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High-grade (HGOC) and low-grade ovarian carcinoma (LGOC) are distinct malignancies with different biological features, treatment paradigms, and life expectancies. However, differences in quality of life (QOL), sleep, and depressive symptoms have not been examined by grade, and neither have inflammatory profiles associated with these symptoms. We aim to characterize QOL and biomarkers by OC grade. Participants included patients with HGOC (N = 578) or LGOC (N = 85). Participants completed baseline assessments of psychosocial factors prior to primary surgery or neoadjuvant chemotherapy and contributed saliva for cortisol and blood for interleukin-6 (IL-6) quantification. Samples were collected intraoperatively to quantify tumor cortisol. General linear models were used to examine differences in biological and psychological variables by grade. At baseline, patients with LGOC reported less depression (p = 0.018) and sleep disturbances (p = 0.014), but no significant difference in depressive mood (p = 0.11) or QOL (p = 0.51) compared to patients with HGOC, adjusting for age and disease stage. There were trends towards lower tumor cortisol levels (p = 0.078) in LGOC compared to HGOC. One-year post-diagnosis, we found a significant improvement in QOL and fatigue, and a decrease in vegetative depression and IL-6 levels irrespective of grade. We present the first characterization of psychosocial experiences of patients with LGOC. Despite having a better disease prognosis, patients with LGOC were just as likely to have mood disturbances as those with HGOC. There was a trend towards differences in tumor cortisol by grade. Our findings highlight the need to address well-being in patients with both low- and high-grade ovarian malignancies. • Low-grade ovarian cancer patients report less vegetative depression than high-grade. • Both low- and high-grade patients report sleep disturbances that do not improve over time. • No difference in overall quality of life by grade at baseline or over time. • Trend towards lower tumor cortisol in low- versus high-grade patients. • No systematic differences in IL-6 or cortisol by grade were observed. [ABSTRACT FROM AUTHOR]

Introduction: To evaluate the efficacy and side effects of re-circulant hyperthermic intravesical chemotherapy versus conventional treatments for intermediate risk non-muscle invasive bladder cancer (NMIBC). Methods: A randomized 3-arm, parallel group trial was conducted at a single tertiary care centre. 135 patients with low-grade intermediate-risk cancer, having undergone complete resection of bladder tumor were included. Patients were assigned 1:1:1, to receive intra-vesical chemo-hyperthermia (C-HT), mitomycin-C (MMC) or BCG therapy. There was no treatment crossover. Patients were followed up with check cystoscopy every 3 months for histopathological recurrence. Results: The three arms were comparable in terms of age, gender, tumor size, number of tumors and clinical stage or grade of tumors. Mean tumor size was 2.58 (± 0.88) cm and the mean number of tumors resected was 2.04 (± 1.02) (Range 1–5). There was no significant difference between the various groups for tumor recurrence (χ2 = 1.96, p = 0.375) or time to recurrence (13.6 vs. 10.8 vs. 9.8 months, p = 0.844) though incidence of non-healing necrotic area was higher with C-HT (22.2% vs. 11.1% and 4.8%, χ2 = 6.093, p = 0.048). Median (IQR) follow up period was 26 (12–52) months. Treatment discontinuation or drug intolerance was significantly higher in BCG arm (p = 0.03). Conclusions: Intravesical C-HT with MMC, conventional MMC and BCG are equally effective and comparable alternatives for intravesical therapy in low-grade intermediate-risk NMIBC. Higher incidence of non-healing resection site with C-HT and higher local symptoms with BCG are a concern. [ABSTRACT FROM AUTHOR]

Low-grade gliomas are the most common brain tumor of childhood, and complete resection offers a high likelihood of cure. However, in many instances, tumors may not be surgically accessible without substantial morbidity, particularly in regard to gliomas arising from the optic or hypothalamic regions, as well as the brainstem. When gross total resection is not feasible, alternative treatment strategies must be considered. While conventional chemotherapy and radiation therapy have long been the backbone of adjuvant therapy for low-grade glioma, emerging techniques and technologies are rapidly changing the landscape of care for patients with this disease. This article seeks to review the current and emerging modalities of treatment for pediatric low-grade glioma. [ABSTRACT FROM AUTHOR]

Abstract Objective In 2016, the ESMO-ESGO-ESTRO consensus included LVSI (Lymph-vascular space invasion, LVSI) status as a risk stratification factor for stage I endometrioid endometrial cancer (EEC) patients and as one of the indications for adjuvant therapy. Furthermore, LVSI is included in the new FIGO staging of endometrial cancer (EC) in 2023. However, the data contribution of the Chinese population in this regard is limited. The present study aimed to further comfirm the influence of LVSI on the prognosis of early-stage low-grade EEC in a fifteen-year retrospective Chinese cohort study. Methods This retrospective analysis cohort included 702 EEC patients who underwent TAH/BSO surgery, total abdominal hysterectomy, bilateral salpingooophorectomy in Peking University People’s Hospital from 2006 to 2020. Patients were stratified based on LVSI expression status as: LVSI negative group and LVSI positive group. Clinical outcome measures related to LVSI, assessed with a univariate and multivariate Cox proportional hazards regression model. Results 702 EEC patients with stage I and grade 1–2 were analyzed. 58 patients (8.3%) were LVSI-positive and 14 patients (2.0%) was relapse. Recurrence rates in LVSI-negative and LVSI-positive were 1.6% and 6.9%, respectively. 5-year disease-free survival (DFS) rate in LVSI-negative and LVSI-positive were 98.4% and 93.1%, respectively. These rates for 5-year overall (OS) survival in LVSI-negative were 98.9% while it was 94.8% in LVSI-positive. Multivariate analysis showed that LVSI is an independent risk factor for 5-year DFS (HR = 4.60, p = 0.010). LVSI has a similar result for 5-year OS(HR = 4.39, p = 0.028). Conclusions LVSI is an independent predictor of relapse and poor prognosis in early-stage low-grade endometrioid endometrial cancer in the Chinese cohort.

Background: Central nervous system (CNS) tumors are among the most common malignancies in various age ranges. Low-grade glioma (LGG) can account for nearly 30% of pediatric CNS malignancies. Progression or recurrence after the first-line treatments is common among these patients. Therefore, more treatments are required. Bevacizumab as an anti-VEGF antibody has come into the spotlight recently and is especially used in relapse or recurrence settings. This review aims to study the safety and efficacy of bevacizumab for patients with recurrent LGG. Methods: This study was conducted according to The Preferred Reporting Items for Systematic Reviews and Meta-Analyses. PubMed, Scopus, Web of Science, and Embase were comprehensively searched using the relevant key terms until 24th August 2023 to retrieve the studies that investigated clinical outcomes of bevacizumab in patients with recurrent LGG. All statistical analysis was performed by STATA v.17. Results: A total of 1306 papers were gathered, out of which 13 were incorporated in the meta-analysis. The pooled incidence rate of treatment according to the RANO scale was 70% (95% CI = 43–98%) for objective response rate, 26% (95% CI = 58–96%) for partial response, 21% (95% CI = 15–28%) for minor response, 14% (95% CI = 3–24%) for complete response, 48% (95% CI = 37–59%) for stable disease, and 8% (95% CI = 4–11%) for progressive disease. Furthermore, according to progressive survival after treatment, it was 4% (95% CI = −1 to 9%) for 6-month PFS, 41% (95% CI = 32–50%) for 2-year PFS, and 29% (95% CI = 22–35%) for 3-year PFS. Conclusion: According to the RANO scale and PFS, clinicians should be aware that Bevacizumab could be a favorable alternative therapy for recurrent LGG. Furthermore, bevacizumab exhibits minimal toxicity and high tolerability in recurrent LGG. [ABSTRACT FROM AUTHOR]

