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Skeletal muscle is integral to the functioning of the human body. Several pathological conditions, such as trauma (primary lesion) or genetic diseases such as Duchenne muscular dystrophy (DMD), can affect and impair its functions or exceed its regeneration capacity. Tissue engineering (TE) based on natural, synthetic and hybrid biomaterials provides a robust platform for developing scaffolds that promote skeletal muscle regeneration, strength recovery, vascularization and innervation. Recent 3D-cell printing technology and the use of nanocarriers for the release of drugs, peptides and antisense oligonucleotides support unique therapeutic alternatives. Here, the authors present recent advances in scaffold biomaterials and nano-based therapeutic strategies for skeletal muscle regeneration and perspectives for future endeavors.

The tonsillar crypt is thought to be a hiding site for early cancer detected after tonsillectomy for primary lesion search in cancer of unknown primary site. In rare cases, a small lesion can be detected unexpectedly during surgical treatment for chronic tonsillitis and tonsillar focal diseases. We report the case of a 47-year-old woman undergoing tonsillectomy for palmoplantar pustulosis (PPP), resulting in the diagnosis of p16-positive oropharyngeal cancer (OPC) in the left tonsil. Postoperative radiation therapy was performed due to the presence of an adhesive lesion during surgery. Radiotherapeutic adverse effects were mild and improved 3 months after the radiotherapy. The symptoms of PPP completely resolved 3 months after the tonsillectomy and no recurrence has been observed so far. With an increase in the cases of HPV-related OPCs, routine pathological examination after tonsillectomy for benign-appearing tonsils in adults is necessary to detect incidental OPC regardless of its low cost-effectiveness.

Local consolidative therapy (LCT) for oligometastatic non-small cell lung cancer (NSCLC) is an evolving treatment paradigm. We investigated whether the biologically effective dose (BED) of consolidative radiation therapy (RT) to the primary tumor predicted for improved local control, progression-free survival (PFS), and overall survival (OS) among NSCLC patients presenting with oligometastatic disease.Patients presenting to a single institution (2000-2017) with stage IV NSCLC, ≤3 synchronous metastatic lesions at diagnosis, and treated with RT to the primary tumor were identified. Univariate and multivariable Cox proportional-hazards regression modeling were performed to identify factors associated with local recurrence-free survival (LRFS), PFS, and OS.One hundred twenty-four patients were identified meeting our inclusion criteria. With a median follow-up of 55.1 months, median PFS and OS for the entire cohort were 11.0 months and 25.3 months, respectively. The median BED (α/β = 10) of RT to the primary tumor was 74.3 Gy. On univariate analysis, increased BED to the primary tumor predicted for improved PFS (p 0.001) and LRFS (p = 0.01), with a median PFS of 8.5 vs 12.8 months and median LRFS of 23.4 vs 58.4 months between patients treated with BED 75 Gy and ≥75 Gy, respectively. Increased BED to the primary tumor was also associated with significantly improved OS (p = 0.02); patients treated with a BED of75 Gy demonstrated a median OS of 22.9 months vs 27.5 months if treated with BED ≥ 75 Gy. On multivariable analysis, primary site BED remained a significant predictor of OS (p = 0.02) and PFS (p = 0.002).We found that delivery of75 Gy BED RT regimens to the primary lesion in patients with synchronous oligometastatic NSCLC is associated with improved local control, PFS, and OS. These data support results of recent prospective trials and other ongoing prospective efforts to characterize therapeutic benefits associated with this management strategy.

