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Macroautophagy/autophagy is an evolutionarily conserved cellular stress response mechanism. Autophagy induction in the tumor microenvironment (stroma) has been shown to support tumor metabolism. However, cancer cell-derived secreted factors that initiate communication with surrounding cells and stimulate autophagy in the tumor microenvironment are not fully documented. We identified CTF1/CT-1 (cardiotrophin 1) as an activator of autophagy in fibroblasts and breast cancer-derived carcinoma-associated fibroblasts (CAFs). We showed that CTF1 stimulated phosphorylation and nuclear translocation of STAT3, initiating transcriptional activation of key autophagy proteins. Additionally, following CTF1 treatment, AMPK and ULK1 activation was observed. We provided evidence that autophagy was important for CTF1-dependent ACTA2/α-SMA accumulation, stress fiber formation and fibroblast activation. Moreover, promotion of breast cancer cell migration and invasion by activated fibroblasts depended on CTF1 and autophagy. Analysis of the expression levels of CTF1 in patient-derived breast cancer samples led us to establish a correlation between CTF1 expression and autophagy in the tumor stroma. In line with our in vitro data on cancer migration and invasion, higher levels of CTF1 expression in breast tumors was significantly associated with lymph node metastasis in patients. Therefore, CTF1 is an important mediator of tumor-stroma interactions, fibroblast activation and cancer metastasis, and autophagy plays a key role in all these cancer-related events. Abbreviations: ACTA2/α-SMA: actin, alpha 2, smooth muscle CAFs: cancer- or carcinoma-associated fibroblasts CNT Ab.: control antibody CNTF: ciliary neurotrophic factor CTF1: cardiotrophin 1 CTF1 Neut. Ab.: CTF1-specific neutralizing antibody GFP-LC3 MEF: GFP-fused to MAP1LC3 protein transgenic MEF LIF: leukemia inhibitory factor IL6: interleukin 6 MEFs: mouse embryonic fibroblasts MEF-WT: wild-type MEFs OSM: oncostatin M TGFB/TGFβ: transforming growth factor beta [ABSTRACT FROM AUTHOR]

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We report a case of adrenal schwannoma, which is an extremely rare neoplasm. The patient was a 49-year-old woman, with abdominal discomfort for three months, who had been referred to our unit after detection of a right adrenal mass on abdominal magnetic resonance imaging. Although the mass was embedded in the liver, laparoscopic adrenalectomy was successfully accomplished. The definitive diagnosis was made only after immunohistochemical studies, which revealed a benign schwannoma. Complete laparoscopic excision is the treatment of choice whenever feasible. [ABSTRACT FROM AUTHOR]

Background: The omission of axillary lymph node dissection (ALND) remains controversial for patients with residual axillary disease after neoadjuvant chemotherapy (NAC), regardless of the residual burden. This study evaluated the oncologic safety and factors associated with outcomes in patients with residual axillary disease. These patients were treated solely with sentinel lymph node biopsy (SLNB) or targeted axillary dissection (TAD), without ALND, after NAC., Methods: A joint analysis of two different multicenter cohorts-the retrospective cohort registry MF18-02 and the prospective observational cohort registry MF18-03 (NCT04250129)-was conducted between January 2004 and August 2022. All patients received regional nodal irradiation., Results: Five hundred and one patients with cT1-4, N1-3M0 disease who achieved a complete clinical response to NAC underwent either SLNB alone (n = 353) or TAD alone (n = 148). At a median follow-up of 42 months, axillary and locoregional recurrence rates were 0.4% (n = 2) and 0.8% (n = 4). No significant difference was found in disease-free survival (DFS) and disease-specific survival (DSS) rates between patients undergoing TAD alone versus SLNB alone, those with breast positive versus negative pathologic complete response, SLN methodology, total metastatic LN of one versus ≥2, or metastasis types as isolated tumor cells with micrometastases versus macrometastases. In the multivariate analysis, patients with nonluminal pathology were more likely to have a worse DFS and DSS, respectively, without an increased axillary recurrence., Conclusions: The omission of ALND can be safely considered for patients who achieve a complete clinical response after NAC, even if residual disease is detected by pathologic examination. Provided that adjuvant radiotherapy is administered, neither the SLNB method nor the number of excised LNs significantly affects oncologic outcomes., (© 2024 The Author(s). Cancer published by Wiley Periodicals LLC on behalf of American Cancer Society.)

Objective: Breast cancer (BC) is a significant health concern and one of the most diagnosed cancers in women, both in Turkey and globally. Despite advances in the management of BC, axillary lymph node involvement remains a significant consideration for treatment planning, local recurrence, and prognosis. We aimed to evaluate the contribution of F-18 fluorodeoxyglucose-positron emission tomography/computed tomography (F-18 FDG-PET/CT) in detecting axillary lymph node metastasis compared to ultrasound (US)., Materials and Methods: Eighty patients who were diagnosed with stage I and II BC and underwent US and F-18 FDG-PET/CT scans before surgery were enrolled in this study. Those who did not undergo F-18 FDG-PET/CT imaging, patients with distant metastases at the time of diagnosis and patients with micrometastases in the axilla were excluded from the analysis. Imaging results of the status of axillary lymph nodes were verified with the final pathology report of axillary lymph nodes., Results: The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of F-18 FDG-PET/CT for the detection of ipsilateral axillary lymph node metastases were 75%, 77.27%, 72.97%, 79.07%, and 76.25%. The corresponding values for US were 72.22%, 81.82%, 76.47%, 78.26%, and 77.50%, respectively. When US finding is negative or suspicious in axillary lymph node evaluation, the accuracy of F-18 FDG-PET/CT for the detection of ipsilateral axillary lymph node metastases were 65.38%, 83.33%, 70.83%, and 79.55%, respectively., Conclusion: This study found that F-18 FDG-PET/CT does not provide an additional advantage over US in assessing the axilla in early-stage disease., Competing Interests: Conflict of Interest: The authors have no conflicts of interest to declare., (©Copyright 2024 by the Turkish Federation of Breast Diseases Societies / European Journal of Breast Health published by Galenos Publishing House.)