The beneficiation of low-grade iron ores is a key research and development topic in the mineral processing industry. The gradual exhaustion of high-grade iron ore reserves, and rising consumer iron and steel demand globally necessitate efficient low-quality iron ore beneficiation to meet steelmaking quality requirements. This comprehensive review explores various beneficiation techniques for low-quality iron ore, focusing on conventional methods including comminution, froth flotation and gravity separation. This article discusses the principles, processes, and equipment used in these techniques and highlights recent advancements and research efforts in the field. This review also emphasizes the importance of effective beneficiation processes in enhancing economic viability, sustainable resource management, and environmental conservation. Furthermore, it presents a case study of iron ore deposits in Botswana, highlighting the potential economic growth and sustainable development that can be achieved by maximizing resource utilization through reductive roasting, followed by magnetic separation of iron ore using semi-bituminous coal as a reductant. Overall, this review provides valuable insights into low-grade iron ore beneficiation techniques and their significance in meeting the growing demand for high-quality iron and steel products. [ABSTRACT FROM AUTHOR]

Objective: In 2016, the ESMO-ESGO-ESTRO consensus included LVSI (Lymph-vascular space invasion, LVSI) status as a risk stratification factor for stage I endometrioid endometrial cancer (EEC) patients and as one of the indications for adjuvant therapy. Furthermore, LVSI is included in the new FIGO staging of endometrial cancer (EC) in 2023. However, the data contribution of the Chinese population in this regard is limited. The present study aimed to further comfirm the influence of LVSI on the prognosis of early-stage low-grade EEC in a fifteen-year retrospective Chinese cohort study. Methods: This retrospective analysis cohort included 702 EEC patients who underwent TAH/BSO surgery, total abdominal hysterectomy, bilateral salpingooophorectomy in Peking University People's Hospital from 2006 to 2020. Patients were stratified based on LVSI expression status as: LVSI negative group and LVSI positive group. Clinical outcome measures related to LVSI, assessed with a univariate and multivariate Cox proportional hazards regression model. Results: 702 EEC patients with stage I and grade 1–2 were analyzed. 58 patients (8.3%) were LVSI-positive and 14 patients (2.0%) was relapse. Recurrence rates in LVSI-negative and LVSI-positive were 1.6% and 6.9%, respectively. 5-year disease-free survival (DFS) rate in LVSI-negative and LVSI-positive were 98.4% and 93.1%, respectively. These rates for 5-year overall (OS) survival in LVSI-negative were 98.9% while it was 94.8% in LVSI-positive. Multivariate analysis showed that LVSI is an independent risk factor for 5-year DFS (HR = 4.60, p = 0.010). LVSI has a similar result for 5-year OS(HR = 4.39, p = 0.028). Conclusions: LVSI is an independent predictor of relapse and poor prognosis in early-stage low-grade endometrioid endometrial cancer in the Chinese cohort. [ABSTRACT FROM AUTHOR]

This case report describes a 45-year-old woman presenting with abnormal uterine bleeding and a cervical mass. Imaging and biopsy revealed low-grade endometrial stromal sarcoma (LGESS), emphasizing the importance of comprehensive evaluation for uterine masses. The report underscores the role of MRI and pathology in diagnosis, with immunohistochemical analysis helping confirmation. A multidisciplinary approach and vigilant follow-up are crucial for optimal management. The rarity of LGESS and its challenging diagnosis highlight the need for continued research to improve diagnostic and therapeutic strategies. Surgical intervention remains primary, but the optimal management approach is debated. This report indicates the necessity of a comprehensive approach to uterine mass evaluation and ongoing research for enhanced patient care.

Abstract Background MEIS1::NCOA2 is a rare fusion gene that has been recently described in a subset of spindle cell rhabdomyosarcomas and multiple low-grade undifferentiated spindle cell sarcomas predominantly arising in the genitourinary and gynecologic tracts with no specific line of differentiation. We present the first documented case of this neoplasm arising as a lung primary tumor. Case Presentation A 74-year-old woman with a 40-year smoking history presented with a 2.1 × 1.7 cm lung nodule discovered on computed tomography (CT) scan. A biopsy and subsequent lobe resection were performed, as well as an extensive metastatic work up, which revealed no additional masses. No specific line of differentiation was found by immunohistochemical staining, and an RNA-based fusion panel revealed a MEIS1::NCOA2 fusion, at which point a diagnosis of Low-Grade Undifferentiated Sarcoma with MEIS1::NCOA2-Rearrangement was rendered. Conclusions This report represents the first diagnosis of this tumor primary to the lung, and provides additional insight into the origin and localization of these rare tumors.

Organometallic lead halide perovskite powders have gained widespread attention for their intriguing properties, showcasing remarkable performance in the optoelectronic applications. In this study, formamidinium lead iodide (α‐FAPbI3) microcrystals (MCs) is synthesized using retrograde solubility‐driven crystallization. Additionally, methylammonium lead bromide (MAPbBr3) and cesium lead iodide (δ‐CsPbI3) MCs are prepared through a sonochemical process, employing low‐grade PbX2 (X = I & Br) precursors and an eco‐friendly green solvent (γ‐Valerolactone). The study encompasses an analysis of the structural, optical, thermal, elemental, and morphological characteristics of FAPbI3, MAPbBr3, and CsPbI3 MCs. Upon analysing phase stability, a phase transition in FAPbI3 MCs is observed after 2 weeks. To address this issue, a powder‐based mechanochemical method is employed to synthesize stable mixed cation perovskite powders (MCPs) by subjecting FAPbI3 and MAPbBr3 MCs with varying concentrations of CsPbI3. Furthermore, the performance of mixed cation perovskites are examined using the Solar Cell Capacitance Simulator (SCAPS‐1D) software. The impact of cesium incorporation in the photovoltaic characteristics is elucidated. All mixed cation absorbers exhibited optimal device performance with a thickness ranging between 0.6–1.5 µm. It's worth noting that the MCPs exhibit impressive ambient stability, remaining structurally intact and retaining their properties without significant degradation for 70 days of ambient exposure. [ABSTRACT FROM AUTHOR]

