Primary Mediastinal Dysgerminoma: A Case Report and Literature Review.

Germ cell tumors are malignant tumors that mostly develop in the gonads. Extragonadal localization is rare and may affect the mediastinal and sacrococcygeal regions. Mediastinal seminoma is a malignant germ cell tumor of the mediastinum. The tumor typically occurs in the anterosuperior mediastinum in males and often has a very slow growth pattern and limited potential for metastasis. And symptoms are not very characteristic, with many patients being asymptomatic and the tumor being discovered incidentally. In this paper, we report the case of a 26-year-old patient admitted for the management of a large anterosuperior mediastinal tumor encasing the vital structures of the mediastinum.

Jaundice and Higher Procalcitonin Level Revealing a Small-Cell Lung Cancer With Pancreatic Metastasis: A Case Report From Eastern Morocco.

Small-cell lung cancer (SCLC) is highly aggressive, with a severe tendency for metastasis. Pancreatic metastasis in SCLC is uncommon, also jaundice as a major symptom of small-cell lung cancer is even rarer. The diagnosis of pancreatic metastasis is a real challenge for the medical team, it relies on both radiological and pathological details. We report a case of a 58-year-old male admitted for SCLC with pancreatic metastasis and a higher level of procalcitonin. He received platinum-based chemotherapy with a swell response. The focus of this study will be on the characteristics of pancreatic metastasis, along with their diagnosis and treatment approaches. Procalcitonin as a paraneoplastic syndrome will also be discussed in this study.

Metastatic Epithelioid Hemangioendothelioma of the Bone: A Case Report and Literature Review.

Epithelioid hemangioendothelioma (EHE) is an extremely rare vascular tumor, which can pose a diagnostic dilemma. It affects women more than men and is mainly found in the liver, lung, and bone. To date, there are no known predisposing factors. Limited data are available on the management of EHE at metastatic stages. The only optimal treatments to prevent metastatic dissemination are surgical resection and amputation in addition to radiotherapy at early stages. The oncologist in this rare entity plays an important role in the guided and standardized management of this disease, especially for advanced stages. In this article, we report the case of a 74-year-old patient admitted with swelling on the outer aspect of the right calf associated with pain and total functional impairment of the limb. The diagnosis favored a high-risk vascular tumor resembling EHE, confirmed by bone (tibia) and soft tissue biopsy. The patient underwent staging investigations, revealing diffuse metastases to the liver, bones, and lungs. The objective of this article is to advocate for oncological intervention in this entity, particularly in the advanced stages of the disease. Despite its rarity, the advancement of clinical trials and therapeutic recommendations remains crucial for optimal treatment.

Global Landscape of the Attack of Predatory Journals in Oncology.

PURPOSE: Open-access publishing expanded opportunities to give visibility to research results but was accompanied by the proliferation of predatory journals (PJos) that offer expedited publishing but potentially compromise the integrity of research and peer review. To our knowledge, to date, there is no comprehensive global study on the impact of PJos in the field of oncology. MATERIALS AND METHODS: A 29 question-based cross-sectional survey was developed to explore knowledge and practices of predatory publishing and analyzed using descriptive statistics and binary logistic regression. RESULTS: Four hundred and twenty-six complete responses to the survey were reported. Almost half of the responders reported feeling pressure to publish from supervisors, institutions, and funding and regulatory agencies. The majority of authors were contacted by PJos through email solicitations (67.8%), with fewer using social networks (31%). In total, 13.4% of the responders confirmed past publications on PJo, convinced by fast editorial decision time, low article-processing charges, limited peer review, and for the promise of academic boost in short time. Over half of the participants were not aware of PJo detection tools. We developed a multivariable model to understand the determinants to publish in PJos, showing a significant correlation of practicing oncology in low- and middle-income countries (LMICs) and predatory publishing (odds ratio [OR], 2.02 [95% CI, 1.01 to 4.03]; P = .04). Having previous experience in academic publishing was not protective (OR, 3.81 [95% CI, 1.06 to 13.62]; P = .03). Suggestions for interventions included educational workshops, increasing awareness through social networks, enhanced research funding in LMICs, surveillance by supervisors, and implementation of institutional actions against responsible parties. CONCLUSION: The prevalence of predatory publishing poses an alarming problem in the field of oncology, globally. Our survey identified actionable risk factors that may contribute to vulnerability to PJos and inform guidance to enhance research capacity broadly.

Synchronous occurrence of primary breast cancer and renal cell carcinoma: A case report and literature review.

