neoplasm

Melanoma is a highly destructive and lethal form of skin cancer. With the contemplation of the concept of plant-based chemotherapeutic and nanomedicine approach, this study aims to develop a liposome of standardized Piper longum L. fruit ethanolic extract (PLFEE), with the evaluation of its pharmaceutical properties and cytotoxic activities against melanoma cell line. To our knowledge, no authentic reports are available for the standardized PLFEE-loaded liposome for melanoma therapy.

The chemical marker-based standardization of PLFEE was performed by validated High-performance liquid chromatography (HPLC) to maintain the dosage uniformity and uniform therapeutic outcome. Thin-film hydration was utilized for the formulation of liposomes. The developed liposome was characterized for its pharmaceutical possessions and therapeutic activity against melanoma cell lines.

The prepared liposome was found to be homogeneous, amorphous, transparent, light yellowish, demonstrated nano vesicular size (Zavg=104.858±0.262 nm), low polydispersity index (PDI=0.271±0.015), high zeta potential (ζ= -21.8±0.07 mV), spherical morphology, excellent % entrapment efficiency (EE=75.920±3.096%), refractive index (RI= 1.335±0.0001), sustained drug release, excellent drug-excipient compatibility, and stability. The liposome showed selective cytotoxicity to B16F10 melanoma cells without affecting healthy HEK293 kidney cells. The PLFEE-loaded liposome showed significantly enhanced cytotoxicity (IC50=59.71 ± 2.364 µg/mL) compared to PLFEE (88.48 ± 3.243 μg/mL).

Cancer cells use various pathways for their uncontrolled, abnormal proliferation, angiogenesis, invasion, and metastasis. It is, therefore, logical to utilize a multicomponent-based standardized herbal extract that may act through multiple molecular pathways. The liposomal formulation containing multiconstituent-based standardized PLFEE may be a potential alternative chemotherapeutic for melanoma therapy. However, comprehensive in-vivo works are essential to reveal its therapeutic potential.

Prostate cancer (PCa) is the most common cancer among men, and type 2 diabetes mellitus (T2DM) increases the risk of PCa. This meta-analysis aimed to investigate the association between metformin administration, PCa incidence, and mortality rates.

The inquiry included databases PubMed, Cochrane, Scopus, Web of Science, and Google Scholar search engine and was updated until June 9, 2024. The primary outcome was the effect of metformin on the risk of PCa. Data were analyzed using STATA version 14 software, and statistical significance was determined at P<0.05.

The results of 30 studies containing 1655591 men showed no significant relationship between metformin use and prostate neoplasm (OR: 0.94; 95% CI: 0.79-1.11). Additionally, the use of metformin in men aged 60 to 69 (OR: 0.97; 95% CI: 0.86-1.09) and men aged 70 to 79 (OR: 1.11; 95% CI: 0.91-1.35) was not associated with the risk of prostate carcinoma. Metformin use was not related to PCa in cohort studies (OR: 0.88; 95% CI: 0.71-1.08) and case-control studies (OR: 1.07; 95% CI: 0.92-1.25). Moreover, no significant relationship was found between metformin use and prostate carcinoma in Asia (OR: 0.78; 95% CI: 0.52-1.17), Europe (OR: 1.13; 95% CI: 0.96-1.32), or America (OR: 0.94; 95% CI: 0.74-1.20). However, metformin use reduced PCa mortality (HR: 0.83; 95% CI: 0.71-0.98).

Although the use of metformin did not reduce the risk of prostate carcinoma, it was associated with a 17% reduction in prostate carcinoma cancer mortality.

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.

 Akt1, a serine/threonine kinase, plays a central role in cancer development and progression. Its overexpression correlates with aggressive phenotypes and poor prognosis in several types of cancers, such as oral squamous cell carcinoma (OSCC). Cinnamic acid derivatives (CADs) from natural sources exhibit anticancer properties, making them potential Akt1 inhibitors.

 The binding affinities of 19 CADs to the Akt1 catalytic cleft were evaluated using molecular docking simulations and then compared with the Akt1 inhibitor capivasertib. Interaction modes were analyzed to identify critical residues involved in ligand binding.

