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Introduction. Kidney cancer is the eleventh most common malignancy in the United States of Mexico. Carcinoma renal cell (CRC) is considered the most frequent type and represents 2-3% of all cancers worldwide. In the setting of metastatic disease, a primary renal tumor is usually identified, and metastases are located in the lung, bone, liver, brain, and rarely in soft tissue. Patients with soft tissue metastases do not have symptoms in the initial stages and are generally found only when the lesions increase in size or during the study of the surgical resection piece. Clinical case. In this case, we report a female patient in the seventh decade of life with a soft tissue metastasis located in the sacral region, 10 years after a nephrectomy secondary to CRC. Results. Clinical and radiological findings of a well-defined tumor. Surgical resection of the lesion is performed under regional anesthesia with complete excision. Conclusions. It is recommended that patients with a resectable and solitary metastatic site be candidates for surgical resection with free margins, as was the case with our patient due to its easy access and single lesion. In CRC, in addition to its initial surgical treatment, close surveillance with physical examination and cross-sectional images is essential to monitor the presence of metastases and thus avoid late treatments. [ABSTRACT FROM AUTHOR]

EUS-FNA/B for pancreatic ductal adenocarcinoma (PDAC) is generally considered to be safe; however, while the incidence is low, there are occurrences of complications. Among these complications, there are serious ones like needle tract seeding (NTS), and it is not known than which types of tumors have the risks of EUS-FNA/B complications. This study aimed to evaluate the risk of EUS-FNA/B complications in patients with PDAC, focusing on morphological features. Overall, 442 patients who underwent EUS-FNA/B for solid pancreatic masses between January 2018 and May 2022 in four institutions were retrospectively surveyed. Finally, 361 patients histopathologically diagnosed with PDAC were analyzed. Among these patients, 79 tumors with cysts or necrotic components were compared with 282 tumors without cysts or necrotic components. The incidence and risk of EUS-FNA/B complications including NTS were evaluated. There were 9 (2.4 %) of total EUS-FNA/B complications and 3 (0.8 %) of NTS. The incidence of total complication rate and NTS in tumors with cysts or necrotic components were significantly higher than in those without cysts or necrotic components (total complication 6.3 % vs. 1.4 %, p = 0.026, NTS 3.7 % vs. 0 %, p = 0.01). The transgastric route of puncture (OR: 93.3, 95 % CI: 3.81–2284.23) and the existence of cysts or necrotic components (OR: 7.3, 95 % CI: 1.47–36.19) were risk factors for EUS-FNA/B complications identified by the multivariate analysis. We should pay attention to the risks of EUS-FNA/B complications, including NTS, when the tumor has cysts or necrotic components. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the incidence, risk factors, and prognosis associated with peritoneal seeding after percutaneous radiofrequency ablation (RFA) for HCC, focusing on viable tumors after previous locoregional treatment, including TACE and RFA. Methods: Exactly 290 patients (mean age, 67.9 years ± 9.74; 223 men) with 383 HCCs (mean size, 15.9 mm ± 5.49) who underwent RFA between June 2012 and December 2019 were included in this retrospective study. Among them, 158 had history of previous treatment (mean number, 1.3 ± 1.8) with 109 viable HCCs. Cumulative seeding after RFA was estimated using the Kaplan–Meier method. Independent factors affecting seeding were investigated using multivariable Cox proportional hazards regression analysis. Results: Median follow-up was 1175 days (range: 28–4116). Seeding incidence was 4.1 (12/290) and 4.7% (17/383) per patient and tumor, respectively. The median time interval between RFA and detection of seeding was 785 days (range: 81–1961). Independent risk factors for seeding included subcapsular tumor location (hazard ratio [HR] 4.2; 95% confidence interval [CI] 1.4, 13.0; p = 0.012) and RFA for viable HCC after previous locoregional treatment (HR 4.5; 95% CI 1.7, 12.3; p = 0.003). Subgroup analysis for viable tumors, revealed no significant difference in cumulative seeding rates between the TACE and RFA groups (p = 0.078). Cumulative overall survival rates differed significantly between patients with and without seeding metastases (p < 0.001). Conclusion: Peritoneal seeding after RFA is a rare, delayed complication. Subcapsular-located and viable HCC after previous locoregional treatment are potential risk factors for seeding. Seeding metastases could affect the prognosis of patients who cannot receive local therapy. [ABSTRACT FROM AUTHOR]

Detailed phylogenies of tumor populations can recount the history and chronology of critical events during cancer progression, such as metastatic dissemination. We applied a Cas9-based, single-cell lineage tracer to study the rates, routes, and drivers of metastasis in a lung cancer xenograft mouse model. We report deeply resolved phylogenies for tens of thousands of cancer cells traced over months of growth and dissemination. This revealed stark heterogeneity in metastatic capacity, arising from preexisting and heritable differences in gene expression. We demonstrate that these identified genes can drive invasiveness and uncovered an unanticipated suppressive role for KRT17 We also show that metastases disseminated via multidirectional tissue routes and complex seeding topologies. Overall, we demonstrate the power of tracing cancer progression at subclonal resolution and vast scale.

CT-guided percutaneous transthoracic needle biopsy (PTNB) plays a key role in the diagnosis of pulmonary abnormalities. Although the procedure is considered safe and effective, there exists a potential for complications, such as pneumothorax, hemorrhage, hemoptysis, air embolism, and tumor seeding. However, pneumatoceles after CT-guided PTNB have been rarely reported. Herein, we report two cases of pneumatoceles that developed immediately after PTNB for primary lung cancer. A pneumatocele filled with hematoma should be considered in cases with a newly developed nodule along the needle tract during short-term follow-up CT after PTNB.