Current guidelines recommend the use of radiotherapy in the management of intermediate and high‐grade soft‐tissue sarcoma of the extremity and trunk wall. Its use in low‐grade sarcoma is less clear. To date there have been no pooled data analyses regarding its role in this context. Its use is not without complications and therefore must be justified. We aim to assess the oncological impact of radiotherapy versus limb‐sparing surgery alone in this subset of sarcoma. Medline, EMBASE and Cochrane's databases were searched from 1982 to present. Studies on or having a subgroup analysis of low‐grade soft tissue sarcoma, with a radiotherapy and a surgery only arm were included. Outcomes included local recurrence and overall survival. Patients were at least 16 years of age with primary de‐novo sarcoma who had not undergone prior resection or treatment. Those undergoing concomitant therapy were excluded. Data extraction was performed independently by two reviewers. Results were pooled using a random‐effects model and presented as a forest plot. Primary outcome measures included local recurrence and overall survival. Eleven unique studies were included, consisting of two RCTs and nine non‐randomized studies. Overall, there were 12 799 patients. Four studies were included in meta‐analysis and the overall pooled effect showed a limited role of radiotherapy in overall survival outcomes when compared to limb‐sparing surgery alone HR 1.00 [0.83–1.20] P = 0.41. Descriptive analysis suggests there is limited role of radiotherapy in improving local recurrence outcomes. This study suggests there is limited role for radiotherapy versus limb‐sparing surgery alone in low‐grade soft‐tissue sarcoma. These findings strongly suggest there is lack of high‐quality data and that further research must be undertaken prior to forming any strong conclusions regarding the management of low‐grade soft‐tissue sarcoma. Demonstrating a role for radiotherapy may help improve the quality of excisional margins and thus potentiate limb‐sparing surgery. [ABSTRACT FROM AUTHOR]

Abstract Background The current era of molecular characterisation has contributed greatly to our understanding and management of low-grade gliomas (LGGs); however, this has also contributed to a paucity in level 1 evidence. Review Diagnostic breakthroughs in LGGs are moving quicker than our experimental capacity can react. The design, analysis, and clinical application of first-level evidence are struggling to compete with the considerable variability in the natural course of LGGs and the rapidly evolving utility of molecular characterisation of tumours. This poses several uncertainties to researchers, clinicians, and more importantly, patients. Conclusion Individualised case-by-case decisions based on best available evidence, albeit lacking level 1 evidence, must be made by considering the tumour behaviour, clinical course, and specific patient needs and goals.

Low-grade fibromyxoid sarcoma is a rare mesenchymal neoplasm with distinctive histopathological features. Although it typically arises in the deep soft tissues of the trunk and extremities, its occurrence in the head and neck region is exceedingly rare. We present the first documented case of low-grade fibromyxoid sarcoma in the laryngopharynx, expanding the spectrum of this rare tumor's anatomical localization. The clinical, radiological, and histopathological features of this unique case are discussed, highlighting the diagnostic challenges and therapeutic considerations associated with this uncommon presentation. [ABSTRACT FROM AUTHOR]

Urothelial carcinoma (UC) of the bladder is a prevalent malignant tumor among the elderly, whereas its incidence is scarce in the first 2 decades of life. The most commonly reported symptom in the literature is isolated hematuria, frequently overlooked during the initial medical assessment. In this study, we present the case of a 3-year-old male with hematuria, accompanied by other irritative symptoms such as flank pain, nausea, and vomiting. Ultrasonography revealed a bladder mass, which was later confirmed to be a noninvasive low-grade papillary urothelial carcinoma (NLPUC) through histopathological examination. This report discusses the clinical and pathological characteristics of the case and examines current literature on the topic.

The World Health Organization/International Society of Urological Pathology (2022 WHO/ISUP) classification categorizes noninvasive carcinomas based on the highest grade observed in a pathology sample. According to this classification, a lesion is classified as mixed-grade (MG) if the highest-grade component comprises less than 5% high-grade (HG) carcinoma [14]. This study included 160 cases of low-grade papillary urothelial carcinoma (LGUC) and 160 cases of HG papillary urothelial carcinoma (HGUC), selected randomly. In addition, 160 consecutive and unselected cases of MG papillary urothelial carcinoma (MGUC) were obtained from all bladder transurethral resection specimens diagnosed with papillary urothelial carcinoma between January 2007 and January 2021. The results of the multivariate analysis showed that histologic grade, invasion of the lamina propria, and the presence of carcinoma in situ at presentation were independent prognostic parameters regarding recurrence-free survival (p = 0.002; hazard ratio (HR) = 1.44, 95% confidence interval (CI) = 1.059–1.956, p = 0.02; and HR = 1.76, 95% CI = 1.159–2.684, p = 0.008, respectively). Histologic grade was the only independent prognostic parameter of disease-specific survival (DSS) (p < 0.001). Comparisons between non-muscle invasive (NMI) MGUC and NMI LGUC, as well as between NMI MGUC and NMI HGUC, revealed statistically significant differences in terms of DSS (HR = 0.07, 95% CI = 0.024–0.252, p < 0.001 and HR = 1.59, 95% CI = 1.023–2.460, p = 0.039, respectively). Our study findings demonstrate statistically significant differences regarding DSS between NMI MGUC and NMI HGUC, as well as between NMI MGUC and NMI LGUC. Therefore, we suggested that considering the presence of less than 5% MGUC as a separate category may be appropriate. However, it is important to validate our results in larger cohorts with longer follow-up periods to establish the clinical significance of MGUC and provide guidance for patient management. [ABSTRACT FROM AUTHOR]

Endometrial cancer (EC) is the most common malignant tumor of the female reproductive system, and the majority of ECs are low histological grade and confined to the uterus, resulting in a good prognosis. However, metastasis to the lung from a low-grade and early-stage endometrial endometrioid carcinoma (EEC) is extremely rare. Therefore, it is crucial to accurately differentiate between primary pulmonary malignancy and extra-thoracic malignancy presenting as metastatic disease, and flexible bronchoscopy with tissue acquisition plays a key role in this process. Despite its importance, there is limited literature available on the cytology of metastatic endometrial carcinoma in liquid-based cytology of bronchial brush (BB). In this article, we present two rare cases of lung metastasis from low-grade and early-stage EEC, along with a detailed analysis of the cytologic features observed in BB samples. These cases highlight the significance of cytological and histological pathology, complemented by immunohistochemistry (ICH) analysis, in the diagnosis and management of EEC patients. Pathologists should pay close attention to these aspects, while gynecologists need to be mindful of the follow-up and management of early-stage, low-grade EEC patients. By focusing on these areas, healthcare professionals can effectively contribute to the improved care and outcomes of patients with EEC. [ABSTRACT FROM AUTHOR]

Liposarcomas are a prevalent subtype of soft tissue sarcomas, constituting less than 1% of all malignancies. Originating in the adipose tissue, they can manifest in various locations and are categorized by the World Health Organization into several subtypes: well-differentiated liposarcomas, dedifferentiated liposarcomas, myxoid liposarcomas, pleomorphic liposarcomas and mixed-type liposarcomas. These tumors typically affect middle-aged and older individuals, and their incidence has been progressively increasing over the years. As liposarcomas advance they tend to encase blood vessels and major organs, particularly in the retroperitoneal area. Often asymptomatic initially, symptoms arise as the tumor reaches a considerable size, exerting pressure on adjacent tissues and organs. This report features a 54-year-old patient incidentally diagnosed with a substantial retroperitoneal tumor extending to the antero-lateral abdominal wall and inner thigh via the right inguinal ligament. The patient, with a previous three-year history of a right inguinal mass, sought acute care for a perianal abscess The histological examination revealed morphological aspects consistent with a low-grade myxoid liposarcoma. While surgery remains the primary treatment for retroperitoneal liposarcomas, controversies exist regarding the role of radiotherapy and chemotherapy in improving survival rates. This case highlights the challenges in managing retroperitoneal tumors and underscores the importance of a personalized, multidisciplinary approach to optimize patient outcomes. [ABSTRACT FROM AUTHOR]

