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Background: Accurate glioma diagnosis requires a combination of histology, radiology and identification of key genetic mutations. Currently, multiple tests are required to identify these mutations. Deoxyribonucleic acid (DNA) methylation microarray coupled with digital classification algorithms can subclassify gliomas and identify multiple mutations in a single experiment, thereby potentially replacing current modalities and reduce turnaround times. Aim: This study aims to compare results obtained by DNA methylation microarray on select adult glioma cases previously classified and graded on the basis of morphology and currently available ancillary tests. Setting: Cape Town, South Africa. Methods: Eight cases comprising astrocytic and oligodendroglial tumours (WHO grades 2-4) were analysed using the Illumina Infinium MethylationEPIC 850k microarray platform. Tumour classification and O6-methylguanine DNA-methyltransferase (MGMT) promoter methylation status were determined via online classification algorithms. Key genetic and chromosomal changes were identified by copy number variation plots. Results: Seven of the eight cases were successfully assigned a methylation class and showed concordance with previously determined histological tumour type, isocitrate dehydrogenase and 1p/19q co-deletion status. Of these, tumour grading remained unchanged in five cases, upgraded in one case and downgraded in the other. The remaining case could not be classified. The MGMT promoter methylation status and diagnostically relevant copy number variants were also identified. Conclusion: Tumour classification and grading can be accurately determined by methylation microarray analysis in adult gliomas. Contribution: Methylation microarray provides greater molecular information than current methods, thereby potentially improving diagnostic accuracy and patient prognostication. [ABSTRACT FROM AUTHOR]

Primary Epithelioid hemangioendothelioma of the spine is an ultra-rare malignant vascular neoplasm with no pathognomonic clinical features and as such requires a high index of suspicion and a multi-disciplinary and multimodality treatment approach., Competing Interests: The authors declare no conflicts of interest., (© 2025 The Author(s). Clinical Case Reports published by John Wiley & Sons Ltd.)

Importance: Increasing detection of early-stage papillary thyroid neoplasms without improvements in mortality has prompted development of strategies to prevent or mitigate overtreatment., Objective: To determine adoption rates of 2 recent strategies developed to limit overtreatment of low-risk thyroid cancers: (1) a new classification, noninvasive follicular thyroid neoplasm with papillarylike nuclear features (NIFTP), and (2) hemithyroidectomy for selected papillary thyroid carcinomas (PTCs) up to 4 cm in size., Design, Setting, and Participants: This is a cross-sectional analysis of 3368 pathology records of 2 cohorts of patients from 18 hospitals in 6 countries during 2 time periods (2015 and 2019). Participating hospitals were included from the US (n = 12), Canada (n = 2), Denmark (n = 1), South Korea (n = 1), South Africa (n = 1), and India (n = 1). The records of the first 100 patients per institution for each year who underwent thyroid-directed surgery (hemithyroidectomy, total thyroidectomy, or completion thyroidectomy) were reviewed., Main Outcomes and Measures: Frequency of diagnosis of NIFTP, PTCs, and thyroidectomies during the study period., Results: Of the 790 papillary thyroid neoplasms captured in the 2019 cohort, 38 (4.8%) were diagnosed as NIFTP. Diagnosis of NIFTP was observed in the US, South Africa, and India. There was minimal difference in the total proportion of PTCs in the 2015 cohort compared with the 2019 cohort (778 [47.1%] vs 752 [44.5%]; difference, 2.6% [95% CI, -16.9% to 22.1%]). The proportion of PTCs eligible for hemithyroidectomy but treated with total thyroidectomy in the 2 cohorts demonstrated a decreasing trend from 2015 to 2019 (341 of 453 [75.3%] vs 253 of 434 [58.3%]; difference, 17.0% [95% CI, -1.2% to 35.2%])., Conclusions and Relevance: Results of this cohort study showed that the 2 mitigation strategies for preventing overtreatment of early-stage thyroid cancer have had mixed success. The diagnosis of NIFTP has only been applied to a small proportion of thyroid neoplasms compared with expected rates. However, more patients eligible for hemithyroidectomy received it in 2019 compared with 2015, showing some success with this deescalation strategy.