CT-guided percutaneous transthoracic needle biopsy (PTNB) plays a key role in the diagnosis of pulmonary abnormalities. Although the procedure is considered safe and effective, there exists a potential for complications, such as pneumothorax, hemorrhage, hemoptysis, air embolism, and tumor seeding. However, pneumatoceles after CT-guided PTNB have been rarely reported. Herein, we report two cases of pneumatoceles that developed immediately after PTNB for primary lung cancer. A pneumatocele filled with hematoma should be considered in cases with a newly developed nodule along the needle tract during short-term follow-up CT after PTNB. [ABSTRACT FROM AUTHOR]

CT-guided percutaneous transthoracic needle biopsy (PTNB) plays a key role in the diagnosis of pulmonary abnormalities. Although the procedure is considered safe and effective, there exists a potential for complications, such as pneumothorax, hemorrhage, hemoptysis, air embolism, and tumor seeding. However, pneumatoceles after CT-guided PTNB have been rarely reported. Herein, we report two cases of pneumatoceles that developed immediately after PTNB for primary lung cancer. A pneumatocele filled with hematoma should be considered in cases with a newly developed nodule along the needle tract during short-term follow-up CT after PTNB. [ABSTRACT FROM AUTHOR]

The incidence of ovarian cancer dramatically increases in early menopause but the factors contributing to cancer onset are unclear. Most ovarian cancers originate in the fallopian tube with subsequent implantation of malignant cells into the ovary. However, the events and conditions that lead to cancer cell implantation are unknown. To quantify which conditions are conducive to the seeding of cancer cells in an immunocompetent mouse model, we surgically implanted mouse ovarian cancer cells into the oviducts of syngeneic mice and simulated conditions associated with ovulatory wound repair, incessant ovulation, ovarian surface scarring, and aging. We found that the dominant site of cancer cell seeding was not the ovary but the nearby surgical wound site, which was associated with a strong and persistent inflammatory reaction. Conditions in the ovary associated with inflammation, such as acute ovulatory wound repair, active healing of the scarred ovarian surface, and mouse aging, contributed to increased seeding of the cancer cells to the surgical wound site and tissues surrounding the ovary. Changes in the ovary not accompanied by inflammation, such as completed ovulatory cycles and fully-healed scars on the ovarian surface, did not contribute to increased cancer cell seeding. We conclude that inflammation is the most likely mechanism by which ovulation and postmenopausal events contribute to the increased risk of ovarian cancer.

Lack of standard response criteria in clinical trials for medulloblastoma and other seeding tumors complicates assessment of therapeutic efficacy and comparisons across studies. An international working group was established to develop consensus recommendations for response assessment. The aim is that these recommendations be prospectively evaluated in clinical trials, with the goal of achieving more reliable risk stratification and uniformity across clinical trials. Current practices and literature review were performed to identify major confounding issues and justify subsequently developed recommendations; in areas lacking scientific investigations, recommendations were based on experience of committee members and consensus was reached after discussion. Recommendations apply to both adult and pediatric patients with medulloblastoma and other seeding tumors. Response should be assessed using MR imaging (brain and spine), CSF cytology, and neurologic examination. Clinical imaging standards with minimum mandatory sequence acquisition that optimizes detection of leptomeningeal metastases are defined. We recommend central review prior to inclusion in treatment cohorts to ensure appropriate risk stratification and cohort inclusion. Consensus recommendations and response definitions for patients with medulloblastomas and other seeding tumors have been established; as with other Response Assessment in Neuro-Oncology recommendations, these need to now be prospectively validated in clinical trials.

A 13-year-old male neutered Cocker Spaniel mixed-breed dog developed a subcutaneous mass 2 years after undergoing surgery to remove a hepatocellular carcinoma. An approximately 4 × 3 cm subcutaneous mass was found on the ventral abdomen at the cranial end of the abdominal incision from the previous surgery. The subcutaneous mass was surgically removed and histopathological examination determined that it was an implantation of the previously excised hepatocellular carcinoma. The diagnosis was confirmed by immunohistochemical labelling with hepatocyte paraffin 1 antibody and pancytokeratin. Based on the location of the subcutaneous mass at the cranial end of the abdominal incision associated with the previous hepatocellular carcinoma resection, it is likely there was iatrogenic metastasis from the primary tumour excision. Subcutaneous iatrogenic metastasis of hepatocellular carcinoma is well recognized in humans but has apparently never been reported in dogs. Clinicians should be aware of this potential surgical complication. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effects of microwave (MW) power and antenna approach methods on extrahepatic tumor seeding and ablation zone size using an ex vivo subcapsular tumor-mimic model., Materials and Methods: Forty-one subcapsular tumor mimics were prepared by injecting a mixture of contrast media into bovine liver blocks. Ablation was performed using low- and high-power protocols (75 W and 100 W for 4 and 3 minutes, respectively). The antenna approach was assessed in two directions: parallel and perpendicular to the capsule. CT scans were obtained before and after the ablation to detect contrast leakage on the hepatic surface. The presence of leakage, ablation zone size, and the timing of the first popping sound were compared between the two groups., Results: Five cases of contrast leakage were observed in the low-power group (n = 21) and 17 in the high-power group (n = 20) (23.8% vs. 85.0%, P < 0.001). Contrast leaks were less frequently observed in the low-power protocol compared to the high-power protocol, regardless of the antenna approach (18.2% [2/11] vs. 80.0% [8/10], P = 0.009 for parallel access; 30.0% [3/10] vs. 90.0% [9/10], P = 0.020 for perpendicular access). The timing of the first popping sound was significantly delayed in the low-power group compared to the high-power group (137.7 ± 51.4 s vs. 77.8 ± 31.4 s, P < 0.001). The size of the ablation zone did not differ significantly between the two power groups ( P = 0.415). The parallel and perpendicular antenna approaches did not show significant differences in the number of contrast leaks, popping sound timing, or ablation-zone size ( P = 0.536, 0.463, and 0.271, respectively)., Conclusion: Low-power MW ablation may be superior to a high-power protocol in reducing the risk of tumor seeding in subcapsular tumors, regardless of the antenna approach., Competing Interests: The authors have no potential conflicts of interest to disclose., (Copyright © 2024 The Korean Society of Radiology.)