INTRODUCTION AND IMPORTANCE: Multiple Primary Malignant Neoplasms (MPMNs) are rare and refer to the occurrence of two or more distinct primary cancers with unrelated histopathological features in one patient. MPMNs can be classified as synchronous when tumors appear simultaneously or within six months of each other, and as metachronous when identified six months or more after the initial cancer diagnosis. While breast cancer often co-occurs with other primary cancers such as colorectal, endometrial, and ovarian cancers, the simultaneous presence of invasive lobular breast carcinoma and clear cell renal cancer is rare. CASE PRESENTATION: Here, we present the case of a 59-year-old postmenopausal woman who initially presented with breast carcinoma. Further investigation revealed a mass in the left kidney. The patient underwent a radical mastectomy and axillary dissection, followed by a left nephrectomy. After 8 months follow up, the patient is doing well and disease-free. CLINICAL DISCUSSION: Based on our case and literature review, the co-occurrence of breast carcinoma with renal cell carcinoma (RCC) is uncommon. Most reported cases involve metastatic tumors or metachronous breast malignancy with RCC. The etiology of synchronous malignancy is complex, and treatment options usually include a combination of surgery and/or adjuvant therapy. CONCLUSION: This case report contributes valuable insights to the limited literature on synchronous breast cancer with renal cell carcinoma. The rarity of this simultaneous occurrence underscores the importance of considering such cases. Documenting these cases is crucial for increasing awareness and reducing the resulting morbidity and mortality.

Unusual Metastasis of Gastric Signet Ring Cell Carcinoma to the Breast: A Case Report of a Young Moroccan Patient.

Although gastric cancer is known to be an aggressive tumor that can spread throughout the body, breast metastases are uncommon. This entity is rarely reported in the literature, with an estimated incidence of 0.5 to 1.3%. We report a case of a rare association between a gastric subtype of signet ring cell carcinoma and metastasis to the breast. This uncommon situation is only documented through case reports. Most breast metastases have been detected after diagnosis of primary gastric cancer, during the first year. Several risk factors have been suggested to explain the aggressive behavior of these tumors, which correlates with very poor prognosis and short survival. We report the case of a 22-year-old female patient presenting with widespread metastatic gastric signet ring cell carcinoma with an unusual secondary site in the breast. The diagnosis was confirmed by immunohistochemistry (IHC) and radiology, and the patient was treated with palliative chemotherapy in accordance with the decision of the multidisciplinary tumor board.

Neck Epithelioid Sarcoma at an Unusual Location Mimicking Lymph Node Metastases of Nasopharyngeal Carcinoma: A Case Report.

Epithelioid sarcoma (ES) is an uncommon soft tissue sarcoma. It is usually located in the extremities and exceptionally in the neck. Its diagnosis constitutes a real challenge which is based on histology and immunohistochemistry staining that must be interpreted with caution given the anatomopathological similarities to other tumors. In this article, we report a case of a 37-year-old man admitted for a locally advanced ES of the neck. There were suspicions of lymph node metastases of nasopharyngeal carcinoma at the first pathological examination. The patient received palliative chemotherapy and was referred to the supportive care department. Through this case, we will discuss the clinical and anatomopathological characteristics and therapeutic options of this extremely rare tumor which poses a diagnostic challenge.

A Case Report of Uterine Müllerian Adenosarcoma With Sarcomatous Overgrowth.

Uterine adenosarcoma remains a highly aggressive tumor and is less described in the literature, with an unfavorable prognosis and an increased risk of local and distant recurrence. However, surgery, chemotherapy, and radiotherapy offer local control of the disease, and overall survival remains reduced. We report the case of a 79-year-old patient with stage IIIB uterine adenosarcoma, confirmed by immunohistochemistry and initially diagnosed with postmenopausal metrorrhagia. The patient was managed through a multimodal treatment by conducting a multidisciplinary consultation.

A testicular mass found to be a rare testicular adult-type granulosa cell tumor: A case report and literature review.

INTRODUCTION AND IMPORTANCE: Granulosa cell tumors (GCTs) are rare tumors, which mostly affect the ovaries. GCTs are classified into two types: juvenile and adult. Adult testicular GCTs are potentially malignant sex cord-stromal tumors. CASE PRESENTATION: Here, we report a case of a 63-year-old man who presented with a right testicular nodule. Testicular ultrasound showed a hypoechoic tissue mass, measuring 3 cm and hyper vascularized in the color Doppler. A radical orchidectomy was performed. Histology showed a typical adult-type Granulosa cell tumor. After 12 months follow up, the patient is doing well and disease-free. CLINICAL DISCUSSION: According to our case and a review of the literature, this type of tumor is an uncommon and slow-growing neoplasm. The diagnosis is confirmed by histology, treatment is based on surgery, radical orchidectomy. Long-term follow-up of patients is essential because distant metastases may emerge late in the clinical course. CONCLUSION: This case report adds valuable insights to the limited literature on adult testicular Granulosa cell tumors. Radical orchidectomy remains the optimal treatment, and early diagnosis, coupled with surgery, significantly enhances prognosis.