 Cynarin demonstrated the highest binding affinity (ΔGbinding =-13.46 kcal/mol, Ki=136.48 pM), forming three hydrogen bonds with Akt1. Rosmarinic acid with six hydrogen bonds also exhibited potent inhibition (ΔGbinding =-11.51 kcal/mol , Ki=3.67 nM). Both compounds represented superior binding compared to capivasertib.

 Cynarin and rosmarinic acid from natural sources showed promising inhibitory potential against Akt1, suggesting their therapeutic values as anticancer agents targeting the PI3K/Akt pathway in OSCC.

Primary spinal tumors are rare, and epidemiologic studies on this topic are limited. These tumors may originate from the spinal cord, cauda equina, or spinal meninges. Various factors, including age and sex, influence the epidemiology of primary spinal tumors.

This study provides a descriptive report on the epidemiology of primary spinal tumors in Fars province, southern Iran.

We retrospectively collected data from patients with primary spinal tumors who underwent surgery at major neurosurgery centers in Fars province from 2001 to 2019. Descriptive statistics were used to analyze data concerning sex, age, tumor histology, and behavior.

The study included 166 patients with primary spinal tumors. The mean age of the patients was 41.9 years (SD, 17.1 years), with 55.4% being female. Among the patients, 66.9% had spinal cord tumors, 25.9% had tumors of the spinal meninges, and 7.2% had tumors in the cauda equina. Most tumors were intradural extramedullary (45.2%), followed by intramedullary tumors (42.2%) and extradural tumors (12.7%). Of the total, 76 tumors (45.8%) were classified as malignant, while 90 tumors (54.2%) were non-malignant. The most frequent histological types were ependymoma (24.1%), nerve sheath tumors (22.3%), and meningioma (20.5%). An increase in the relative incidence of astrocytic and ependymal tumors was observed compared to previous studies conducted in the same region.

This study presents a comprehensive epidemiologic report on primary spinal tumors in Fars province, Iran. Further nationwide studies, including all diagnosed spinal tumors, are recommended.

Survival rates for pediatric cancer patients have undergone rapid growth due to advancements in anticancer treatments. Despite these developments, cancer survivors continue to experience a range of persistent symptoms, including pain, fatigue, anxiety, depression, insomnia, and nausea/vomiting. Consequently, the use of complementary therapies has increased among this population as a means of alleviating these symptoms. This cross-sectional study involved 124 parents of children diagnosed with cancer and referred to Aliasghar Children’s Hospital in Tehran, selected via census sampling from January 2018 to January 2019. Data were collected using a validated and reliable questionnaire. Statistical analyses, including chi-square tests, Fisher’s exact test, and independent samples t-tests, were conducted to explore relationships between variables. A p value of < 0.05 was considered statistically significant, and data analysis was performed using SPSS version 25. Cronbach's alpha coefficient of this questionnaire was 0.85. Prior to diagnosis, 51.6% of patients reported using complementary medicine, which increased significantly to 77.4% after diagnosis. Herbal medicine emerged as the most commonly used form of complementary therapy. The primary motivation for using therapies was to manage chemotherapy side effects, reported by 83.3% of patients. The predominant barrier to the use of complementary medicine was insufficient knowledge regarding its benefits and risks. Notably, only one-third of mothers disclosed their children's use of integrative medicine to their physicians. The high prevalence of complementary medicine use among pediatric oncology patients underscores the necessity for healthcare providers to routinely inquire about such practices and educate patients about potential drug interactions. Additionally, the tendency for patients to conceal their use of complementary therapies from their healthcare providers warrants further attention and proactive engagement from clinicians.

Business intelligence is the electronic display of summarized key data in dashboards. Due to the importance of business intelligence in the collection and integration of treatment data of cancer patients and its management, knowledge of business intelligence tools and their characteristics in the field of cancer is most important for managers and health professionals. Therefore, this study aims to explore the application of business intelligence in cancers.

