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Purpose: Spinal schwannomas are benign tumours that can compress the spinal cord or nerve roots, causing neurological symptoms. Despite successful surgical resection, some patients experience suboptimal functional recovery. Several risk factors for poor prognosis have been identified, but limited research has explored the influence of tumour distribution and characteristics. In this study, we aimed to identify prognostic variables associated with residual neurological deficit in patients undergoing surgical resection for sporadic spinal schwannomas. Methods: Clinical and radiological data of consecutive patients who underwent surgery for spinal schwannomas at Saitama Medical Centre between January 2010 and March 2024 were retrospectively reviewed. Patients with neurofibromatosis type 2 or foraminal and paravertebral schwannomas were excluded. Data collected included patient demographics, radiological features, and surgical complications. Residual neurological deficit was defined as a Modified McCormick scale grade of II–V, persistent neurogenic pain, or bladder/bowel dysfunction. Results: Gross total resection was achieved in 55 cases (76.4%). Postoperative complications occurred in 6 cases (8.3%), including cerebrospinal fluid fistula and vascular injury. At a median follow-up of 26.4 months, 20 patients (27.8%) had residual neurological deficits. Univariable and multivariable logistic regression identified thoracic spine involvement (odds ratio [OR], 5.03; 95% confidence interval [CI], 1.47–18.6; p = 0.01) and dumbbell-shaped tumours (OR, 0.15; 95% CI, 0.02–1.28; p = 0.04) as significantly associated with residual neurological deficits. Moreover, thoracic spinal schwannomas were associated with a significantly higher incidence of persistent postoperative neurogenic pain than that associated with cervical or lumbosacral tumours (p = 0.001). Conclusions: Thoracic spine involvement and tumours that are not dumbbell-shaped were identified as significant risk factors for residual neurological deficits in patients undergoing surgical treatment for spinal schwannomas. Awareness of tumour distribution and characteristics may assist in refining preoperative assessments, guiding strategic decisions, and potentially improving surgical management for better patient care. [ABSTRACT FROM AUTHOR]

Introduction: Adnexal masses are a common health issue in gynecology; the challenge lies in the differential diagnosis of these masses. The International Ovarian Tumor Analysis Simple Rules (IOTA-SR) offers the first scoring system to aid in diagnosis. It is based on a set of five ultrasound imaging features indicative of a malignant ovarian tumor and five features indicative of a benign tumor. This review aims to assess the diagnostic performance of IOTA-SR for classifying ovarian tumors as benign or malignant. Methods: A systematic review was conducted on MEDLINE, Embase, Google Scholar, Scopus, and Web of Science. The terminologies "IOTA-SR", "adnexal, mass", and "ovarian tumors scoring" were employed. Twenty-seven research articles conducted from 2008 to 2022 were included in the meta-analysis; the publication outcome indicates that performance quality tests were extracted directly or indirectly, including true positive (TP), false positive (FP), true negative (TN), and false negative (FN). The Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) was used to evaluate the study quality and estimate the risk of bias. After estimating the pooled effect of the sensitivity, specificity, and diagnostic odds ratio (DOR), the summary receiver operating characteristic (SROC) curve was estimated using the bivariate random effects model. Utilizing Cochran's Q statistics and Higgins's inconsistency test through the I2 index for pooled analysis, the heterogeneity of studies was quantitatively evaluated. The funnel plot and Egger's test were utilized to visually and quantitatively evaluate potential publication bias. Results: Among 27 studies, including 7,841 adnexal masses, the results of this meta-analysis showed excellent diagnostic performance with a pooled sensitivity of 92% [95% confidence interval (CI), 0.89–0.94] and a pooled specificity of 92% (95% CI, 0.89–0.94). The IOTA-SR was applicable in 85.7% of adnexal masses. Conclusion: The IOTA-SR is highly effective in the presurgical differentiation of malignant versus benign adnexal masses when applied by an expert ultrasonography operator. [ABSTRACT FROM AUTHOR]

Background: Desmoplastic fibroma is a rare, benign bone tumor that exhibits locally aggressive behavior and typically occurs in the mandible and long bones. Its presence in small bones, particularly in the hallux, is exceedingly rare. Desmoplastic fibroma's unusual presentation in this region often mimics other lesions, such as glomus tumors, and poses significant diagnostic challenges. Case presentation: We present the case of a 38-year-old female with a history of trauma to the affected toe and thyroid cancer, who experienced persistent subungual pain, localized tenderness, and cold hypersensitivity in the hallux. Initial imaging (X-ray and MRI) revealed findings consistent with a glomus tumor, including bone erosion in the distal phalanx. Surgical excision with wide margins was performed due to the patient's cancer history, and histopathology unexpectedly identified the lesion as desmoplastic fibroma. The patient underwent regular follow-up with X-rays over two years, showing complete healing and no recurrence. Conclusions: The case emphasizes the necessity of sending excised specimens for pathological analysis to confirm the diagnosis. Documenting such atypical presentations contributes valuable information to the limited literature on desmoplastic fibroma and aids clinicians in recognizing this rare tumor in unusual locations, potentially improving diagnostic accuracy and management. [ABSTRACT FROM AUTHOR]

Objective: To determine whether small, incidentally detected testicular lesions can be safely followed up, by assessing growth rate and volume threshold for benign vs. malignant lesions. Methods: This retrospective observational study includes a consecutive series of 130 testicular incidentalomas < 1 cm and with negative tumour markers identified from October 2001 to November 2022, which were initially followed up with ultrasound. A total of 39 cases proceeded to surgery during the study period, either due to lesion growth (n = 28) or patient preference/recommendation by the referring urologist (n = 11). For the lesions that were growing, specific growth rate (SGR) and doubling time (DT) were calculated assuming an exponential growth pattern. In addition, the velocity of increase of the average diameter (∆Dav) and of the maximum diameter (∆Dmax) were calculated. Results: Of the 130 nodules that were initially followed up, six disappeared, eight were reduced in size, eighty-eight were stable, and twenty-eight increased in size. For operated nodules all 18 malignant tumours, 8/9 benign tumours, and 2/12 surgically proved non-neoplastic lesions were growing. The best cut-off values of the growth indicators to differentiate between malignant and non-malignant histology were 3.47 × 10−3%volume/day, ≤ 179 days, > 10 × 10−3 mm/day, and > 5 × 10−3 mm/day for SGR, DT, ∆Dmax, ∆Dav, respectively. Conclusions: Malignant and non-malignant small incidentalomas can be effectively differentiated based on growing parameters, even though overlap exists. An increase of the maximum diameter of about 1 mm and 2 mm in three months and in six months, respectively, suggests malignancy. Clinical relevance statement: Growing parameters allow an educated assessment of benign and malignant small testicular incidentalomas. Non-aggressive management is justified and safe when follow-up includes self-examination and tumour marker assessment to reduce the risk of interval tumour growth. Key Points: Small, non-palpable and asymptomatic testicular nodules < 1 cm are unexpectedly discovered during scrotal ultrasound. Growth indicators estimate the potential malignancy, even though overlap with non-malignant lesions exists. Non-growing incidentalomas can be safely followed up. [ABSTRACT FROM AUTHOR]

Background: Setting minimum annual volume thresholds for pituitary surgery in England is seen as one way of improving outcomes for patients and service efficiency. However, there are few recent studies from the UK on whether a volume-outcome effect exists, particularly in the era of endoscopic surgery. Such data are needed to allow evidence-based decision making. The aim of this study was to use administrative data to investigate volume-outcome effects for endoscopic transsphenoidal pituitary surgery in England. Methods: Data from the Hospital Episodes Statistics database for adult endoscopic transsphenoidal pituitary surgery for benign neoplasm conducted in England from April 2013 to March 2019 (inclusive) were extracted. Annual surgeon and trust volume was defined as the number of procedures conducted in the 12 months prior to the index procedure. Volume was categorised as < 10, 10–19, 20–29, 30–39 and ≥40 procedures for surgeon volume and < 20, 20–39, 40–59, 60–79 and ≥80 procedures for trust volume. The primary outcome was repeat ETSPS during the index procedure or during a hospital admission within one-year of discharge from the index procedure. Results: Data were available for 4590 endoscopic transsphenoidal pituitary procedures. After adjustment for covariates, higher surgeon volume was significantly associated with reduced risk of repeat surgery within one year (odds ratio (OR) 0.991 (95% confidence interval (CI) 0.982–1.000)), post-procedural haemorrhage (OR 0.977 (95% CI 0.967–0.987)) and length of stay greater than the median (0.716 (0.597–0.859)). A higher trust volume was associated with reduced risk of post-procedural haemorrhage (OR 0.992 (95% CI 0.985–0.999)), but with none of the other patient outcomes studied. Conclusions: A surgeon volume-outcome relationship exists for endoscopic transsphenoidal pituitary surgery in England. [ABSTRACT FROM AUTHOR]

