Mixed Adenosquamous Cell Carcinoma of the Prostate with Paired Sequencing on the Primary and Liver Metastasis.

This report aims to shed light on the intricate challenges encountered during the diagnosis and treatment of an uncommon variant of prostate cancer-mixed adenosquamous cell carcinoma of the prostate. Prostate cancers of this nature pose distinctive diagnostic and therapeutic dilemmas due to their rarity and complex histological composition. We present a case of a 63-year-old man with metastatic prostate cancer, featuring adenocarcinoma with squamous cell differentiation, who underwent a multimodal treatment approach. The patient responded to first-line carboplatin, docetaxel, and androgen deprivation therapy, followed by androgen receptor pathway inhibitor (ARPI) maintenance. However, disease progression led to radiation therapy and a subsequent switch to Lutetium (177Lu) vipivotide tetraxetan after chemotherapy challenges. Comprehensive genetic profiling revealed shared mutations in the prostate and liver lesions, emphasizing the role of targeted therapies. Prostate-specific membrane antigen (PSMA)-targeted therapy resulted in a notable PSA decline. This case highlights the evolving treatment landscape for rare prostate cancers, integrating genetic insights for tailored interventions. In conclusion, squamous cell carcinoma (SCC) of the prostate is rare, emphasizing the imperative for enhanced comprehension in diagnosis and management. Our case suggests the potential efficacy of ARPI and PSMA-targeted therapies. Our findings advocate for a more nuanced approach to the management of this rare prostate cancer variant, leveraging genomic insights for personalized treatment strategies. This exploration serves as a foundation for further research and clinical considerations in addressing the challenges posed by mixed adenosquamous cell carcinoma of the prostate.

The Materials Utilized in Cranial Reconstruction: Past, Current, and Future.

BACKGROUND: Cranioplasty (CP) is associated with high complication rates compared to other common neurosurgical procedures. Several graft materials are used for CP, which may contribute to the high complication rates, but data in the literature regarding the influence of graft material on post-CP outcomes are inconsistent making it difficult to determine if, when, and to what extent the graft material impacts the rate of perioperative complications. There is an increased demand to identify and develop superior graft materials. OBJECTIVE: To review and compare the indications, risks, complications, and patient results associated with the use of different graft materials for cranial reconstructions. DESIGN: A search through EBSCOhost was conducted using the keywords "craniectomy" or "decompressive craniectomy," "cranioplasty," and "materials." The search was limited to literature published in the English language from 2005 until the present. Ultimately, 69 articles were included in this review. Due to the heterogeneity of the study populations, results, statistical analyses, and collecting methods, no statistical analyses could be performed. CONCLUSIONS: Several graft materials have been adapted for use in cranial reconstructions with inconsistent results making it unclear if or when one material may be indicated over others. Advances in computer-aided design have led to improved patient-specific implants, but the ideal graft material is still being sought after in ongoing research efforts. Reviewing materials currently available, as well as those in clinical trials, is important to identify the limitations associated with different implants and to guide future research.

HISTORIQUE: Par rapport aux autres interventions neurochirurgicales fréquentes, la cranioplastie est associée à un taux de complications élevé. Divers matériaux de greffe sont utilisés, ce qui peut contribuer au fort taux de complications, mais les données tirées des publications sur l'effet qu'ont les matériaux de greffe sur les résultats cliniques après une cranioplastie sont contradictoires. C'est pourquoi il est difficile de déterminer si ces matériaux contribuent aux complications périopératoires, de même que le moment et la mesure selon laquelle ils le font. La demande est croissante pour trouver et créer des matériaux de greffe de qualité supérieure. OBJECTIF: Analyser et comparer les indications, les risques, les complications et les résultats cliniques des patients en fonction des divers matériaux de greffe utilisés pour les reconstructions crâniennes. MÉTHODOLOGIE: Les chercheurs ont effectué une recherche dans EBSCOhost au moyen des termes craniectomy ou decompressive craniectomy, cranioplasty et materials. Ils ont limité la recherche aux publications parues en anglais entre 2005 et maintenant. Ils ont finalement inclus 69 articles dans la présente étude. Étant donné l'hétérogénéité des populations, des résultats, des analyses statistiques et des modes de collecte, les chercheurs n'ont pu réaliser aucune analyse statistique. CONCLUSIONS: Plusieurs matériaux de greffe ont été adaptés pour les reconstructions crâniennes, mais comme les résultats sont variables, on ne sait pas si un matériau est indiqué par rapport aux autres ni les circonstances dans lesquelles il l'est. Les progrès de la conception assistée par ordinateur ont permis d'améliorer les implants, mais les recherches se poursuivent pour trouver les matériaux idéaux. Il est important d'examiner les matériaux actuellement utilisés, de même que ceux faisant l'objet d'essais cliniques, pour établir les limites associées aux divers implants et orienter les futures recherches.

