Juxta-cortical chondroma of the phalanges : is there a role for cone-beam computed tomography in diagnosis and local staging?

Juxta-cortical chondroma is a rare cartilaginous tumor originating from the periosteum. On conventional radiography, the lesion typically causes saucerization of the adjacent cortex with well-delineated sclerotic margins. Projection radiography may be less accurate than cross-sectional imaging to demonstrate the precise extent of pressure erosion and bone and soft tissue extent. Although magnetic resonance imaging (MRI) is the imaging technique of choice for further preoperative evaluation, cone-beam computed tomography (CT) may be of additional value. Due to its high spatial resolution, cone-beam CT may detect very tiny matrix calcifications and allows a more precise evaluation of the saucerized cortex at a low radiation dose

EWSR1—The Most Common Rearranged Gene in Soft Tissue Lesions, Which Also Occurs in Different Bone Lesions: An Updated Review

EWSR1 belongs to the FET family of RNA-binding proteins including also Fused in Sarcoma (FUS), and TATA-box binding protein Associated Factor 15 (TAF15). As consequence of the multifunctional role of EWSR1 leading to a high frequency of transcription of the chromosomal region where the gene is located, EWSR1 is exposed to aberrations such as rearrangements. Consecutive binding to other genes leads to chimeric proteins inducing oncogenesis. The other TET family members are homologous. With the advent of widely used modern molecular techniques during the last decades, it has become obvious that EWSR1 is involved in the development of diverse benign and malignant tumors with mesenchymal, neuroectodermal, and epithelial/myoepithelial features. As oncogenic transformation mediated by EWSR1-fusion proteins leads to such diverse tumor types, there must be a selection on the multipotent stem cell level. In this review, we will focus on the wide variety of soft tissue and bone entities, including benign and malignant lesions, harboring EWSR1 rearrangement. Fusion gene analysis is the diagnostic gold standard in most of these tumors. We present clinicopathologic, immunohistochemical, and molecular features and discuss differential diagnoses.</jats:p

Prognostic implications of cellular senescence in resected non-small cell lung cancer

Background: Cure and long-term survival for non-small cell lung cancer (NSCLC) remains hard to achieve. Cellular senescence, an emerging hallmark of cancer, is considered as an endogenous tumor suppressor mechanism. However, senescent cancer cells can paradoxically affect the surrounding tumor microenvironment (TME), ultimately leading to cancer relapse and metastasis. As such, the role of cellular senescence in cancer is highly controversial. Methods: In 155 formalin-fixed paraffin-embedded (FFPE) samples from surgically resected NSCLC patients with pathological tumor-node-metastasis (pTNM) stages I-IV (8th edition), cellular senescence was assessed using a combination of four immunohistochemical senescence markers, i.e., lipofuscin, p16INK4a, p21WAF1/Cip1 and Ki67, and correlated to clinicopathological parameters and outcomes, including overall survival (OS) and disease-free survival (DFS). Results: A tumoral senescence signature (SS) was present in 48 out of 155 NSCLC patients, but did not correlate to any clinicopathological parameter, except for p53 mutation status. In a histologically homogenous patient cohort of 100 patients who fulfilled the following criteria: (I) one type of histology, i.e., adenocarcinoma, (II) without known epidermal growth factor receptor (EGFR) mutation, (III) curative (R0) resection and (IV) no neoadjuvant systemic therapy or radiotherapy, the median OS and DFS for patients with a tumoral SS (n=30, 30.0%) compared to patients without a tumoral SS (n=70, 70.0%) was 53 versus 141 months (P=0.005) and 45 versus 55 months (P=0.25), respectively. In multiple Cox proportional hazards (Cox PH) model analysis correcting for age, pTNM stage I-III and adjuvant therapy, a tumoral SS remained a significant prognostic factor for OS (HR =2.03; P=0.014). Conclusions: The presence of a tumoral SS particularly based on high p16INK4a expression significantly affects OS in NSCLC adenocarcinoma. In this light, adjuvant senolytic therapy could be an interesting strategy for NSCLC patients harboring a tumoral SS, ultimately to improve survival of these patients

World Health Organization classification of odontogenic tumors and imaging approach of jaw lesions

Tumors of the jaws represent a heterogeneous group of lesions that are classified histologically in the World Health Organization Classification of Odontogenic Tumors (2017). This article provides an update of the current nomenclature. The main role of imaging is to describe the precise location and extent of these lesions. Although characterization of imaging is often difficult due to overlapping characteristics, imaging is helpful to define which lesions should be referred for histologic examination and subsequent treatment planning. Location and density are the cardinal criteria for potential characterization on imaging. Radiologically, lesions may be radiolucent, radiopaque, or of mixed density. Additional criteria include lesion demarcation, morphology, cortical breakthrough, periosteal reaction, and adjacent soft tissue changes. Final lesion characterization is only definitive after interdisciplinary discussion and radiopathologic correlation. Correct diagnosis is obtained by a combination of the patient's age, lesion location, and clinical and radiologic presentation. It is important that all physicians use a uniform nomenclature

A clitoral verrucous carcinoma in an area of lichen planus has aggressive features

Abstract Background Verrucous carcinoma of the vulva is extremely rare. It is a slow growing, low malignant variant of a squamous cell carcinoma with a cauliflower appearance. Women with lichen planus have an increased risk of developing vulval cancer. Case presentation A 79-year-old woman consulted for vulval itching. On clinical examination, a 3-cm large verrucous clitoral cancer in an area of lichen planus was seen. Based on her last clinical examination, the growth was estimated to be 1\ua0cm 2 per month with an invasion depth after 6\ua0months of 5\ua0mm. A tumor developing in an area of lichen planus appears to have more aggressive features. This is the first time that the growth of a verrucous carcinoma has been documented in an area of lichen planus. Conclusions Clinicians and patients should be aware of the aggressive behavior of cancers developing in areas of lichen planus and adjust their surgical management together with the follow-up strategy