Phyllodes tumor is an uncommon breast fibroepithelial neoplasm mainly found in middle-aged patients, presenting a morphologic continuum from benign to malignant. Juvenile papillomatosis represents a rare benign proliferative breast tumor primarily affecting young individuals and carries a potential elevated risk of subsequent breast cancer development. Juvenile fibroadenoma is a well-circumscribed biphasic neoplasm that often occurs in adolescent girls, characterized by a pericanalicular growth pattern with usual-type epithelial hyperplasia and gynaecomastia-like micropapillary proliferation. Herein, we present an unusual example of a 26-year-old woman with a left breast outer lower quadrant palpable mass. Ultrasonography identified a 5.9 cm lobulated hypoechoic solid mass with scattered small cysts. The preoperative biopsy initially diagnosed a fibroepithelial lesion, considering giant cellular fibroadenoma and phyllodes tumor in the differential. Subsequent complete excision revealed areas of benign phyllodes tumor features closely admixed with distinctive elements such as prominent multiple cysts exhibiting apocrine and papillary apocrine metaplasia, duct papillomatosis, and duct stasis characteristic of juvenile papillomatosis, and hyperplastic ductal epithelium with micropapillary projections demonstrating a pericanalicular growth pattern indicative of juvenile fibroadenoma. The diagnosis was conclusively established as a fibroepithelial lesion with combined features of benign phyllodes tumor, juvenile papillomatosis, and juvenile fibroadenoma. Further investigation uncovered a family history of breast cancer. Molecular analysis revealed a pattern of unique and overlapping mutations within these distinct histopathological areas. This unusual presentation with hybrid features within a single tumor is described for the first time in the literature along with the molecular signature of the individual components. [ABSTRACT FROM AUTHOR]

Chondroblastoma is currently described as a benign bone tumor, histopathologically characterized by its classical features including chondroblasts, pink cartilage, and a variable number of osteoclast-like giant cells with foci of dystrophic calcification. Although recurrent and metastasizing chondroblastomas are reported, a malignant chondroblastoma is exceedingly rare and somewhat a contentious entity. A 35-year-old male presented with a lump in his ankle of 15 years' duration. Imaging disclosed a lytic destructive lesion involving the lower ends of the tibia and fibula with a soft tissue component, indicative of atypical/"worrisome" features. Microscopic examination of the biopsy revealed distinct foci of chondroblastoma, transitioning to areas of high-grade sarcoma, including pleomorphic cells, increased mitoses, and prominent stromal hyalinization. Immunohistochemically, the entire tumor was positive for H3K36M, while DOG1 highlighted the areas of chondroblastoma. SATB2 highlighted the areas of high-grade sarcoma, sparing the areas of chondroblastoma. Additionally, the areas of a high-grade sarcoma showed multifocal desmin immunostaining. A diagnosis of a malignant transformation in a chondroblastoma was offered. The patient defaulted to further treatment and unfortunately died 8 months, post-diagnosis. The conceptual evolution of a malignant chondroblastoma with H3K36M immunostaining in the few reported tumors is described herewith. [ABSTRACT FROM AUTHOR]

Bronchial papillomas are benign tumors, which can be divided into different subtypes based on the cellular features. So far, no bronchial papilloma with basaloid cell features has been reported. We report a bronchial basaloid papillary tumor in a 67-year-old woman. Tumor recurrence and malignant transformation were observed after a long-term follow-up. The clinical, histological, immunohistochemical, and genetic features were reappraised. The primary tumor was characterized by papillary growth pattern and basaloid neoplastic cells, only a small amount of neoplastic cells showed mature characteristics. The tumor originated from respiratory epithelium and had a low proliferation index by Ki-67. Keratin (KRT) 5/6 and KRT7 showed patchy or partial positivity. Myoepithelial markers were negative. P63 was diffusely positive, but it was negative in the small amount of tumor cells with mature characteristics. The common genetic alterations (EGFR, KRAS, BRAF V600E, HER2, and ALK) of lung cancers were not detected. However, tumor recurrence was observed in the mediastinum and esophagus 12 years after surgery. The recurrent tumor had a morphology overlapping with that of the primary tumor; however, it displayed significantly malignant characteristics. The recurrent tumor was not related to high-risk HPV. A high variant allele frequency was observed in tumor suppressor gene BRCA1, TP53, oncogene GNA11, and KIT, which were all missense mutations. Considering the bland features of the primary tumor and the fact of tumor recurrence and undisputed malignant transformation, the basaloid papillary tumor was considered a tumor with uncertain malignant potential. [ABSTRACT FROM AUTHOR]

Background: Cardiac rhabdomyoma (RHM) is considered one of the most frequent benign heart tumors in children. However, encounters with cardiac RHM in clinical practice remain rare. Clinical information is primarily available in the form of single case reports or smaller studies with a shortage of large-scale reviews encompassing a substantial number of cases. Results: In order to congregate existing and future information on cardiac RHM we established a web-based cardiac RHM online registry using an online survey tool. In addition we integrated previously published data from individual case reports and case series. The evaluation of this paper is intended to provide a brief overview of the cohort that we have been able to include so far. Our findings mainly confirm the previous knowledge on cardiac RHM. At the same time, our cohort shows a clear heterogeneity in the treatment methods with regard to rhabdomyomas requiring therapy and revealed a bias between literature data and our registry data with regard to symptoms and need for therapy. Conclusion: In the view of the heterogeneity of treatment methods, a systematic overview of cardiac RHM is all the more important, especially as specific drug treatment options now exist. The registry should not just provide a comprehensive and informative overview of causes, time course, symptoms and therapeutic options of cardiac RHM but also facilitate information sharing among clinicians and researchers and serve as a basis for future clinical and pharmacological studies. [ABSTRACT FROM AUTHOR]

Introduction: Craniopharyngiomas are challenging benign tumors arising from Rathke's pouch remnants, often requiring multidisciplinary management due to their proximity to critical neurovascular structures. This meta-analysis systematically compares conventional radiation therapy (RT) and stereotactic radiosurgery (RS) in treating residual or recurrent craniopharyngiomas. Method: A comprehensive literature search identified 44 studies, including 46 reports, meeting inclusion criteria such as progression-free survival (PFS) and post-radiotherapy complications. Data extraction followed PRISMA guidelines. Results: The pooled 5-year PFS favored RT (0.843; 95% CI: 0.767–0.898) over RS (0.680; 95% CI: 0.631–0.727), as did 10-year PFS (RT: 0.813; 95% CI: 0.683–0.888; RS: 0.553; 95% CI: 0.470–0.634). RT demonstrated mitigating tumor recurrence risks. Visual and hormonal complication rates between the modalities were comparable (visual: ~4%; hormonal: ~6%). Conclusion: RT consistently achieved superior long-term PFS compared to RS, reaffirming its role as the standard for adjuvant therapy in craniopharyngiomas. This analysis highlights the need for tailored treatment strategies balancing efficacy and safety, ultimately enhancing patient outcomes. [ABSTRACT FROM AUTHOR]