Since the treatment of lung squamous cell carcinoma (SCC) was limited due to a lack of appropriate biomarkers and novel target agents. Immune checkpoint inhibitors can offer an effective treatment for patients with advanced non-small cell lung cancer. Here, we described the cases of two patients with SCC who showed a good response following treatment with tislelizumab. We encountered two patients with unresectable lung SCC who were treated with immunotherapy and chemotherapy. One patient had negatively programmed death-ligand 1 expression, and the primary lesion becomes a thick wall cavity after the tislelizumab combined with chemotherapy. Another patient was diagnosed with advanced lung SCC with negative programmed death-ligand 1 expression. After the treatment, the fluorine-18-fluorodeoxyglucose PET/computed tomography indicated that no abnormal increase in radioactivity uptake and tend to complete remission. We found a significant response or even complete response in unresectable SCC treated with tislelizumab combined with chemotherapy. Our cases added evidence of the feasibility and efficacy of tislelizumab combined with chemotherapy in unresectable lung SCC.

PURPOSE Isolated case reports mention the uptake of radiolabeled PSMA in lymphoma. However, it is not clear if the intensity of 68Ga-PSMA expression varies among different histological subtypes or if it correlates with 18F-FDG uptake. This study compared both tracers in patients with diverse lymphoma subtypes. METHODS Ten patients with biopsy-proven-lymphoma underwent 18F-FDG and 68Ga-PSMA-PET/CT (maximum time interval: 6 days). Lymphoma subtypes included Hodgkin's lymphoma (HL, three patients) and aggressive and indolent non-Hodgkin's lymphoma (NHL, seven patients). The intensity of PSMA uptake was classified visually as low, intermediate, or high, using blood pool, liver and parotid gland uptake as references. Maximum standardized-uptake value (SUVmax) of each affected site was measured in both sets of images. RESULTS FDG detected 59/59 involved sites in 10 patients and PSMA 47/59 sites in nine patients. PSMA uptake was generally low, regardless of the intensity of FDG uptake, but it was classified as intermediate in two patients. The median SUVmax varied from 2.0 (2.0-8.2) to 30.9 for FDG and from 1.7 (1.7-1.7) to 4.4 for PSMA, P < 0.0001. The primary lesion of one patient had a marked intralesional mismatch uptake pattern of the tracers, with areas of higher PSMA expression than FDG uptake, and vice-versa. A brain lesion was more easily identified with PSMA than with FDG images. CONCLUSION HL and several NHL subtypes may present PSMA uptake. The intensity of PSMA expression is generally lower than that of FDG uptake and seems to present less variation among the different histological subtypes of lymphomas.

Objective To investigate the molecular characteristics in tumor immune microenvironment that affect long-term survival of patients with pancreatic adenocarcinoma (PAAD). Methods The tumor related genetic features of a female PAAD patient (over 13-year survival) who suffered from multiple recurrences and metastases, and six operations over one decade were investigated deeply. Genomic features and immune microenvironment signatures of her primary lesion as well as six metastatic tumors at different time-points were characterized. Results High-frequency clonal neoantigenic mutations identified in these specimens revealed the significant associations between clonal neoantigens with her prognosis after each surgery. Meanwhile, the TCGA and ICGC databases were employed to analyse the function of KRAS G12V in pancreatic cancer. Conclusions The genomic analysis of clonal neoantigens combined with tumor immune microenvironment could promote the understandings of personalized prognostic evaluation and the stratification of resected PAAD individuals with better outcome.

Introduction: Colon and rectal cancers are common malignancies all over the world. The estimated 5-year relative survival is about 65%. Although curative resection of the primary lesion improves survival, still about 40% of patients, mostly patients with distant metastasis, die from colon and rectal cancer.The most common site of distant metastasis is considered the liver. This is true regarding many types of malignancies. Although Metastases of the liver can result from a wide variety of malignancies, with the most widely known being from colorectal origins PET/CT is a very valuable tool in the follow up of colorectal cancer patients, SUVmax is the most commonly used PET parameter and represent the voxel of the highest activity within the ROI. However, other parameters as MTV and TLG gain an interest in recent studies.Aim of the work: The objective of this review is to highlight the value of PET/CT metabolic parameters as SUVmax, MTV and TLG in colorectal patient with liver metastasis.

