Superficial Spread of Nonkeratinizing Squamous Cell Carcinoma of the Cervix to the Endometrium: A Case Report.

Squamous cell carcinomas (SCCs) are the most prevalent malignant tumors affecting the cervix. The superficial spread of SCC along the inner surface of the uterus, replacing the endometrium with malignant cells, is a rare subtype of cervical cancer. We present the case of a 55-year-old woman who complained of per-vaginal white discharge and generalized weakness for one month. Clinical examination revealed a bulky and fibrosed cervical os. A cervical biopsy confirmed the diagnosis of poorly differentiated nonkeratinizing SCC. MRI showed an endocervical infiltrative, heterogeneously enhancing mass lesion involving the cervix, along with cervical stenosis and hydrometra. Irregular thickening with nodular enhancing deposits showing morphology similar to the cervical lesion and restricted diffusion were noted along the endometrial lining contiguous with the cervical lesion. The patient underwent a radical hysterectomy, and histopathological examination revealed poorly differentiated nonkeratinizing squamous cell cervical carcinoma with contiguous squamous cell extension into the uterine endometrium, confirming the diagnosis of superficially spreading cervical SCC. Establishing the continuity of the lesion on imaging and histopathological testing is critical to confirm the presence of a superficial spread of cervical cancer and rule out contemporaneous endometrial cancer.

MRI Evaluation of Soft Tissue Tumors and Tumor-Like Lesions of Extremities.

AIM: The current study aimed to evaluate the use of magnetic resonance imaging (MRI) in the diagnosis of extremity soft tissue tumors and tumor-like abnormalities. METHODS: This prospective observational study of 71 patients with soft tissue lesions of extremities was conducted at a tertiary hospital and teaching center in western India after obtaining Institutional Ethical Committee (IEC) clearance. All patients underwent an MRI of the region of interest on Siemens Magnetom Vida 3 Tesla MRI (Erlangen, Germany). MRI findings and diagnosis were correlated clinically and with histopathological examination. RESULTS: A total of 71 patients (49 males and 22 females) in the age group of six to 90 years were included in our study. Out of 44 patients with soft tissue tumors, the most common lesion was neurofibroma (18.1%), followed by lipoma and undifferentiated sarcoma (9.1% each). Liposarcoma, myxoid liposarcoma, giant cell tumor of the tendon, pigmented villonodular synovitis, and schwannoma were seen in 4.5% of patients each. The soft tissue tumor-like lesions were seen in 27 (38%) patients, the most common being slow-flow vascular malformation, which was seen in 9/27 (33%) patients. The second most common pathology was actinomycosis, seen in four (14.8%) patients. Out of 44 patients with soft tissue tumors, 27 (61.4%) were benign and 17 (38.6%) were malignant. Tumor size of more than 5 cm was more commonly seen in malignant tumors (70.5%) than benign tumors (40.7%). The smooth margin was more common in benign tumors (70.3), while most malignant tumors (70.5%) had irregular or lobulated margins. Heterogenous enhancement was more common in malignant tumors (82.3%) than benign tumors (62.9). The odds of a benign histopathological diagnosis for a tumor suspected to be benign by MRI were 93.75 times higher than the odds of a benign histopathological diagnosis for a tumor suspected to be malignant by MRI. CONCLUSION: MRI is extremely useful in the evaluation of different soft tissue masses and helps in evaluating the characteristics of the masses, their extent and relationship to surrounding structures, and bone destruction, multiplicity, composition, and enhancement pattern. The systematic imaging analysis approach helps to differentiate a benign lesion from a malignant lesion and also in differentiating various soft tissue tumor mimics.

Virus-associated neuroendocrine cancers: Pathogenesis and current therapeutics.

Neuroendocrine neoplasms (NENs) comprise malignancies involving neuroendocrine cells that often lead to fatal pathological conditions. Despite escalating global incidences, NENs still have poor prognoses. Interestingly, research indicates an intricate association of tumor viruses with NENs. However, there is a dearth of comprehension of the complete scenario of NEN pathophysiology and its precise connections with the tumor viruses. Interestingly, several cutting-edge experiments became helpful for further screening of NET for the presence of polyomavirus, Human papillomavirus (HPV), Kaposi sarcoma-associated herpesvirus (KSHV), Epstein Barr virus (EBV), etc. Current research on the neuroendocrine tumor (NET) pathogenesis provides new information concerning their molecular mechanisms and therapeutic interventions. Of note, scientists observed that metastatic neuroendocrine tumors still have a poor prognosis with a palliative situation. Different oncolytic vector has already demonstrated excellent efficacies in clinical studies. Therefore, oncolytic virotherapy or virus-based immunotherapy could be an emerging and novel therapeutic intervention. In-depth understanding of all such various aspects will aid in managing, developing early detection assays, and establishing targeted therapeutic interventions for NENs concerning tumor viruses. Hence, this review takes a novel approach to discuss the dual role of tumor viruses in association with NENs' pathophysiology as well as its potential therapeutic interventions.