A comprehensive search of major bibliographic databases, including PubMed, Scopus, Web of Science, and Embase, was conducted without applying time restrictions. A total of 24 studies were ultimately selected, and data extraction was performed using an enhanced version of the Arksey and O'Malley framework.

Research has demonstrated that business intelligence plays a crucial role in the management of cancer data. Additionally, the result indicated enhancing patient safety, improving the performance of medical staff in patient monitoring, and supporting decision-makers and administrators in the adoption of optimal resource allocation policies. Furthermore, business intelligence has been applied to monitor the performance of health service departments for cancer patients, ensure effective resource management, and optimize workflow processes within these departments.

Business intelligence is among the most effective and efficient approaches for optimizing the use of large volumes of data, enabling healthcare providers and other decision-makers to access valuable information for making timely decisions in the field of cancer.

Frontal anterior laryngectomy with epiglottic reconstruction (Tucker’s reconstructive surgery) is a technique of partial laryngectomy that has been used by several authors since its introduction in the 80s.The aim of this serie is to specify the indications of this operation and to present the functional and oncological outcomes of our study and those found in the literature.  We report a retrospective study of 65 cases who underwent Tucker’s operation by many surgeons at our educational center over a period of 31 years (1988 - 2020). This serie included 62 men (95%) and 3 women (5%), with a mean age of 62,8 years. The cases were classified as follows: 42 patients with T1aN0M0 (65%), 21 patients with T1bN0M0 (32%) and 2 patients with T2N0M0 (3%). Following surgery, the mean time for tracheal cannula extraction was 18,4 days and for nasogastric tube was 14,4 days. Five cases developed aspiration pneumonia. Voice quality was then assessed based on its intensity and intelligibility with 11,7% rated as very good, 53,3% as good, 31,7% as average and 3,3% as poor. There were 4 cases of local recurrence, 2 cases of nodal recurrence, and 2 cases of tumour pursuit. The median survival rate was 7,5 years. The functional and oncological outcomes of Tucker´s reconstructive surgery were generally satisfactory in our patients and are consistent with those reported in the literature. This technique holds an important position of this technique in the therapeutic arsenal for early glottic carcinoma.

We aimed to investigate the length of hospital stay for resection of juvenile nasopharyngeal angiofibroma (JNA) as it relates to preoperative embolization status.

Pediatric males (0-18 years old) with the diagnosis of a benign neoplasm of the nasopharynx who underwent surgical resection between 2004 and 2022 were included in this retrospective cohort study. Patients were then separated into two groups based on their preoperative embolization status. Length of stay between the two groups and intercenter variation in length stay was investigated.

706 patients, with a mean age of 14 years, were analyzed. 114 patients received embolization prior to surgical resection while 592 patients did not receive preoperative embolization. The age of admission, gestational age, and ethnicity were consistent between the two groups. The length of stay for the group that received preoperative embolization was 3 days, while the length of stay for the no embolization group was 2 days. In addition, nine centers were identified as having significantly higher inter-center variation in LOS.

Embolization prior to removal of JNA increases the length of stay, despite having similar rates of transfusion. While the difference in length of stay can likely be explained by the fact that patients get admitted a day prior to surgery for embolization, it is unclear why there is significant inter-center variation.

Pancreatic duct (PD) dilation could be presented in both benign and malignant diseases. Endoscopic ultrasonography (EUS) is a sensitive modality that provides both structural assessment and tissue sampling. This study aims to explore the importance of PD dilation as a potential indicator related to various pancreatobiliary pathologies identified via  EUS.

Among 3109 subjects who underwent EUS, 599 had evidence of dilated PD and met the inclusion criteria of this retrospective study. Also, the patients underwent EUS fine needle aspiration (EUS-FNA) to evaluate the etiology when required. All data were extracted from patients’ medical records to perform statistical analysis.

The study sample revealed 64% being male with a median age was 65-years. Pancreatic adenocarcinoma was the most common etiology diagnosed in 236 patients (39.4%), followed by sphincter of Oddi dysfunction (SOD) in 13% of subjects. Ampullary carcinoma, common ‎bile duct stone, and cholangiocarcinoma were found at 9.5%,  8.8%, and 6.8%, respectively. Abdominal pain was the most common symptom seen in 440 (73.4%) patients. Opium consumption was reported in 170 (28.4%) subjects. ‎Opium consumption was significantly more prevalent in patients with SOD (P<0.05).