Abstract: We present the case of a 61-year-old male patient with a history of intracranial IDH-wildtype glioblastoma with an isolated cutaneous metastasis within the previous surgical site scar. The cytomorphology of the cutaneous deposits was reminiscent of metastatic melanoma, which is a differential diagnostic pitfall. The tumor molecular characteristics are described, as these have become essential diagnostic criteria for many central nervous system tumors, along with a discussion of the role of immunohistochemical markers and potential pitfalls in the differential diagnosis of melanoma and poorly differentiated carcinoma. We discuss the biology of metastatic glioblastoma and provide a focused literature review of previous glioblastomas with tumor cell seeding within prior surgical scars., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Purpose: To study the long-term efficacy of intravitreal topotecan (IVT) for vitreous seeds in eyes with retinoblastoma and risk factors for their recurrence., Design: Retrospective, non-comparative, interventional study., Participants: Ninety-one eyes of 90 patients with retinoblastoma treated between January 2013 and April 2019., Methods: Patients with recurrent or refractory vitreous seeds after completion of intravenous or intra-arterial chemotherapy were treated with IVT (30 μg/0.15 ml) by the safety-enhanced technique. The injection was repeated every 4 weeks until the regression of seeds. Patients with a minimum follow-up of 12 months were included in the analysis., Main Outcome Measures: Primary outcome measures were vitreous seed regression and eye salvage. Secondary outcomes were risk factors for vitreous seed recurrence after treatment with IVT, vision salvage, and complications of IVT., Results: The median age of the patients was 18 months, with most having group D (n = 58 [64%]) and group E (n = 26 [29%]) retinoblastoma. Vitreous seeds were refractory in 46 eyes (51%) and recurrent in 45 eyes (49%). A total of 317 IVT injections were administered, with the median being 3 injections. The median number of IVT injections required was 2.5 injections for dust, 3 injections for sphere, and 5 injections for cloud morphologic features. Recurrence of vitreous seeds after IVT was seen in 17 eyes (19%) at a mean follow-up of 7.9 months. At a mean follow-up 34 months, vitreous seed regression was achieved in 88 eyes (97%) and eye salvage was achieved in 77 eyes (85%). Older age (P = 0.018) and recurrence of retinal tumor (15/17 eyes; P < 0.01) significantly increased the risk of vitreous seed recurrence. Cataract was the most common complication seen in 17 eyes (9%)., Conclusions: Intravitreal topotecan at an every 3- to 4-week regimen is effective against both refractory and recurrent vitreous seeds. The vitreous seed morphologic features correspond to the number of injections required for regression. Increasing age and recurrence of retinal tumor increase the risk of vitreous seed recurrence after treatment with IVT., Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article., (Copyright © 2024 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)

Craniopharyngiomas are tumors of the central nervous system, typically located in the sellar/parasellar region. Despite being benign, they behave aggressively due to their propensity to invade nearby important structures, making total resection challenging. Distant spread of craniopharyngioma is a rare but significant complication. Most cases result from spread along the surgical path, while others result from dissemination along the cerebrospinal fluid (CSF) pathways. We report a case of a parasellar adamantinomatous craniopharyngioma with progressive visual loss. The patient was operated on through a right pterional craniotomy three times due to recurrence. After the last surgery, fractionated stereotactic radiotherapy was performed on the tumor residue. On follow-up brain MRI, a new extra-axial lesion was found in the left frontal region with solid and cystic components, with apparent dural implantation. Left frontal craniotomy was performed, and the lesion was excised with resection of its dural implant. Histological findings revealed it to be adamantinomatous craniopharyngioma, grade 1, according to the World Health Organization (WHO). Despite being rare, craniopharyngioma ectopic recurrence is a possible surgical complication. Despite the poorly understood mechanism, the literature highlights the importance of paying attention to tumor spillage during surgery to prevent distant recurrences., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Nogueira et al.)