Background Lipoma arborescens is characterized by the villous proliferation of the synovium and diffuse hyperplasia of fatty tissue in the subsynovial layer, almost always with a periarticular lesion. According to past articles, fewer cases have depicted the imaging features of lipoma arborescens. Purpose To evaluate the computed tomography (CT) and magnetic resonance imaging (MRI) features of lipoma arborescens. Material and Methods The imaging features of 15 patients with pathologically proven lipoma arborescens were retrospectively analyzed including lesion number, shape, location, size, margins, attenuation on CT, and signal intensity and enhancement patterns on MR images. Results All cases (n=15) showed joint or bursa effusion. The primary lesion attached to the bursa wall adjacent to the bone in 13 cases and to the lateral wall in two cases. CT shows a mass with fatty tissue attenuation values in the suprapatellar pouch (n=3) or subdeltoid bursa with an erosion of the humeral head (n=2), among them two cases showed branched slightly high density in the center of the fat density tissue. Fifteen cases on routine MRI display mass-like subsynovial mass with fatty tissue signal on all of the sequences and suppression of the signal on fat-suppression sequences. Among them, five lesions showed branched slightly low T1-weighted imaging, high proton density-weighted imaging, and T2-weighted imaging signals in the center. It showed the enhancement of the linear surface and the bursa wall in contrast-enhanced MRI (n=3). Conclusion Lipoma arborescens have specific CT and MRI features that enable them to make a conclusive diagnosis of this rare condition, which helps the diagnosis before treatment.

Standard of care for high‐risk cutaneous squamous cell carcinoma (cSCC) is surgical excision of the primary lesion with clear margins when possible, and additional resection of positive margins when feasible. Even with negative margins, certain high‐risk factors warrant consideration of adjuvant therapy. However, which patients might benefit from adjuvant therapy is unclear, and supporting evidence is conflicting and limited to mostly small retrospective cohorts. Here, we review literature from the last decade regarding adjuvant radiation therapy and systemic therapy in high‐risk cSCC, including recent and current trials and the role of immune checkpoint inhibitors. We demonstrate evidence gaps in adjuvant therapy for high‐risk cSCC and the need for prognostic tools, such as gene expression profiling, to guide patient selection. More large‐cohort clinical studies are needed for collecting high‐quality, evidence‐based data for determining which patients with high‐risk cSCC may benefit from adjuvant therapy and which therapy is most appropriate for patient management.

The analysis of current views on Crohn’s disease (CD) has been carried out. A case report of the sudden onset of CD by symptoms of acute appendicitis in young patient is described. The events took place as follows: cumulative negative impact of risk factors — acute CD with primary lesion of vermiform appendix — clinical manifestations of acute appendicitis — appendectomy — recovery, possibly deceptive.

Objective The aim of this study was to determine the clinical outcomes and long-term stability of individualized titanium mesh combined with free flap for orbital floor reconstruction after maxillectomy and to identify the risk factors for titanium mesh exposure. Material and methods The data of 66 patients who underwent maxillectomy and orbital floor defect reconstruction by individualized titanium mesh in Peking University School and Hospital of Stomatology between 2011 and 2019 were retrospectively reviewed. Postoperative ophthalmic function and success of aesthetic restoration were assessed. Titanium mesh exposure was recorded and the risk factors were identified. Results Mean follow-up was for 24.8 months (range, 6-92 months). Ophthalmic function was successfully restored in 63/66 patients. Aesthetic restoration was not considered satisfactory by 10 patients. Titanium mesh exposure occurred in six patients (exposure rate, 9.1%). Preoperative radiotherapy was identified as an independent risk factor for mesh exposure (OR = 28.8, P = 0.006). Previous surgery, postoperative radiotherapy, pathological type of the primary lesion, the type of tissue flap applied, and the use of intraoperative navigation were not significant risk factors. Six patients with titanium mesh exposure underwent second surgery, but mesh exposure recurred in two patients due to insufficient soft tissue coverage. Conclusion Individualized titanium mesh with free flap can effectively restore maxilla-orbital defects. Preoperative radiotherapy is an independent predictor of postoperative titanium mesh exposure. Adequate soft tissue coverage of the mesh may reduce the risk of mesh exposure. Level of evidence Level 4 (case-control study) Laryngoscope, 2021.

