Distribution and Frequency of Salivary Gland Tumours: An International Multicenter Study.

BACKGROUND: Salivary gland tumours (SGT) are a relatively rare group of neoplasms with a wide range of histopathological appearance and clinical features. To date, most of the epidemiological studies on salivary gland tumours are limited for a variety of reason including being out of date, extrapolated from either a single centre or country studies, or investigating either major or minor glands only. METHODS: This study aimed to mitigate these shortcomings by analysing epidemiological data including demographic, anatomical location and histological diagnoses of SGT from multiple centres across the world. The analysed data included age, gender, location and histological diagnosis from fifteen centres covering the majority of the world health organisation (WHO) geographical regions between 2006 and 2019. RESULTS: A total of 5739 cases were analysed including 65% benign and 35% malignant tumours. A slight female predilection (54%) and peak incidence between the fourth and seventh decade for both benign and malignant tumours was observed. The majority (68%) of the SGT presented in major and 32% in the minor glands. The parotid gland was the most common location (70%) for benign and minor glands (47%) for malignant tumours. Pleomorphic adenoma (70%), and Warthin's tumour (17%), were the most common benign tumours whereas mucoepidermoid carcinoma (26%) and adenoid cystic carcinoma (17%) were the most frequent malignant tumours. CONCLUSIONS: This multicentre investigation presents the largest cohort study to date analysing salivary gland tumour data from tertiary centres scattered across the globe. These findings should serve as a baseline for future studies evaluating the epidemiological landscape of these tumours.

Not ery small bowel submucosal mass is a GIST A rare case of small bowel schwannoma.

INTRODUCTION: Schwannomas are slow-growing tumors, rarely occurring in the GI tract. When found, their location is mostly in the stomach. Presentation in the small bowel is extremely rare, anecdotal. CASE REPORT: We present the case of a 47-year old male who underwent laparoscopic elective left hemicolectomy for recurrent diverticulitis. RESULTS: At surgery an exophytic mass originating from the first jejunal loop was identified and resected, under the suspicion of a GIST. Post-operative pathologic report was consistent with the diagnosis of jejunal schwannoma. Unfortunately resection margins were positive and the patient was taken back to the OR for an additional jejunal segmental resection. CONCLUSIONS: GI schwannomas have excellent prognosis after surgical resection. It is important to differentiate them from GISTs, which may have a malignant behavior in 10-30% of the cases. To ensure complete surgical resection with negative margins is mandatory and is the curative treatment of choice. KEY WORDS: GIST, Jejunum, Submucosa Minimally-invasive surgery, Schwannoma, Small bowel.

Chronic azacitidine treatment results in differentiating effects, sensitizes against bicalutamide in androgen-independent prostate cancer cells.

BACKGROUND: About 20-30% of hormone-independent PCa are characterized by the extensive loss of AR expression that appears to occur at the transcriptional level. Treatment of AR-negative PCa cells with demethylating agents (Aza-CR) leads to expression of AR mRNA and protein. Here, we investigate the effect of Aza-CR administered both acutely and chronically on AR expression, PSA expression, cell survival, and proliferation in androgen-independent/AR-negative PCa cells. We also studied whether epigenetically reactivated AR is a target for bicalutamide therapy. METHODS: The in vitro effect of Aza-CR as single agent and its ability to induce AR expression and to augment the efficacy to bicalutamide were assessed using two androgen-independent and AR-negative cell lines (PC3 and DU145). RESULTS: Our results show that acute treatment (4 days) with Aza-CR results in a relatively low decrease in cell proliferation with G2 cell cycle arrest and no significant evidence of apoptosis or AR expression. Interestingly, when Aza-CR was chronically administered (20 days), this treatment resulted in marked decrease in tumor cell proliferation with significant increase in AR and PSA protein levels. Furthermore, following Aza-CR chronic treatment the formerly androgen-independent PC3 and DU145 cells increase their susceptibility to the apoptotic effects of bicalutamide. CONCLUSIONS: Aza-CR acute treatment has modest effects on androgen-independent and AR-negative PCa cell survival and proliferation, but chronic administration results in profound decrease in proliferation and in sensitization to antiandrogen agents. All these effects seem, in some measure, dependent on a partial restoration of androgen regulation.

An original protocol for standardized histopathology reporting of prostate carcinoma.

Standardized histopathology reporting represents the most effective approach to the diagnosis of malignant tumors. The use of checklists is considered the best single practice in ensuring the completeness of daily reporting and enables the pathologist to provide crucial information, affecting therapeutic decisions. Despite the huge amount of available protocols, a great variability is still found in prostate cancer reports, particularly on the expense of core needle biopsies. The aim of the present study is to evaluate the effectiveness of an original reporting system, based on the most recent contributions about prognostic factors of prostate carcinoma. The protocol is designed to provide guidance in formulating histopathology reports, by using three different checklists, each devoted to a single kind of specimen (needle biopsy, TURP/simple prostatectomy, radical prostatectomy). Before introducing this protocol in daily practice we tested its effectiveness on a series of cases undergone conventional, descriptive reporting. The omissions in conventional reports and the differences between the two systems enabled us to confirm the value of our method. Despite an additional workload for the pathologist, this standardized reporting system allows the urologist to easily obtain significant prognostic data, select the patients to be treated and predict the clinical outcome after surgery.