Aim: Angiolipoma is uncommon lesion in the breast and has clinical importance due to the potential of confusion with malignant breast lesions. To date, there is no defined diagnosis and treatment algorithm for breast angiolipomas. We aim to contribute to the literature for the diagnosis and treatment of angiolipomas with this case report and literature review., Case Report: A 29-year-old male patient presented with a newly emerged palpable mass in the right breast. Physical examination revealed a palpable mass in the lower inner quadrant of the right breast without any presence of skin changes, nipple discharge or palpable axillary lymph nodes. The lesion was found to be 3 cm in diameter and showed minimal vascularization on Doppler Ultrasound examination. Surgical excision of the lesion was performed and the lesion was diagnosed as angiolipoma., Conclusion: Angiolipomas of the breast in male are rare pathological entities and must always be considered during differential diagnosis, as it can be confused clinically, radiologically and pathologically with other lesions, especially with malignant lesions KEY WORDS: Angiolipoma, Breast, Male breast lesions.

Background/aims: Preoperative tumor marker assays have been used to predict the prognosis of gastric cancer, but the exact role they may play is still unclear. The aim of this study was to evaluate the clinical significance of preoperative serum carcinoembryonic antigen (CEA) and carbohydrate antigen (CA) 19-9 levels in resectable gastric cancer patients., Methodology: Seventy-five resectable, nonmetastatic gastric cancer patients were analysed in regard to their clinicopathological characteristics and their relation with tumor markers and influence on survival have been evaluated., Results: Twenty-eight patients were female and 47 were male. The mean age was 61 years (range 21-85 years). Fifty-two patients had total gastrectomy, and 23 had a subtotal gastrectomy with D2 lymph node dissection. The median follow up period was 24 months (6-74 months). Elevated serum CA 19-9 levels correlated well with lymph node metastasis (p = 0.008), stage (p = 0.012), vascular invasion (p = 0.03) and tumor size (p = 0.001). The survival of the patients were not correlated with the tumor markers (p > 0.05)., Conclusions: Elevated CA 19-9 levels are significantly correlated with lymph node metastasis, which may improve the selection of patients with advanced disease. CEA and CA 19-9 levels do not provide any predictive information about survival of operable, nonmetastatic gastric cancer patients.

Small bowel intussusception is a rare cause of adult acute abdomen, in which an intraluminal neoplasm is the most frequent cause. Small bowel tumors are uncommon and can have a long delay prior to diagnosis. We present a case of intestinal intussusception originating from a rare variant of small bowel mesenchymal tumor, presenting with a hematologic disorder.

Background/aims: The aim of this study was to evaluate the prognostic significance of serum carcinoembryonic antigen (CEA) and carbohydrate antigen (CA19-9) levels in patients with gastric cancer., Methodology: During the period January 2000 and January 2003, 36 patients operated for primary gastric cancer, at Sisli Etfal Training and Research Hospital, Department of General Surgery, were analyzed. Serum CEA and CA19-9 levels were determined preoperatively and the correlation between the elevated levels of tumor markers and several clinicopathological features, and survival were evaluated., Results: Elevated serum CEA and CA19-9 levels were determined in 10 of 35 patients (28.6%), and 9 of 31 patients (29%), respectively, and both markers were elevated in 3 of 31 patients (9.6%). Elevated levels of CEA correlated with depth of invasion (p=0.018) and pathological stage (p=0.029); elevated levels of CA19-9 correlated with lymph node metastasis (p=0.026); and elevated levels of both markers correlated well with lymph node metastasis (p=0.031). The survival of patients with normal CEA levels was significantly better than those with elevated levels (p=0.0072)., Conclusions: Preoperative serum CEA and CA19-9 levels may add useful information in patients with gastric carcinoma, and CEA level is a predictor of prognosis.

Background: We investigated the value of 5-hydroxyindolacetic acid (5-HIAA) levels in spot urine in the diagnosis of acute appendicitis., Methods: Forty-three patients (11 females, 32 males; mean age 26.3 years; range 16 to 73 years) who were admitted to the emergency room with acute abdominal pain and suspected acute appendicitis were evaluated by means of physical examination, leukocyte counts, urine analysis, measurements of 5-HIAA in spot urine, abdominal x-rays, and sonography. Of these, 25 patients underwent appendectomy after a clinical diagnosis of acute appendicitis. Spot urine analyses were made in all the patients within the first hour of admission with the use of spectrophotometric and colorimetric methods; 5-HIAA levels were read at 540 nm., Results: At laparotomy, 22 patients (88%; 3 females, 19 males; mean age 26.18 years; range 15 to 38 years) were found to have acute appendicitis (11 phlegmonous, 11 gangrenous), whereas three patients (12%; 2 females, 1 male) had negative findings. No significant differences were found between patients with confirmed acute appendicitis, patients without appendectomy, and those with negative laparotomy with respect to the mean leukocyte counts and 5-HIAA levels (p>0.05). The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 5-HIAA for the diagnosis of acute appendicitis were calculated as 22%, 93%, 71%, 62%, and 63%, respectively., Conclusion: Measurement of 5-HIAA levels in spot urine is not helpful in the diagnosis of acute appendicitis.