Background and aims: Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is frequently used for the preoperative histologic diagnosis of pancreatic cancer. However, debate continues regarding the clinical merits of preoperative EUS-FNA for the management of resectable pancreatic cancer. We aimed to evaluate the benefits and safety of preoperative EUS-FNA for resectable distal pancreatic cancer. Methods: The medical records of 304 consecutive patients with suspected distal pancreatic cancer who underwent EUS-FNA were retrospectively reviewed to evaluate the clinical benefits of preoperative EUS-FNA. We also reviewed the medical records of 528 patients diagnosed with distal pancreatic cancer who underwent distal pancreatectomy with or without EUS-FNA. The recurrence rates and cancer-free survival periods of patients who did or did not undergo preoperative EUS-FNA were compared. Results: The diagnostic accuracy of preoperative EUS-FNA was high (sensitivity, 87.5%; specificity, 100%; positive predictive value 100%; accuracy, 90.7%; negative predictive value, 73.8%). Among patients, 26.7% (79/304) avoided surgery based on the preoperative EUS-FNA findings. Of the 528 patients who underwent distal pancreatectomy, 193 patients received EUS-FNA and 335 did not. During follow-up (median 21.7 months), the recurrence rate was similar in the two groups (EUS-FNA, 72.7%; non-EUS-FNA, 75%; P = 0.58). The median cancer-free survival was also similar (P = 0.58); however, gastric wall recurrence was only encountered in the patients with EUS-FNA (n = 2). Conclusion: Preoperative EUS-FNA is not associated with increased risks of cancer-specific or overall survival. However, clinicians must consider the potential risks of needle tract seeding, and care should be taken when selecting patients. [ABSTRACT FROM AUTHOR]

Perineal recurrence after brachytherapy is an exceedingly rare complication. Moreover, ductal adenocarcinoma is a rare histological variant of prostate cancer. Herein, we describe a case of perineal recurrence from ductal adenocarcinoma of prostate after low-dose-rate brachytherapy (LDR-BT) in a 65-year-old male patient. The patient had localized prostate cancer, for which he received LDR-BT; however, he experienced perineal recurrence 2 years after receiving LDR-BT. Surgical excision was attempted, but we were unable to remove the whole tumor, owing to invasion to surrounding tissue. Pathological examination of resected tumor showed ductal adenocarcinoma of the prostate. External beam radiation therapy and high-dose-rate brachytherapy (HDR-BT) were performed for residual tumor. Mild mediastinal lymph node swelling was observed during clinical course of the disease. Hence, androgen deprivation therapy was administered with abiraterone after radiation therapy, and prostate-specific antigen level decreased to undetectable level. Biochemical failure after transperineal brachytherapy for prostate cancer should be considered as a perineal recurrence.

BackgroundNeedle tract metastasis is a rare complication following percutaneous procedures for malignancy.Case SummaryThis report describes a 49-year-old female with a lump on her right breast. Mass core needle biopsy showed the specimen was an invasive carcinoma, and mastectomy with sentinel lymph node biopsy was performed. What is special about this case was that the patient reported a history of lung cancer and the position of the breast mass was the puncture site of computed tomography-guided core needle biopsy for lung cancer. Immunostaining of paraffin specimen findings indicated the breast mass as a result of lung carcinoma metastasis. The patient's medical history indicated that the malignant tumor in the breast was a core needle tract pulmonary metastasis. The patient underwent the examination and received therapy based on the lung cancer metastasis principle. At 9 months from breast surgery, the patient is alive, in good condition, and with stability of the disease.ConclusionsThis patient was misdiagnosed. Careful medical history review and multidisciplinary team discussions are important, especially for patients with a history of cancer or invasive operation.

A 90 year-old man underwent endoscopic mucosal resection for lesions in the descending and sigmoid colons as well as endoscopic submucosal dissection (ESD) for a lesion in the rectal peritoneal reflection (Ra) 1 month before undergoing laparoscopic resection and D3 dissection for advanced cancer in the descending colon. One year later, he underwent a surveillance colonoscopy, and advanced colorectal cancer was detected on the ESD scar. The history suggested that this newly detected recurrent colorectal neoplasm on the ESD scar may have originated from cancer cells derived from the descending colon cancer that were implanted in the ESD ulcer, thereby initiating a new colorectal neoplasm. Cancer genomic testing further indicated that three of the four pathogenic variants detected in the recurrent colorectal neoplasm were consistent with pathogenic variants of descending colon cancer. This finding strongly supports our contention that cancer cells derived from the descending colon cancer were implanted in the post-ESD ulcer of the rectal Ra and proliferated, forming the recurrent colorectal neoplasm. This case report highlights the potential for tumor cell implantation on endoscopic resection ulcers and the utility of cancer genomic testing in validating this phenomenon., (© 2024. The Author(s).)

Background: It is controversial whether the use of a double-J stent (DJ) in patients with bladder cancer before radical cystectomy (RC) increases the risk of tumour seeding in the upper tract and thus the risk of metachronous upper tract urothelial carcinoma (UTUC). The aim of our study is to investigate the risk of upper tract recurrence after RC in patients previously managed with a DJ stent., Methods: A total of 699 patients who had undergone RC between January 2003 and March 2022 with complete perioperative data and pathological outcome were included in our study. Patients treated preoperatively with a DJ stent were identified and compared for development of metachronous UTUC with those who did not receive prior internal stenting. Multivariable Cox regression analysis was used to determine predictors of UTUC occurrence among the possible pathological features; risk factors for mortality after RC were also examined., Results: Of 699 patients, 117 (16.7%) were managed preoperatively with a DJ stent. The overall probability of metachronous UTUC was 1%, 4% and 6% at 1, 3 and 5 years, respectively. The groups with and without DJ stenting were comparable regarding their clinicopathologic features, except for the higher incidence of hydronephrosis in the DJ group. At similar follow-up periods (median follow-up 32 months), metachronous UTUC was detected in four (3.4%) patients in the DJ group and in 13 (2.2%) in the non-stented group (P=0.44). The median interval (IQR) from cystectomy to UTUC was 40.5 (20-49) months in the DJ group and 37 (24-82) in the non-stented group (P=0.7). In the multivariable analysis, only presence of CIS (HR 3.83, 95% CI 1.19-12.29, P=0.024) and positive ureteral margin (HR=5.2, 95% CI 1.38-19.57, P=0.015) were predictors of metachronous UTUC. The study is limited by the retrospective nature and relatively short follow-up., Conclusions: Ureteral stenting for management of hydronephrosis in patients with bladder cancer undergoing RC is a viable option, without higher risk for UTUC or mortality. Patients with positive ureteral margin and CIS are considered high-risk groups for upper tract recurrence and should receive long-term, rigorous follow-up.