Pelvic Floor Organ Prolapse After Radical Cystectomy in Patients With Uroepithelial Carcinoma.

OBJECTIVE: The aim of this study was to identify whether women who undergo a radical cystectomy for uroepithelial carcinoma are at increased risk of pelvic organ prolapse after surgical treatment. METHODS: A retrospective cohort study compared female subjects who had undergone a radical cystectomy for uroepithelial carcinoma, as identified through an institutional cancer survivor database, with subjects who presented to the Pelvic Health and Continence Clinic with symptoms of either uterovaginal prolapse or urinary incontinence. Demographic data were collected regarding risk factors for prolapse, and study subjects were asked to complete a Pelvic Organ Prolapse Distress Inventory (POPDI-6). Data were collected through retrospective chart review. The primary outcome is difference in the POPDI-6 between the groups. Statistical evaluation of responses was performed, with analysis of variance used to compare the questionnaire scores between groups and correction for risk factors with χ2 tests, with a P value of 0.05 selected for statistical significance. RESULTS: There were 36 postcystectomy subjects who responded to the survey, 37 subjects in the prolapse group, and 44 subjects in the incontinence group. With correction for age, body mass index, and number of vaginal deliveries, the postcystectomy group reported significantly lower scores on the POPDI-6 than both the prolapse group (P < 0.0001) and the incontinence group (P = 0.0003). CONCLUSIONS: Radical cystectomy for uroepithelial carcinoma does not correlate with an increased risk of patient-reported symptoms of pelvic organ prolapse.

Adult intradural intramedullary astrocytomas: a multicenter analysis.

BACKGROUND: Intramedullary tumors constitute approximately 20-30% of all spinal cord tumors and approximately 30-40% of these are astrocytomas. Furthermore, they comprise only about 2-4% of all primary central nervous system (CNS) tumors. Due to their rarity and poor prognosis, large population-based studies are needed to assess the epidemiology and survival risk factors associated with these tumors in the hope of improving outcomes. The authors undertook this retrospective study to explore factors that may influence survival in adult patients with intramedullary astrocytomas. METHODS: Utilizing the Surveillance, Epidemiology, and End Results (SEER) database, a prospective cancer registry, the authors retrospectively assessed survival in histologically confirmed, intramedullary spinal cord astrocytomas in patients 18 years of age and older. Survival was described with Kaplan-Meier curves and multivariate regression analysis was used to assess the association of several variables with survival while controlling for confounding variables. RESULTS: Analysis by multivariate regression of 131 cases showed that increasing age of diagnosis [hazard ratio (HR) 1.52, 95% CI: 1.17-1.99, P=0.001], WHO grade IV classification (HR 8.85, 95% CI: 2.83-27.69, P<0.001), tumor invasiveness (HR 2.94, 95% CI: 1.00-8.64, P=0.047), and sub-total resection (HR 5.80, 95% CI: 1.20-28.03, P=0.029) were associated with statistically significant decreases in survival. CONCLUSIONS: This study suggest that older age, higher WHO grade, tumor invasiveness as well as sub-total resection were all associated with a worse prognosis.