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Background: Non-gestational ovarian choriocarcinomas (NGOC) are rare, distinct, highly aggressive tumors, primarily affecting young women. It accounts for less than 0.6% of malignant ovarian germ cell tumors. It is associated with a poorer prognosis compared to gestational choriocarcinoma.

Case presentation: A 36-year-old woman (P2L2) presented with intermittent heavy menstrual bleeding for the past three months. The urinary pregnancy test was positive. On abdominal examination, a solid mass consistent with 20-weeks gravid uterus was palpated in right iliac fossa. Bimanual pelvic examination revealed uterus deviated to the left and large (~12 × 10 cm) predominantly solid mass arising from right adnexa, adherent to the uterus. A mobile cystic mass (6 × 5 cm) was palpated in the left fornix. Ultrasonography showed normal-sized uterus with no gestational sac and a well-defined, solid-cystic right adnexal mass (10.2 × 7.8 × 7.8 cm) with vascularized solid areas and hemorrhage, initially suggesting an ectopic pregnancy. Serum β-hCG was markedly elevated (262,809 mIU/mL; normal level <5.0 mIU/mL). Magnetic Resonance Imaging (MRI) and Contrast-enhanced Computed Tomography (CECT) revealed right ovarian germ cell tumor, likely choriocarcinoma, without evidence of metastatic disease. On staging laparotomy, hemorrhagic right tubo-ovarian mass (8.5 × 8 × 7 cm) and left ovarian serous cystadenoma (8 × 7 × 3.5 cm) were identified. Histopathology and genomic studies confirmed stage IA1 NGOC. Patient completed two cycles of adjuvant chemotherapy with Bleomycin, Etoposide, Cisplatin, achieving complete response (β-hCG <5 mIU/mL), and is following up with serial β-hCG monitoring and CT scans for two years.

Conclusions: NGOC closely mimics ectopic pregnancy and gestational trophoblastic disease and requires early diagnosis with prompt surgical and chemotherapeutic intervention to optimize outcomes.

Lipoleiomyomas, rare variants of uterine leiomyomas, are characterized by the presence of mature adipocytes along with benign smooth muscle cells. The literature on this is limited to a few case reports and observational studies only. Presented here is a rare case of co-existing intramural and subserosal uterine lipoleiomyoma in a post-menopausal woman who had attained menopause 25 years prior. The 75-year-old patient, with a history of hypertension and diabetes, presented with lower abdominal pain. Imaging revealed an intramural degenerated fibroid in the anterior wall, measuring 7 × 6 × 5 cm, and another subserosal fibroid, measuring 2.5 × 2 × 1.5 cm, in the posterior uterine wall. A total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed, with microscopy revealing lipoleiomyoma with high intra-tumoral mast cells and eosinophils. This case highlights that lipoleiomyomas can present many years after attaining menopause. Diligent microscopic examination should be carried out to render an accurate diagnosis and to rule out other adipocyte-containing neoplastic lesions. This uncommon variant of uterine lipoleiomyoma poses a distinctive set of considerations for healthcare professionals, and our report seeks to contribute to the expanding knowledge base surrounding this unique condition.

Introduction: Prostate cancer (PCa) is one of the most common malignancies in men and accurate diagnostic tools are needed for early detection and risk stratification. Standard diagnostic modalities have limitations including low specificity, overdiagnosis, and procedural invasiveness. We investigate the utility of molecular diagnostics, restriction fragment length polymorphism (RFLP) for identifying mutations in genes that predispose to PCa.

Methods: The present prospective case-control study included 136 participants (66 cases and 70 controls). DNA was extracted for the evaluation of specific BRCA1, BRCA2, HOXB13, RNASEL, and ELAC2 single nucleotide polymorphisms (SNPs) using PCR-RFLP.

Result: The association of BRCA2 (rs80359550) and HOXB13 (rs9900627) mutations with the risk of developing PCa was statistically significant (p < 0.0001 and p = 0.0139, respectively) and the odds ratios confirmed a strong genetic susceptibility.

Discussion: Our findings further underscore the relevance of RFLP-based genotyping as an affordable substitute for NGS, in light of limited accessibility in many resource-limited settings.

Conclusions: Integrating genetic, molecular, or imaging readouts with additional imaging modalities, such as mpMRI offers opportunities for improved diagnostic accuracy and conceivable tailored treatment approaches. Larger multiethnic studies are needed to confirm these findings and define a genetic screening protocol for PCa.

Introduction: Sertoli-Leydig cell tumors (SLCTs) are rare ovarian neoplasms, accounting for less than 0.2% of all primary ovarian tumors. Among these, pure Sertoli cell tumors (SCTs) are exceptionally rare, comprising only 4% of Sertoli-stromal tumors. While SCTs are more commonly observed in young women, they can occur across all age groups. They are often associated with estrogen or progesterone production, whereas testosterone production is extremely uncommon.

Case report: A 70-year-old postmenopausal woman with a history of hysterectomy 20 years ago presented with complaints of a vaginal bulge and reduced urine output for 4-5 months. She had a prior diagnosis of periampullary carcinoma (pT1aN0), treated with surgery and adjuvant chemotherapy using gemcitabine. Clinical examination revealed a fair general condition and unremarkable abdominal findings. Per speculum examination showed vault prolapse with third-degree cystocele and minimal rectocele but no signs of stress urinary incontinence. The patient underwent abdominal sacrocolpopexy for vault prolapse. During surgery, both atrophic ovaries and fallopian tubes were identified and removed. Histopathological examination confirmed a Stage Ia pure SCT in the right ovary, with no malignancy in the left ovary or fallopian tubes.