Background: In recent years, due to the increase in medical mal-practice complaints, the Sicilian Regional Health System has adopted procedures for the direct management of claims by each health facility with the aim of reducing the costs of insurance premiums and related taxes. Mandatory sentinel event monitoring is a crucial part of this strategy to improve patient safety and quality of care. The reported case relates to a laparoscopic myomectomy surgery performed by means of morcellation, a controversial technique. After the FDA's intervention in 2014, it is believed that morcellation may worsen the staging of the disease by spreading malignancies such as leiomyosarcoma into the abdomen., Case Report: A 28-year-old woman, underwent laparoscopic surgery for uterine fibroids and an ovarian cyst removal in August 2018. Post-surgery, she was diagnosed with Leiomyoma. She returned to the hospital due to metrorrhagia and was discharged after a week. Persistent symptoms led to her readmission and subsequent exploratory laparoscopic surgery at another hospital. This resulted in a total hysterectomy and the discovery of uterine leiomyosarcoma, with FIGO STAGE IIIB staging. Despite chemotherapy, she passed away six months later., Discussion and Conclusions: This case highlights medical-legal issues. Informed consent for morcellation and its risks was not obtained. The morcellation technique was used, increasing cancer spread risk. The histopathological process was inadequate, with three biopsies leading to misdiagnosis. This could be medical malpractice, making providers legally responsible for the patient's deteriorating condition and the anticipation of possible death.

Background: Seeding of skin cancer cells following diagnostic or therapeutic surgical procedures can occur and might cause local recurrences. As current preferred therapy for skin malignancy is surgical excision, seeding of tumour cells by manipulating malignant tissue or suturing can be another factor leading to recurrences., Objective: To evaluate whether genetic material and malignant cells adhere to standard suture materials., Methods: This prospective study included patients who underwent excision of skin lesions. Monofilament and braided sutures were examined. Sutures were passed through the observed tumour or healthy skin margins and were examined for DNA material and cells by cytological analysis, cell culture and characterization, and DNA analysis., Results: Twenty-two patients and 148 sutures were included. DNA quantification showed DNA material on all sutures, with no significant difference between braided and monofilament sutures. Cytological analysis showed that all slides prepared from cell blocks contained normal squamous and atypical cells. Cell culture and characterization showed viable cells adhering to the sutures under direct light microscopy. Cell cultures showed rapid proliferation of epithelial cells from squamous cell carcinoma specimens., Conclusion: Suture materials carry DNA material and cells, including malignant cells of cutaneous origin and may seed them at distant sites., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Purpose: Regression of retinoblastoma vitreous seeds (VS) during intravitreal chemotherapy can be delayed, resulting in supernumerary injections. Similarly, VS relapse may not be clinically evident at first. A predictive biomarker of tumor regression and relapse could help guide real-time clinical decision making. Retinoblastoma is an oxygen-sensitive tumor; paradoxically, VS survive in the hypoxic vitreous. We hypothesized that VS elaborate pro-angiogenic cytokines. The purpose was to determine if pro-angiogenic cytokine signatures from aqueous humor could serve as a biomarker of VS response to treatment., Methods: Multiplex ELISA was performed on aqueous from rabbit eyes with human retinoblastoma VS xenografts to identify expressed proangiogenic cytokines and changes in aqueous cytokine levels during intravitreal treatment were determined. Confirmatory RNAscope in situ hybridization for VEGF-A was performed on human retinoblastoma tumor sections and VS xenografts from rabbits. For human eyes undergoing intravitreal chemotherapy, serial aqueous VEGF-A levels measured via VEGF-A-specific ELISA were compared to clinical response., Results: VEGF-A was highly expressed in human retinoblastoma VS in the xenograft model, and was the only proangiogenic cytokine that correlated with VS disease burden. In rabbits, aqueous VEGF-A levels decreased in response to therapy, consistent with quantitative VS reduction. In patients, aqueous VEGF-A levels associated with clinical changes in disease burden (regression, stability, or relapse), with changes in VEGF-A levels correlating with clinical response., Conclusions: Aqueous VEGF-A levels correlate with extent of retinoblastoma VS, suggesting that aqueous VEGF-A may serve as a predictive molecular biomarker of treatment response.