New horizons for platinum-resistant ovarian cancer: insights from the 2023 American Society of Clinical Oncology (ASCO) and European Society for Medical Oncology (ESMO) Annual Meetings.

Platinum-resistant ovarian cancer is difficult to treat and has a poor prognosis. Patients with platinum-resistant ovarian cancer have limited treatment options and often have a limited benefit from existing chemotherapeutic agents. There is a lack of contemporary effective anticancer drugs and reliable predictive biomarkers for this aggressive cancer. Recent cutting-edge research presented at the 2023 American Society of Clinical Oncology (ASCO) and the European Society for Medical Oncology (ESMO) Annual Meetings has provided insights into several potential therapeutic targets, such as DNA damage repair proteins, cell-cycle regulators, and immune-modulating agents. In addition, antibody-drug conjugates have provided new practice-changing results in platinum-resistant ovarian cancer. Here, we review the results of research presented at this annual event, with a focus on clinical trials investigating novel treatment approaches for platinum-resistant ovarian cancer, in addition to predictive and prognostic biomarkers for optimal patient selection, and other topics, such as real-world evidence.

Serum procalcitonin as a tumor marker in lung adenocarcinoma with ovarian metastasis: a case report.

Primary lung cancer is the leading cause of mortality worldwide. The major sites of lung cancer metastasis are the bones, liver, brain, lung, and adrenal glands. However, secondary localizations in the genital tract are extremely rare. Case presentation: The authors report the case of a 36-year-old woman who consulted for a right scapular swelling evolving for 4 months associated with a chronic cough. Clinical examination showed a hard fixed right scapular mass with any inflammatory signs. The extension assessment followed by histological analysis concluded in a secondary ovarian location of a lung adenocarcinoma. A very high serum procalcitonin level unrelated to sepsis was detected in the patient along with a substantial hematological paraneoplastic disease. The patient died after 6 months of palliative chemotherapy. Clinical discussion: Ovarian localization is found in only 0.4% of metastatic ovarian tumors, which is extremely low, the differentiation between primary and secondary ovarian adenocarcinoma is fundamental since the treatment and prognosis are very different. The serum procalcitonin can be elevated in lung adenocarcinoma. Conclusion: This case report highlights the interest to encourage doctors to look for ovarian metastasis during the clinical course of lung cancer, and explain the elevation of serum procalcitonin during lung adenocarcinoma.

Undifferentiated Sarcoma: A Rare Tumor of the Prostate.

Prostate cancer is the most common malignant tumor in men. The vast majority of prostate tumors are represented by prostatic adenocarcinomas (up to 95%). Sarcoma is a very rare tumor in adults with a formidable prognosis. Early diagnosis and radical surgery offer patients the best chance of a cure. We report the case of a 44-year-old patient with stage VI unresectable high-grade undifferentiated prostate sarcoma, initially presenting with urinary disorders and a large pelvic mass of prostatic origin, with normal Prostate-specific antigen (PSA) levels. The patient was managed by palliative chemotherapy.

Unusual Synchronous Colonic Metastasis of Ovarian Cancer.

Colorectal metastasis is rare and can be confused with primary colorectal cancer. We report the case of a 63-year-old patient who presented with synchronous metastasis of the rectosigmoid junction and ovarian cancer. Initially thought to be a Krukenberg tumor, the diagnosis of metastasis from ovarian origin was confirmed through an immunohistochemical study of the colonic biopsy.

An unusual presentation of ovarian carcinoma with supraclavicular lymph node and colorectal metastases leading to spontaneous rectovaginal fistula.

INTRODUCTION AND IMPORTANCE: Secondary metastases to the rectum from primary ovarian cancer are a rare entity and their diagnosis and management are challenging. In this report, we discuss the findings of the case of metastatic ovarian cancer to supraclavicular lymph nodes and the rectum complicated with rectovaginal fistula. CASE PRESENTATION: A 68-year-old woman was admitted for abdominal pain with rectal bleeding. Pelvic examination revealed a left latero-uterine mass. Abdominal-pelvic CT scan showed a tumor mass on the left ovary. A cytoreductive surgery and resection of a non-imaged rectal nodule identified during surgery were performed. The tumor specimens including the rectal metastasis were immunohistochemically confirming a metastatic ovarian cancer using CK7, WT1 and CK20. The patient received chemotherapy and had complete remission. However, she had a recto-vaginal fistula confirmed by imaging and had developed right supraclavicular lymphadenopathy from ovarian cancer later. CLINICAL DISCUSSION: The dissemination of ovarian cancer in the digestive tract can be frequently, through direct invasion, abdominal implantation and lymphatic system. Unusually, ovarian cancer cells may spread to supra-clavicular nodes, because of the connection of the two diaphragmatic stages allowing the lymph flows through the lymphatic vessels. Moreover, rectovaginal fistula is an uncommon complication which can be seen spontaneously or due to certain patient's features. CONCLUSION: In advanced ovarian carcinoma, it is required to properly assess the digestive tract during surgery because imaging can miss metastatic lesions such as our case. The use of immunohistochemistry is recommended to differentiate between primary ovarian carcinoma and secondary metastasis.

