malignancy

Epithelioid hemangioendothelioma (EHE) is a rare vascular tumor that can affect various organs. This report describes a 65-year-old woman who presented with abdominal pain, weight loss, and elevated liver enzymes. After the diagnostic workup, a percutaneous biopsy of the liver lesions showed histological changes in EHE. What stands out in this case is that imaging studies revealed multiple cystic lesions with fluid-fluid levels; even though such manifestation is not typically seen in this disease. This case emphasizes the importance of considering EHE in the differential diagnosis of hepatic lesions even in atypical presentations.

The number of individuals undergoing dialysis is rising. Impaired renal function has been linked to a heightened risk of cancer. This study aimed to examine cancer incidence among hemodialysis (HD) patients.

This retrospective cross-sectional study analyzed the medical records of individuals with newly diagnosed end-stage renal disease (ESRD) who initiated HD sessions between July 2018 and December 2023 at Urmia Imam Khomeini hospital. The data collected for this study included patient demographics, underlying diseases, malignancy status, and duration of malignancy (less than ten years, 10–20 years, and over 20 years). The obtained data were analyzed using SPSS 21.

The study included 192 patients, with a mean age of 64.45±13.70 years. Of these, 117 (60.9%) were male and 75 (39.1%) were female. The majority of participants (68.8%) resided in urban areas. Hypertension (HTN) was the most common underlying disease (25%), while 32.8% had no reported underlying conditions. Eighteen (9.4%) patients were diagnosed with malignancy, with multiple myeloma being the most prevalent type (43.4%). The remaining 174 (90.6%) patients were not diagnosed with cancer. The onset of malignancy occurred within ten years for the majority of patients (72.2%). No significant association was found between the prevalence of malignancy and patients’ age (P<0.136) and gender (P<0.763).

A significantly elevated incidence of cancer was observed in patients undergoing chronic HD for ESRD, underscoring the critical development of a targeted cancer screening strategy for this vulnerable population.

The aim of this meta-analysis was to assess the readiness for discharge of patients with malignancy when carrying a peripherally inserted central catheter (PICC) as well as to explore the associated factors affecting readiness for discharge.

PubMed, EMBASE, Web of Science, CNKI, WanFang and VIP databases from inception to Mar 2024 were systematically searched to collect relevant cross-sectional studies. Fixed-effects and random-effects models were used for effect size synthesis, and the stability of the results was assessed by heterogeneity testing, sensitivity analysis, and publication bias detection.

Eight cross-sectional studies comprising 748 participants were included, and the mean score for patients' readiness to discharge was 146.98 (95% CI: 127.17, 166.79) under a random-effects model, but the analysis showed a very high degree of heterogeneity (I²=100%, P<0.01). In our in-depth analysis of factors influencing discharge readiness, we found that literacy level (OR=1.30, 95% CI: 1.07, 1.59) and income level (OR=1.77, 95% CI: 1.13, 2.78) were significantly associated with better readiness for discharge, and that age had a non-significant effect on readiness for discharge, with a combined effect size (OR = 1.03, 95% CI: 0.97, 1.08).

Among patients with malignant tumours, self-efficacy, distance from home to the hospital, and income level have a significant impact on discharge readiness in their PICC carriers. Optimising discharge instructions and patient education strategies for these factors may improve patients' readiness for discharge, reduce the risk of PICC-related complications, and improve outcomes.

Ovarian dermoid cysts or mature cystic teratomas are pathologically defined as having at least two elements out of three germ cell layers (ectoderm, mesoderm, and endoderm) with different presentations. The present study was conducted with aim to describe the characteristics of 148 patients with dermoid cyst.

This case series study was conducted in Imam Hossein Medical Center, a public center located in Tehran, Iran on dermoid cyst patients who were operated on between 2011 to 2021. The data were analyzed with SPSS (version 19.0). P<0.05 was considered statistically significant.

The most common presenting symptom was abdominal pain in 51 patients (34.5%) and 29 (19.6%) were asymptomatic. Cystectomy was the most frequent surgery (n=110, 74.3%). Most of the dermoid cyst cases revealed typical sonographic findings. ROMA was positive in all tested cases (26 out of 148) as the most common abnormal tumor marker followed by CA19-9 in 43.9% and CA125 in 14.4 %. CA125 was significantly increased in larger tumors (P=0.018).

Different manifestations of dermoid cyst discussed in this study can provide clues for better management of these patients and make it possible to distinguish it from malignancies and other diseases. Diversity and wide range in presentation, age of diagnosis, ultrasonic findings, and serum tumor marker level in dermoid cyst should always be considered.