Introduction: Benign and malignant myxoid soft tissue tumors have shared clinical, imaging, and histologic features that can make diagnosis challenging. The purpose of this study is comparison of the diagnostic performance of a radiomic based machine learning (ML) model to musculoskeletal radiologists. Methods: Manual segmentation of 90 myxoid soft tissue tumors (45 myxomas and 45 myxofibrosarcomas) was performed on axial T1, and T2FS or STIR magnetic resonance imaging sequences. Eighty-seven radiomic features from each modality were extracted. Five ML models were trained to classify tumors as benign or malignant in 40 tumors and then tested with an additional 50 tumors using cross validation. The accuracy of the best ML model based on area under the receiver operating characteristic curve (AUC) was compared to the consensus diagnosis of three musculoskeletal radiologists. Correlation between radiologist confidence (equivocal, probably, consistent with) and accuracy was tested. Results: The best ML classifier was a logistic regression model (AUC 0.792). Using T1 + T2/STIR images, the ML model classified 78% (39/50) of tumors correctly at a similar rate compared to 74% (37/50) by radiologists. When radiologists disagreed, the consensus diagnosis classified 50% of tumors (7/14) correctly compared to 86% (12/14) by the ML model, though this did not reach statistical significance. Radiologists had a cumulative accuracy of 91% (30/33) when they rated their confidence 'consistent with' compared to 61% (31/51) when they rated their confidence 'equivocal/probably' (P = 0.006). For cases when radiologists rated their confidence 'equivocal/probably', the ML model had 76% accuracy (39/51). Conclusions: A radiomic based ML model predicted benign or malignant diagnosis in myxoid soft tissue tumors similarly to the consensus diagnosis by three musculoskeletal radiologists. Radiologist confidence in the diagnosis strongly correlated with their diagnostic accuracy. Though radiomics and radiologists perform similarly overall, radiomics may provide novel diagnostic utility when radiologist confidence is low, or when radiologists disagree. [ABSTRACT FROM AUTHOR]

Background: Fibrous dysplasia (FD) is the most common benign tumor of the ribs, with surgical resection being the preferred treatment modality for rib FD, leading to enhanced quality of life and favorable outcomes. The complexity of surgical intervention varies depending on the location of costal FD, presenting challenges for both open surgical and thoracoscopic approaches. In this study, we present a novel technique for three-port robotic-assisted costectomy utilizing a Gigli saw, detailing our initial findings and outcomes. Methods: We reviewed five patients with benign rib tumors who underwent three-port robotic-assisted rib resection using a Gigli saw between May 2021 and December 2022. Data on patient characteristics, relevant short-term surgical outcomes and clinical long-term treatment effects were collected. Results: The surgery was successful in all five patients without any need for an additional port and emergency conversion to open surgery. Median operative time was 76.8 min (range, 73–116 min), and the median intraoperative blood loss volumes was 75 ml (range, 40– 105 mL). On average, chest tubes were removed 1.2 days postoperatively (range, 1–2 days), with a mean drainage volume of 93 ml on postoperative day 1 (range, 70–135 ml). Patients were discharged between the 2nd and 4th postoperative day. During 1-year follow-up period, no recurrence was observed in either patient. Conclusions: The utilization of a three-port robotic-assisted costectomy in conjunction with a Gigli saw represents a viable, secure, and efficient approach for treating isolated benign rib lesions. Our aim is to provide clinical guidance on this technique and promote its broader application. [ABSTRACT FROM AUTHOR]

Breast cancer (BC) is a prevalent malignancy in women, often necessitating tumor resection and breast reconstruction surgeries. However, the post-operation scars can be of concern, as hypertrophic scars (HS) can profoundly impact patients' quality of life. Our study used the bidirectional Mendelian randomization (MR) method to explore the potential relationship between BC and HS. We conducted a comprehensive genetic analysis using a large meta-analysis dataset comprising the BCAC, FinnGen, MRC-IEU, and GTEx eQTL datasets. We identified independent genetic loci associated with BC and HS among individuals of European ancestry. These loci served as instrumental variables (SNPs) in MR analysis. We used the inverse-variance weighted and weighted median methods, with the odds ratio (OR) as the effect measure, to investigate the causal relationship between breast disease and HS, and all significance was corrected by FDR and Bonferroni. We assessed heterogeneity and horizontal pleiotropy through Cochran's Q, MR-PRESSO, and MR-Egger intercept tests. Moreover, a leave-one-out sensitivity analysis was performed to evaluate the impact of individual SNPs on the MR study. The MR analysis showed a significant positive association between BC and HS (OR = 1.31, 95% CI 1.10–1.56, P = 0.002). However, there was no significant association between benign breast neoplasm and HS (OR = 0.97, P = 0.73). Subgroup analysis of BC revealed that estrogen receptor-positive (ER+) BC increased the risk of HS (OR = 1.32, 95% confidence interval: 1.11–1.57, P = 0.0016), while ER-negative (ER−) BC did not increase the risk of HS (OR = 0.99, P = 0.91). Analysis of the GTEx database demonstrated that increased ER level alone in healthy individuals (n = 3301) did not increase the risk of HS (P = 0.42). This result was well replicated in two independent HS datasets, and the causal effect of BC on HS was unidirectional. BC is positively associated with the incidence of HS, especially in the case of ER+BC. However, there is a lack of substantial evidence regarding the relationship between ER−BC and HS. [ABSTRACT FROM AUTHOR]

Background: Low-grade fibromyxoid sarcoma is a rare soft tissue tumor characterized by a benign histological appearance but with a high potential for recurrence and metastasis. First described by Evans in 1987, recurrence and metastasis can occur decades after the initial diagnosis, complicating long-term management. Case presentation: We report the case of an 83-year-old Jewish female patient diagnosed with low-grade fibromyxoid sarcoma in her right shoulder. The patient underwent wide resection with positive margins, followed by regular follow-ups. At 9 months postoperatively, she developed recurrence involving the right trapezius, thoracic vertebrae, ribs, and pleural cavity, a second local resection was performed. At 2 years post-surgery, the patient remains recurrence free. Conclusion: Low-grade fibromyxoid sarcoma, though rare, presents a high risk for recurrence and metastasis. Long-term follow-up and vigilant monitoring are crucial, particularly in cases where positive surgical margins are involved. Surgery remains the cornerstone of treatment, but ongoing research into systemic therapies may offer new options for managing metastatic or recurrent low-grade fibromyxoid sarcoma in the future. [ABSTRACT FROM AUTHOR]

Ossifying fibroma (OF) is a rare, benign fibro-osseous neoplasm that primarily originates from membranous bones. While most frequently documented in equines, OF has also been reported in other species, including dogs, though it remains uncommon. The condition poses significant diagnostic challenges due to its ambiguous presentation, often requiring differentiation from other benign and malignant intraosseous lesions. This case report describes an ossifying fibroma localized to the zygomatic bone in a 9-year-old Hungarian Vizsla. A zygomatic arch ostectomy was successfully performed, and long-term follow-up was excellent. This is only the second documented case of zygomatic localization of OF in a dog, highlighting the rarity of this presentation. The discussion emphasizes the importance of distinguishing OF from other proliferative fibro-osseous lesions, such as fibrous dysplasia (FD) and cemento-osseous dysplasia (COD), and considering the potential for malignancies, such as low-grade osteosarcoma (LG-OSA), to mimic these benign growths. This case contributes valuable insights to the limited veterinary literature on ossifying fibroma, particularly regarding its atypical presentations in canine patients. [ABSTRACT FROM AUTHOR]

Background: Undifferentiated pleomorphic sarcoma, previously called malignant fibrous histiocytoma, is a type of malignant mesenchymal tumor (sarcoma) of soft tissue and sometimes bone. It is uncommon in the oral cavity and very sporadic in the maxillary sinus. Microscopic diagnosis of this malignancy in the maxillary sinus can be very challenging, because there is a range of features that may overlap with other benign and malignant tumors. Case presentation: In this paper, we report a case of undifferentiated pleomorphic sarcoma in the maxillary sinus of a 61-year-old Iranian man who was referred to the maxillofacial surgery ward due to pain and swelling of the upper jaw and visual problems in the right eye. In the initial incisional biopsy, peripheral giant cell granuloma was diagnosed in the hospital service. Yet, on request of the surgeon, during reviewing the slides in the oral pathology service of the School of Dentistry, and using an immunohistochemical method, undifferentiated pleomorphic sarcoma was diagnosed. In this paper, a case of undifferentiated pleomorphic sarcoma in the maxillary sinus is reported, with an emphasis on the management of its problems and diagnostic errors. Conclusion: This study reviews the challenges and histopathological diagnostic errors of this uncommon tumor in this rare location. This lesion may be similar to other malignant tumors, and its correct diagnosis requires a detailed and complete examination. [ABSTRACT FROM AUTHOR]