The efficiency of physical separation techniques of heavy minerals usually encounters some set-backs. The reason is often not far from the inability to develop suitable mineral characterization strategies in order to comprehend/evaluate certain physicochemical features such as surface chemistry, specific gravity difference, magnetic and electrical responses distributed among the mineral particles. The intense need for the development/advancement of efficient gravity concentration route on heavy minerals, more especially for the recovery and upgrade of fine, near-dense, low-grade heavy mineral deposits cannot be over-emphasized. However, the process application of gravity concentration on heavy minerals has not been widely investigated, and has often times been neglected. Existing literature on investigations conducted does not completely incorporate process routes, operating principles, parameters and applications; and as such, information in this area is somewhat scanty, hence the purpose of this study. A bulk of more recently developed gravity concentration medium such as enhanced gravity concentrations possess essential potentials which can be applied in certain physical beneficiation routes. On this premise, the need for further investigation is highly imperative. This review is therefore aimed at revealing the advantageous features of enhanced gravity concentrations over the conventional techniques, as well as the process selection for optimal beneficiation and high-grade yields. Thus, process applications, operating mechanism/principles, general performance evaluation in treating/upgrading heavy minerals using gravity techniques, the merits/shortcomings involved in conventional/enhanced gravity concentrators and recommendations have been captured in this review. This study will thus contribute greatly to the body of knowledge in the physical treatment/concentration of heavy minerals.

In the present work, gadolinium-doped ceria-based powders were co-fired with additions of 1% (w /w) of SiO 2 , and 5% (w/w) of Y 2 O 3 to test the role of yttrium ion on improving the grain boundary conductivity across the grain boundary regions of low grade gadolinia-doped ceria (CGO) electrolytes. The samples were prepared by hot press at low temperature (1000 °C) to minimize bulk dissolution of yttrium in the CGO lattice. Structural characterization by XRD of the prepared ceramics confirms a CGO single phase material with the fluorite type structure. All the samples were characterized by impedance spectroscopy as a function of temperature in air, in order to de-convolute different microstructural contributions to the overall electrical behaviour. The results showed, as expected, that the presence of small amounts of impurity of silica reduces the total conductivity, when compared with pure CGO ceramic sample. The grain boundary resistance of these ceramics, under low operating temperatures, has a large effect on the total conductivity and is related, on one hand with the presence of a space charge layer created by the local segregation of trivalent rare earth elements, and the consequently depletion of oxygen vacancies, and on the other hand by the blocking effect of the silicon impurity. However, the obtained results show that addition of yttria increases total conductivity when compared with impure samples without yttria. This effect was related with the partial recover of specific grain boundary conductivity, suggesting a preferential location of Si and Y cations on grain boundaries. The space charge potential values, calculated using impedance data, provided an approach to the promoting effect of recovering grain boundary conductivity by the yttrium ion. • The use of low-grade raw materials for solid oxide fuel cells electrolytes. • Scavenge of silica impurities by yttria additions. • Electrical conductivity improvements by hoy press low temperature sintering. • Optimization of space charge and grain boundary conductivity. [ABSTRACT FROM AUTHOR]

Based on exploration and sampling work on the Siberian platform (SP) the uneven diamond content of various diatremes was established. During the exploration apart from the pipes with high or medium content of a useful component also the diatremes with low to very low diamond content were discovered. To obtain representative data the diatremes of two kimberlite fields of the Central Siberian (CS) and six kimberlite fields of the Lena-Anabar (LA) diamondiferous sub-provinces (DSP) were studied. A comprehensive study of diamonds from low-grade pipes of the Alakit-Markhinsky and Daldynskoye kimberlite fields of CSDSP was carried out. 16 kimberlite bodies from six kimberlite fields from the LADSP were studied. Geology and mineral-petrographic composition of kimberlites, crystal-morphological and physical properties of diamonds from certain prospective areas were investigated. In addition to classifying diamonds into specific varieties according to Yu. L. Orlov (1984), for many crystals, we examined impurity centers, the ratio of the concentration of optically active defects, spectra of absorption of diamonds IR and UV for the visible regions. For many grains we determined the isotopic composition of carbon; carried out analyses using the electron paramagnetic resonance (EPR) method; measured the photoconductivity upon excitation with visible light; analyzed photoluminescence spectra; studied the internal structure and composition of the mineral inclusions. The obtained results were compared with similar materials for the known primary (and sometimes alluvial) deposits of the region. Based on the study of the typomorphic features of diamonds from low-grade kimberlite pipes from selected fields of the SP we conclude that they are characterized by a high content of typical rounded minerals of the Ural (Brazilian) type with shagreen and plastic deformation bands. This indicates a significant dissolution of the mineral in the kimberlite of such diatremes, which distinguishes them from similar bodies with high diamond content and makes it possible to predict the grade already at the initial stages of exploration work. Increased content of small semitransparent smoky-brown rounded diamonds with shagreen and plastic deformation bands for crystals from veins was noted, which is also typical for low-grade pipes.

Cases of low-grade cerebral arteriovenous malformations (cAVMs) showing dynamic changes and large areas of brain edema on short-term MRI follow-up have rarely been reported. This report describes an incidentally discovered and initially misdiagnosed cAVM in a patient with malignancies. The presence of abnormal signals surrounded by large areas of brain edema combined with tortuous or dilated vessels indicates the possibility of an AVM, especially in young people.

Treatment of an unruptured brain arteriovenous malformation (bAVM) is a matter of debate, especially for low-grade bAVM (Spetzler-Martin grade I and II). The aim is to compare the outcomes of patients with low-grade unruptured bAVM after interventional or medical management in a pragmatic manner. Adults with unruptured low-grade bAVM diagnosed between 2006 and 2016 were included. The primary end points were death from all causes and disabling stroke that resulted in a modified Rankin Scale (mRS) score >2 at last follow-up. Eighty-four patients presented with an unruptured Spetzler-Martin low-grade bAVM. Among these patients, 55 (65.5%) were treated and 29 (34.5%) were untreated, with no differences regarding clinical and radiologic characteristics. The modality of treatment was embolization in 25.5%, radiosurgery (alone, 30.9%; with embolization, 18.2%), and surgery (alone, 5.5%; with embolization, 20%). The rupture rate was 6.7% person-year in the untreated group; 12.7% (n = 7) of treated and 16.7% (n = 5) of untreated patients achieved the primary evaluation criteria (P = 0.744). Using a Kaplan-Meier curve, the probability of reaching this criterion at 5 years was not different between groups (P = 0.07). Complications resulting in an mRS score >2 at last follow-up occurred in 9.1%, in 80% of cases after embolization. This study shows no differences between treated and untreated low-grade bAVM. Embolization seems to carry a high risk of complication and should be used with caution. The small number of cases must encourage cautious interpretations especially because of the spontaneous high-rupture rate. One major interest is to investigate center habits in pathology when treatment standards are limited. [ABSTRACT FROM AUTHOR]

