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Liposarcomas are malignant mesenchymal neoplasms that, although derived from adipocytes, may dedifferentiate to other cell types. We present an exceedingly rare case of epithelioid/neuroendocrine dedifferentiation with somatostatin expression of a pararenal retroperitoneal liposarcoma.

Purpose This study aims to confirm the diagnostic accuracy of extra-prostatic extension (EPE) grading system and to explore the predictive capabilities of the prostate MRI while considering various MRI features such as lesion location, apparent diffusion coefficient (ADC) values and capsular enhancement sign (CES). Methods Our monocentric study is based on a retrospective analysis of 99 patients who underwent radical prostatectomy from January 2021 to January 2023. The observers reviewed for each lesion, including location (transitional or peripheral zone, anterior or posterior location), capsular contact length, irregular bulging of the capsule, asymmetry of the neurovascular bundle, obliteration of the recto-prostatic angle, macroscopic EPE, ADC value, and CES. Results Among 99 patients, 31 patients had EPE. Lesions with EPE have broadercapsule contact (24 mm vs 12 mm) with contact ≥14 mm being the optimal cut-off for EPE discrimination. Among the morphological MRI criteria used to determine the EPE, the one with major sensitivity was shown to be bulging (sen 81%), while macroscopic extension had highest specificity (100%). Univariate analysis showed as significative risk factors for EPE: capsular contact ≥14 mm (P  < .001), International Society of Urological Pathology score ≥3 (P  = .005), CES (P  < .001), bulging (P  = .001), neurovascular bundle asymmetry (P  < .001) and EPE score ≥2 (P  < .001), and in multivariate analysis CES (P  = .001) and EPE score ≥2 (P  = .004) were significant. The AUC of the EPE score was 0.76, raised to 0.83 when combining it with CES (P  = .11). Conclusion CES in the setting of multiparametric MRI can increase diagnostic accuracy for the prediction of extracapsular disease. Advances in knowledge This study highlights the potential of contrast media in prostate cancer local staging. [ABSTRACT FROM AUTHOR]

Severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) causes COVID-19 that has been spreading worldwide since December 2019. Viral entry into cells requires expression of both angiotensin-converting enzyme 2 (ACE2) and transmembrane protease serine 2 (TMPRSS2) on the surface of the host cell. The male reproductive system, including the prostate, was supposed to be a potential target for SARS-CoV-2 since the presence of ACE and TMPRS2 receptors. This paper investigated for the first time the presence of SARS-CoV-2 mRNA in the prostatic tissue of a patient with active infection. In addition, we searched for the virus in the prostate of five patients after their recovery from COVID-19. The SARS-CoV-2 RNA was not detected in any of the prostate tissues tested even during the acute phase of infection. As case series have limitations, causality cannot be excluded and sporadic evidence of prostatic tissue invasion by SARS-CoV-2 may be detectable. [ABSTRACT FROM AUTHOR]

During the restoration works of the Conversion of St. Paul Church in Roccapelago (Modena, Italy, 2009), a burial crypt containing the remains of about 400 individuals was discovered. Natural mummification has occurred in 60 cases. Our Research Group, focused the paleopathological investigation on the pulmonary tract, since the reported massive coal dust exposure of Roccapelago’s dwellers even in parish records. In 24 mummies, the alleged pulmonary tissue was biopsied through preexisting solutions of continuity of the rib cage. In 18 cases (75%), lung tissue was recognized. In 7 cases (29,16%) we observed a massive deposition of black pigment, often nodular shaped, surrounded by dense fibrous tissue more evident with the Masson Trichrome staining. The morphological findings appeared diagnostics for anthracofibrosis secondary to massive pulmonary anthracosis. [ABSTRACT FROM AUTHOR]

Here we report the case of concomitant favorable-risk prostate cancer and Hodgkin Lym- phoma in a 38-year old male. 68Ga-Prostate Specific Membrane Antigen-11 Positron Emission To- mography/Computed Tomography (68Ga-PSMA-11 PET/CT) was performed for staging purposes, showing the focal PSMA prostatic uptake as well as the presence of enlarged low-PSMA expressing mediastinal lymphadenopathies, thus raising the suspicion of another malignancy. A subsequent 18F-Fluorodeoxyglucose (18F-FDG) PET/CT demonstrated a high FDG-avidity by mediastinal lym- phadenopathies as opposed to the low prostate cancer FDG uptake. Of note, both tumor entities were clearly detected by the two scans. However, different ranges in terms of Maximum Standardized Uptake Value (SUVmax) uptake allowed the discrimination between the two tumor entities. At the subsequent mediastinal lymph nodal biopsy, the coexistence of Hodgkin lymphoma was documented. The present case suggests that even if specific for prostate cancer, 68Ga-PSMA-11 PET/CT may raise the suspicion of other concurrent malignancies thanks to its non-receptor bounding mechanism. Further, it shows that in certain cases, the combination of 18F-FDG and 68Ga-PSMA PET/CT imag- ing may non-invasively guide the clinical management, optimizing the diagnostic process and the subsequent therapeutic interventions. [ABSTRACT FROM AUTHOR]

Introduction: We present the management of the second reported case of carcinosarcoma of the kidney parenchyma with malignant degeneration of both epithelial and mesenchymal components. Case report: A 36-year-old woman came to our attention for an incidental sonographic finding of a lesion in the lower pole of the left kidney. A contrasted computed tomography scan confirmed the presence of a 50 × 52 mm2 contrasted lesion in the left lower kidney pole. The patient underwent a challenging laparoscopic left partial nephrectomy and para-aortic lymphadenectomy. The histological examination led to the diagnosis of a carcinosarcoma of the kidney parenchyma with malignant degeneration of both epithelial and mesenchymal components. The patient underwent adjuvant chemotherapy with paclitaxel at 175 mg/m2 plus carboplatin area under the curve 6 intravenously for six cycles. At a follow-up of 42 months, the patient is alive and does not show any local recurrences or distant metastases. Conclusion: A multi-disciplinary therapeutic approach, combined with an adequate doctor–patient relationship and a close and detailed follow-up, is of fundamental importance in obtaining good outcomes in such rare and challenging cases. [ABSTRACT FROM AUTHOR]

Introduction The concordance rate of bladder cancer (BCa) histological variants (HV) between transurethral resection of bladder tumor (TURBT) and radical cystectomy (RC) is sub-optimal and is unclear which factors may influence it. The aim of this study was to identify factors that may be correlated to a higher TURBT-RC concordance rate. Material and methods Consecutive patients who had undergone RC between 2000 and 2019 at a single Institution with pathological evidence of HV were included. Patients with diagnosis of HV both at RC and at the previous TURBT were enlisted in the TURBT-RC Concordance Group (CG), whereas patients with only evidence of HV at RC in the TURBT-RC Non-Concordance Group (NCG). Surgical factors evaluated were the source of energy (mono-vs bipolar), surgeon's experience (10 mm represented an independent predictor of concordance [OR 2.95; CI (1.01-8.61); p = 0.048]. Tumor recurrence, focality and dimension, source of energy, surgeon's experience, performance of re-TURBT and total number of specimens at TURBT did not significantly predict the concordance. Conclusions Longer specimens at TURBT yield a higher chance to detect HV before RC. In this light, improving the quality of bladder resection means improving the management of BCa. [ABSTRACT FROM AUTHOR]