence of certain imaging findings. The main difficulty is the differentiation between the benign and malignant nature; therefore, the main objective of this pictorial essay is to review the main skull lytic lesions found in pediatric age, describing the main findings in different imaging modalities (CT and MRI), allowing the neuroradiologist greater confidence in establishing the differential diagnosis, through a systematic and simple characterization of the lesions. [ABSTRACT FROM AUTHOR]

Malignant peripheral nerve sheath tumors (MPNSTs) are neoplasms originating from or differentiating into nerve sheaths of peripheral nerves. Vaginal origin is rare, with only six vaginal primary cases reported to date. A 55‐year‐old woman presented to our hospital with a 7 cm vulvar mass. Tumor biopsy results were suspicious of sarcoma, and pelvic magnetic resonance imaging and hysterofiberscopy showed that the tumor originated from the lower vagina. The mass was transvaginally excised, and histological examination confirmed the diagnosis of a vaginal MPNST with negative surgical margins. The patient underwent radiotherapy because the risk of recurrence was high, owing to the large tumor size and high mitotic index. The patient remained recurrence‐free for 1 year after the primary treatment. This is the first case of a high‐risk vaginal MPNST that avoided early disease recurrence with additional radiotherapy after complete tumor resection. [ABSTRACT FROM AUTHOR]

Background: Malignant bowel obstruction (MBO) is a serious clinical entity that requires surgical intervention in almost 50% of cases. However, overall survival remains low even for operable cases. The aim of the present study was to investigate the correlation between patients' characteristics, perioperative details, histopathological results and postoperative outcomes of patients who were operated on due to MBO. Methods: A retrospective search of patients who were operated on due to MBO in a university and a rural hospital was conducted. Patients' characteristics, perioperative details, histopathological results and postoperative outcomes were reported. Univariable and multivariable analysis was performed. Results: Seventy patients were included with a mean age of 76.1 ± 10.6 years. The 30-day mortality rate was 18.6%, the Intensive Care Unit (ICU) admission rate was 17.1% and the mean length of stay (LOS) was 12.4 ± 5.7 days. Postoperative 30-day mortality was associated with increased age, known malignant recurrence, microscopically visible metastatic foci and defunctioning stoma creation. Colorectal malignancy type, sigmoid obstruction and primary anastomosis were correlated with decreased 30-day mortality. In addition, operation at the university hospital led to increased LOS, while stoma creation led to decreased LOS. Finally, ICU admission rates were increased for operations at university hospitals, at least one comorbidity, known malignant recurrence and longer preoperative waiting interval, whereas they were decreased for colorectal primary malignancy type. Conclusions: Surgery due to MBO leads to increased morbidity and mortality. Therefore, prospective studies are needed to highlight inter-patient differences regarding the best individualized therapeutic strategy. [ABSTRACT FROM AUTHOR]

This article discusses the use of dynamic contrast-enhanced MRI (DCE MRI) and diffusion-weighted imaging (DWI) in the evaluation of endometrial lesions. The study found that DWI and DCE MRI were more accurate than conventional MRI in distinguishing between benign and malignant lesions and in assessing the depth of myometrial invasion. Combining these techniques with morphological T2 imaging can improve the diagnosis and planning of therapy for endometrial lesions. The study also found that certain MRI characteristics, such as enhancement curves and signal intensity, were associated with the nature of the endometrial lesion. Overall, MRI can be a useful tool in distinguishing between benign and malignant endometrial lesions and in staging endometrial cancer. [Extracted from the article]

Background: With the advances in the diagnostic parameters, CT with the use of various software allowing manipulation and increase in the spatial resolutions lead to a considerable reduction in time needed for scanning. Aims: This study was conducted to study the attenuation and enhancement pattern of renal masses during different phases (Cortico-medullary, nephrographic, and unenhanced phases). To evaluate renal parenchymal enhancement characteristics during these above-mentioned phases. Also, comparison of findings from CT and histopathological diagnosis was being made. Methods: For enhancement pattern and attenuation values of renal masses during various phases namely nephrographic, corticomedullary, and unenhanced phase multidetector CT was used for better assessment. Subjects with the complaint of flank pain/fullness, and/or hematuria, and also subjects having renal masses on ultrasound were referred for CT abdomen. 20 subjects with confirmed presence of renal masses on CT were finally included. Results: Mean size of the masses detected in the kidney was found to be 6.4 ± 4 cm with the range of 2cm to 20 cms. 8 lesions were benign whereas 12 lesions detected were found to be malignant. For margins of the tumors, well-defined margins were seen in 7 of the benign lesion, and only 1 benign lesions had ill-defined margins. In malignant lesions, only 2 lesions had well-defined margins and ill-defined margins were seen in the rest 10 lesions. This difference in the margins of the benign and malignant tumors was statistically significant. For enhancement pattern, it was homogenous in 5 whereas, heterogeneous in remaining 3 in benign lesion. Among 11 malignant lesions, only 1 lesion was homogenous and 11 lesions were heterogeneous. In the corticomedullary phase and nephrographic phase, HU values for malignant renal masses respectively were 94,00 and 72.41. Enhancement was lower in the nephrographic phase compared to the corticomedullary phase. Conclusion: For differentiating benign tumors from malignant tumors, their characterization, attenuation values, and the enhancement patterns serve as an important tool in this regard. Regarding enhancement patterns of benign tumors, no statistically significant difference was seen nephrographic and corticomedullary phases. For malignant renal masses, enhancement was greater in the corticomedullary phase compared to the nephrographic phase. The present study concludes that renal masses should be evaluated in all phases including unenhanced, corticomedullary, and nephrographic phases for appropriate characterization and detection of the renal masses. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to investigate the combined use of ultrasonography and clinical features for the differentiation of malignant peripheral nerve sheath tumors (MPNST) from benign peripheral nerve sheath tumors (BPNST) and to compare the efficacy of ultrasonography with that of magnetic resonance imaging (MRI). Methods: This retrospective study included 28 MPNSTs and a control group of 57 BPNSTs. All patients underwent an ultrasound scan using the Logiq E9 (GE Health Care, Milwaukee, WI) or EPIQ7 equipment (Philips Medical System, Bothell, WA). A 3.0‐T MRI machine (Ingenia; Philips Healthcare, Best, the Netherlands) was used for scanning, and conventional MRI was performed on different regions based on the patient's clinical situation. The following variables were evaluated: palpable mass, pain, nerve symptoms, maximum diameter, location, shape, boundary, encapsulation, echogenicity, echo homogeneity, presence of a cystic component, calcification, target sign, posterior echo, and intertumoral vascularity of the tumors. The diagnostic efficacy of ultrasonography and clinical factors was compared with that of MRI. Independent factors for predicting MPNST versus BPNST were also assessed. Results: The parameters of location, shape, boundary, encapsulation, and vascularity were significantly different between MPNSTs and BPNSTs. Multiple logistic regression analysis showed that shape, boundary, and vascularity were independent predictors of MPNSTs. The sensitivity, specificity, and Youden index of the three clinical and ultrasound factors (shape, boundary, and vascularity) were 0.89, 0.81, and 0.69, respectively, whereas those of MRI were 0.71, 0.89, and 0.61, respectively. No significant differences in the area under the curve (AUC) of the three combined clinical and ultrasound factors and those of MRI were found (P >.05). Conclusions: MRI was useful in the differential diagnosis between MPNSTs and BPNSTs. However, the combination of clinical and ultrasound diagnoses can achieve the same effect as MRI, including shape, boundary, and vasculature. [ABSTRACT FROM AUTHOR]