The role of percutaneous tumour biopsies had gain importance in the management of renal cell carcinoma to provide diagnostic specimen for the patients with metastatic disease that could benefit a systemic treatment. Among the possible complications of this procedure, however, there is the risk of tumoral cells seeding along the biopsy's tract; this complication, albeit being reported as anecdotal, could have devastating effects. Here we report a case of a young male who developed subcutaneous chest metastasis of renal cell carcinoma after a biopsy of a lung nodule. We subsequently reviewed other cases reported in literature [ABSTRACT FROM AUTHOR]

The role of percutaneous tumour biopsies had gain importance in the management of renal cell carcinoma to provide diagnostic specimen for the patients with metastatic disease that could benefit a systemic treatment. Among the possible complications of this procedure, however, there is the risk of tumoral cells seeding along the biopsy's tract; this complication, albeit being reported as anecdotal, could have devastating effects. Here we report a case of a young male who developed subcutaneous chest metastasis of renal cell carcinoma after a biopsy of a lung nodule. We subsequently reviewed other cases reported in literature [ABSTRACT FROM AUTHOR]

BackgroundIntra-operative tumor spill increases the risk of local recurrence of Wilms tumor, and adversely impacts relapse-free (RFS) and overall survival (OS) rates.MethodsSurgical checklists, operative notes, institutional pathology reports, central pathology review and flow sheets of 602 patients registered between August 1986 and September 1994 on National Wilms Tumor Study-4 as randomized, followed or switched and coded as Final Stage II, favorable histology (FH) were reviewed. RFS and OS were estimated using the Kaplan-Meier method. Hazard ratios (HRs) were estimated using the Cox model and tested for statistical significance by the log-rank test.ResultsFour hundred ninety-nine patients were found after review to have Stage II, FH Wilms tumor. The 8-year RFS percentages were 85.0% (95% confidence interval (CI): 81.1%, 88.1%) for those with no spill compared to 75.7% (65.8%, 83.2%) for those with spill. The 8-year OS percentages were 95.6% (93.1%, 97.3%) for those with no spill compared to 90.3% (82.2%, 94.9%) for those with spill. The HR for relapse among those with spill was 1.55 ((95%CI: 0.97,2.51), P = 0.067) and the HR for death was 1.94 ((0.92,4.09), P = 0.077).ConclusionsRFS and OS were lower for patients who had intra-operative tumor spill. The majority of NWTS Stage II, FH patients with intra-operative tumor spill have an overall excellent outcome when treated with two drug chemotherapy (vincristine and actinomycin D) and no abdominal irradiation.

Implantation metastasis occurs when tumor seeds into a wound or tissue by a significant amount of viable tumor cells. Here we describe the case of a 30-year-old man suffering from pain and swelling of the foot, which was misdiagnosed as a bone cyst. Surgery was performed involving curettage followed by bone grafting. After surgical pathology, the exact diagnosis was revealed as the synovial sarcoma (SS) of the foot. Implantation metastasis of SS in the iliac region, the grafting site, occurred 9 months post-surgery. Although there are a few reports on implantation metastasis of other types of tumoral lesions, to the best of our knowledge, we describe seeding of this type of tumor for the first time. Similar to other studies, we recommend that tumor surgeries should be carried out in a special setting to prevent any spread to or contamination of other sites by the tumor.

Introduction: Incidental gallbladder carcinoma refers to a discovery of gallbladder cancer during or after cholecystectomy. Late port-site metastasis (PSM) following Laparoscopic cholecystectomy (LC) is rare with an incidence rate of 10.3%., Patient Concerns: We report a case of a 58-year-old man who presented with a painful abdominal wall mass for 6 weeks. He had a history of LC for symptomatic cholelithiasis, 8 years prior., Diagnosis: Histopathological examination revealed a positive result for metastatic adenocarcinoma from the abdominal wall mass. Moreover, Positron emission tomography (PET) showed a small focus of intense fluorodeoxyglucose (FDG) uptake in the gallbladder bed, which was highly suspicious for malignancy., Intervention: Decision was to proceed with surgery owing to uptake in the gallbladder bed with single-site metastasis to the previous port site. In addition, in the board meeting, an agreement was reached for performing distal pancreatectomy with splenectomy owing to uncertainty of malignancy based on what was discovered during the full metastatic workup. Diagnostic laparoscopy followed by midline laparotomy performed. Radical completion cholecystectomy with lymphadenectomy was done. Followed by complete resection of the anterior abdominal wall. Distal pancreatectomy and splenectomy were then performed., Outcome: Pathological diagnosis showed metastatic/invasive, moderately differentiated adenocarcinoma with positive margins on the posterior surface of excised port-site mass. The positive margins necessitated further chemoradiotherapy, followed by adjuvant chemotherapy until lung metastasis was identified. After this, the patient was scheduled for palliative chemotherapy., Conclusion: Presence of PSM is often associated with peritoneal metastasis. For this reason, it is advised to evaluate the patient for possible metastasis., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

Purpose: To report a rare case of infusion port site tumor seeding of choroidal melanoma after pars plana vitrectomy-assisted biopsy and successful treatment with second plaque brachytherapy., Methods: Observational case report with clinical data and diagnostic images., Results: A 55-year-old White woman diagnosed with choroidal melanoma of the left eye was found to have a second intraocular tumor 30 months after plaque brachytherapy and pars plana vitrectomy-assisted tumor biopsy. The second melanoma developed at the 5 o'clock vitrectomy infusion port site. The tumor regressed after plaque brachytherapy, and the patient has not developed systemic metastasis 5 years after diagnosis of intraocular seeding., Conclusion: Intraocular seeding into the infusion port site, although rare, may be encountered after pars plana vitrectomy-assisted biopsy of choroidal melanoma.

