bims-netuvo Biomed News
on Nerves in tumours of visceral organs
Issue of 2023–04–30
eight papers selected by
Maksym V. Kopanitsa, The Francis Crick Institute
  1. Time to Introduce Nerve Density in Cancer Histopathological Assessment.
  2. Atypical Neurofibromatous Lesions: Epigenetic Cousins of Other Benign Peripheral Nerve Sheath Tumors?
  3. Prognostic value of perineural invasion in resected non-small cell lung cancer: A meta-analysis.
  4. The significance of peri-neural invasion in patients with gallbladder carcinoma after curative surgery: a 10 year experience in China.
  5. Lymphovascular Invasion and High Mitotic Count Are Associated With Increased Risk of Recurrence in Pleomorphic Dermal Sarcoma.
  6. Superficial Peroneal Nerve Schwannoma.
  7. [Histological and molecular characteristics of tumours of the peripheral nervous system].
  8. Rare case of Malign Peripheral Nerve Sheath Tumor complicating a solitary giant neurofibroma of the thigh.
  1. Clin Cancer Res. 2023 Apr 28. pii: CCR-23-0736. [Epub ahead of print]
    Time to Introduce Nerve Density in Cancer Histopathological Assessment.
    Hubert Hondermarck, Chen Chen Jiang.
      The density of nerves in the tumor microenvironment is increasingly reported to be associated with worse clinical outcome in various cancers. Therefore, it is time to consider the assessment of nerve density in clinical cancer pathology, and interestingly, the development of artificial intelligence may facilitate this clinical translation.
    DOI:  https://doi.org/10.1158/1078-0432.CCR-23-0736
  2. Neuro Oncol. 2023 Apr 29. pii: noad083. [Epub ahead of print]
    Atypical Neurofibromatous Lesions: Epigenetic Cousins of Other Benign Peripheral Nerve Sheath Tumors?
    Cristiane M Ida, Kenneth Aldape.
      
    DOI:  https://doi.org/10.1093/neuonc/noad083
  3. Heliyon. 2023 Apr;9(4): e15266
    Prognostic value of perineural invasion in resected non-small cell lung cancer: A meta-analysis.
    Wenliang Liu, Siying Ren, Chao Zeng, Yan Hu.
       Objective: The prognostic role of perineural invasion (PNI) in resected non-small cell lung cancer (NSCLC) remains unclear. A meta-analysis was performed to compare the overall survival (OS) of patients with resected NSCLC with and without PNI.
    Methods: The PubMed, EMBASE, and Web of Science databases were systematically searched to identify relevant studies investigating the effect of PNI on OS in patients with resected NSCLC. Pooled hazard ratio (HR) and 95% confidence intervals (CI) were estimated using a random-effects model. Separate meta-analyses using adjusted or unadjusted HR for OS were performed using Stata/SE 12.0.
    Results: Eleven studies comprising 2,279 patients were included. In total, PNI was identified in 9% (median, 4%-31%) of patients with resected NSCLC. The unadjusted pooled effect of the PNI was significantly associated with worse OS (HR, 2; 95% CI, 1.65-2.43). Adjusting for potential confounders yielded a similar result, with OS being significantly worse (HR, 2.13; 95% CI, 1.8-2.51) for patients exhibiting PNI.
    Conclusion: This meta-analysis indicates that the PNI is a strong prognostic factor for unfavorable outcomes in patients with resected NSCLC. Further large-scale prospective lung cancer trials are required to validate these results.
    Keywords:  Meta-analysis; Non-small cell lung cancer; Overall survival; Perineural invasion
    DOI:  https://doi.org/10.1016/j.heliyon.2023.e15266
  4. Updates Surg. 2023 Apr 26.
    The significance of peri-neural invasion in patients with gallbladder carcinoma after curative surgery: a 10 year experience in China.
    Tian-Run Lv, Hai-Jie Hu, Fei Liu, Wen-Jie Ma, Yan-Wen Jin, Fu-Yu Li.
