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Pulmonary sarcomatoid carcinoma (PSC) is a rarely occurring variant of non-small cell lung cancer with sarcoma-like features. Compared with traditional non-small cell lung cancer, PSC patients typically present later and have poorer prognoses, irrespective of stage. The standard of care is resection, but guidelines for the use of adjuvant chemotherapy have not been established. To advance the development of evidence-based management algorithms for PSC after resection, a statistical analysis on a nationwide representative sample of patients was performed. A retrospective cohort study was performed by querying the National Cancer Database for patients with a diagnosis of PSC between 2004 and 2015. Patients who received complete anatomical resection with or without adjuvant chemotherapy were included. Multivariable regression was used to detect factors associated with the receipt of adjuvant chemotherapy. Multivariable Cox regression of overall survival and Kaplan-Meier survival analysis on propensity-matched groups was conducted to study the association between adjuvant chemotherapy and prognosis. We included 1497 patients with PSC in the final analysis. Factors associated with receiving adjuvant chemotherapy were age, histology, and receipt of adjuvant radiation. The results of multivariable Cox analysis and Kaplan-Meier analysis on propensity matched groups yielded similar trends: adjuvant chemotherapy was associated with improved 5-year overall survival for stage II and III disease, but not for stage I disease. Multiple factors are associated with receipt of adjuvant chemotherapy for PSC, and this treatment appears to be associated with improved survival in stage II and stage III, but not stage I patients. Overview of study and findings. In this work, the National Cancer Database (NCDB) was probed for patients with a diagnosis of pulmonary sarcomatoid carcinoma diagnosed between 2004 and 2015 and who received R0 surgery. Patients who received adjuvant chemotherapy and who did not receive adjuvant chemotherapy were matched by propensity scores incorporating age, sex, race, tumor size, tumor histology, facility type, extent of resection, receipt of adjuvant radiation, and Charlson-Deyo Comorbidity scores. Kaplan-Meier analysis on the resulting groups showed that chemotherapy has no effect on survival in stage I disease, but improved overall survival in stage II and even further in stage III disease. On the basis of this analysis, adjuvant chemotherapy appears least effective in the earliest stages of pulmonary sarcomatoid carcinoma and the most effective in later stages. [Display omitted] [ABSTRACT FROM AUTHOR]

Leiomyosarcoma is a malignant mesenchymal tumor derived from the smooth muscle, it represents approximately 7% of all soft tissue sarcomas. Male genitourinary leiomyosarcomas are rare (Abdullazade et al., 2013 [ 1 ]). Primary testicular leiomyosarcoma is an exceptional entity with only 30 cases reported in the literature (Giridhar et al., 2011). Due to its rarity, additional studies are necessary to better define the optimal therapeutic management. We report a case of a 42-years-old male diagnosed in the urology department A of the University Hospital Ibn Sina in Rabat who complains of testicular swelling. The anatomopathological examination and immunohistochemical study revealed a leiomyosarcoma therefore, a radical inguinal orchiectomy with a primary ligation of the spermatic cord was performed for diagnostic and therapeutic purposes. The assessment of extension did not reveal any lymph node location or secondary appearance thus the decision of the multidisciplinary meeting opted for regular cancer check-ups without adjuvant treatment. The actual etiology of testicular leiomyosarcoma is still unknown added to its clinical presentation and radiological results that are non-specific. Leiomyosarcoma of the testis is a very rare tumor and its clinical and radiological presentation remains similar to other testicular malignancies. • Leiomyosarcoma of the testis is a rare tumor. • Its clinical aspects doesn't differ from other testicular malignancies. • The exact diagnosis is based on histological studies. • Radical inguinal orchiectomy is the treatement of choice. • The actual etiology of testicular leiomyosarcomas is already unknown. [ABSTRACT FROM AUTHOR]