Conclusion: The incidental discovery of a pure SCT in an atrophic ovary during pelvic surgery in a postmenopausal woman is exceedingly rare. This case highlights the importance of meticulous intraoperative inspection and histopathological evaluation, even in asymptomatic atrophic ovaries.

Stomach cancer (SC) is the fifth most prevalent and deathly type of cancer worldwide. This is a multifactorial disease, and its development can be influenced by both genetic factors and dietary habits. On the other hand, a regular consumption of fruit and vegetables rich in bioactive compounds, such as polyphenols and flavonoids, has demonstrated anti-inflammatory, antioxidant, and chemopreventive effects on SC. Brazil, which has a vast plant diversity, appears to be a promising scenario for investigating species with potential anti-tumor action. Thus, the objective of this review is to present and discuss the chemopreventive aspects of native Brazilian species in SC. Less-explored fractions of native plants, such as açaí (Euterpe oleracea), araçá-do-campo (Psidium guineense), yellow araçá (Psidium cattleianum Sabine), cacao (Theobroma cacao), coriander (Eryngium foetidum), physalis (Physalis angulata), guava (Psidium guajava), jambu (Acmella oleracea), pitanga (Eugenia uniflora), and ubaia (Eugenia patrisii), have demonstrated the ability to slow down the progression of the disease, indicating suppression of cell proliferation and survival, induction of apoptosis, and regulation of the cell cycle, despite showing not mechanism of action in the great majority of these studies. Although, still little studied, Brazilian plant matrices could show a promising impact against SC.

Introduction: Ovarian cystadenofibromas are rare benign tumors, accounting for only 1.7% of benign ovarian neoplasms. Even rarer are ovarian collision tumors, with the coexistence of collision tumors and other benign ovarian neoplasms being exceptionally uncommon. This report presents a unique case of serous cystadenofibroma in one ovary, accompanied by collision features involving serous and mucinous cysts in the contralateral ovary.

Case report: A 41-year-old woman presented with lower abdominal pain and swelling persisting for 2-3 months. Clinical evaluation of the abdomen revealed a mobile, non-tender, cystic mass resembling a 26-28-week gravid uterus, with no free fluid. Local and per speculum examinations showed a healthy vulva, cervix, and vagina, with a Pap smear negative for intraepithelial lesions or malignancy. A bimanual examination identified a mobile, multiparous uterus and a large (~15 × 12 cm), predominantly cystic lesion originating from the right adnexa and extending anteriorly and superiorly to the uterus. MRI findings confirmed these observations. Given the endometrial biopsy indicating endometrial intraepithelial neoplasia, the patient underwent an exploratory laparotomy with total abdominal hysterectomy and bilateral salpingo-oophorectomy. Histopathological analysis revealed serous cystadenofibroma in the right ovary and multiple serous and mucinous cysts in the left ovary, consistent with collision features. Additionally, the uterine endometrium showed hyperplasia without atypia.

Conclusion: This case underscores the rare coexistence of a benign surface epithelial-stromal tumor in one ovary and collision features in the other. It emphasizes the importance of comprehensive evaluation, precise diagnosis, and timely surgical management to ensure optimal patient outcomes.

Postmenopausal bleeding (PMB) with a diffusely enlarged uterus necessitates Magnetic Resonance Imaging (MRI) to reach an accurate diagnosis. Adenomyosis, especially extensive glandular variant, is an extremely rare cause reported in a postmenopausal woman. We present a challenging case of an 81-year-old woman with PMB where preoperative MRI suggested possible invasive endometrial neoplasm. However, final histopathological evidence of the hysterectomy specimen suggested Adenomyosis with extensive glandular proliferation. The patient was a multiparous lady with controlled diabetes and hypertension (controlled on medications) and a Body Mass Index of 36 kg/m². Bimanual examination suggested a diffusely enlarged uterus corresponding to 8-10 weeks gestation. Transvaginal ultrasound (TVUS) and Contrast Enhanced (CE) MRI were performed that reported multiple cystic areas with myometrial thinning at the fundal region- suspected infiltrating endometrial neoplasm. A hysteroscopic guided endometrial biopsy was suggestive of endometrial hyperplasia. In view of concerning MRI findings, a total abdominal hysterectomy and bilateral Salpingo-oophorectomy was performed. Histopathological examination revealed Adenomyosis with extensive glandular proliferation co-existing with endometrial hyperplasia and no atypia. This case highlights an important variant of Adenomyosis that potentially mimics an invasive uterine neoplasm. There is a dearth of uniform reporting standards for Adenomyosis and rarity of this condition in postmenopausal woman posing a significant preoperative diagnostic challenge.

Systemic mastocytosis (SM) encompasses a wide spectrum of myeloproliferative disorders defined by the aggregation of abnormal mast cells in various tissues, including the bone marrow, gastrointestinal tract, liver and lymph nodes. The release of tryptase, interleukins and cytokines by the accumulated mast cells causes a multi-system response that can range from mild flushing and pruritus to severe anaphylactic reactions, gastrointestinal disturbances, and cardiovascular symptoms, including hypotension and syncope. Furthermore, severe osteoporosis manifesting as bone-lytic lesions or pathologic fractures due to mast cell mediator-triggered bone resorption, is a rather common manifestation of SM, occurring in more than two-thirds of patients. The vast majority of SM cases harbor the D816V KIT mutation, which is an independent prognostic factor, and serves as a therapeutic target. This is a rare case of a young male who presented with new-onset back pain due to osteoporotic fractures and was diagnosed with SM without the D816V KIT mutation. Our case aims to emphasize one of the most underrecognised causes of osteoporosis in adults, and to shed light on a frequently misdiagnosed yet potentially severe hematologic disorder.