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The term, "myeloid sarcoma" refers to an extramedullary collection of immature myeloid cells. Rarely may it precede peripheral blood or bone marrow involvement, presenting as a diagnostic challenge. We report here a case of myeloid sarcoma in a 45 year-old man, who presented with a painful right orbital swelling of one month′s duration. Fine needle aspiration cytology (FNAC) was performed and a diagnosis of myeloid sarcoma was offered. Subsequently, a complete blood count revealed 60% blasts in the peripheral blood and a diagnosis of acute myeloid leukemia (AML) was confirmed on bone marrow examination. This case is being documented to emphasise the utility of FNAC in making the correct diagnosis of this entity in a case of unsuspected AML.

Objectives: Our aims in this study were to: 1) review diabetes apps available in Canada using the Mobile App Rating Scale tool and generate usability scores for each, 2) characterize availability of features across all apps, 3) evaluate the clinical safety of bolus insulin calculators and 4) evaluate the quality of exportable blood glucose reports meant for use by health-care providers., Methods: Two primary reviewers searched for, screened and evaluated diabetes apps from the Android Play Store and iOS App Store, resulting from the search terms "glucose" and "diabetes.", Results: Overall Mobile App Rating Scale quality rating score was 3.1 out of 5. The Functionality subsection scored the highest (3.9 out of 5) and Information scored the lowest (2.0 out of 5). The majority of apps have the ability to track carbohydrate intake (54 of 75, 72%), send reminders (46 of 75, 61%) and can generate blood glucose reports (53 of 75, 71%), but few have bolus insulin calculators (6 of 75, 9%) and remote diabetes support (10 of 75, 13%)., Conclusion: Despite the widespread availability of many iOS and Android diabetes management apps, few are of high quality., (Copyright © 2020 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.)

Purpose: To date there has not been an extensive analysis of the outcomes of biomarker use in oncology., Methods: Data were pooled across four indications in oncology drawing upon trial outcomes from www.clinicaltrials.gov: breast cancer, non-small cell lung cancer (NSCLC), melanoma and colorectal cancer from 1998 to 2017. We compared the likelihood drugs would progress through the stages of clinical trial testing to approval based on biomarker status. This was done with multi-state Markov models, tools that describe the stochastic process in which subjects move among a finite number of states., Results: Over 10000 trials were screened, which yielded 745 drugs. The inclusion of biomarker status as a covariate significantly improved the fit of the Markov model in describing the drug trajectories through clinical trial testing stages. Hazard ratios based on the Markov models revealed the likelihood of drug approval with biomarkers having nearly a fivefold increase for all indications combined. A 12, 8 and 7-fold hazard ratio was observed for breast cancer, melanoma and NSCLC, respectively. Markov models with exploratory biomarkers outperformed Markov models with no biomarkers., Conclusion: This is the first systematic statistical evidence that biomarkers clearly increase clinical trial success rates in three different indications in oncology. Also, exploratory biomarkers, long before they are properly validated, appear to improve success rates in oncology. This supports early and aggressive adoption of biomarkers in oncology clinical trials., (© 2021 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.)

Gliomas have substantial mortality to incidence rate ratio and a dismal clinical course. Newer molecular insights, therefore, are imperative to refine glioma diagnosis, prognosis and therapy. Meningioma 1 (MN1) gene is a transcriptional co-regulator implicated in other malignancies, albeit its significance in glioma pathology remains to be explored. IGFBP5 is regulated transcriptionally by MN1 and IGF1 and is associated with higher glioma grade and shorter survival time, prompting us to ascertain their correlation in these tumors. We quantified the expression of MN1, IGFBP5 and IGF1 in 40 glioma samples and examined their interrelatedness. MN1 mRNA-protein inter-correlation and the gene's copy number were evaluated in these tumors. Publicly available TCGA datasets were used to examine the association of MN1 expression levels with patient survival and for validating our findings. We observed MN1 overexpression correlated with low-grade (LGGs) and not high-grade gliomas and is not determined by the copy number alteration of the gene. Notably, gliomas with upregulated MN1 have better overall survival (OS) and progression-free survival (PFS). IGFBP5 expression associated inversely with MN1 expression levels in gliomas but correlated positively with IGF1 expression in only LGGs. This suggests a potential grade-specific interplay between repressive and activating roles of MN1 and IGF1, respectively, in the regulation of IGFBP5. Thus, MN1 overexpression, a promising predictor of OS and PFS in gliomas, may serve as a prognostic biomarker in clinical practice to categorize patients with survival advantage., (© The Author(s) 2020. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)

Competing Interests: There are no conflicts of interest

Recent genome wide sequencing has identified mutations in IDH1/IDH2 predominantly in grade II-III gliomas and secondary glioblastomas which are associated with favorable clinical outcome. These mutations have become molecular markers of significant diagnostic and prognostic relevance in the assessment of human gliomas. In the current study we evaluated IDH1 (R132) and IDH2 (R172) in 32 gliomas of various grades and tumor subtypes. Sequencing analysis revealed R132H mutations in 18.7% tumors, while none of the cases showed IDH2 (R172) mutations. The frequency of IDH1 mutations was higher in females (21.4%) than males (11.1%), and it was significantly higher in younger patients. Histological analyses demonstrated presence of necrosis and micro vascular proliferation in 69% and 75% respectively. Interestingly, IDH1 mutations were predominantly present in non-necrotic tumors as well as in cases showing microvascular proliferation. Of the six IDH1 positive cases, three were glioblastomas (IV), and one each were anaplastic oligoastrocytoma (III), anaplastic oligodendroglioma III (n=1) and diffuse astrocytoma. In conclusion, IDH1 mutations are quite frequent in Indian glioma patients while IDH2 mutations are not observed. Since IDH mutations are associated with good prognosis, their use in routine clinical practice will enable better risk stratification and management of glioma patients.

Donovanosis is an acquired sexually transmitted disease predominantly affecting the external genitalia. The cervix is an uncommon site of involvement, and can clinically mimic carcinoma of the cervix. The imaging (MR) appearance of donovanosis has not been described previously in the literature. We report a case wherein the MR appearance of cervical donovanosis is indistinguishable from carcinoma of the cervix.