Background/Objectives: Defects in maxillary and mandibular continuity are common in maxillofacial practice. They can occur after trauma, osteonecrosis, congenital jaw deformities, or surgical resection of benign or malignant tumours. Reconstruction with microvascular bone flaps and subsequent prosthetic rehabilitation is considered the contemporary first line treatment. This study assessed the extent to which the underlying disease influences the treatment course of microvascular segmental jaw reconstruction. Methods: A retrospective review of prospectively collected data from all patients who underwent microvascular segmental jaw reconstruction from January 2011 to December 2020 was completed. The course of treatment as well as the process of dental rehabilitation was assessed. Results: Two hundred patients were included in the study. A total of 15.5% of patients were fitted with a conventional removable prosthesis, and implant-supported prosthetic restoration could be realized in 53.5% of patients. However, dental rehabilitation was not possible in 31.0% of patients. The outcomes of prosthetic restoration showed a statistically significant difference between the different underlying diseases (p < 0.0001). About 50% of patients with malignant diseases and osteonecrosis remained without dental rehabilitation. In contrast, more than 90% of patients with jaw continuity defects, due to benign diseases or malformations, were able to receive an implant-supported prosthesis. Among the diagnostic groups, there was a significant difference regarding the number of implants placed (p < 0.0001). There was a significant correlation between increased incidence of complications and the size of the bone flaps. Conclusions: The underlying disease influenced significantly the treatment course and the outcome of dental rehabilitation after microvascular jaw reconstruction. [ABSTRACT FROM AUTHOR]

Infantile hemangioma (IH) is the most common pediatric benign vascular tumor. Its pathogenesis is still poorly understood, and it usually appears during the first few weeks of life and follows a characteristic natural course of proliferation and involution. Most IHs are small, benign, resolve spontaneously, and do not require active treatment but only active observation. A minority of IHs are potentially problematic because they can cause life-threatening complications, permanent disfigurement, and functional impairment. Diagnosis is usually clinical, and propranolol is currently the mainstay of treatment. Other therapeutic modalities may be used alone or in combination, depending on the characteristics of the specific IH. New treatment options are being explored every day, and some are showing promising results. It is undeniable that therapeutic modalities for IHs must be selected based on the child's age, the size and location of the lesion, the presence of complications, the implementation conditions, and the possible outcomes of the treatment. The future of IH management will certainly be reflected in improved advanced imaging modalities, research into the genetic and molecular basis, the development of new pharmacological agents or techniques, and the development of standardized protocols, all to optimize outcomes with minimal side effects. [ABSTRACT FROM AUTHOR]

Pleural thickening can be the result of inflammation or infection but can also have a neoplastic origin. Depending on the clinical context, a pleural lesion or mass is often initially suspected of malignancy. Benign pleural tumors are rare, and their appearance on ultrasound (US) is also described less frequently than pleural metastases or malignancies. There are few descriptions of contrast-enhanced Ultrasound (CEUS) in particular. This review introduces the basics of transthoracic ultrasound (TUS) of the pleura and CEUS of the pleura and lung. CEUS is recommended for pulmonary applications in the EFSUMB guidelines in non-hepatic applications. This article provides an overview of the characteristics of benign pleural thickening, tumor-like lesions, and benign pleural tumors on transthoracic B-mode US with color Doppler imaging (CDI) and CEUS. In detail, characteristics in TUS and CEUS are described for infectious/inflammatory pleural thickening (empyema, tuberculous pleuritis, hemothorax, fibrothorax), pleural thickening in various systemic diseases, in tumor-like conditions (plaques, splenosis, endometriosis, mesothelial cysts, lymphangiomatosis) and benign tumors (lipoma, benign SFT, schwannoma, solitary extramedullary/extraosseous plasmacytoma). The descriptions are illustrated by corresponding US and CEUS images. [ABSTRACT FROM AUTHOR]

Pleomorphic adenoma of the lacrimal gland (PALG) is a benign neoplasm typically presenting with gradual, painless globe displacement and/or lid swelling. We report an atypical case of PALG in a 53-year old male presenting acutely, mimicking orbital cellulitis. Imaging demonstrated an extraconal rim-enhancing soft-tissue lesion medial to the left lacrimal gland, involving superior rectus and levator palpebrae superioris. Surgical excision and histopathology revealed PALG with central infarction, necrosis, and chronic and acute pseudocapsular arteriolar occlusion. These findings correlated with the fluctuating symptoms and suggested a multifactorial mechanism involving both underlying vasculopathy, thrombosis, and tumor growth. Infarction in PALG may occur iatrogenically or from spontaneous tumor infarction, and can cause an acute inflammatory presentation. We discuss unique histopathologic features of necrotic PALG and mechanisms of infarction. Recognition of these features and the varied presentations of PALG is crucial for proper diagnosis. Complete resection is necessary to prevent recurrence or malignant transformation. [ABSTRACT FROM AUTHOR]

Recently, as the number of cancer patients has increased, much research is being conducted for efficient treatment, including the use of artificial intelligence in genitourinary pathology. Recent research has focused largely on the classification of renal cell carcinoma subtypes. Nonetheless, the broader categorization of renal tissue into non-neoplastic normal tissue, benign tumor and malignant tumor remains understudied. This gap in research can primarily be attributed to the limited availability of extensive datasets including benign tumor and normal tissue in addition to specific type of renal cell carcinoma, which hampers the ability to conduct comprehensive studies in these broader categories. This research introduces a model aimed at classifying renal tissue into three primary categories: normal (non-neoplastic), benign tumor, and malignant tumor. Utilizing digital pathology while slide images (WSIs) from nephrectomy specimens of 2,535 patients from multiple institutions, the model provides a foundational approach for distinguishing these key tissue types. The study utilized a dataset of 12,223 WSIs comprising 1,300 WSIs of normal tissue, 700 WSIs of benign tumors, and 10,223 WSIs of malignant tumors. Employing the ResNet-18 architecture and a Multiple Instance Learning approach, the model demonstrated high accuracy, with F1-scores of 0.934 (CI: 0.933–0.934) for normal tissue, 0.684 (CI: 0.682–0.687) for benign tumors, and 0.878 (CI: 0.877–0.879) for malignant tumors. The overall performance was also notable, achieving a weighted average F1-score of 0.879 (CI: 0.879–0.880) and a weighted average area under the receiver operating characteristic curve of 0.969 (CI: 0.969–0.969). This model significantly aids in the swift and accurate diagnosis of renal tissue, encompassing non-neoplastic normal tissue, benign tumor, and malignant tumor. [ABSTRACT FROM AUTHOR]

Objective: Rare disease Background: Primary cardiac malignancies are extremely rare, with an incidence of 0.07% on autopsy series. Primary sarcomas represent up to 95% of malignant neoplasms, with myxofibrosarcomas accounting for only 10%. Around 90% of patients present with unspecific symptoms and a tumor with polypoid appearance on imaging, thus frequently receiving a misdiagnosis of myxoma. Case Report: A 65-year-old man presented with abrupt chest pain, blood pressure of 130/80 mmHg, and heart rate of 180 beats/min. Electrocardiogram showed atrial fibrillation, and imaging revealed a polypoid tumor on the atrioventricular septum obstructing the mitral valve. The tumor was removed and sent for histopathological evaluation, revealing a multinodular pattern with spindled hypocellular areas and hypercellular areas featuring pleomorphic cells. The mitotic count was 11 in 10 high-power fields, and necrosis was present in less than 50% of the tumor area. Tumor cells were calretinin and MDM2 negative and CD34 positive. Heterologous elements, necrosis and hemorrhage, were noted. Considering these findings, this tumor was classified as intermediate-grade myxofibrosarcoma. Conclusions: Due to the rarity of myxofibrosarcomas, evidence for optimal diagnostic and therapeutic management is limited. Despite being frequently polypoid, seemingly benign tumors on imaging, the extent of infiltration at their base is usually deep. Their innocent appearance can hinder adequate presurgical planning, leading to suboptimal resections. We present the example of a seemingly benign tumor as a potential pitfall in evaluating cardiac neoplasms, highlighting the importance of histopathological and immunohistochemical evaluation in their correct characterization, in order to offer the best follow-up and adjuvant treatment, when needed. [ABSTRACT FROM AUTHOR]