Patients with cancer are at risk of malnutrition because of reduced food intake, thus making oral intake challenging. Thus, nutritional support is used to provide the nutrient requirements. Feeding tube site implantation among patients with cancer has been reported after endoscopic feeding gastrostomy installation. This manuscript aims to further explore this phenomenon using a structured database review. Among 33 seeding cases included in this review, case reports (70 %) were the most common study design, predominantly using percutaneous endoscopic gastrostomy via the pull method. The duration between tube implantation and seeding detection ranged from 7.12 ± 3.7 months, with some missing data among the included studies. The most common primary cancer diagnosis was head and neck cancer. Tumor seeding was higher among male patients than that in female patients. However, large-scale, statistically powered studies are needed to further investigate this complication.

Objective: To summarize the treatment process of a case of Iodine-125 Brachytherapy for Palliative Treatment of Painful Colorectal Cancer Port-Site Metastases., Methods: We present a case report of multifocal port-site metastases ( PSMs ) that developed in a patient with stage IV ascending colonic adenocarcinoma and mucinous cancer following laparoscopic surgery. After multiline therapy failed, painful PSMs treated with repeated iodine-125 seed implantation., Results: Severe abdominal discomfort were eventually successfully managed after receiving iodine-125 brachytherapy., Conclusion: For painful PSMs, iodine-125 brachytherapy can be a safe and effective treatment option., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Objectives: Percutaneous liver biopsy (PLB) poses specific challenges in oncological patients such as bleeding and tumour seeding. This study's aim was to compare a coaxial (C-PLB) and non-coaxial (NC-PLB) biopsy technique in terms of diagnostic yield, safety and seeding risk of image-guided PLB techniques in an oncological setting. Methods: Local research committee approval was obtained for this single-site retrospective study. Patients who underwent a PLB between November 2011 and December 2017 were consecutively included. Medical records were reviewed to determine diagnostic yield and complications. Follow-up imaging was re-reviewed for seeding, defined as visible tumour deposits along the PLB track. Mann-Whitney U and chi-squared tests were performed to investigate differences between biopsy techniques in sample number, complications and seeding rate. Results: In total, 741 patients (62 ± 13 years, 378 women) underwent 932 PLB (C-PLB 72.9% (679/932); NC-PLB 27.1% (253/932)). More tissue cores (p < 0.001) were obtained with C-PLB (median 4 cores; range 1–12) compared with NC-PLB (2 cores; range 1–4) and diagnostic yield was similar for both techniques (C-PLB 92.6% (629/679); NC-PLB 92.5% (234/253); p = 0.940). Complication rate (9.3%; 87/932) using C-PLB (8.2% (56/679)) was lower compared with NC-PLB (12.3% (31/253); p = 0.024). Major complications were uncommon (C-PLB 2.7% (18/679); NC-PLB 2.8% (7/253)); bleeding developed in 1.2% (11/932; C-PLB 1.2% (8/679); NC-PLB 1.2% (3/253)). Seeding was a rare event, occurring significantly less in C-PLB cases (C-PLB 1.3% (7/544); NC-PLB 3.1% (6/197); p = 0.021). Conclusions: C-PLB allows for high diagnostic tissue yield with a lower complication and seeding rate than a NC-PLB and should be the preferred method in an oncological setting. Key Points: • A coaxial percutaneous liver biopsy achieves a significant higher number of cores and fewer complications than a non-coaxial biopsy technique. • The risk of tumour seeding is very low and is significantly lower using the coaxial biopsy technique. • In this study, a larger number of cores (median = 4) could be safely acquired using the coaxial technique, providing sufficient material for advanced molecular analysis. [ABSTRACT FROM AUTHOR]

PurposeTo retrospectively assess percutaneous core needle biopsies performed by radiologists and the association with tumor seeding along the biopsy tract when anatomic compartment guidelines are not consistently observed.Materials and methodsRetrospective data from computerized patient records and digital images from 363 consecutive computed tomography-guided biopsies of the lower extremity (thigh and leg) performed by radiologists at a single institution from August 2002 to August 2008 were analyzed for breaches of biopsy guidelines.ResultsOf the 363 biopsies, 243 (67%) were of soft tissue lesions and 120 (33%) were of bony lesions. There were 188 (52%) malignant and 175 (48%) benign lesions. The following biopsy breaches were observed: 13 (3.6%) of anatomic compartment, 42 (11.6%) of "vital structures," and 82 (68.3%) of needle path for bony tumors. Vital structures as defined by the literature included, but were not limited to, the following: knee joint capsule, greater trochanteric bursa, rectus femoris and vastus intermedius muscles, tibial tubercle, peroneus brevis and peroneus longus distal tendons, and neurovascular bundles. No cases of tumor recurrences could be attributed to needle seeding along a biopsy tract for any of these biopsy guideline breaches.ConclusionsThe concern for needle tract seeding with musculoskeletal tumors is more widespread than the evidence supporting it as a significant or frequent complication. In this study, breaching anatomic compartment, vital structures (other than neurovascular structures), and suggested exact needle path guidelines were not associated with needle tract seeding in the lower extremity.

Oncologic recurrence can occur after Robot-Assisted Radical Prostatectomy. Prostate cancer metastasizes often in bones, however the peritoneum is infrequently targeted. Even more, peritoneal dissemination without any other organ involved especially the bones is very rare, only few cases are reported. Through the available literature we discuss about the presumed seeding theory leading to this atypical location for prostatic metastases. Here we report a case of isolated non-ascitic prostatic peritoneal metastases most probably due to iatrogenic spillage during surgery.

