Gastrointestinal stromal tumors(GISTs) are the most common mesenchymal neoplasms of the gastrointestinal tract, and are characterized by a broad spectrum of clinical, histological and molecular features at presentatio...Gastrointestinal stromal tumors(GISTs) are the most common mesenchymal neoplasms of the gastrointestinal tract, and are characterized by a broad spectrum of clinical, histological and molecular features at presentation. Although focal and scattered calcifications are not uncommon within the primary tumor mass, heavy calcification within a GIST is rarely described in the literature and the clinical-biological meaning of this feature remains unclear. Cases with such an atypical presentation are challenging and may be associated with diagnostic pitfalls. Herein, we report a gastric GIST with the unusual presentation of prominent calcifications that was identified incidentally on imaging during a post-trauma diagnostic work-up. The patient underwent laparoscopic surgery with a radical resection of the mass, which was subsequently characterized by histological analysis as spindle-shaped tumor cells, positive for CD117/c-KIT, CD34 and DOG1, and with calcified areas. Given the intermediate risk of recurrence, no adjuvant therapy was recommended andthe patient underwent regular follow-up for 22 mo, with no evidence of relapse. Our case can be considered of interest because of the rarity of clinical presentation and the uniquely large size of the GIST at diagnosis(longest diameter exceeding 9 cm). In closing, we discuss the pathophysiology and clinical implications of calcifications in GISTs by reviewing the most up-to-date relevant literature.展开更多
Hepatocellular carcinoma (HCC) is the fifth most common cancer worldwide and ranks second among global causes of cancer-related death (1). The epidemiological and etiological landscape of the disease is facing remarka...Hepatocellular carcinoma (HCC) is the fifth most common cancer worldwide and ranks second among global causes of cancer-related death (1). The epidemiological and etiological landscape of the disease is facing remarkable changes, due to an increasing incidence of non-alcoholic fatty liver disease (NAFLD)-associated HCC and a concomitant decrease of virus-related cases over the last two decades in Western countries (1). High prevalence of metabolic syndrome in particular in Caucasian patients is contributing to this trend. Moreover, the growing spread of these metabolic conditions in Asian countries is likely to translate into a significant increase in NAFLD-related HCC in the future even in this geographic area (1). In this scenario, exploring the impact of diabetes and anti-diabetic medications on HCC tumorigenesis and prognosis has become of paramount importance.展开更多
In the last few years,the success of anti-PD1 and anti-PDL1 drugs in solid cancers treatment and the advances in molecular biology have provided new potential treatment strategies for patients with metastatic colorect...In the last few years,the success of anti-PD1 and anti-PDL1 drugs in solid cancers treatment and the advances in molecular biology have provided new potential treatment strategies for patients with metastatic colorectal cancer.Unfortunately,only patients with mismatch repair deficiency seem to benefit from immunotherapy and they represent a small subset of the metastatic population.New ongoing studies focus on converting an immune ignorant tumour into an inflamed one by combination therapies and on introducing an immunotherapeutic approach in earlier stages of disease(neoadjuvant and adjuvant setting).In this review we summarize the current knowledge about the molecular and immune landscape of colorectal cancer and propose new potential combination strategies to enhance the efficacy of immunotherapy.展开更多
文摘Gastrointestinal stromal tumors(GISTs) are the most common mesenchymal neoplasms of the gastrointestinal tract, and are characterized by a broad spectrum of clinical, histological and molecular features at presentation. Although focal and scattered calcifications are not uncommon within the primary tumor mass, heavy calcification within a GIST is rarely described in the literature and the clinical-biological meaning of this feature remains unclear. Cases with such an atypical presentation are challenging and may be associated with diagnostic pitfalls. Herein, we report a gastric GIST with the unusual presentation of prominent calcifications that was identified incidentally on imaging during a post-trauma diagnostic work-up. The patient underwent laparoscopic surgery with a radical resection of the mass, which was subsequently characterized by histological analysis as spindle-shaped tumor cells, positive for CD117/c-KIT, CD34 and DOG1, and with calcified areas. Given the intermediate risk of recurrence, no adjuvant therapy was recommended andthe patient underwent regular follow-up for 22 mo, with no evidence of relapse. Our case can be considered of interest because of the rarity of clinical presentation and the uniquely large size of the GIST at diagnosis(longest diameter exceeding 9 cm). In closing, we discuss the pathophysiology and clinical implications of calcifications in GISTs by reviewing the most up-to-date relevant literature.
文摘Hepatocellular carcinoma (HCC) is the fifth most common cancer worldwide and ranks second among global causes of cancer-related death (1). The epidemiological and etiological landscape of the disease is facing remarkable changes, due to an increasing incidence of non-alcoholic fatty liver disease (NAFLD)-associated HCC and a concomitant decrease of virus-related cases over the last two decades in Western countries (1). High prevalence of metabolic syndrome in particular in Caucasian patients is contributing to this trend. Moreover, the growing spread of these metabolic conditions in Asian countries is likely to translate into a significant increase in NAFLD-related HCC in the future even in this geographic area (1). In this scenario, exploring the impact of diabetes and anti-diabetic medications on HCC tumorigenesis and prognosis has become of paramount importance.
文摘In the last few years,the success of anti-PD1 and anti-PDL1 drugs in solid cancers treatment and the advances in molecular biology have provided new potential treatment strategies for patients with metastatic colorectal cancer.Unfortunately,only patients with mismatch repair deficiency seem to benefit from immunotherapy and they represent a small subset of the metastatic population.New ongoing studies focus on converting an immune ignorant tumour into an inflamed one by combination therapies and on introducing an immunotherapeutic approach in earlier stages of disease(neoadjuvant and adjuvant setting).In this review we summarize the current knowledge about the molecular and immune landscape of colorectal cancer and propose new potential combination strategies to enhance the efficacy of immunotherapy.