Background: Pulmonary hamartoma is an extremely rare benign neoplasm of the lungs. Patients usually present in the 4th and 5th decades of life and usually present as a hilar mass that needs to be biopsied to confirm the nature of the lesion. We report a case of pulmonary hamartoma that was diagnosed with EBUS-TBNA. Case presentation: A 45-year-old female patient, non-smoker presented with dyspnea at moderate exertion. A CT scan showed a well-circumscribed left hilar mass. EBUS was planned and 3 passes EBUS-TBNA were taken and the final histopathological diagnosis was surprisingly pulmonary hamaroma. Conclusions: EBUS-TBNA allows to locating of undiagnosed mediastinal lesions and performing a targeted needle aspiration, in a less invasive way, that can provide enough material for a certainty diagnosis in mediastinal hamartoma disease. [ABSTRACT FROM AUTHOR]

Objective Methods Results Conclusion To analyze the recent status of laparoscopic adrenalectomy for benign adrenal tumors, focusing on the relationship between the number of surgeries and complication rates per facility.Data were obtained from the Diagnosis Procedure Combination database, covering surgeries performed between April 2012 and March 2020. The inclusion criteria were laparoscopic adrenalectomy for benign adrenal tumors. Basic characteristics and outcomes, including anesthesia time, blood transfusion, and medical costs, were analyzed. The facilities were divided into five categories in increments of five adrenalectomies per year. The relationship between the number of surgeries per facility and complication rates was analyzed using the Cochran‐Armitage trend test and chi‐square tests with the Holm method applied for multiple comparisons.A total of 15 174 laparoscopic adrenalectomies for benign adrenal tumors were performed across 543 facilities during the 9‐year study period. The number of adrenalectomies performed annually was <5, 5–9, 10–14, 15–19, ≥20 in 434 (79.9%), 58 (10.7%), 28 (5.2%), 12 (2.2%), and 11 (2.0%) facilities, respectively, showing that only 51 facilities (9.4%) conducted 10 or more surgeries per year. The overall complication rate was 9.1%. A trend was demonstrated showing that facilities with a higher number of surgeries per year had reduced complication rates. Facilities with 20 or more surgeries per year had the shortest anesthesia times and the lowest medical costs. No significant differences were found in blood transfusion rates or in‐hospital mortality.Laparoscopic adrenalectomy for benign adrenal tumors can be performed at lower complication rates in facilities with a higher number of surgeries. [ABSTRACT FROM AUTHOR]

Background: Cardiac myxomas are benign tumors of the heart. They occur mostly in the left atrium. The preferred treatment is surgical resection, which can be performed via conventional median sternotomy, minimally invasive, or robotic-assisted approaches. This study aimed to evaluate the outcomes, advantages, and limitations of these surgical methods, with a focus on their safety, efficacy, and impact on patient recovery. Methods: This systemic review was conducted according to PRISMA guidelines. The chosen databases were systematically searched using the keywords "cardiac myxoma", "resection", "approach", "minimally invasive", and "robotic surgery". The comparison between the surgical strategies was based on thirteen articles, which met the inclusion criteria. Results: Median sternotomy remains the standard technique, providing excellent surgical access but is associated with longer hospital stays, higher blood loss, and increased risk of complications such as stroke. Minimally invasive approaches demonstrated comparable safety with shorter ICU stays, reduced blood loss, and lower postoperative pain but presented challenges, including limited exposure and longer procedure times. Robotic-assisted surgery showed potential as a safe alternative but was limited by high costs and technical demands. However, the data on minimally invasive and robotic methods are limited due to the rarity of cardiac myxomas. Conclusions: The choice of surgical technique should be individualised by considering the tumour size, location, patient condition, and surgeon expertise. Routine postoperative echocardiographic monitoring is essential to detect residual or recurrent tumours. Further studies are needed to validate the long-term efficacy of minimally invasive and robotic approaches. [ABSTRACT FROM AUTHOR]

Background: Uterine fibroids are benign monoclonal neoplasms of the myometrium, representing the most common female pelvic neoplasms globally. Treatments may be invasive, such as hysterectomy and myomectomy, non-invasive, such as medical therapy or focused ultrasound, or minimally invasive, such as transcervical radiofrequency ablation (TFA). To date, more than 12,000 women have been treated worldwide using TFA with the Sonata® System. Case Presentation: We present the first case report of TFA on a presumptive fibroid that was initially reclassified as a STUMP (smooth muscle tumor of uncertain malignant potential) and, after additional surgical treatment, leiomyosarcoma. Conclusion: This case highlights that, while uterine sarcoma is rare, inadvertent treatment may still result due to a lack of reliable diagnostic modalities. Nonetheless, TFA with the Sonata System represents a minimally invasive option that might not alter the prognosis of an undiagnosed uterine sarcoma as this treatment is not intraperitoneal and does not resect/morcellate tissue. [ABSTRACT FROM AUTHOR]

Angiomatoid fibrous histiocytoma (AFH) is a rare intermediate tumor that is often difficult to diagnose radiologically and pathologically. Herein, we report a case of AFH in the knee that was initially misdiagnosed as a cystic lesion. The tumor was first identified eight years earlier during the patient's initial visit, when plain magnetic resonance imaging (MRI) was performed, leading to a diagnosis of a cystic lesion. At the current visit, the tumor had subsequently enlarged, and pain had appeared. Contrast-enhanced MRI was performed at our hospital, revealing enhancement suggestive of a solid tumor. A needle biopsy was performed, raising suspicion of AFH. Wide resection was performed, and AFH was diagnosed using histopathological findings and fluorescence in situ hybridization (FISH). Although there are several characteristic imaging findings of AFH, they are non-specific, and small tumors can be easily overlooked. Furthermore, histopathological findings lack specific immunohistochemical markers, making morphological appearance, combined with FISH findings recently reported as useful, important for preventing misdiagnosis. Since cystic lesions can occur in various locations besides the knee, it is recommended to perform contrast-enhanced MRI for accurate diagnosis when there is an increase in size or the appearance of symptoms, as plain MRI alone may lead to misdiagnosis. [ABSTRACT FROM AUTHOR]

Background/Objectives: Renal cell carcinoma is an aggressive form of kidney cancer, contributing to an estimated 138,000 deaths globally in 2017. Traditional treatments like chemotherapy and radiation are generally considered ineffective. Additionally, CD47 has been identified as a crucial tumor antigen involved in the development and progression of various cancers, including renal cell carcinoma. The interaction of CD47 with SIRPα triggers a "don't eat me" signal to the macrophages, inhibiting phagocytosis. Much progress has been made in targeting CD47 for cancer immunotherapy in solid tumors (STs) and hematological malignancies. This study aimed to evaluate CD47 expression in malignant and benign renal cell tumors and compare it with prognostic histopathological parameters. Methods: We included 160 malignant and 26 benign tumors. The malignant tumors consisted of renal cell carcinoma (RCC) subtypes including 37 clear cell, 30 chromophobe, 30 papillary type 1, 29 papillary type 2, and 34 unclassified RCC cases. As for the benign tumors, we included 26 oncocytoma cases. All samples were stained with anti-CD47 antibodies by immunohistochemistry methods. Results: The statistical analysis yielded a significant correlation between CD47 expression and survival, metastasis, and capsule invasion for the unclassified RCC cases. We did not find any further significant correlation between CD47 expression and the studied parameters. Conclusions: To the best of our knowledge, our study is the first to research CD47 expression in benign and malignant renal carcinoma subtypes. Further large-scale studies are needed to determine the expression profile of CD47 in renal cell tumors. [ABSTRACT FROM AUTHOR]