Predicting the response to neoadjuvant chemoradiotherapy (NCRT) and the prognosis of esophageal squamous cell carcinoma (ESCC) is challenging. This study evaluated the potential of a preoperative computed tomography (CT) analysis for predicting the pathological response and survival of patients with ESCC who received trimodality therapy. A total of 119 patients with cT3 or T4 ESCC who underwent surgery following NCRT between 2007 and 2019 were assessed. The CT-based parameters were measured with enhanced CT preoperatively, prior to and during treatment. Associations between these parameters and the pathologic response, as well as the prognosis, were examined. Pretreatment maximum CT value (p = 0.009), pretreatment mean CT value (p = 0.022), preoperative whole tumor volume (WTV, p = 0.003), preoperative largest cross section (LCS, p = 0.002), ΔLCS (pretreatment to preoperative, p = 0.004), ΔWTV (pretreatment to preoperative, p = 0.012), and Δmean CT value (pretreatment to preoperative, p = 0.012) of the primary lesion were significantly associated with a good pathological response. A Cox-regression analysis of recurrence-free survival (RFS) and overall survival (OS) showed that preoperative LCS was an independent CT-based predictor. RFS and OS were significantly higher at the optimal cut-off value of the preoperative LCS (p = 0.036 and p = 0.016, respectively). CT-based parameters are thus considered to be valuable predictors of the tumor response and survival after trimodality therapy for ESCC.

Pancreatic neuroendocrine neoplasms occasionally have a cystic component. We herein report a case of multiple hepatic tumors, including a huge one and a 24-mm sized pancreatic cystic lesion. The hepatic tumor showed an enhancement pattern consistent with hepatic adenoma. The pancreatic cystic lesion revealed a thickened outside border and a solid inside component, which was enhanced following a contrast study, suggesting cystic pancreatic neuroendocrine neoplasm. Surgical resection was performed. After the surgery, somatostatin receptor scintigraphy detected an occult lumbar spine metastasis. Huge multiple liver and bone metastases of the neuroendocrine neoplasm G2 component were seen, with a G1 small primary lesion.

Background: In case of multiple pulmonary and extrapul-monary lesions, it is difficult to determine if the lung mass was primary lesion or metastasis from a distant organ, even in multiple pulmonary lesions. it is difficult to determine sit of primary one. Aim of Study: We retrospectively measure the SUVmax and D SUVmax in pulmonary and extrapulmonary lesions and identify if there is a cutoff value of SUVmax between patho-logically proved synchronous second primary and metastatic lesions. Patients and Methods: 65 patients (50 male and 15 female with age ranged from 35 to 70 years) who had multiple pulmonary and extrapulmonary lesions were evaluated by PET/CT, all patients were evaluated by oncology physicians, patients were selected after histopathological evaluation, patients with lung metastasis taken as a control group. SUVmax and D SUVmax were measured in both groups. Results: A significant (DSUV) max difference between both included groups: Metastatic lung cancers and second primary lung tumours with a cutoff value of 35% while no significant DSUVmax between the studied cases in the same groups, as below this level approved for metastatic lesion and above this cutoff values consistent with the synchronous second primary tumour, this help in better staging and man-agement of lung cancer. Conclusion: PET CT is considered as a functional non-invasive technique, we recommended that all patients with multiple pulmonary and extrapulmonary lesions to add this investigation, before taking the decision of management, it can differentiate between multiple primaries and metastatic lesion depending upon the FDG activity.