Ovarian cancer affects women worldwide. Immunoregulatory cytokines, particularly interleukin (IL)-6, can enhance tumorigenicity and are persistently secreted by ovarian cancer cells. This study aims to examine IL-6 as a marker of preoperative epithelial ovarian malignancy.

This study used a cross-sectional design on 81 eligible patients with ovarian neoplasms who were undergoing surgery at the Dr. Wahidin Sudirohusodo Hospital and its networking hospital from October 2021 to June 2022. The ELISA technique was used to measure serum IL-6 from the peripheral vein. In addition, the CA-125 levels, risk of malignancy (RMI) index, and proportion of blood cells were analyzed. Chi-square analysis of the data had been used.

Most of the subjects were presented as malignant ovarian neoplasms (66.7%), followed by benign ovarian neoplasms (33.3%). IL-6 level ≥ 3.75 pg/mL was found in 72.8% of patients. In individuals with epithelial ovarian neoplasms, IL-6 levels did not significantly differ between malignant and benign types (p > 0.05). CA-125 levels, RMI, ascites, and tumor size differed significantly in patients with ovarian epithelial neoplasms between malignant and benign types (p <0.05). Leukocyte levels, hemoglobin levels, platelet levels, age, parity, and age of menarche were not significantly different in epithelial ovarian neoplasm patients between malignant and benign types (p > 0.05).

The preoperative serum IL-6 level cannot be used as a marker of ovarian malignancy. However, this study confirms the relationship between the CA-125 level, RMI, ascites, and tumor size with the malignancy of ovarian tumors.

The impact of COVID-19 on pediatric cancer patients remains a critical area of investigation.

This study aimed to compare the clinical characteristics and outcomes of COVID-19 in children with and without malignancies.

A retrospective cohort study was conducted at Mofid Children's Hospital in Tehran, Iran, from July 2020 to December 2022. The study included 210 children with confirmed SARS-CoV-2 infection: 105 with malignancies (case group) and 105 without malignancies (control group). Clinical presentations, laboratory parameters, imaging findings, and outcomes were analyzed.

Children with malignancies exhibited lower rates of fever (P = 0.044), respiratory distress (P = 0.035), and nausea/vomiting (P = 0.002). Significant differences in laboratory findings were observed between the case and control groups, including WBC count (P = 0.007), hemoglobin levels (P < 0.001), platelet count (P = 0.002), and ESR (P = 0.001). Ground-glass opacity on chest imaging was significantly associated with malignancy (P = 0.003). Although not statistically significant, the malignancy group showed a trend toward higher mortality (OR = 2.686, P = 0.105). Thrombotic events were rare in both groups.

Pediatric cancer patients with COVID-19 exhibited more severe symptoms and distinct laboratory and imaging findings compared to non-cancer patients. While mortality rates were similar, the trend toward higher risk in the malignancy group highlights the need for specialized management strategies for this vulnerable population.

Thyroid cancer is the most common endocrine malignancy. This often involves the middle-aged and active population, typically younger compared to those with other types of cancers. Some people with thyroid cancer may develop secondary malignancy. The reason for this is not well understood. This study was designed to evaluate the prevalence of second primary cancers in patients with differentiated thyroid cancer and its probable relationship with the severity of treatment and staging of the primary tumor. Among 2638 patients who underwent thyroidectomy between 1996 and 2018, we checked cases who suffered from non-thyroidal second primary cancers before, during, or after the diagnosis of thyroid cancer. Forty-nine patients met the criteria and were included in the study. The information was gathered from the medical records and supplemented by direct communication with the patients. The Data was then analyzed using appropriate statistical test with   SPSS version 22, considering a P-value of 0.05 was considered as significant. Out of the 2638 checked records reviewed, 49 patients (1.85%) were found to have second primary cancers with 75.5% being female. One patient had two concurrent second primary cancers, while the remaining 48 patients had a single second primary cancer. Most of the thyroid cancers were papillary (89.8%, 44 cases), with the others remaining cases being follicular type. Stage 2, according to the 8th AJCC staging system, was the most common (50%), followed by stage 1 (36.8%) among the primary staging categories. Breast cancer was the most prevalent (17 cases), followed by hematologic malignancies (8 cases) and GI tract cancers (8 cases).  The findings revealed a significant increase in the number of breast cancers in patients with the differentiated thyroid cancer (DTC), which was not observed for other malignancies.

Pediatric cancers account for nearly 2% of all cancers worldwide. In 2018, there were approximately 200,000 newly diagnosed cases of childhood cancer.

The aim of this study was to assess the need for a national pediatric cancer registry based on case incidence.