Keywords: surgical margins; soft tissue sarcoma; local recurrence; metastases; high-grade; low-grade EN surgical margins soft tissue sarcoma local recurrence metastases high-grade low-grade 1694 13 11/17/22 20221101 NES 221101 1. 10.1002/bjs.5906 15 Tsagozis P., Bauer H.C., Styring E., Trovik C.S., Zaikova O., Brosjo O. Prognostic factors and follow-up strategy for superficial soft-tissue sarcomas: Analysis of 622 surgically treated patients from the scandinavian sarcoma group register. [Extracted from the article]

Purpose: Recently, Eggener et al. reignited a debate consisting to redefine Gleason Grade Group (GGG) 1 prostate cancer (PCa) as a precancerous lesion to reduce overdiagnosis and overtreatment. However, historical cohorts showed that some GGG1-labeled disease at biopsy may be underestimated by the standard PCa diagnostic workup. The aim was to assess whether the risk of adverse features at radical prostatectomy (RP) in selected GGG1 patients still exists in the era of pre-biopsy mpMRI and image-guided biopsies. Methods: We retrospectively reviewed our data from a European RP dataset to assess in contemporary patients with GGG1 at mpMRI-targeted biopsy the rate of adverse features at final pathology, defined as ≥ pT3a and/or pN+ and/or GGG ≥ 3. Results: A total of 419 patients with cT1-T2 cN0 GGG1-PCa were included. At final pathology, 143 (34.1%) patients had adverse features. In multivariate analysis, only unfavorable intermediate-risk/high-risk disease (defined on PSA or stage) was predictive of adverse features (OR 2.45, 95% CI 1.11–5.39, p = 0.02). A significant difference was observed in the 3-year biochemical recurrence-free survival between patients with and without adverse features (93.4 vs 87.8%, p = 0.026). In sensitivity analysis restricted low- and favorable intermediate-risk PCa, 122/383 patients (31.8%) had adverse features and no preoperative factors were statistically associated with this risk. Conclusion: In this European study, we showed that there is still a risk of underestimating GGG1 disease at biopsy despite the routine use of image-guided biopsies. Future studies are warranted to improve the detection of aggressive disease in GGG1-labeled patients by incorporating the latest tools such as genomic testing or radiomics. [ABSTRACT FROM AUTHOR]

Abstract Objective Primary osteosarcoma of the jaw bones is very rare, and histological features of gnathic osteosarcoma remain obscure. The purpose of this study was to describe the clinicopathological features of gnathic osteosarcoma. Materials and methods Seven cases of gnathic osteosarcoma from Japan diagnosed during the period between 2000 and 2016 were examined retrospectively. The histology of the surgical pathology materials was reviewed by two pathologists. Clinical information was obtained from the hospital's information system. Results Of the seven cases, two patients had secondary osteosarcomas. As for the five cases of primary osteosarcoma, their ages ranged from 26 to 58 years (mean: 36.2, median: 28). Histologically, three cases were fibrotic tumors composed of spindle‐shaped cells with mild to moderate nuclear atypia and the collagenous stroma accompanied by woven bones or mature lamellar‐like bones. Two cases had cartilage formation. MDM2 and CDK4 expression was observed in two out of three cases on immunostaining. The histopathology of these three cases was regarded as the counterpart of low‐grade osteosarcomas, namely, parosteal osteosarcoma and low‐grade central osteosarcoma, arising in long bones. Conclusions The surprisingly high incidence (60%, 3/5 cases) of low‐grade osteosarcoma explains the reason why gnathic osteosarcomas present a more favorable prognosis than osteosarcomas arising in long bones. Furthermore, it provides insight into the tumorigenesis mechanism of low‐grade osteosarcomas arising in the jaw and other sites.

We present and discuss the results of a field-based approach including accurate geological mapping and micro- to map-scale structural analysis to highlight the finite strain pattern recorded in Marguareis Unit, a massif deformed at shallow crustal levels at the boundary between Maritime and Ligurian Alps. We describe superposed tectonic structures developed under low-grade metamorphic conditions during the Alpine collision and nowadays exceptionally well recorded in the area of interest. We demonstrate that the structural frame of the Marguareis Unit results from superposition of fourfold systems, later segmented, but without significant displacements, by brittle faults.

Patients with CD5-expressing lymphomas presenting with splenomegaly are frequently diagnosed with chronic lymphocytic leukemia. The most important differential diagnosis is mantle cell lymphoma, both in its classical and leukemic, non-nodal forms, given its prognostic and therapeutic implications. Other small B-cell neoplasms that frequently involve the spleen and occasionally express CD5 include the splenic marginal zone lymphoma, hairy cell leukemia and, rarely, lymphoplasmacytic lymphoma. The frequency of CD5 positivity depends in part on the sensitivity of the detection methods employed. Usually, a combination of morphological, immunophenotypic and molecular findings allows for a precise sub-classification of CD5-positive, low-grade B-cell lymphomas of the spleen. Some of these tumors may display a mixture of small and larger B cells, raising the possibility of more aggressive lymphomas, such as diffuse large B-cell lymphomas (DLBCL). Approximately 5–10% of DLBCL are CD5-positive and some may manifest as primary splenic lesions. When available, the morphology of DLBCL in the splenic tissue is distinctive and a leukemic picture is very rare. In conclusion, the appropriate morphological and clinical context assisted by flow cytometry panels and/or immunohistochemistry allows the differential diagnosis of CD5-positive, non-Hodgkin, B-cell lymphomas involving the spleen.

We report the rare case of a giant low-grade appendiceal mucinous neoplasm (LAMN), presenting as ileocecal intussusception. An 80-year-old woman presented in the emergency department of our institution with progressively worsening diffuse abdominal pain during the last 24 h. A CT scan revealed a giant abdominal mass (98.7 × 127.3 × 107.6 mm) with air-fluid level and imaging characteristics of ileocecal intussusception. An emergency exploratory laparotomy was performed, and a well-circumscribed cystic mass deriving from the appendix was found. A right hemicolectomy was performed, and the histopathological examination confirmed the diagnosis of LAMN. This report aims to raise awareness among surgeons and radiologists, about LAMNs as a differential diagnosis of right iliac fossa masses presenting as acute abdomen. [ABSTRACT FROM AUTHOR]

Aims: Desmoplastic infantile astrocytomas and gangliogliomas (DIA/DIGs) are rare brain tumours of infancy. A distinctive feature of their histopathology is a combination of low‐grade and high‐grade features. Most DIA/DIGs can be surgically resected and have a good prognosis. However, high‐grade features often dominate recurrent tumours, some of which have a poor outcome. In this study, we test the hypothesis that low‐grade and high‐grade areas in DIA/DIGs have distinct molecular characteristics. Methods: Tissue samples from microdissected low‐grade and high‐grade areas in 12 DIA/DIGs were analysed by DNA methylation profiling, whole exome sequencing, RNA sequencing and immunohistochemistry to search for potential differences at multiple molecular levels. Results: Copy number variants among tumours and between the two morphologically distinct areas were infrequent. No recurrent genetic alterations were identified across the tumour series, and high‐grade areas did not have additional genetic alterations to explain their distinct morphology or biological behaviour. However, high‐grade areas showed relative hypomethylation in genes downstream of the transcription factors SOX9 and LEF1 and evidence of a core SOX9 transcription network alongside activation of the BMP, WNT and MAPK signalling pathways. Conclusions: This study contributes to our knowledge of molecular genetic alterations in DIA/DIGs, uncovers molecular differences between the two distinct cell populations in these tumours and suggests potential therapeutic targets among the more proliferative cell population in DIA/DIGs. [ABSTRACT FROM AUTHOR]