Synchronous primary malignancies are a rare finding which can be difficult to diagnose. We present the case of a 57-year-old patient with a high prostate specific antigen who was found to have prostate cancer on subsequent magnetic resonance imaging. A skeletal metastasis was also identified at the time, although no osteoblastic activity or sclerosis was identified on skeletal scintigraphy or computed tomography, respectively. The patient was started on hormonal therapy and follow-up imaging revealed the prostate cancer to have reduced in volume. Despite this, the skeletal metastasis appeared unchanged on magnetic resonance imaging and an F18-choline positron emission tomography study was negative. A computed tomography guided bone biopsy was organized and this demonstrated metastatic leiomyosarcoma. As a result, an F18-fluorodeoxyglucose positron emission tomography study was performed to find the primary lesion which demonstrated a large malignant tumor within the calf. Subsequently, the patient was referred to a tertiary sarcoma unit. This case highlights the challenges involved in diagnosing and managing synchronous malignancies.

Cutaneous metastasis may be the initial sign of internal malignancy but more often represents a late manifestation of widely disseminated disease. Breast carcinoma is the most common malignancy to metastasize to the skin. Although several studies have detailed the histopathologic patterns of cutaneous metastasis from internal malignancies, very little has been published regarding metastases of breast carcinoma to the skin. Furthermore, the histopathologic and clinical features observed in the cases of breast carcinoma with local skin involvement as opposed to cases exhibiting distant cutaneous metastases have not been adequately investigated. We have reviewed 232 cases of breast carcinoma with cutaneous metastases from 2 large institutions. All cases of carcinoma of the breast with involvement of the skin of the anterior chest wall were compared with those with distant cutaneous metastases. Two hundred thirty-two cases in 199 patients were included, of which 126 had skin involvement exclusively involving the ipsilateral anterior chest, and 106 had biopsy-proven distant cutaneous metastases. Twelve patients had both local and distal spread. Distant cutaneous metastases showed a predilection for the contralateral anterior chest wall area, followed by the head and neck, back, and abdomen. Histologically, most of the tumors presented in this series showed features of infiltrating ductal carcinoma. In both ipsilateral and distant metastases, the tumors demonstrated little change in histologic features from the primary lesion; however, the distant metastases showed a tendency to display more poorly differentiated features. The mean patient survival when cutaneous involvement was localized to the skin of the anterior chest wall was 23 months as compared with 20.6 months when distant sites were affected. A comparison of the clinicopathologic features of the patients presented in this series suggests that alternate biological mechanisms may apply for local and distant skin metastases from breast carcinoma.

Sellar metastases account for 0.87% of all intracranial metastases. They are usually asymptomatic and can be the first manifestations of some occult malignancy. The diagnosis is made mainly during the screening of patients with known primary lesions or can present with neurologic or hormonal changes related to compression or invasion of surrounding structures. Differentiating these lesions from other more common lesions such as pituitary adenoma maybe difficult. Management is mainly aimed at the primary lesion and is palliative to improve quality of life or for pathologic confirmation.

Traditionally, treatment responses to chemotherapy had been based on Response Evaluation Criteria in Solid Tumours (RECIST) criteria evaluating tumor shrinkage, stabilization of disease, growth, or development of new metastatic lesions. Using the same criteria to determine response in patients on immunotherapy has proven difficult, as some patients have initial growth of disease or develop new small metastatic lesions. The phenomenon of pseudoprogression is the initial growth of a primary lesion followed by latent or delayed response. Advanced practitioners need to be aware of the possibility of pseudoprogression in order to educate patients and help them stay on effective treatment.

Surgical ciliated cysts (SCC) are rare entities that were first described in the Japanese literature after treatment for chronic maxillary sinusitis. Classically associated with surgery to the maxillary sinus, they have also been reported in association with orthognathic surgery, bone grafting, and trauma. These lesions can develop from a few months up to several years after the surgical procedure. The authors report 2 new cases of SCC after a LeFort I osteotomy for class III dentofacial deformity correction. One of them presented with bilateral lesions and suffered from a recurrence after 5 years, 2 rare events associated with SCC.A review of the literature of the past 5 years was undertaken, in order to ascertain the reported time of follow-up and recurrence. A PubMed search retrieved a total of 15 articles with 17 cases reported. Nine cases were associated with orthognathic surgery, 4 with Caldwell-Luc procedures, 2 with sinus lift and 2 with trauma. The mean follow-up after removal of the SCC was of 8.6 months. Four cases did not specify the follow up time; 1 case was lost to follow-up. No relapses were reported.Like what happens with the primary lesion, a recurrence can take place several years after removal. It is the authors' opinion that adequate long-term follow-up must be granted for a timely diagnosis and treatment of relapsed SCC.