This pilot study was conducted on 100 children with cancer who were treated in a recently established pediatric hematology oncology department of Golestan Hospital. Demographic and epidemiological data were collected and analyzed using SPSS software version 25.

Sixty-four percent of children with cancer were girls, and the average age of the patients was 7.6 ± 0.42 years. The most common types of cancer diagnosed were leukemia, brain tumor, lymphoma, and retinoblastoma respectively. Metastasis was confirmed in 11 cases. The most prevalent clinical manifestations of cancer included fever, weakness, loss of appetite, paleness, and weight loss.

The results of this study align with global rates and data. Based on the findings, the authors emphasize the necessity and priority of establishing a pediatric cancer registry in Iran's health ministry. Therefore, all healthcare workers and specialists in pediatric hematology and oncology should make concerted efforts to establish this registry.

Fungemia is a life-threatening infection which requires an early diagnosis and use of appropriate antifungal agents to be treated effectively.

Here, we describe the clinical-epidemiological characteristics as well as the antifungal susceptibility patterns of fungal agents in pediatric patients with malignancy.

Two hundred and five blood samples were cultured to detect infection. The infectious agents were identified by phenotypic methods and 21-plex PCR. Antifungal susceptibility testing was performed using an E-test and disc diffusion test based on CLSI standard M27-A3 protocol. The demographic data of the studied population were extracted and analyzed.

In total, 36 out of 205 patients (17.6%) were positive for fungemia. 32 (88.9%) and 4 (11.1%) cases were found to be caused by Candida and Rhodotorula species, respectively. The patient's age ranged from 1 to 14 years. The majority of the patients were males (28; 77.8%) and were hospitalized for more than seven days (33; 91.7%). Non- Candida albicans species were the most common agents of fungemia (27 patients; 75%), with C. parapsilosis (77.8 %) as the dominant agent. Fever, central venous catheters, and broad-spectrum antibiotic therapy were observed in all cases. Itraconazole resistance was observed in a species of C. orthopsilosis . While the Candida isolates were susceptible to fluconazole, C. parapsilosis showed a significant rate of resistance to caspofungin, followed by itraconazole and amphotericin B. Overall, no mortality was reported among the fungemia cases.

This study identified acute lymphoblastic leukemia (ALL) as a hematologic malignancy associated with fungemia. The increase of non- C. albicans species, including C. parapsilosis , along with reduced susceptibility to antifungal drugs, maybe a warning sign in pediatric patients with malignancies. Furthermore, fluconazole was the most effective antifungal agent against the recovered isolates. Therefore, the best strategy for the management of fungemia is to increase knowledge based on local epidemiological and mycological characteristics.

Melorheostosis is a rare disease also known as Leri disease with about 400 cases in the world with unknown etiology although relations with mitogen-activated protein kinase 1 gene and LEM domain-containing protein 3 gene mutations are described. We presented a case of melorheostosis referred to the rheumatology clinic with pain and swelling in the middle phalanx of the index finger and second metacarpal bone of right hand. X-ray of the hand showed a hyperdense lesions in the hand bones with obliteration of the medulla. Right hand magnetic resonance imaging showed signal loss of bone marrow in the second metacarpal bone and middle phalanx of the index finger along with severe periosteal edema. Bone biopsy confirmed melorheostosis.

CD4+/CD8+ double-positive (DP) thymocytes are normal cells within the thymus. However, the presence of mature DP T cells is indicative of cancer and abnormality in peripheral blood. Philadelphia+ (Ph+) T-ALL is extremely rare, but it holds significant therapeutic and prognostic implications. The incidence and outcomes of BCR-ABL+ T-ALL remain uncertain, and distinguishing it from T-cell lymphoblastic crises of CML can be challenging. The current document discussed a rare case of CD4+/CD8+ BCR-ABL+ T-ALL in an 11-year-old Iranian male, detailing his medical conditions, laboratory findings, and treatment. The patient presented with enlarged lymph nodes, splenomegaly, anemia, leukocytosis, and severe thrombocytopenia. The blood smear was nearly filled with irregular/convoluted and cleaved nuclear blasts with fine chromatin. The patient received imatinib with induction chemotherapy. After two months, the patient achieved complete remission with undetectable Minimal/Measurable Residual Disease (MRD). By detailing the patient's characteristics and the required tests, the manuscript contributes to a deeper understanding of this complex disease subtype. Furthermore, by examining and comparing the current case with other available cases, the study lays the groundwork for better characterizing the disease and developing more effective therapeutic strategies.