Out-of-grade pine timber is an abundant material resource that is underutilised because its mechanical properties are not well understood. Increasing trends toward shorter rotation times and fast-grown plantation pines around the world such as Pinus elliottii × P. caribaea var. hondurensis hybrid (PEE × PCH) mean low-stiffness corewood is becoming a larger portion of this out-of-grade population. This study characterised the modulus and strength properties in bending, compression parallel to grain (CParG) and compression perpendicular to grain (CPerpG), shear and tension strength of low-stiffness out-of-grade PEE × PCH. The effect of resin, knots and pith on these properties were also investigated. The results show that in clear wood, the MOE in bending, CParG, CPerpG and shear modulus are 6.9 GPa, 5.78 GPa, 0.27 GPa and 0.59 GPa, respectively, while strengths are 45.8 MPa, 29.4 MPa, 6.7 MPa, 5.7 MPa, respectively. The tensile strength is 32.4 MPa. Resin significantly increased density 45% higher than clear, but performed similar with the exception of CPerpG MOE and strength which were significantly different. Resin area ratio (RAR) has a moderate correlation with density with an R2 of 0.659 but low to no correlation for mechanical properties. Knots were significantly different to clear for all test types and within a range of 48% to 196%. Knots were high in CPerpG MOE and strength but lower for all other properties and had the largest negative impact on tensile strength. Knot area ratio (KAR) had low to moderate correlation with tension strength and CPerpG MOE with R2 of 0.48 and 0.35, respectively. Pith was within the range of 76% to 121% of non-pith samples for structural performance, some of which were significantly different, and pith samples were higher in density than non-pith. This new information is crucial for the effective establishment of grading rules, design optimisation and utilisation of low-stiffness out-of-grade PEE × PCH as a new material resource in civil engineering applications. [ABSTRACT FROM AUTHOR]

This study presents the novel idea of a cyanide-free leaching method, i.e., glycine-ammonia leaching in the presence of permanganate, to treat a low-grade and copper-bearing gold tailing. Ammonia played a key role as a pH modifier, lixiviant and potential catalyst (as cupric ammine) in this study. Replacing ammonia with other pH modifiers (i.e., sodium hydroxide or lime) made the extractions infeasibly low (<30%). The increased additions of glycine (23–93 kg/t), ammonia (30–157 kg/t) and permanganate (5–20 kg/t) enhanced gold and copper extractions considerably. Increasing the solids content from 20 to 40% did not make any obvious changes to copper extraction. However, gold leaching kinetics was slightly better at lower solids content. It was indicated that the staged addition of permanganate was unnecessary under the leaching conditions. Recovery of gold by CIL was shown to be feasible, and it improved gold extraction by 15%, but no effect was observed for copper extraction. Percentages of 76.5% gold and 64.5% copper were extracted in 48 h at 20 g/L glycine, 10 kg/t permanganate, 20 g/L carbon, pH 10.5 and 30% solids. Higher extractions could be potentially achieved by further optimization, such as by increasing permanganate addition, extending leaching time and ultra-fine grinding. [ABSTRACT FROM AUTHOR]

Simple Summary: Low-grade gliomas (LGGs) comprise 13–16% of glial tumors. As survival for LGG patients has been improving, it is important to consider the effects of diagnosis and treatment on mental health. The aims of this retrospective cohort study were to determine the incidence, prevalence, and risk factors of mental health disorders (MHD) in LGG patients. In our analysis including 20,432 LGG patients, we identified an MHD prevalence of 60.9%. Of those with no history of prior MHD, 16.9% of LGG patients developed a new onset of MHD within 12 months of LGG diagnosis. Risk factors included female gender, ages 35–54, presence of seizures, and first-line surgical treatment. Therefore, proactive surveillance and counseling surrounding MHDs are recommended among LGG patients. Impact of surgery on brain networks affecting mood should also be considered. Low-grade gliomas (LGGs) comprise 13–16% of glial tumors. As survival for LGG patients has been gradually improving, it is essential that the effects of diagnosis and disease progression on mental health be considered. This retrospective cohort study queried the IBM Watson Health MarketScan® Database to describe the incidence and prevalence of mental health disorders (MHDs) among LGG patients and identify associated risk factors. Among the 20,432 LGG patients identified, 12,436 (60.9%) had at least one MHD. Of those who never had a prior MHD, as documented in the claims record, 1915 (16.7%) had their first, newly diagnosed MHD within 12 months after LGG diagnosis. Patients who were female (odds ratio (OR), 1.14, 95% confidence intervals (CI), 1.03–1.26), aged 35–44 (OR, 1.20, 95% CI, 1.03–1.39), and experienced glioma-related seizures (OR, 2.19, 95% CI, 1.95–2.47) were significantly associated with MHD incidence. Patients who underwent resection (OR, 2.58, 95% CI, 2.19–3.04) or biopsy (OR, 2.17, 95% CI, 1.68–2.79) were also more likely to develop a MHD compared to patients who did not undergo a first-line surgical treatment. These data support the need for active surveillance, proactive counseling, and management of MHDs in patients with LGG. Impact of surgery on brain networks affecting mood should also be considered. [ABSTRACT FROM AUTHOR]

Beneficiation of low-grade phosphate deposits through direct froth flotation has captured more attention to satisfy the future needs of phosphorous industry. This is owing to the excessive consumption of the global reserves of high-grade phosphate deposits. Phosphate flotation using mixed collectors has been proved to give greater selectivity and high recovery of apatite comparing with fatty acids, which require selective depressant to be effective. However, the recovery of apatite from gangue minerals does not only rely on the selection of flotation reagents, but also the adsorption mechanism all together with solution chemistry. Accordingly, the current paper reviews the froth flotation studies conducted on phosphate ores, with highlighting the crucial role and optimization of collector types, depressants, and pH. Also, this review will provide some directions as an encouragement to the phosphate industries for the valorization of phosphorus from low-grade phosphate ore. [ABSTRACT FROM AUTHOR]

A mixed epithelial and stromal tumor of the seminal vesicle gland is an uncommon neoplasm characterized by a dual population of epithelial and stromal cells. In this case report, we present a 59-year-old male patient who presented with a large, 10 cm mass in the left seminal vesicle, which was preliminarily suspected to be a malignant tumor of the seminal vesicle based on magnetic resonance imaging findings. Histopathological evaluation, however, revealed a tumor with biphasic epithelial-mesenchymal differentiation, predominantly displaying mesenchymal characteristics. The epithelium and stroma displayed papillary and foliar structures, respectively. The epithelial cells were bland, arranged in either single or multi-layered cuboidal patterns, and the stromal cells were spindle shaped with a sparse distribution. The patient experienced a favorable postoperative outcome. The diagnosis of mixed epithelial and stromal tumor is challenging based on clinical and imaging findings alone, and definitive diagnosis relies on pathological examination. This case report addresses a rare presentation of low-grade mixed epithelial and stromal tumor in the seminal vesicle gland and aims to expand the understanding of this entity by reviewing the relevant literature., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)