We suggest that PD dilation could be associated with a wide range of pancreaticobiliary pathologies, especially pancreatic neoplasms. In this regard, PD dilation should be considered as a crucial indicator of pancreatic neoplasm despite it may be associated with no clear etiologies.

The coronavirus resulted in a global pandemic and infected millions of people worldwide in 2019. The number of chest CT scans significantly increased due to the virus's effect on the upper respiratory tract. This retrospective cross-sectional analytic study aimed to investigate the COVID-19 effect on the number of chest CT scans and to estimate the probability of radiation-induced cancers as a result of the incremental number of scans in hospitals in Zanjan, Iran.

This study included all chest CT scans performed during a three-month period before the pandemic (2019) and the pandemic (2020). In 2020, the scans were meticulously examined for COVID-19 signs, and relevant epidemiological and dosimetric factors were recorded to calculate the risk of radiation-induced cancer using the IRCP103.

The results reveal a four-fold increase in the number of scans in 2020, with 9095 scans compared to 2235 in 2019. Patients referred for a chest CT scan during the COVID-19 outbreak were significantly younger. Although the Dose-length Product (DLP) decreased in 2020, the anticipated number of new cases of radiation-induced cancers exhibited an approximately four-fold increase for different organs in the thorax region. Also, 55.6% of CT scans were considered normal in 2020.

The current study shows that the high probability of radiation-induced cancers should be considered the long-term effects of the COVID-19 pandemic.

Wilms tumor (WT) is the most common malignant tumor (neoplasm) of the urinary tract in early childhood. The median age at WT diagnosis is 3-4 years, and 90% of cases are diagnosed before the age of 7 years. In this report, three adolescent patients with WT, aged 12, 17 and 16, are investigated. Left kidney involvement was observed in these three cases. The clinical presentation in case one was the complaint of abdominal pain with a palpable abdominal mass. The second case was presented with hematuria and an abdominal mass. The clinical symptoms in case three included left flank pain and weight loss. Although WT is usually observed in children under 7 years of age, its diagnosis should also be expected in older children with abdominal pain, palpable mass and gross hematuria.

Schwannoma seldom occurs in female genitalia; with only a few cases being reported in the medical literature. This tumor can present on labia majora, labia minora, clitoris, and vagina. In this study, a case of vulvar schwannoma, which resembled a leiomyoma, is reported.

Case report: 

A 44-year-old woman presented with a history of a small palpable mass located on the left labium. Ultrasonography showed a heterogeneous mass suggestive of a leiomyoma. Subsequently, the patient underwent surgical excision of the mass with clear margins. Histopathological examination confirmed the diagnosis of vulvar schwannoma. The patient was discharged in good condition following the excision.

Schwannoma of the vulva represents a rare neoplasm that can be treated by surgical excision. The prognosis is excellent and recurrence is uncommon. Therefore, histopathological assessment is recommended for management of Schwannoma of the vulva.

Lymphoma and multiple myeloma account for a small but significant proportion of all oral malignancies. Oral manifestations of hematopoietic malignancies are sometimes diagnosed with delay as most of them mimic various other diseases like osteomyelitis and periodontal diseases. We present five unusual, challenging cases of head and neck lymphomas and one case of oral myeloma.

In this article, we report six cases, five cases of oral lymphomas, and one oral multiple myeloma case. All cases were initially diagnosed by oral histopathologists and then referred to specialists for further treatment.

We report these cases to understand these lesions better, as we saw some worrisome delays in their diagnoses. We aim to raise awareness about these hematopathological diseases among general dentists.

It is crucial for the multidisciplinary team members to thoroughly examine the oral cavity for any worrisome lesions like these, as they might be an initial sign of a systemic disease. Pathologists must also be aware of the pitfalls in the interpretation of immunohistochemical sections and the immune profile of a tumor.