Retinal ganglion cell axons forming the optic nerve (ON) emerge unmyelinated from the eye and become myelinated after passage through the optic nerve lamina region (ONLR), a transitional area containing a vascular plexus. The ONLR has a number of unusual characteristics: it inhibits intraocular myelination, enables postnatal ON myelination of growing axons, modulates the fluid pressure differences between eye and brain, and is the primary lesion site in the age-related disease open angle glaucoma (OAG). We demonstrate that the human and rodent ONLR possesses a mitotically active, age-depletable neural progenitor cell (NPC) niche, with unique characteristics and culture requirements. These NPCs generate both forms of macroglia: astrocytes and oligodendrocytes, and can form neurospheres in culture. Using reporter mice with SOX2-driven, inducible gene expression, we show that ONLR-NPCs generate macroglial cells for the anterior ON. Early ONLR-NPC loss results in regional dysfunction and hypomyelination. In adulthood, ONLR-NPCs may enable glial replacement and remyelination. ONLR-NPC depletion may help explain why ON diseases such as OAG progress in severity during aging.

We report our PET/MRI experience from a pilot study that compared the diagnostic performance of 18F-FDG PET/MRI versus PET/CT in staging of cervical cancer. Methods: Six adults with newly diagnosed cervical cancer underwent a single 18F-FDG injection with a dual-imaging protocol: standard-of-care PET/CT followed by research PET/MRI. The diagnostic interpretation and SUVmax for the 2 modalities were compared. Results: Both modalities detected all primary tumors (median size, 3.9 cm) and all 4 metastases present in 2 of the 6 patients (median size, 0.9 cm). PET/MRI provided greater diagnostic confidence than PET/CT and upstaged the disease in 4 patients. On the basis of the imaging findings alone, the additional information from PET/MRI would have led to a change in clinical management in 3 of 6 patients. The primary lesion showed a median SUV of 12.8 on PET/CT and 18.2 on PET/MRI (P = 0.03). SUVs, however, correlated strongly between the 2 modalities (ρ = 0.96, P

Pregnancy- associated melanoma (PAM) is reported between 2.8 and 5.0 per 100,000 pregnancies and approximately 35% of women with melanoma are of childbearing age. The diagnosis and treatment of melanoma during pregnancy needs a balance of risks and benefits for both maternal and fetal well-being. It is a type of malignancy, which requires a multidisciplinary approach, not limited to the obstetrician, but also to oncologists, neonatologists, pharmacists and psychologists.We present a case of a 36-year-old pregnant woman, who was admitted to our 3The patient was affected by an 11 cm pregnancy-associated melanoma in the lower part back, with 2 hepatic metastasis. Due to the quickly development of general symptoms of sepsis it was decided to perform an urgent C-section. For the systematic review, we found 11 articles of advanced clinical melanoma, providing data from 12 patients. Maternal-perinatal outcomes is different depending on gestational age, general clinical condition, stage at diagnosis.Advanced melanoma is usually associated with a higher rate of termination of pregnancy, If the pregnancy continues, for the mother is associated with an higher risk of Cesarean section, sepsis, maternal progression of disease; for the baby is associated with prematurity, low birth weight, neonatal metastatic disease, neonatal morbidity and mortality. The future aim of clinicians should be the creation of an international database of the clinical cases of pregnancy-associated melanoma, to evaluate the same data, to improve treatments, to develop common protocols, and, finally, to improve the obstetric and perinatal outcomes.

