Pathology reporting in neuroendocrine neoplasms of the digestive system: everything you always wanted to know but were too afraid to ask

During the 5th NIKE (Neuroendocrine tumors Innovation in Knowledge and Education) meeting, held in Naples, Italy, in May 2019, discussions centered on the understanding of pathology reports of gastroenetropancreactic neuroendocrine neoplasms. In particular, the main problem concerned the difficulty that clinicians experience in extrapolating relevant information from neuroendocrine tumor pathology reports. During the meeting, participants were asked to identify and rate issues which they have encountered, for which the input of an expert pathologist would have been appreciated. This article is a collection of the most rated questions and relative answers, focusing on three main topics: 1) morphology and classification; 2) Ki67 and grading; 3) immunohistochemistry. Patient management should be based on multidisciplinary decisions, taking into account clinical and pathology-related features with clear comprehension between all health care professionals. Indeed, pathologists require clinical details and laboratory findings when relevant, while clinicians require concise and standardized reports. In keeping with this last statement, the minimum requirements in pathology datasets are provided in this paper and should be a baseline for all neuroendocrine tumor professionals

Commentary: Case Report: Abdominal Lymph Node Metastases of Parathyroid Carcinoma: Diagnostic Workup, Molecular Diagnosis, and Clinical Management

In the issue of March 2021, Lenschow et al. reported the case of a 46-year-old woman with recurrent, programmed death-ligand-1 (PD-L1) negative, tumor mutational burden (TMB)-high parathyroid carcinoma (PC), who showed stable disease as her best response on imaging, and a three-fold drop in PTH after treatment with intravenous pembrolizumab. Given the remarkable results obtained by Lenschow et al. with the anti-PD-1 agent pembrolizumab in the above-mentioned case, we performed an extensive search for possible further relevant data sources, including a) full published articles in international online databases (PubMed, Web of Science, Scopus, and Embase); b) preliminary reports in selected international meeting abstract repositories (American Society of Clinical Oncology, ASCO; European Neuroendocrine Tumor Society, ENET; European Society for Medical Oncology, ESMO); c) registered clinical trials in the U.S. National Institutes of Health registry of clinical trials (http://clinicaltrials.gov) and in any primary register of the WHO International Clinical Trials Registry Platform (ICTRP)

How future surgery will benefit from SARS-COV-2-related measures: a SPIGC survey conveying the perspective of Italian surgeons

COVID-19 negatively affected surgical activity, but the potential benefits resulting from adopted measures remain unclear. The aim of this study was to evaluate the change in surgical activity and potential benefit from COVID-19 measures in perspective of Italian surgeons on behalf of SPIGC. A nationwide online survey on surgical practice before, during, and after COVID-19 pandemic was conducted in March-April 2022 (NCT:05323851). Effects of COVID-19 hospital-related measures on surgical patients' management and personal professional development across surgical specialties were explored. Data on demographics, pre-operative/peri-operative/post-operative management, and professional development were collected. Outcomes were matched with the corresponding volume. Four hundred and seventy-three respondents were included in final analysis across 14 surgical specialties. Since SARS-CoV-2 pandemic, application of telematic consultations (4.1% vs. 21.6%; p < 0.0001) and diagnostic evaluations (16.4% vs. 42.2%; p < 0.0001) increased. Elective surgical activities significantly reduced and surgeons opted more frequently for conservative management with a possible indication for elective (26.3% vs. 35.7%; p < 0.0001) or urgent (20.4% vs. 38.5%; p < 0.0001) surgery. All new COVID-related measures are perceived to be maintained in the future. Surgeons' personal education online increased from 12.6% (pre-COVID) to 86.6% (post-COVID; p < 0.0001). Online educational activities are considered a beneficial effect from COVID pandemic (56.4%). COVID-19 had a great impact on surgical specialties, with significant reduction of operation volume. However, some forced changes turned out to be benefits. Isolation measures pushed the use of telemedicine and telemetric devices for outpatient practice and favored communication for educational purposes and surgeon-patient/family communication. From the Italian surgeons' perspective, COVID-related measures will continue to influence future surgical clinical practice

Laparoscopic \u201cdouble-port\u201d splenectomy. A new minimally-invasiveoption in a giant spleen.

tINTRODUCTION: In case of massive splenomegaly, laparoscopic splenectomy (LS) becomes challenging,uncomfortable and risky both for the surgeon and for the patient. As a consequence of ongoing researchto obtain efficient and cheaper \u201cscarless surgery\u201d, single-port technique and hand-assisted devices weredeveloped and improved in this field.PRESENTATION OF CASE: We present the clinical case of a patient affected by idiopathic myelofibrosis(MF) and splenomegaly who was admitted to our Department to perform a splenectomy for a suspected5-cm splenic lesion.DISCUSSION: The splenic longitudinal diameter measured 26 cm. The patient underwent splenectomyby laparoscopy, combining a single-port access and a gel-port device. The operation was completedlaparoscopically. The operating time was 220 min and the estimate blood loss was 100 ml. The patientwas discharged at 11 post-operative day in overall good conditions. Upon pathological analysis the spleniclesion was a localization of diffuse large B-cell Lymphoma in the context of MF.CONCLUSION: this novel \u201chybrid technique\u201d of splenectomy, combining the advantages of reduced num-ber of abdominal incisions of the single-port technique to those of the hand assistance, is feasible inmassive splenomegaly with good results. Furthermore, the use of the sovrapubic retrieval incision as theintroduction site for the hand assisted device is convincing, since it\u2019s useful for both tasks. Further studieswith large casuistries are necessary to confirm the effectiveness of the technique

Uptodate on GH/IGF-1 axis actions

In December 2010, a workshop was held at “Regina Elena” National Cancer Institute in Rome, Italy, to develop an update on GH/IGF-1 system. The workshop was supported by NoGeRo group and was sponsored by SIE Lazio (Società Italiana di Endocrinologia-Lazio Regional Section) and AME Lazio (Associazione Medici Endocrinologi-Lazio Regional Section). Invited participants included italian endocrinologists skilled in the field of GH and IGF-I system both in basic and clinical research. In the following two years an extensive review has been structured summarizing the most important points achieved in the discussions during the workshop