Low-grade myofibrosarcoma of the maxillary sinus:Two case reports

BACKGROUND Low-grade myofibroblastic sarcoma(LGMS)is an extremely rare tumor characterized by the malignant proliferation of myofibroblasts.LGMS most commonly develops in adults,predominantly in males,in the head and neck region,oral cavity,especially on the tongue,mandible,and larynx.This article presents 2 cases of LGMS localized to the maxillary sinus and provides an overview of the available literature.CASE SUMMARY Two patients with LGMS located in the maxillary sinus underwent surgery at the Department of Head and Neck Surgery.Case 1:A 46-year-old patient was admitted to the clinic with suspected LGMS recurrence in the right maxillary sinus(rT4aN0M0),with symptoms of pain in the suborbital area,watering of the right eye,thick discharge from the right nostril,and augmented facial asymmetry.After open biopsy-confirmed LGMS,the patient underwent expanded maxillectomy of the right side with immediate palate reconstruction using a microvascular skin flap harvested surgically from the middle arm.The patient qualified for adjuvant radiotherapy for the postoperative bed,with an additional margin.Currently,the patient is under 1.5 years of observation with no evidence of disease.Case 2:A 45-year-old man was admitted to our clinic with facial asymmetry,strabismus,exophthalmos,and visual impairment in the right eye.Six months earlier,the patient had undergone partial jaw resection at another hospital for fibromatosis.A contrast-enhanced computed tomography scan revealed a tumor mass in the postoperative log after an earlier procedure.An open biopsy confirmed lowgrade fibrosarcoma(rT4aN0M0).The patient qualified for an extended total right maxillectomy with orbital excision and right hemimandibulectomy with immediate microvascular reconstruction using an anterolateral thigh flap.The patient subsequently underwent adjuvant radiotherapy to the postoperative area.After 9 months,recurrence occurred in the right mandibular arch below the irradiated area.The lesion infiltrated the base of the skull,which warranted the withdrawal of radiotherapy and salvage surgery.The patient qualified for palliative chemotherapy with a regimen of doxorubicin+dacarbazine+cyclophosphamide and palliative radiotherapy for bone metastases.The patient died 26 months after surgical treatment.The cases have been assessed and compared with cases in the literature.CONCLUSION No specific diagnostic criteria or treatment strategies have been developed for LGMS.The treatment used for LGMS is the same as that used for sinonasal cancer radical tumor excision;adjuvant radiotherapy or chemoradiotherapy should also be considered.They have low malignant potential but are highly invasive,tend to recur,and metastasize to distant sites.Patients should undergo regular follow-up examinations to detect recurrence or metastasis at an early stage.Patients should be treated and observed at the highest referral centers.

Mass spectrometry-based metabolomic profiling of prostate cancer - a pilot study

Aim:Prostate cancer(PCa)is the most commonly diagnosed non-skin cancer among men.Serum prostate-specific antigen level is used as a standard PCa biomarker for over 20 years.However,it has only 33%specificity and 86%sensitivity(for the cutoff value for prostate biopsy of>4 ng/mL).This leads to overdiagnosis and overtreatment.In-depth insight into PCa metabolomics enables discovery of novel PCa biomarkers.Methods:Metabolomic alternation in PCa serum,urine and interstitial fluid was examined using gold-nanoparticle-based laser mass spectrometry imaging.This study included 5 patients who underwent prostate biopsy with positive result,5 patients with negative result and 10 healthy controls.Results:Over two hundred differentiating metabolites(87 in urine,54 in serum and 78 in interstitial fluid)were detected.Four,twenty two and ten metabolites from urine,serum and interstitial fluid respectively showed statistical significant differential abundance between cancer and control group.Conclusion:Comprehensive metabolomic profile of PCa has been identified.Out of 36 metabolites,20 were identified and should be further evaluated in clinical trials as a potential PCa biomarker.Urine concentration of triglyceride(12:0/20:1)showed over 10 times higher abundance in PCa samples in comparison to healthy controls and is considered the most promising potential biomarker.