 Colistin use is primarily associated with nephrotoxicity, which has been shown to be reversible with a low incidence of long-term kidney impairment. This study aimed to investigate the risk factors for acute kidney injury (AKI) in patients receiving intravenous colistin.

 A retrospective cohort study was conducted at Nakornping Hospital in northern Thailand from 2015 to 2020. Adult patients who received intravenous colistin were included, while those with chronic kidney disease or prior renal replacement therapy were excluded. The study assessed potential AKI risk factors, including demographics, comorbidities, and concurrent use of medications. Cases of AKI are identified among the cohort, while the control group includes individuals not experiencing AKI during the follow-up but similar to the cases in terms of the exposure. Univariate and multivariable logistic regression analyses were performed to identify risk factors associated with AKI.

 Among the 206 patients included in the study, a majority were admitted to the intensive care unit, required mechanical ventilation, and experienced septic shock. Univariate analysis revealed diabetes (odd ratio (OR)=2.82, 95% CI: 1.21–6.59, p=0.016), malignancy (OR=2.06, 95% CI:1.12–3.77, p=0.020), and baseline Scr (OR=0.71, 95% CI: 0.51–0.99, p=0.048) as significant risk factors for AKI. Multivariate analysis confirmed the association of diabetes (adjusted odd ratio(aOR)= 3.09, 95% CI: 1.20–7.96, p=0.019), malignancy (aOR= 2.31, 95% CI: 1.18–4.52, p=0.015), septic shock (aOR = 2.80, 95% CI: 1.02–7.69, p=0.045), and vasopressor use (aOR = 2.85, 95% CI: 1.12–7.23, p=0.028) with an increased risk of AKI. Conversely, baseline Scr (aOR = 0.54, 95% CI: 0.36–0.82, p=0.004) were associated with a decreased risk of AKI. Other factors, including concomitant use of aminoglycosides, vancomycin, rifampin, combination therapy, nephrotoxins, hypertension, and intensive care unit admission, did not show significant associations.

 This study identified diabetes, malignancy, septic shock, and vasopressor use as significant risk factors for AKI in patients receiving colistin. Baseline Scr levels were found to be inversely associated with the risk of AKI. These findings contribute to a better understanding of colistin-related nephrotoxicity and can guide clinical management to mitigate the risk of AKI in this patient population.

 The widespread use of high-resolution computed tomography (HRCT) in lung cancer screening has allowed for an increased detection rate of ground-glass nodules (GGNs) in the lung. Hence, obtaining the correct clinical diagnosis of benign and malignant GGNs has become crucial.

 Most artificial intelligence and computer-aided diagnosis (AI-CAD) systems for the classification of pulmonary GGNs fail to extract CT features. This study used HRCT and AI to analyze the CT features of GGNs to improve the prediction of benign and malignant pulmonary GGNs.

 This case-control study was performed on a malignant group consisting of patients and a benign group consisting of controls. A total of 204 patients with GGNs were recruited and divided into 2 groups according to their pathological results. Group A consisted of 69 cases with precursor glandular lesions (atypical adenomatous hyperplasia [AAH] and adenocarcinoma in situ [AIS]), inflammatory nodules, and benign nodules. Group B consisted of 135 cases with invasive lesions (minimally invasive adenocarcinoma [MIA], invasive adenocarcinoma [IAC], and other malignant lesions). Various CT features were compared between the 2 groups. The diagnostic efficacy of an AI-CAD system and radiologists’ reports for benign and malignant nodules were analyzed. A multivariate logistic regression analysis was performed to determine independent predictors of malignant GGN. A model that combined the AI system and manual extraction of radiological features was constructed. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic efficiency of the model.

 Significant differences were found between malignant and benign groups according to the following 7 CT features: The GGN size (long and short diameters), vacuole sign, air bronchogram sign, vascular convergence sign, vascular perforator sign, interlobular septal obstruction sign, and spiculation (P < 0.05). The volume and mean CT values of precursor glandular lesions of the lungs were significantly different from those of invasive lesions (P < 0.05). The logistic regression model showed that the sensitivity and specificity of the AI system in diagnosing malignant groups were 0.756 and 0.696, respectively. The sensitivity and specificity of radiologists’ reports in diagnosing the malignant groups were 0.726 and 0.783, respectively. The combination of the 2 had a sensitivity of 0.768 and a specificity of 0.793.

 Prediction of the nature of GGNs based on CT features, including the vacuole sign, vascular perforator sign, and interlobular septal obstruction sign, were relatively accurate for a preliminary diagnosis. The AI system had a poorer diagnostic accuracy for GGNs than radiologists’ reports of CT images. The combination of AI and radiologists’ reports showed the highest diagnostic efficacy.