      The significance of peri-neural invasion (PNI) in patients with gallbladder carcinoma (GBC) after curative surgery remains unknown. Current study was performed to evaluate the significance of PNI in resected GBC patients in terms of tumor-related biological features and long-term survival. Patients with GBC between September 2010 and September 2020 were reviewed and analyzed. SPSS 25.0 software were used for statistical analysis. A total of 324 resected GBC patients were identified (No. PNI: 64). An elevated preoperative Ca19.9 level (P = 0.001), obstructive jaundice (P = 0.001), liver invasion (P < 0.0001), lymph-vascular invasion (P < 0.0001), lymph-node metastasis (P < 0.0001), and poor or moderate differentiation status (P = 0.036) were more frequently detected in patients with PNI. Major hepatectomy (P = 0.019), bile duct resection (P < 0.0001), combined multi-visceral resections (P = 0.001), and combined major vascular resections and reconstructions (P = 0.002) were also more frequently detected. However, a significantly lower R0 rate (P < 0.0001) was acquired in patients with PNI. Patients with PNI were generally more advanced disease and shared a much worse prognosis even after matching. PNI was an independent prognostic factor of disease-free survival as well as an independent predictor of early recurrence. Postoperative adjuvant chemotherapy has brought an obvious survival benefit in resected GBC patients with PNI. PNI could be regarded as an indicator of worse prognosis and could serve as an independent predictor of early recurrence. Postoperative adjuvant chemotherapy was correlated with an improved survival for resected GBC patients with PNI. Upcoming multicenter studies covering various races are warranted for further validation.
    Keywords:  Gallbladder carcinoma; Peri-neural invasion; Prognosis
    DOI:  https://doi.org/10.1007/s13304-023-01519-2
  5. Actas Dermosifiliogr. 2023 Apr 21. pii: S0001-7310(23)00301-0. [Epub ahead of print]
    Lymphovascular Invasion and High Mitotic Count Are Associated With Increased Risk of Recurrence in Pleomorphic Dermal Sarcoma.
    M Pons Benavent, E Ríos-Viñuela, E Nagore, C Monteagudo, M Aguerralde, D Mata Cano, B Llombart, C Serra-Guillén, I Pinazo Canales, C Requena, O Sanmartín.
       BACKGROUND AND OBJECTIVE: Atypical fibroxanthoma and pleomorphic dermal sarcoma (PDS) are rare mesenchymal tumors. Due to the low incidence of PDS and a historically confusing nomenclature, little is known about the true aggressiveness of this tumor. The aim of this study was to investigate clinical and histologic risk factors for recurrence in PDS.
    MATERIAL AND METHODS: Retrospective, observational, bicentric study of 31 PDSs diagnosed and treated at Hospital Clínico Universitario de Valencia and Instituto Valenciano de Oncología in Valencia, Spain, between 2005 and 2020. We described the clinical and histologic features of these tumors and performed univariate analysis and multivariate Cox regression analysis.
    RESULTS: In the univariate analysis, tumor recurrence (P < .001), necrosis (P = .020), lymphovascular invasion (P = .037), perineural invasion (P = .041), and mitotic count (< 18 vs ≥ 18 mitoses per 10 high-power fields) (P = .093) were associated with worse disease-free survival. In the multivariate Cox regression analysis, mitotic count and lymphovascular invasion retained their significance as predictors of worse disease-free survival (P < .05).
    CONCLUSIONS: PDS is an aggressive tumor in which a high mitotic count (≥ 18) and lymphovascular invasion are associated with a higher risk of recurrence and worse disease-free survival. Necrosis and perineural invasion are also probably linked to increased tumor aggressiveness.
    Keywords:  Atypical fibroxanthoma; Lymphovascular invasion; Mitosis; Pleomorphic dermal sarcoma; Pleomorphic sarcoma; fibroxantoma atípico; invasión linfovascular; mitosis; sarcoma pleomórfico; sarcoma pleomórfico dérmico
    DOI:  https://doi.org/10.1016/j.ad.2023.04.018
  6. Plast Reconstr Surg Glob Open. 2023 Apr;11(4): e4950
    Superficial Peroneal Nerve Schwannoma.
    Metasebia W Abebe, Hanna A Weldemicheal.