Necrosis in postoperative histology has been reported as being specific for adrenocortical carcinoma (ACC) compared to adenoma. We therefore retrospectively analyzed the diagnostic accuracy of the finding of necrosis in preoperative cross-sectional imaging and postoperative histology as a marker for ACC in our patient cohort. Among the 411 adrenalectomies in 396 patients performed between 2008 and April 2022, 30 cases of ACC (7.6%) were identified, with one tumor measuring less than 40 mm excluded. All 45 benign adrenocortical tumors of at least 40 mm in diameter, including Cushing, Conn, and hormonally inactive adenomas, served as controls. Preoperative imaging was available for 40 benign and 27 malignant adrenocortical tumors. In total, 10 of 40 (25%) benign adrenocortical tumors and 22 of 27 (81%) ACCs showed signs of possible necrosis in preoperative imaging. Pathologic examination confirmed necrosis in 1 of 40 (2.5%) benign tumors and in 26 out of 27 (96%) malignant tumors. The specificities of possible necrosis in preoperative imaging and necrosis in histology for diagnosing ACC were 75% and 97.5%, respectively, whereas the sensitivities were 81% and 96%, respectively. Signs of possible necrosis in radiologic imaging and tumor necrosis in histology proved to be very good predictive markers for the diagnosis of malignant adrenocortical tumors. [ABSTRACT FROM AUTHOR]

Fibrous dysplasia (FD) is a benign tumor condition in which normal bone is replaced by structurally deficient fibrous lamellar bone. It represents approximately 5-7% of benign bone tumors and occurs in two presentations: monostotic, which is the most common, and polyostotic. The proximal femur is one of the most common locations for benign tumors, including FD. Fractures in pathological terrain are often the first symptom. In the context of a proximal femur fracture with a benign tumor, the indications for carrying out a total femoral resection are: multiple lesions in the femur or primary diaphyseal tumors, lesions that extend proximally and distally to exceed the epimetaphyseal junction area, and those that do not allow the joint to be adequately preserved. Currently, proximal or total femoral resection is considered a good therapeutic option to carry out endoprosthetic replacement using modular megaprosthetic systems. We present the case of a 27-year-old male patient, who came to the emergency department with a basicervical fracture of the right femur in Garden II Pauwells III AO 31B2.3r pathological terrain, after presenting a low-energy injury mechanism characterized by axial loading with rotational component of the right hip. This patient has a history of intralesional resection, application of bone graft and prophylactic fixation using unspecified osteosynthesis material in the pertrochanteric region 20 years ago; the biopsy would later show DF; the osteosynthesis material was subsequently removed one year later. Due to the characteristics of the fracture and as a definitive and curative therapeutic method, it was decided to carry out wide resection of the proximal femur and total hip arthroplasty with a modular prosthesis with cerclage placement, as well as taking an excisional biopsy that would later corroborate that it was the same FD treated in childhood. [ABSTRACT FROM AUTHOR]

BackgroundMethodsResultsConclusionsReport the results of Ruthenium plaque brachytherapy (106Ru) for the management of intraocular tumors in Thailand.We retrospectively reviewed the medical records of 46 eyes of 45 patients who received 106Ru brachytherapy for the treatment of various intraocular tumors in the Department of Ophthalmology of Ramathibodi Hospital, Mahidol University, Bangkok, Thailand, between April 2013 and December 2020.Of 46 eyes, 21 (46%) were diagnosed with small to medium choroidal melanoma, 13 (28%) with retinoblastoma, 4 (9%) with choroidal metastases, 2 (4%) with retinal vasoproliferative tumor (VPT), 3 (7%) with choroidal hemangioma (CH), 2 (4%) with RPE adenoma, and 1 (2%) with retinal hemangioblastoma. The mean tumor thickness was 4.8 mm (range, 2.4–6.6). After a mean follow-up of 62.4 months (range, 4.8–122.7), local tumor control was achieved in 39 eyes (85%), which were 100% for choroidal melanoma, 46% for RB, 100% for choroidal metastasis and 100% for benign tumors. Radiation-related complications were found in 28 eyes (61%), including cataracts in 10 (25%), radiation retinopathy in 14 (30%), radiation maculopathy in 14 (30%), radiation papillopathy in 6 (13%), and vitreous hemorrhage in 3 (7%) eyes. All patients with retinoblastoma currently alive without metastasis. Two patients with choroidal melanoma developed systemic metastases and three patients with choroidal metastases died at the end of the study.Patients with intraocular tumors treated with 106Ru brachytherapy showed excellent outcomes in relation to tumor control with few complications. [ABSTRACT FROM AUTHOR]

Purpose: Angiocentric glioma (AG), a benign tumor identified within the last two decades, was officially included in the 2007 WHO Classification of Tumors of the Central Nervous System, WHO grade I. The tumor is relatively rare, with only approximately 100 cases reported. We aim to complement the characteristics and long-term prognosis of AG, as well as to detect MYB-QKI fusions. Methods: The characteristics of all cases collected between 1 March 2009 and 1 March 2023 at the Beijing Sanbo Brain Hospital, Capital Medical University, were summarized and analyzed. Additionally, all fourteen patients were tested for MYB-QKI fusions. Results: AG more predominantly occurs in adolescents (median age 16.5-year-old), and commonly presents with drug-resistant epilepsy. AG is frequently localized in the supratentorial regions and only one patient is in the brainstem. Brain parenchyma atrophy, and stalk-like signs can observe in imaging. Pathologically, tumor cells are perivascular pseudorosettes, presenting immunoreactivity for GFAP, S-100, Vimentin, "dot-like" staining for EMA, and low proliferative activity. Focal cortex dysplasia was observed in four patients. Twelve of fourteen (85.7%) patients were found with MYB-QKI fusions. Completely surgical resection typically has a satisfactory prognosis with long-term follow-up. Conclusion: AG is a rare benign tumor with a favorable prognosis after complete resection, characterized by refractory epilepsy, frequently occurring in adolescents. MYB-QKI fusions were detected in most AG patients, as a good defining genetic alteration pathologically. The potential presence of focal cortical dysplasia (FCD) may affect the prognosis of epilepsy. [ABSTRACT FROM AUTHOR]

Uterine leiomyomas (uLMs) are the most prevalent benign tumors of the female reproductive system. MED12 is one of the mediator complex subunits that has been implicated in uLMs pathogenesis. Somatic mutations in exon2-MED12 have been found in ~ 70% of uLMs. In this study, we investigated the status of exon2-MED12 in uLMs from Syrian patients. Sixteen leiomyomas from nine patients were assessed. Genomic DNA was isolated from tumors and exon2-MED12 was amplified by PCR and sequenced. Three specimens showed in frame point mutations consisted of missense substitutions in codon 44 (c.130). A novel insertion in codon 35 (c.103insG) was detected in one of the mutated cases and is expected to cause a frameshift in translation and an altered or truncated product. Some of the wild-type uLMs were collected from the same uteri that revealed mutations, which emphasizes the individuality of the uLM lesions and highlights the complexity of uLMs pathogenesis. The study is the first report from Syria on the topic and the second from the Arab world. It indicates genetic heterogeneity and independent clonal origin of the somatic mutations in exon2-MED12. In wild-type uLMs where exon2-MED12 mutations are absent, other players are in place and should be investigated. [ABSTRACT FROM AUTHOR]

Background: Treatment of Primary metatarsal aneurysmal bone cyst (ABC) with curettage and bone grafting unfortunately has a high recurrence rate, particularly in short tubular bones. This study presents a 16-year experience treating ABCs in the bones of the foot at an orthopaedic oncology referral center. Treatment involved en bloc resection and reconstruction of the defect with fibular allograft in all cases. Retrospectively collected data were used to document the outcomes. Methods: This retrospective review includes patients with primary metatarsal ABC treated en bloc resection at a single center between 2004 and 2020. Information on the diagnosis, treatment, complications, and outcomes was collected from our database for all eligible patients. Radiologic healing was used as our primary outcome measure. The patient's function was assessed using the Toronto Extremity Salvage Score (TESS) and Musculoskeletal Tumor Society (MSTS) score. Results: The study included 19 subjects (11 women, 8 men) with a mean age of 18 years (SD 11-35). The average resected length was 4.24 cm (3-6 cm). The mean follow-up time was 79.26 months (28-160 months). The mean TESS score and MSTS were 94.52 and 28.42, respectively. The average healing time was 10.2 weeks. No patient had local recurrence. Arthrodesis was performed in 3 patients because of joint involvement. Repeat surgery was performed for 2 patients, debridement for one because of infection and bone graft for another because of nonunion. One patient had experienced an allograft fracture. Conclusion: Based on the Enneking classification, our experience has shown that a reasonable surgical approach for primary active and invasive metatarsal ABC is en bloc resection and reconstruction with fibula allograft. This method has a low risk of recurrence and does not result in significant functional impairment. [ABSTRACT FROM AUTHOR]

