Clinicopathological features and surgical outcomes of four rare subtypes of primary liver carcinoma

Objective：This study aimed to analyze clinicopathological and prognostic features of four rare pathological subtypes of primary liver malignancies to make better understanding of their clinical features.Methods：The clinicopathological data of 114 patients who were diagnosed with histologically proven four subtypes：clear cell carcinoma（CCC）,giant cell carcinoma（GCC）,sarcomatoid carcinoma（SC）,and combined hepatocellular-cholangiocarcinoma（CHC）between October 1998 and August 2015 were reviewed.Their survival data were compared with those of 908 patients with histologically proven common hepatocellular carcinoma（HCC）（early-and advanced-stage HCC）during the same period.Results：The outcome of the CCC group was better than that of the other three subgroups,and was similar to that of the early-stage HCC group.Also,the smallest tumor size and the highest incidence of pseudocapsule formation were observed in the CCC group.The SC group had the worst outcome among these four subgroups;the prognosis was much poorer than that of any other subgroups,even poorer than that of the advanced-stage common HCC group.No statistical difference was observed between the GCC,CHC and advanced-stage HCC groups on survival analysis.The incidences of tumor vascular emboli,TNM staging and non-radical resection were three risk factors of the prognosis.Conclusions：CCC is a low-degree malignancy and relatively favorably prognostic subtype of HCC.However,GCC,SC,and CHC are three rare high-degree malignancy subtypes of HCC with poor prognosis.

Primary Mucinous Adenocarcinoma of the Thymus: A Case Report and Literature Review

THYMIC carcinoma is a rare malignant tumor,but the most common malignant tumor of the anterior mediastinum.According to the latest World Health Organization(WHO)classification,primary thymic carcinoma has a variety of histological types,mainly including squamous cell,basaloid,mucoepidermoid,

Primary Malignant Amelanotic Melanoma in the Female Genital Tract:A Report of Six Cases and a Review of the Literature

OBJECTIVE To analyze the clinical characteristics,pathologic diagnosis,treatment and prognosis of amelanotic melanoma in the female genital tract(AMFGT).METHODS The medical records of 6 patients with AMFGT between 1991 and 2006 in our hospital were reviewed.RESULTS Of these cases,4 were preliminarily misdiagnosed as chorioepithelioma,sarcoma,adenocarcinoma or lymphoma.Two patients were determined to have AMFGT preoperatively after positive immunohistochemical staining for both S-100 protein and HMB-45.Specimens removed from all 6 cases were tested for immunohistochemical staining,as well as H&E histochemical stains.S-100 and vimentin were both positive in all patients,and HMB-45 was positive in 3 out of 5 patients.Four patients recurred(at 6,6,12 and 19 months) a er primary treatments.Three patients died(at 13,18 and 19 months) a er the initial diagnosis.CONCLUSION Because of an absence of pigmentation AMFGT is extremely difficult to diagnose.Combined immunohistochemical staining,such as the S-100 protein,HMB-45 and vimentin etc,is important in the evaluation of AMFGT.Correct diagnosis plays a crucial role in the treatment of this disease.

Clinicopathological practice in the differential diagnosis of mucoepidermoid carcinoma from neoplasms with mucinous component

Background:The differential diagnosis of mucoepidermoid carcinoma(MEC)from neoplasm undergoing mucinous features brings more pitfalls to pathologists.Combining specific MAML2 gene rearrangement and histological characteristics may be the solution.Methods:Twenty-five tumors with mucinous components were selected for differential diagnosis of MEC.All the cases were detected for MAML2 gene rearrangement.The cases diagnosed as MEC were classified into four variants:classic,oncocytic,Warthin-like,and nonclassified,and they were graded using the Brandwein system.The histological characteristics of non-MECs were summarized for differential diagnosis.Univariate survival analysis was performed on MECs.Results:There were 16 MECs;62.5%were MAML2 rearranged.For the low-,intermediate-,and high-grade MECs,the rate of rearrangement was 83.3%,100%,and 28.6%,respectively.Both the oncocytic and Warthinlike MECs were MAML2 rearranged.For the classic and nonclassified MECs without MAML2 rearrangement,non-keratinized squamoid cells and distinctive mucinous cells were essential diagnostic criteria.On survival analysis,all the disease progression occurred in high-grade MECs(p=0.038).Nine cases were diagnosed as non-MECs:pleomorphic adenoma with mucinous metaplasia showed no ex-capsular involvement;metaplastic Warthin tumor appeared with overt keratinization and residual oncocytic bilayered epithelium;mix squamous cell and glandular papilloma showed an endobronchial papillary growing pattern;adenosquamous carcinoma was accompanied by squamous carcinoma in situ of the overlying mucosa.All the non-MECs were negative for MAML2 rearrangement.Conclusion:The application of combining MAML2 rearrangement and histological characteristics is helpful in the differential diagnosis between MEC and other tumors with mucinous components.

Novel gold nanoparticles targeting somatostatin receptor subtype two with near-infrared light for neuroendocrine tumour therapy

Neuroendocrine tumours(NETs)are rare cancers with positive somatostatin receptor 2(SSTR2)expression,and treatment strategies for NETs are not satisfactory.Nanomaterial-mediated therapy targeting SSTR2 in NETs is very promising.This study firstly combined mesoporous silica-coated gold nanorods(AuNRs@mSiO_(2))and targeting-SSTR2 dodecane tetraacetic acidtyrosine3-octreotate(DOTA-TATE)into AuNRs@mSiO_(2)@DOTA-TATE to investigate NETs inhibition under near-infrared light.AuNRs@mSiO_(2)@DOTA-TATE showed good photothermal conversion efficiency.In vitro,under light irradiation,the cell viability significantly decreased with increasing AuNR@mSiO_(2)@DOTA-TATE concentration;in two successfully established neuroendocrine tumour organoids with SSTR2 expression,AuNRs@mSiO_(2)@DOTA-TATE with light inhibited tumours significantly better than AuNRs@mSiO_(2) with light.In vivo,the SSTR2-targeting ability and biodistribution of AuNRs@mSiO_(2)@DOTA-TATE were confirmed with AuNRs@mSiO_(2)@64Cu-DOTA-TATE under micro-positron emission tomography/computed tomography(micro-PET/CT);in the AuNRs@mSiO_(2)@DOTA-TATE with laser group,the tumour surface temperature increased rapidly,with tumour volumes similar to those in the octreotide group and significantly lower than those in other groups.There was no significant difference in mice body weight between the AuNRs@mSiO_(2)@DOTA-TATE with laser group and other groups.No significant inflammatory lesions or cell necrosis was found in the main organs.In summary,we presented a feasible strategy to construct AuNRs@mSiO_(2)@DOTA-TATE with good photothermal conversion efficiency,targetingSSTR2 ability,significant antitumour effects,and good biocompatibility,warranting further explorations of AuNRs@mSiO_(2)@DOTA-TATE for NETs therapy applications.