A transurethral resection of bladder tumor (TURBT) is the primary treatment modality for bladder cancer. The common complications of TURBT include urinary tract infections, a hemorrhage requiring transfusion, and bladder perforation. Extravesical metastasis and intraperitoneal seeding of tumor cells following TURBT are very rarely reported. This report reviews a case of extravesical metastasis occurring after a repeated TURBT of non-invasive bladder cancer.

Copyright of Der Onkologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Der Onkologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: The percutaneous ablation of subcapsular hepatocellular carcinoma (S-HCC) may involve a risk of complications such as hemorrhage and tumor seeding, mainly linked to the direct tumor puncture often inevitable with mono-applicator ablation devices. The purpose of this study was to assess the efficacy and safety of no-touch multi-bipolar radiofrequency ablation (NTMBP-RFA) for the treatment of S-HCC ≤ 5 cm not puncturable via the non-tumorous liver parenchyma.Materials and Methods: Between September 2007 and December 2014, 58 consecutive patients (median age: 63 years [46-86], nine females) with 59 S-HCC ≤ 5 cm (median diameter: 25 mm [10-50 mm]), not puncturable via the non-tumorous liver parenchyma, were treated with NTMBP-RFA. Response and follow-up were assessed by CT or MRI. Complications were graded using the Cardiovascular and Interventional Radiological Society of Europe classification. Overall local tumor progression (OLTP)-free survival was assessed using the Kaplan-Meier method. A Cox proportional model evaluated the factors associated with OLTP. Signs of peritoneal or parietal tumor seeding were noted during follow-up imaging studies.Results: A complete ablation was achieved in 57/58 patients (98.3%) after one (n = 51) or two (n = 6) procedures. Three patients (5.2%) experienced complications (sepsis, cirrhosis decompensation; CIRSE grade 2 or 3). After a median follow-up period of 30.5 months [1-97], no patients had tumor seeding. The 1, 2 and 3-year OLTP-free survival rates were 98%, 94% and 91%, respectively. No factors were associated with OLTP.Conclusion: NTMBP-RFA is a safe and effective treatment for S-HCC not puncturable via the non-tumorous liver parenchyma. [ABSTRACT FROM AUTHOR]

Radiofrequency ablation (RFA), a local ablative modality, is gaining acceptance for the treatment of liver malignancies. Despite a relatively low complication rate, tumor seeding resulting from RFA in hepatocellular carcinoma (HCC) treatment can occur. A 44-year-old woman was diagnosed with HCC. Spiral computed tomography (CT) revealed a 2.3 × 2.0-cm mass in the S5 segment, which was treated with RFA on May, 2005. Follow-up imaging, performed at 6-month intervals after RFA, showed complete tumor necrosis. In October 2009, CT revealed a heterogeneous mass, 5.7 cm in diameter, in the right ovary. Since the lesion was limited to the right ovary without evidence of spread, bilateral salpingo-oophorectomy was performed. Histopathology indicated that the metastatic spread from the HCC to the ovary was positive for hepatocyte-specific antigen on immunohistochemistry. The ovary is a rare site for HCC metastasis. Moreover, needle tract implantation of HCC in the ovary is very rare.

Implantation metastasis occurs when tumor seeds into a wound or tissue by a significant amount of viable tumor cells. Here we describe the case of a 30-year-old man suffering from pain and swelling of the foot, which was misdiagnosed as a bone cyst. Surgery was performed involving curettage followed by bone grafting. After surgical pathology, the exact diagnosis was revealed as the synovial sarcoma (SS) of the foot. Implantation metastasis of SS in the iliac region, the grafting site, occurred 9 months post-surgery. Although there are a few reports on implantation metastasis of other types of tumoral lesions, to the best of our knowledge, we describe seeding of this type of tumor for the first time. Similar to other studies, we recommend that tumor surgeries should be carried out in a special setting to prevent any spread to or contamination of other sites by the tumor. [ABSTRACT FROM AUTHOR]

ObjectiveThe objective of our study was to report the occurrence of benign inflammatory nodules that develop in or near applicator tracks after percutaneous radiofrequency ablation and cryoablation of renal tumors.ConclusionBenign inflammatory nodules occur rarely after percutaneous ablation of renal tumors and may mimic tumor seeding of the applicator track.

Tumor implantation of lung cancer at the wire localization site has not been reported previously while there have been several reported cases of chest wall implantation after percutaneous core needle biopsy and chest tube insertion for malignant pleural effusion. We report the case of a 64-year-old-man with lung cancer (squamous cell carcinoma). The patient had lung cancer implantation in the chest wall 8 months after computed tomography-guided wire localization and subsequent anterior segmentectomy of right upper lobe with mediastinal lymph node dissection.

Endoscopic thyroidectomy is considered appropriate for follicular neoplasms, but on occasion, it leads to unexpected complications such as seeding along the port insertion site. Only 4 cases of operative track seeding after endoscopic thyroidectomy have been reported. Furthermore, simultaneous seeding at both operative track of upper chest wall and operative bed is also very rare. We present a case of thyroid follicular adenoma seeding at both the subcutaneous tunnel of the upper chest wall and the operative bed after endoscopic thyroidectomy, with an emphasis on magnetic resonance imaging and ultrasonography with pathologic correlations.