Epithelioid osteoblastoma (EOB) is a rare, benign bone tumor characterized by the proliferation of atypical epithelioid osteoblasts within a vascular stroma. It typically presents as a slow-growing painful mass and requires careful differentiation from more aggressive lesions like osteosarcoma for appropriate management. We present a case of an otherwise healthy 30-year-old man who presented with a mandibular EOB measuring 23 cm × 17 cm x 19 cm, causing significant disfigurement and functional impairment. Surgical management involved radical resection and immediate reconstruction using an osteocutaneous fibula free flap. The case emphasizes the importance of multidisciplinary care, advanced surgical planning, and the impact of socioeconomic factors on healthcare access and outcomes. • Largest documented mandibular EOB at 23.5 cm with delayed diagnosis. • Use of VSP for precise surgical planning and reconstruction. • Complex resection with fibula free flap reconstruction. • Case emphasizes the impact of socioeconomic factors on delayed care. • Multidisciplinary approach vital for managing large bone tumors. [ABSTRACT FROM AUTHOR]

The existing literature provides little insight into the efficacy of transoral endoscopy in exposing benign tumors originating from salivary glands in the parapharyngeal space at the parotid gland base and resecting part of the deep lobe with a safe margin. This study aims to investigate the efficacy of the endoscopic transoral approach for the visualization and resection of such tumors. Through transoral endoscopic cadaveric dissections and surgical procedures, we examined the anatomical structures of the parapharyngeal space and the deep lobe of the parotid gland, identifying key anatomical landmarks. We conducted a retrospective analysis of 19 patients with benign salivary gland-derived tumors in the parapharyngeal space who underwent transoral endoscopic resection. Intraoperative visualization of the tumor pedicle and the deep lobe of the parotid gland was successfully achieved in all cases, allowing for resection with safe margins. During a median follow-up period of 54.0 months, imaging revealed no signs of recurrence. Endoscopic transoral approach provides effective visualization of the deep lobe of the parotid gland and the medial portion of the parotid bed from the parapharyngeal space. Benign tumors of salivary gland-derived in this area can be well exposed and safely resected with adequate margins. [ABSTRACT FROM AUTHOR]

Background: Sinonasal inverted papilloma (SNIP) is a benign epithelial tumor with distinctive histopathological features. However, the role of inflammation in SNIP remains poorly characterized. Objectives: This study aimed to compare the histopathological patterns and inflammatory characteristics of SNIP with those of chronic rhinosinusitis with nasal polyps (CRSwNPs) or normal ethmoid sinus mucosa. Methods: Fifty-eight tissue biopsies were prospectively collected from 38 patients with SNIPs, 12 CRSwNPs, and 8 normal ethmoid sinus mucosae. SNIP was histopathologically divided into four grades based on the extent of epithelial remodeling. The immunohistochemical characteristics of epithelial remodeling (p63, CK5) and infiltration of inflammatory cells (eg, eosinophils, neutrophils, and macrophages) and cytokines (eg, interleukin-1β, interleukin-6, and tumor necrosis factor-α) were analyzed. Results: Among the 38 SNIPs, 21.1%, 36.8%, 23.7%, and 18.4% were grades I, II, III, and IV, respectively. The expression levels of p63 and CK5 were significantly higher in SNIP than in the other two groups (both, p < 0.05). Neutrophil and macrophage infiltration was more pronounced in SNIP and with differences among the four grades. The expression levels of inflammatory cytokines were significantly higher in the SNIP group than in the CRSwNP group. A positive correlation between the expression levels of p63 and inflammatory cytokines was observed in both SNIPs and CRSwNPs. Conclusion: Excessive epithelial remodeling is an important histological feature of SNIP; it is accompanied by sinonasal mucosal inflammation. [ABSTRACT FROM AUTHOR]

Introduction: Asprosin (ASP) plays many important roles in the central nervous system, peripheral tissues, and organs, such as appetite, glucose metabolism, insulin resistance, and cell apoptosis. Many experimental and clinical studies have examined the effects of meteorinlike peptide (METRNL) on inflammation. This study aimed to examine the immunohistochemical analysis of ASP and METRNL in healthy skin, melanocytic nevus, and malignant melanoma and to investigate their possible role in melanocyte proliferation an d whether ASP and METRNL are potential biomarkers for melanocytic tumor development. Materials and Methods: A total of 36 skin samples, including 12 benign nevi, 8 dysplastic nevi, 6 malignant melanoma, and 10 healthy skin around lesions removed from breast tissue that was not exposed to the sun as a control group were included in this study. The skin samples were stained immunohistochemically using the avidin-biotin-peroxidase complex method. Results: ASP and METRNL expressions were detected in the epidermis and hair follicles of healthy s kin. No significant difference was detected in ASP and METRNL histoscores in tumor tissues of benign nevus, dysplastic nevus, and malignant melanoma (p>0.05). Conclusion: Current findings suggest that ASP and METRNL may be associated with cell -to-cell interactions between keratinocytes, melanocytes, and inflammatory cells and may be effective in melanocyte functions. Future studies will clarify whether ASP and METRNL are potential biomarkers for melanocytic tumor development. [ABSTRACT FROM AUTHOR]

Fetal primary cardiac tumors (FPCTs) are very rare. The majority of them correspond to cardiac rhabdomyomas, followed by other benign neoplasms or hamartomas. We describe the case of a third trimester female stillborn with an incidental autopsy finding of Hamartoma of Mature Cardiac Myocytes (HMCM), a rare benign cardiac tumor previously unreported in the fetal or neonatal period. The intrauterine demise occurred at 32 + 6 weeks gestation after an uneventful pregnancy. The fetal autopsy revealed a structurally normal heart with a small subendocardial nodule just below the membranous septum. Microscopically, the nodule was well-demarcated from the surrounding penetrating bundle of the conduction axis and the adjacent left ventricular myocardium and consisted of disorganized mature cardiac myocytes in a haphazard arrangement with patchy mild interstitial fibrosis, consistent with HMCM. Awareness that HMCM can occur in the fetus is important in order to consider it among the differential diagnosis of FPCTs. [ABSTRACT FROM AUTHOR]

Chromosomal aneuploidy, that is, numerical chromosome aberrations, is one of the molecular hallmarks of cancer. However, when neoplasms are studied with sequencing‐ and array‐based approaches, chromosome numbers and ploidy states are typically inferred from bulk DNA data. Furthermore, published molecular estimates of neoplasia‐associated aneuploidy often also include genomic imbalances resulting from various types of structural rearrangement, which likely result from other mechanisms than numerical chromosome aberrations. We thus analyzed chromosome numbers using single‐cell cytogenetic data from 83,862 tumors, and show that both benign and malignant tumors are highly heterogeneous with regard to deviations from the normal, diploid state. Focusing on the chromosome numbers in 112 specific tumor types, defined by both exact morphologic diagnosis and organ location and from which data from ≥50 cases were available, we found two major clusters: one predominated by near‐diploid neoplasms and one by neoplasms with extensive aneuploidy and one or more whole genome doublings. The former cluster included most benign solid tumors, myeloid neoplasms, and malignant gene fusion‐associated solid tumors, whereas the latter was predominated by malignant solid tumors and lymphomas. For 16 malignant tumor types, the distribution of chromosome numbers could be compared to TCGA ploidy level data. Cytogenetic and molecular data correlated well, but the former indicates a higher level of clonal heterogeneity. The results presented here suggest shared pathogenetic mechanisms in certain tumor types and provide a reference for molecular analyses. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Methods Results Conclusion To meet their high energy needs, tumor cells undergo aberrant metabolic reprogramming. A tumor cell may expertly modify its metabolic pathways and the differential expression of the genes for metabolic enzymes. The physiological requirements of the host tissue and the tumor cell of origin mostly dictate metabolic adaptation. Ameloblastoma (AB) is a benign odontogenic tumor of epithelial origin. Due to its unrestricted growth potential, local aggressiveness, and high likelihood of recurrence, this condition poses a significant risk to the patient's health. This study aimed to characterize the metabolic heterogeneity at single‐cell resolution of AB.Single‐cell RNA sequencing (scRNA‐seq) was performed on 17,284 cells from three AB donors. Bioinformatic analysis was used to examine differentially expressed genes, subtypes, and regulatory mechanisms when combined with odontogenic keratocyst scRNA‐seq data. Based on metabolic pathway gene sets, the metabolic landscape of AB tumor cells was examined.Using scRNA‐seq, we discovered that AB tumor cells had substantial heterogeneity. The biggest contributor to tumor cell metabolic characteristics is determined to be variation in mitochondrial programming and glycolysis. Surprisingly, hypoxia corresponds with both oxidative phosphorylation and glycolysis activity in AB tumor cells at the single‐cell level.This study presents a computational framework for defining metabolism using single‐cell expression data and identifies oxidative phosphorylation and glycolysis as critical components of metabolism for AB tumor cells. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions Submandibular gland pathology is common but rarely reported. This study was performed to evaluate demographic, pathological, and survival outcomes associated with submandibular gland extirpation.Retrospective analysis of patients treated in a single quaternary‐care institution between 1989 and 2022 was performed.Four hundred and sixty patients underwent submandibular gland extirpation with a female preponderance (n = 271, 59%) and a mean age of 51 years. Older age was associated with increased risk of malignancy (P < 0.001). Submandibular calculus was the most common pathology, with gland extirpation for this indication decreasing over time (P = 0.005). Pleomorphic adenoma was the most common benign tumour (n = 96, 52.7% of total tumours), and adenoid cystic carcinoma was the most common malignant tumour (n = 25, 13.7% of total tumours).Submandibular calculus remains the most common indication for submandibular gland extirpation, although the rate is decreasing over time. Pleomorphic adenoma continues to be the most common tumour of the submandibular gland, whilst adenoid cystic carcinoma is the most common malignant tumour. The incidence of benign versus malignant tumours has remained constant over the period of this study. [ABSTRACT FROM AUTHOR]