Purpose: The objectives of this study were (1) to systematically review current definitions of head and neck squamous cell carcinoma (HNSCC) recurrence and (2) to propose a definition of locally recurrent HNSCC. Methods: A systematic literature review was performed according to the ‘Preferred Reporting Items for Systematic Reviews and Meta-Analyses’ statement in Medline, Embase, and Cochrane databases guided by the study question “What is the definition of local recurrence for patients with HN:SCC?”. All retrieved studies were reviewed and qualitatively analyzed. Results: The systematic literature search resulted in 3467 publications after removal of duplicates. Forty studies were examined as full text, and a total of five were found suitable for inclusion. All five included studies dealt with definitions of second primary HNSCC and were based on the Warren and Gates Criteria; (1) each of the tumors are malignant, (2) each must be distinct, and (3) the probability of one being a metastasis of the other must be excluded. Each of the included studies added specific anatomical and/or temporal separation measures to the criteria of second primary HNSCC. We propose the definition of locally recurrent HNSCC to be: (1) Same anatomical subsite or adjacent subsite within 3 cm of the primary lesion, (2) time-interval no more than 3 years (from completed treatment of the primary lesion), and (3) same p16-status for oropharyngeal carcinomas. Conclusions: No uniform definition of locally recurrent HNSCC currently exists. We propose the Odense–Birmingham definition based on the anatomical subsite combined with a specific measurable distance and a temporal separation of three years.

In general, patients with neurofibromatosis type I have a higher risk than those with other types of neurofibromatosis of developing soft-tissue sarcomas related to the nervous system. We here present a 42-year-old man with neurofibromatosis type I who developed a protruding mass over only 2 weeks. The histopathological diagnosis was epithelioid sarcoma. Epithelioid sarcomas are rare and, to the best of our knowledge, no epithelioid sarcomas have been reported in patients with neurofibromatosis type I. Radical excision of the primary lesion was performed and postoperative radiotherapy and chemotherapy administered, as is recommended for epithelioid sarcoma. Our case emphasizes that patients with neurofibromatosis type I may develop malignant tumors.

Use of yttrium-90 (Y-90) is used for primary liver tumors and a handful of liver metastatic lesions. Y-90 treatment for metastatic adrenocortical carcinoma (ACC) to the liver is currently off-label, with one previously documented case report. In this case report, we present a 52-year-old woman with ACC and extensive liver metastatic disease. After failed chemotherapy, multidisciplinary discussion suggested potential Y-90 treatment for palliative purposes. After undergoing Y-90 treatment separately to the right and then the left hepatic lobes, subsequent patient visits demonstrated significantly improved clinical function as well as complete radiographic resolution of liver metastatic disease mainly from ACC. This case report demonstrates the potential efficacy of Y-90 for off-label uses in liver metastatic disease. This case and similar cases may open the door to a wide variety of potential indications for Y-90 treatment.

We examined a 10-year-old cow in which about half of the liver was displaced by malignant tissue consisting of hepatocellular carcinoma (HCC) and cholangiocarcinoma (CC). Cytokeratin (CK) 18 and 7 were expressed in the latter. Metastasis was present in the hepatic, pancreaticoduodenal and mediastinal lymph nodes, where malignant cells had hepatocellular features, but more pleomorphic and atypical than in the primary lesion. Areas composed solely of CC cells or less-differentiated HCC cells were observed. In contrast, well-differentiated HCC cells were almost always admixed with the other two types, and may have had the ability to transform into CC cells and to dedifferentiate into less-differentiated cells. This report suggests that CK18 is an excellent marker for biliary differentiation in cattle.

The present article is a case report of solitary neurofibroma of oral cavity in a 50-year-old male patient. Patient reported with chief complaint of swelling in relation to upper front teeth region since 2 months. Based on clinical, radiographical, and histopathological findings the diagnosis of neurofibroma was made. Neurofibroma involving oral cavity as primary lesion is very rare in occurrence. It mainly involves tongue, palate, and buccal mucosa. Surgical excision is performed in the present case.