Background and Objective: Management of low-grade (LG) urothelium-confined (Ta stage) non-muscle-invasive bladder cancer (NMIBC) poses a distinct therapeutic challenge. Transurethral resection of bladder tumor (TURBT), the standard treatment, frequently has to be repeated because of high tumor recurrence rates. This places a considerable strain on both patients and health care infrastructure, underscoring the need for alternative management approaches. Herein, the IBCG (International Bladder Cancer Group), conducted a review to explore the efficacy and safety of deintensified treatment strategies for recurrent LG Ta NMIBC., Methods: We conducted a collaborative review of relevant literature in the PubMed/MEDLINE and Cochrane CENTRAL databases. Our focus was on high-quality evidence, including randomized controlled trials, systematic reviews, and meta-analyses. We also reviewed guidelines published by prominent urological associations., Key Findings and Limitations: Active surveillance, chemoablation, and office fulguration are valid treatment options for recurrent LG Ta NMIBC. These deintensified approaches offer several advantages over TURBT: lower complication rates, less morbidity, lower health care costs, and better quality of life for patients. Importantly, these benefits are achieved without compromising oncological safety., Conclusions and Clinical Implications: Our review demonstrates that less intensive treatment strategies for recurrent LG Ta NMIBC are both feasible and valuable. The IBCG recommends use of these approaches for carefully selected patients to help lower health care costs and enhance patients' quality of life., Patient Summary: We reviewed studies on less invasive management options for low-grade noninvasive bladder cancer, including active surveillance, chemical ablation, and heat treatment. Recent results confirm that these less intense treatment options can reduce the treatment burden and costs for patients and preserve their quality of life without negatively affecting cancer control outcomes., (Copyright © 2024 European Association of Urology. Published by Elsevier B.V. All rights reserved.)

Patients with CD5-expressing lymphomas presenting with splenomegaly are frequently diagnosed with chronic lymphocytic leukemia. The most important differential diagnosis is mantle cell lymphoma, both in its classical and leukemic, non-nodal forms, given its prognostic and therapeutic implications. Other small B-cell neoplasms that frequently involve the spleen and occasionally express CD5 include the splenic marginal zone lymphoma, hairy cell leukemia and, rarely, lymphoplasmacytic lymphoma. The frequency of CD5 positivity depends in part on the sensitivity of the detection methods employed. Usually, a combination of morphological, immunophenotypic and molecular findings allows for a precise sub-classification of CD5-positive, low-grade B-cell lymphomas of the spleen. Some of these tumors may display a mixture of small and larger B cells, raising the possibility of more aggressive lymphomas, such as diffuse large B-cell lymphomas (DLBCL). Approximately 5-10% of DLBCL are CD5-positive and some may manifest as primary splenic lesions. When available, the morphology of DLBCL in the splenic tissue is distinctive and a leukemic picture is very rare. In conclusion, the appropriate morphological and clinical context assisted by flow cytometry panels and/or immunohistochemistry allows the differential diagnosis of CD5-positive, non-Hodgkin, B-cell lymphomas involving the spleen. [ABSTRACT FROM AUTHOR]

Pyrophyllite (Al2Si4O10(OH)2) is a phyllosilicate often associated with quartz, mica, kaolinite, epidote, and rutile minerals. In its pure state, pyrophyllite exhibits unique properties such as low thermal and electrical conductivity, high refractive behavior, low expansion coefficient, chemical inertness, and high resistance to corrosion by molten metals and gases. These properties make it desirable in different industries such as refractory; ceramic, fiberglass, and cosmetic industries; as filler in the paper, plastic, paint, and pesticide industries; as soil conditioner in the fertilizer industry; and as a dusting agent in the rubber and roofing industries. Pyrophyllite can also serve as an economical alternative in many industrial applications to different minerals as kaolinite, talc, and feldspar. To increase its market value, pyrophyllite must have high alumina (Al2O3) content, remain free of any impurities, and possess as much whiteness as possible. This paper presented a review of pyrophyllite's industrial applications, its important exploitable properties, and the specifications required for its use in industry. It also presents the most effective and economical techniques for enriching low-grade pyrophyllite ores to make them suitable for various industrial applications. [ABSTRACT FROM AUTHOR]

Objective: Primary osteosarcoma of the jaw bones is very rare, and histological features of gnathic osteosarcoma remain obscure. The purpose of this study was to describe the clinicopathological features of gnathic osteosarcoma. Materials and methods: Seven cases of gnathic osteosarcoma from Japan diagnosed during the period between 2000 and 2016 were examined retrospectively. The histology of the surgical pathology materials was reviewed by two pathologists. Clinical information was obtained from the hospital's information system. Results: Of the seven cases, two patients had secondary osteosarcomas. As for the five cases of primary osteosarcoma, their ages ranged from 26 to 58 years (mean: 36.2, median: 28). Histologically, three cases were fibrotic tumors composed of spindle‐shaped cells with mild to moderate nuclear atypia and the collagenous stroma accompanied by woven bones or mature lamellar‐like bones. Two cases had cartilage formation. MDM2 and CDK4 expression was observed in two out of three cases on immunostaining. The histopathology of these three cases was regarded as the counterpart of low‐grade osteosarcomas, namely, parosteal osteosarcoma and low‐grade central osteosarcoma, arising in long bones. Conclusions: The surprisingly high incidence (60%, 3/5 cases) of low‐grade osteosarcoma explains the reason why gnathic osteosarcomas present a more favorable prognosis than osteosarcomas arising in long bones. Furthermore, it provides insight into the tumorigenesis mechanism of low‐grade osteosarcomas arising in the jaw and other sites. [ABSTRACT FROM AUTHOR]

Only 30% of patients with major depressive disorder (MDD) reach full recovery or remission. Treatment-resistant depression (TRD) is MDD that does not respond to adequate treatment attempts with at least two antidepressants. TRD is associated more with immune activation than with treatment responsive depression. The current retrospective population-based cross-sectional study, utilizing data from a large nation-wide health maintenance organization in Israel which provides services to estimated 725,000 members, aimed to assess the clinical signs and laboratory markers of autoimmune comorbidity and low-grade inflammation, in patients with TRD. Included were participants aged 18–70 years, diagnosed twice within one year with ICD-9-CM MDD and two control groups, MDD responders (MDD-r) consisting of people with MDD and no TRD and a non-MDD group that included people with no MDD or TRD. The case (570 subjects in TRD group) to control ratio in both control groups (2850 subjects in MDD-r and 2850 subjects in non-MDD control group) was 1:5. Compared to MDD-r, the overall proportion of allergic diseases was higher among the TRD than among the MDD-r [OR 1.52 (1.19–1.94); p ​1:80) antinuclear antibodies [33 (5.79%)] were found among the TRD than among the MDD-r [98 (3.44%); p ​= ​0.011). More allergy and autoimmune comorbidities and presence of low-grade inflammation biomarkers, were found mainly in TRD.

Soft tissue sarcomas (STSs) are a diverse group of rare malignant soft tissue tumors with a high disease burden. Treatment protocols are complex and, to this day, a precise recommendation for the surgical margin width is lacking. The present study aims to analyze the width of the surgical margins in STS resection specimens and analyze them for local and systemic disease-free survival as well as for most frequent histologic STS subtypes. A total of 169 consecutive patients diagnosed and treated in curative intent in our institution following a primary and localized STS of the extremities or trunk from January 2010 to December 2020 were included in this study regardless of age. Our data reveal that low-grade STSs are best controlled locally by a surgical margin ≥2 mm and in this way also preventing distant metastases effectively. Local recurrence-free survival and metastasis-free survival in high-grade STS were improved by intact muscle fascia or periosteum at the margin when compared only to soft tissue. However, the outcome was independent of the surgical margin width, suggesting a close but negative margin may be safe in high-grade STS subtypes with less invasive growth patterns when combined with adjunct radiochemotherapy.