ABSTRACT Infantile hemangiomas (IH) are the most common benign tumors of infancy and progress through recognized stages of evolution including early proliferation, plateau, and involution. Ulceration is a common complication of IHs typically observed during the early proliferative stage characterized by rapid growth. In rare cases, ulceration is the primary clinical manifestation of IHs. We present the case of a newborn with an IH manifesting as an aggressive, early‐onset ulcerative lesion on the lower extremity associated with transient thrombocytopenia and coagulation abnormalities. [ABSTRACT FROM AUTHOR]

Although craniopharyngiomas are rare benign brain tumors primarily managed by surgery, they are often burdened by a poor prognosis due to tumor recurrence and long-term morbidity. In recent years, BRAFV600E-targeted therapy has been promising, showing potential as an adjuvant or neoadjuvant approach. Therefore, we aim to develop and validate a radiomics nomogram for preoperative prediction of BRAFV600E mutation in craniopharyngiomas. A total of 398 patients with craniopharyngioma (training cohort: n = 278; validation cohort: n = 120) were retrospectively reviewed. We extracted 851 radiomic features from MRI images and adopted a support vector machine (SVM) classifier to develop a radiomic model. Also, a clinical-radiomics nomogram was constructed based on a multivariable logistic regression analysis. The performance of the nomogram was evaluated by its discrimination, calibration, and clinical utility. The radiomic model using the SVM based on three selected features showed good discrimination in the training and validation cohorts (area under the curve [AUC], 0.941 and 0.945, respectively). A higher Rad-score, smaller tumor volume, and homogenous enhancement were demonstrated as independent predictors of BRAFV600E mutation in craniopharyngioma. The nomogram incorporating the Rad-score and clinical-radiological factors exhibited AUCs of 0.958 (95% CI, 0.936–0.980) and 0.956 (95% CI, 0.921–0.991) in the training and validation cohorts, respectively, showing good clinical benefit and calibration. The radiomics nomogram could provide an accurate, non-invasive preoperative prediction of BRAFV600E mutation in craniopharyngioma and may provide potential guidance for the preoperative administration of BRAFV600E mutation inhibitors and promote personalized treatment. Further prospective validation is still needed. [ABSTRACT FROM AUTHOR]

Summary Uterine leiomyomata, commonly known as fibroids, are prevalent benign tumours affecting a significant percentage of women of reproductive age. Although many patients remain asymptomatic, a substantial proportion experience severe symptoms, including abnormal uterine bleeding and adverse reproductive outcomes. Surgical intervention often becomes necessary for patients with symptomatic fibroids, despite advancements in medical therapies. This article explores the critical role of Magnetic Resonance Imaging (MRI) in the preoperative planning and management of fibroid surgeries. MRI has been proven superior to traditional imaging methods, such as transvaginal ultrasound (TVS), offering a more accurate evaluation of fibroid size, location, number, and characteristics. This enhanced imaging aids in surgical planning by providing detailed anatomical insights, helping gynaecologists choose the appropriate surgical techniques and predict potential complications. Moreover, MRI is instrumental in assessing the risk of malignancy, guiding decisions on whether to proceed with myomectomy or hysterectomy. Technological advancements, such as 3D MRI modelling and augmented reality, promise further improvements in surgical outcomes by enhancing anatomical understanding and precision. These innovations, along with artificial intelligence integration, show potential in reducing operation times and improving patient outcomes. This review underscores the essential role of MRI in contemporary fibroid management and highlights future directions in the field. [ABSTRACT FROM AUTHOR]

This study proposes a novel surgical technique for the excision of benign parotid tumors, utilizing a extracapsular dissection guided by a three dimensional digital model of the facial nerve(3DFN-ECD) and compares its clinical efficacy with the extracapsular dissection (ECD) method. This prospective study included 68 patients with benign parotid tumors. The control group (40 patients) received the ECD treatment, while the experimental group (28 patients), underwent the 3DFN-ECD approach proposed in this study. Preoperative three-dimensional double-echo steady-state water excitation sequence (3D-DESS-WE) of MRI was employed to visualize the tumor and facial nerve, and the Mimics software was used to reconstruct a three-dimensional digital model of the facial nerve and parotid tumor. The surgical incision and facial nerve dissection were planned based on the relationship between the tumor and the facial nerve. Postoperative facial nerve function and aesthetic outcomes of the incisions were compared between the two surgical techniques. There was no significant difference in the postoperative complications between the two groups. Postoperative facial nerve function scores in the 3DFN-ECD group were significantly higher than those in the control group at 1 week (p < 0.001) and 4 weeks (p < 0.001). The incidence of temporary facial nerve paralysis was significantly lower in the 3DFN-ECD group (P = 0.036), and the visual analogue scale score for aesthetic outcomes of the surgical incision was significantly improved (p < 0.001). The novel 3DFN-ECD surgical approach proposed in this study significantly reduces the risk of facial nerve injury and improves the aesthetic outcomes of the parotid tumor surgical incision. [ABSTRACT FROM AUTHOR]

Platelets possess cancer-induced reprogramming properties, thereby contributing to RNA profile alterations and further cancer progression, while the former is considered a promising biosource for cancer detection. Hence, tumor-educated platelets (TEP) are considered a prospective novel method for early breast cancer (BC) screening. Our study integrated the data from 276 patients with untreated BC, 95 with benign disease controls, 214 healthy controls, and 2 who underwent mastectomy in Chinese and European cohorts to develop a 10-biomarker diagnostic model. The model demonstrated high diagnostic performance for BC in an independent test set (n = 177) with an area under the curve of 0.957. The sensitivity for BC diagnosis was 89.2%, with 100% specificity in asymptomatic controls, while that for the symptomatic group, including benign tumors and inflammatory diseases, was 62.1%. The model demonstrated substantial accuracy for stages 0–III BC (80% for stage 0 [n = 5], 83.3% for stage I [n = 12], 94.6% for stage II [n = 37], and 88.9% for stage III [n = 9]) and precisely helped determine residual cancer in two patients who underwent mastectomy. Moreover, our developed classifiers distinguish different BC subtypes properly. In summary, we created and tested a new TEP-RNA-based BC diagnostic model that was confirmed valid and demonstrated high efficiency in detecting early-stage BC and heterogeneous subtypes, including recurrent tumors. However, these results warrant more validation in larger population-based prospective studies before clinical implementation. [ABSTRACT FROM AUTHOR]