An Extranodal Site of Diffuse Large B-cell Lymphoma Presenting as Ovarian Cancer.

Due to its uncommon nature, primary ovarian lymphoma has no clinical particularities and can be confused with other ovarian cancers. It poses a twofold diagnostic and therapeutic challenge. An anatomopathological and immunohistochemical study is the crucial step in the diagnosis. Our case was a 55-year-old woman diagnosed with an Ann Arbor stage II E ovarian non-Hodgkin's lymphoma who initially presented with a painful pelvic mass. This case reflects the major role of an immunohistochemical study in the diagnosis workup, leading to the appropriate management of such rare tumors.

Immune-Checkpoint Inhibitors: A New Line of Attack in Triple-Negative Breast Cancer.

Poor prognosis is a distinctive feature of triple-negative breast cancer (TNBC). Chemotherapy has long represented the main and unique treatment for patients with TNBC. Recently, immune checkpoint inhibitors (ICIs) were investigated in several clinical trials and were approved for clinical use in TNBC patients that express programmed cell death protein-1 (PD-1) in combination with chemotherapy in the first-line setting. ICIs are also being investigated in the neoadjuvant and adjuvant settings for TNBC. This chapter aims to discuss different ICIs used to treat all TNBC stages to date.

Antibody-Drug Conjugates: A New Therapeutic Approach for Triple-Negative Breast Cancer.

Triple-negative breast cancer (TNBC) is an aggressive breast cancer subset associated with a worse prognosis and poor response to conventional chemotherapy. Despite recent advances in drug discovery, its management is still a challenge for clinicians, illuminating the unmet need to develop novel treatment approaches. Antibody-drug conjugates (ADC) are innovative oncology drugs that combine the specificity of monoclonal antibodies and the high efficacy of anticancer payloads, to deliver cytotoxic drugs selectively to cancer cells. Various ADCs were investigated for TNBC and have provided a promise for this aggressive women's cancer including the FDA-approved sacituzumab govitecan. In this chapter, we reviewed different ADCs studied for TNBC including their mechanisms of action, efficacy, and tolerability. Moreover, we have also discussed their therapeutic potential based on combinatorial approaches with other targeted therapies in early and metastatic TNBC.

Exploring the prognostic impact of tumor sidedness in ovarian cancer: A population-based survival analysis of over 10,000 patients.

Very recently, emerging evidence demonstrated that laterality might be an independent prognostic factor in patients with advanced ovarian cancer (OC). Based on preliminary provocative observations, our study aimed to investigate the prognostic impact of sidedness in a large cohort of women with OC. Survival was estimated based on Kaplan-Meier method and survival curves were compared using Log-rank test. Cox proportional-hazards model was used to study the association between survival and covariates. A total of 10,177 women with OC were included. Mean age at diagnosis was 59.58 years (±13.5); 36.7% OC right-sided, 36.9% were left- sided, and 26.4% had bilateral OC. The median overall survival (OS) for the entire population was 77 months, with the lowest median OS observed in bilateral OC (median OS: 34 months). The prognostic value of OC sidedness was not confirmed at the univariable analysis (HR = 0.958; 95% CI: 0.888-1.033, p = 0.268). However, women with bilateral OC has a 45% higher risk of death as compared with unilateral diagnosis (HR = 1.453; 95% CI: 1.410-1.497; p< 0.001). The independent prognostic value was further confirmed on multivarible analysis after adjusting for covariates including age, marital status, histological type, CA-125 at diagnosis, grade, stage, chemotherapy and surgery (HR = 1.087; 95% CI: 1.043-1.136, p = 0.02). However, the ultimate prognostic significance appeared less prominent, with bilateral OC conferring a relative increase of 8.7% of mortality. Our real-world study demonstrated that impact of tumor sidedness has no prognostic implication (right vs left OC) but bilateral OCs might be marginally more prognostically unfavorable. Prospective validation might be warranted, to confirm the prognostic significance of OC sidedness, including for the presence of key genetic alterations and lymph nodes asymmetry, to better stratify patients with OC and predict outcomes according to tumor sidedness at diagnosis.