The Donchai Group are low-grade metamorphic rocks which are distributed in Northern Thailand. Their protoliths are pelitic rocks, quartzo-feldsparthic rocks, and mafic/ultramafic rocks. The Donchai Group in the study area experienced at least two metamorphism events. They show the spotted porphyroblasts that are the evidence of contact metamorphism overprinted on the early regional metamorphism. The andalusite porphyroblast aggregate sized 2-10 cm while the cordierite relicts sized 1-5 mm in diameters. The first event (D1) created their foliation that mostly dipping to the east while the second (D2) created the crenulation cleavages. In microscales, the microstructures show a dextral sense of shear. The mineral assemblages of metapelites are biotite, muscovite, quartz, andalusite, sillimanite, cordierite, garnet, and tourmaline. The metapsammites contain quartz, k-feldspar, plagioclase, biotite, muscovite, chlorite, apatite, zircon and titanite. The metabasites compose of plagioclase, quartz, amphibole, orthopyroxene, biotite, chlorite, and opaque minerals. From the petrographic study, the Donchai Group metamorphic rocks are metamorphosed under the greenschist facies. [ABSTRACT FROM AUTHOR]

This article presents a case of low-grade cribriform cystadenocarcinomas (LGCCC), a rare salivary gland tumor manifesting in the infratemporal fossa (ITF). The lesion in this case is unique in its location, histopathology, and management in that the tumor resection was performed using an exclusively endoscopic, endonasal approach. This case highlights the expanding application of endoscopic skull base techniques to address an indolent, slow-growing malignancy of the ITF.

Abstract Background Chondrosarcoma is the second most frequent malignant bone tumor. Grade I chondrosarcoma (syn.: atypical cartilaginous tumor) is classified as an intermediately and locally aggressive neoplasm and typically is treated less aggressively (i.e., by intralesional curettage). Does the data regarding local recurrence (LR) and metastatic disease justify this? Methods From 1982 to 2014, 37 consecutive patients with G1 chondrosarcoma had been resected or curetted. The margin was defined as R0 (wide resection) or R1 (marginal resection). All patients were followed for evidence of local recurrence or metastatic disease. Overall and recurrence-free survival were calculated, and various potentially prognostic factors were evaluated. Results In 23 patients (62%), the tumor was widely (R0) resected, whereas in 14 patients, (38%) the resection was marginal (R1). Overall survival was 97% after 5 years, 92% after 10 years, and 67% after 20 years. Five-year local recurrence-free survival was 96%. Ten-year local recurrence-free survival was 83%. Local recurrence-free survival showed a significant correlation to margin status but no correlation to location or age. None of the patients with local recurrence died during the follow-up. One patient had metastatic disease at initial presentation, and a further five patients developed metastatic disease during follow-up. Metastatic disease proofed to be a highly significant factor for survival but was not correlated to local recurrence. Conclusions There was no significant correlation between the outcome and the primary tumor location. Marginal resection was a risk factor for LR, but there was no significant difference in the overall survival in patients with or without LR. Metastatic disease (16%) was more common than expected from the literature and a significant predictor for poor overall survival.

Abstract Background Metastatic tumors to the pancreas are uncommon, accounting for approximately 2% of pancreatic malignancies. The most common primary tumors to give rise to pancreatic metastases are carcinomas. Case presentation A 50-year old female patient was investigated for a cause of abdominal discomfort. She had a 2-year history of menorrhagia and dysmenorrhea which was ascribed to a fibroid uterus. On imaging, she was found to have a large solid and cystic mass in the tail of the pancreas. Imaging also confirmed a fibroid uterus. A distal pancreatectomy and splenectomy showed a 9 cm circumscribed mass within, and grossly confined to, the parenchyma of the pancreatic tail. Microscopically, the pancreatic lesion was lobulated, and well-circumscribed, but focally infiltrative. It comprised sheets of uniform spindled to epithelioid cells with round to oval nuclei, coarse to vesicular chromatin, visible nucleoli, nuclear grooves and clear to eosinophilic cytoplasm. Prominent arterioles were identified. The stroma was collagenized in areas. Occasional hemosiderin-laden macrophages were seen, and focal cystic change was present. There was no evidence of nuclear pleomorphism, mitotic activity or necrosis, and there was no evidence of endometriosis despite multiple sections being taken. Immunohistochemistry showed that the tumor cells were positive for CD10, estrogen receptor (ER), progesterone receptor (PR), Wilms tumor-1 (WT-1) and smooth muscle actin (SMA). RNA sequencing detected a PHF1 rearrangement. The morphological, immunohistochemical and molecular features were of a low-grade endometrial stromal sarcoma (LG-ESS). Subsequent total hysterectomy and bilateral salpingo-oophorectomy 3 months later, showed uterine fibroids and a 5 cm low-grade endometrial stromal sarcoma confined to the uterus, with lymphatic invasion. Conclusions To the best of our knowledge, this is the first documented case of metastatic endometrial stromal sarcoma of uterus presenting as a primary pancreatic neoplasm. An unexpected extra-uterine location and unusual presentation of ESS may make the diagnosis challenging, despite classic histological features. Morphological, immunohistochemical and molecular findings must be combined to render the correct diagnosis.

Objective: To examine admission and transfer patterns of isolated low-grade renal trauma given lack of evidenced based guidelines.Methods: We employed a retrospective cohort design to analyze patients with low grade renal trauma from 2005 to 2018. We used an Abbreviated Injury Score (AIS) <3 for non-abdominal categories to ensure that intensive care unit admission/hospital transfer was due to renal trauma (n = 87). Treatment and discharge survival were compared.Results: Mean age for floor (n = 31) and intensive care unit (ICU) (n = 46) patients were 33 (IQR = 20) and 42 (IQR = 46) years old, respectively. Mean injury severity score (ISS) was 7.7 (IQR 4) for floor and 8 (IQR=3.75) for ICU admissions (P = .61) Mean ISS was 7.53 (IQR = 4) for transfers and 8.27 (IQR = 3.25) for non-transfers (P = .26). Blood products were administered only to 3 (6.5%) ICU patients all over 60 years old. Fourteen (45.1%) and 26 (56.5%) of floor and ICU admissions were transferred from a lower-level trauma center. ICU mean length of stay (LOS) was 37 hours (IQR = 23 h.). Mean hospital LOS was 43.4 hours and 71.9 hours for the floor and ICU patients (P = .08), and 69.02 hours and 52.58 hours for transfer vs non-transferred (P = .31). All patients were discharged alive and the majority (94%) was discharged home.Conclusion: Given expedient ICU discharge, low transfusion rate, and low complication rate, inter-hospital transfer and ICU admission are unnecessary for patients under 65 years. Transfer and admission protocols for isolated renal trauma are needed to avoid resource overutilization. [ABSTRACT FROM AUTHOR]