Crooke cell adenomas (CCAs) are a rare, aggressive subset of secretory pituitary corticotroph adenomas (sCTAs) found in 5%–10% of patients with Cushing disease. Multiple studies support worse outcomes in CCAs but are limited by small sample size and single-institution databases. We compared outcomes in CCA and sCTA using a multicenter, international retrospective database of high-volume skull base centers. Patients surgically treated for pituitary adenoma from January 2017 through December 2020 were included. Among 2826 patients from 12 international centers, 20 patients with CCA and 480 patients with sCTA were identified. No difference in baseline demographics, tumor characteristics, or postoperative complications was seen. Microsurgical approaches (60% CCA vs. 62.3% sCTA) were most common. Gross total resection was higher in CCA patients (100% vs. 83%, P = 0.05). Among patients with gross total resection according to intraoperative findings, fewer CCA patients had postoperative hormone normalization of pituitary function (50% vs. 77.8%, P < 0.01) and remission of hypersecretion by 3–6 months (75% vs. 84.3%, P < 0.01). This was the case despite CCA having better local control rates (100% vs. 96%, P < 0.01) and fewer patients with remnant on magnetic resonance imaging (0% vs. 7.2%, P < 0.01). A systematic literature review of 35 studies reporting on various treatment strategies reiterated the high rate of residual tumor, persistent hypercortisolism, and tumor-related mortality in CCA patients. This modern, multicenter series of patients with CCA reflects their poor prognosis and reduced postsurgical hormonal normalization. Further work is necessary to better understand the pathophysiology of CCA to devise more targeted treatment approaches. [ABSTRACT FROM AUTHOR]

The economic potential for unconventional shale oil and gas production in the Silurian of the Berkine – Ghadames and Illizi basins (BGI) in south-eastern Algeria has been recently confirmed through exploration drilling. The aim of the present paper attempts a better understanding of the Intra-Tassilian depression within the entire Silurian of the Tassili n’Ajjer plateau. The continuous deposits of the Silurian are exposed at the southern margin of the prolific BGI basins, in the Tassili n’Ajjer plateau, offering the chance to understand the sedimentology, ichnology, and to present a detailed sequence stratigraphy framework for the region. The 410 m-thick clastic Silurian sedimentary strata are subdivided into three formations in the context of sequence stratigraphy, namely: (i) the Oued Imihrou Fm. (Llandoverian) overlain by (ii) the Atafaïtafa Fm. (late Llandoverian to Wenlockian), and (iii) the Oued Tifernine Fm. (late Wenlockian to Pridolian). These can be also distinguished across the entire investigated area and laterally traceable over kilometers. Clear cyclic stacking patterns are identified within the four studied sections showing progressively a general trend of thickening- and coarsening-upward, over a complete 2nd-order megasequence (SIL-1 MS). This transgressive-regressive succession suggests deltaic progradation, shallowing and basin infilling as evidenced by numerous diagnostic sedimentary features and trace fossils, largely from eastern-to western-Tassili plateau. Indeed, the wealth of outcrop data in the Silurian siliciclastic succession enables us to distinct thirteen facies (facies A-M), ranging from shallow-to marginal-marine facies, and in turn, grouped into six facies associations (FA1-FA6). The lowermost part of the succession, which is the most prolific sources of hydrocarbons in North Africa, consists of thick organic-rich graptolite-yielding black ‘hot’ shales and ‘lean’ shales with sparse bioturbation with small Thalassinoides belonging to the distal Cruziana ichnofacies. In contrast, the uppermost part of the Silurian deposits becomes progressively coarser and fluvial in response to the progradation of the North African Akakus deltaic system, during regional sea level fall and uplifting of the region. These progradational deposits exhibit well-preserved trace fossils with moderate to high degree of bioturbation, such as Skolithos or the so-called “Tigillites” pipe-rock, Cruziana isp., Rusophycus isp., Monocraterion isp., and Syringomorpha . The SIL-1 MS is bounded by a post-glacial latest Hirnantian unconformity on the basal (SB1), as confirmed by the moderately diverse early Silurian graptolite faunas, and by the Caledonian unconformity on the top (SB7). Each of the three formations of SIL-1 MS reveals two major 3rd-order progradational sequences, commonly delineated by discontinuity surfaces (in ascending order, SB1 to SB7), and in turn, these six sequences (i.e. Si-1 to Si-6) are subdivided into at least ten shorter-term cycles. The regional extent of each unconformity is directly linked to significant facies changes and to inflection points on the global sea level curve. [ABSTRACT FROM AUTHOR]