      Schwannomas are benign tumors of the nerve sheath that arise from the proliferation of active peripheral Schwann cells. Although schwannomas are the most common benign peripheral nerve sheath tumors, superficial peroneal nerve schwannomas are rare in published works of literature. We report a 45-year-old woman with a 4-year history of progressively worsening dull aching pain and paresthesia over the right lateral leg. Physical examination revealed a 4 × 3 cm firm palpable mass and a decreased touch and pain sensation over the lateral aspect of the right calf and dorsum of the foot. She also had an electric shock-like pain on palpation and percussion of the mass. Magnetic resonance imaging demonstrated a well-defined, oval, smooth-walled heterogeneous lesion beneath the peroneus muscle with avid postcontrast enhancement and a split fat sign. Fine needle aspiration cytology also suggested the diagnosis of schwannoma. Based on clinical findings of a mass, decreased sensation, and a positive Tinel sign on the dermatome of superficial peroneal nerve, surgical management was decided. Upon surgical exploration, a firm, glistening mass arising from the superficial peroneal nerve was identified, carefully dissected, and shelled out while maintaining continuity of the nerve. At the 5-month follow-up, the patient reported complete resolution of the pain and paresthesia. Physical examination revealed intact sensation in the lower lateral aspect of the right calf and dorsum of the foot. Therefore, surgical excision should be considered a reasonable option in the management of this rare condition, with most patients achieving good to excellent results.
    DOI:  https://doi.org/10.1097/GOX.0000000000004950
  7. Pathologie (Heidelb). 2023 Apr 28.
    [Histological and molecular characteristics of tumours of the peripheral nervous system].
    Patrick N Harter, Katharina J Weber, Michael W Ronellenfitsch.
      Tumours of the peripheral nervous system occur sporadically in adults and except for a minority of entities, these tumours are usually benign. The most common are nerve sheath tumours. Because these tumours grow in direct proximity or even invade peripheral nerve bundles, they can lead to severe pain and motion deficits. From the neurosurgical perspective these tumours are technically challenging, and especially for tumours with an invasive growth pattern complete resection may not be possible. Peripheral nervous system tumours that are associated with tumour syndromes such as neurofibromatosis type 1 and 2 or schwannomatosis are a particular clinical challenge. The goal of the current article is to present histological and molecular characteristics of peripheral nervous system tumours. Furthermore, future targeted therapy strategies are presented.
    Keywords:  Neoplastic syndromes, hereditary; Nerve sheath neoplasms; Neurofibromatosis, type 1; Neuropathology; Schwannoma
    DOI:  https://doi.org/10.1007/s00292-023-01198-1
  8. Int J Surg Case Rep. 2023 Apr 25. pii: S2210-2612(23)00352-8. [Epub ahead of print]106 108224
    Rare case of Malign Peripheral Nerve Sheath Tumor complicating a solitary giant neurofibroma of the thigh.
    Yassine Ben Bouzid, Omar Krimech, Hamza El Ouagari, Othmane Ibnoussina, Moulay Omar Lamrani, Fouad Zouaidia.
       INTRODUCTION AND IMPORTANCE: Malign Peripheral Nerve Sheath Tumor is rare and can occur on a solitary neurofibroma or as part of neurofibromatosis type 1. The occurrence of a giant solitary neurofibroma in the thigh is rare and its complication in MPNST is much rarer. The diagnosis is based on a combination of radiological, histological and immunohistochemical evidence.
    CASE PRESENTATION: We present the case of a 55 years old woman who presented a mass of the posterior aspect of the thigh without any other abnormality on systemic examination. MRI showed a T1 hyposignal and a T2 hypersignal and the biopsy performed was in favor of a neurofibroma. After surgical resection, the histological study of the surgical specimen revealed an MPNST developing on a pre-existing neurofibroma. After 5 months, the patient had moderate knee stiffness with thigh amyotrophy.
    CLINICAL DISCUSSION: The occurrence of MPNST on a giant solitary neurofibroma of the thigh is extremely rare. MRI allows evoking the diagnosis but radiologists are confronted with a problem of differential diagnosis. Histological examination supports the diagnosis in addition to immunohistochemical examination. Only surgical treatment can give hope for a cure. Recurrences remain frequent with a 5-year survival of 50 %.
    CONCLUSION: Early diagnosis is essential to prevent the evolution of the tumor and the occurrence of poor prognostic factors compromising the management, increasing the risk of recurrence and affecting the overall survival of patients.
    Keywords:  MPNST; Neurofibroma; Rare; Thigh
    DOI:  https://doi.org/10.1016/j.ijscr.2023.108224
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