Statement of the Problem: 

Salivary gland tumors represent about 3% of the head and neck tumors. Pleomorphic adenoma (PA) is the most common benign salivary gland tumor.

This study was conducted to investigate and describe some clinical and histopathological aspects of salivary pleomorphic adenomas with special reference to the epithelial and mesenchymal components.

One hundred tissue samples diagnosed as PA were sourced from archival tissue blocks between 2009 and 2019 in this retrospective study. Some clinical and demographic features, including age, sex, tumor size, and tumor location were recorded. This study included only samples taken by excisional biopsy. Then, the samples were histologically classified into three subtypes according to the proportion of epithelial and stromal components. The demographic and clinicopathological variables were statistically analyzed using Chi-square test or Fisher’s exact test, considering a significance level of 5% (p< .05).

In the present study, most cases (61%) were found in females, representing a female–male ratio of 1.6:1. The peak incidence was seen in the 4th and 5th decades of life. In 87% of cases, PA occurred in major salivary glands. There was a significant difference between the age of the patient and squamous metaplasia (p= 0.036). There was also a significant difference between the size of tumor and the amount of myxoid stroma (p= 0.021). Extensive myxoid stroma was mostly seen in tumors larger than 3.37cm (p= 0.001). In addition, there was a statistically significant difference between capsular invasion and the development of squamous metaplasia (p= 0.001).

 In this study, there was a significant correlation between the gland type and capsular features and between the size of tumor and rate of squamous metaplasia. A detailed clinical and histopathological analysis of PAs may provide a better insight to the pathophysiology of the lesion, tumor cell differentiation, and prognostic factors.

To determine the pooled prevalence of cancer in subjects with multiple sclerosis (MS) who received Natalizumab.

Two researchers systematically searched PubMed, Scopus, EMBASE, Web of Science, google scholar, and gray literature including references of the included studies. The search strategy which was used in PubMed was (“Disseminated Sclerosis” OR “multiple sclerosis” OR “MS” OR “Acute Fulminating”) AND (“Cancer” OR “Neoplasia*” OR “Neoplasm*” OR “Tumor*” OR “Malignancy” OR “Benign Neoplasm” OR “Malignant neoplasm”) AND (“Tysabri” OR “Antegren” OR “natalizumab” OR “Modifying Therapy”).

We found 1,993 articles by literature search, and 1,573 studies remained after removing duplicate studies. For metaanalysis, we used the extracted data of eight studies. The pooled prevalence of cancer in patients who received Natalizumab was 2% (95%CI: 1–3%; I 2: 99.4%, P < 0.001). The pooled prevalence of basal cell carcinoma in patients with cancer was 12% (95%CI: 5–20%; I2 :50.3%, P = 0.13).

The main finding of this systematic review and metaanalysis is that the pooled prevalence of cancer in subjects who suffer from MS and received natalizumab was 2%.

Context: 

Breast cancer (BC) is the most prevalent cancer diagnosed in women and the second most common cancer worldwide.

This study aimed to determine the rates of depression and identify the characteristics that put women at risk for developing depression while coping with BC in the Middle East. Evidence Acquisition: The present meta-analysis was performed by searching for keywords related to BC and depression in Middle East countries, including Egypt, Iran, Jordan, Lebanon, Pakistan, Qatar, and Turkey, in 4 main databases (PubMed, Embase, Web of Science, and Scopus) between January 2000 and November 2021. The results were analyzed using R and CMA software.

Fifteen English-language papers were included in this meta-analysis. The estimated prevalence of depression was 40.8% among a total of 2369 BC women, with the highest depression rate (83.9%) among Pakistani women (95% CI, 73.6 - 89.5; P = 0.000) and the lowest depression rate (27.5%) among Turkish women (95% CI, 17.2 - 40.9; P = 0.002). The women who were under treatment had higher levels of depression compared with those who were treated.

The diagnosis of depression during a clinical treatment process can provide accurate assessments of the mental and social well-being of patients and consequently inform them about their own care. Thus, cancer treatment centers need to integrate mental illness assessment and support significant parts of the treatment plan to prevent and treat depression among BC patients.