bims-netuvo Biomed News
on Nerves in tumours of visceral organs
Issue of 2023–10–29
fourteen papers selected by
Maksym V. Kopanitsa, The Francis Crick Institute
  1. Unraveling the Mysteries of Perineural Invasion in Benign and Malignant Conditions.
  2. The value of SOX10 expression in predicting perineural invasion in gastric cancer.
  3. The Impact of Clinical and Histopathological Factors on Disease Progression and Survival in Thick Cutaneous Melanomas.
  4. Diagnosis and Management of Intrascrotal Nerve Tumors: A Systematic Review of the Literature.
  5. When biopsy goes wrong: a case series of misdiagnoses and complications from biopsies of masses of unknown origin potentially originating from a peripheral nerve.
  6. Imaging Findings of Axillary Granular Cell Tumor in a Patient with Breast Cancer History: A Case Report.
  7. Giant intrathoracic cystic schwannoma resected by video-assisted thoracoscopic surgery.
  8. Targeted STAT1 therapy for LZTR1-driven peripheral nerve sheath tumor.
  9. Colorectal Carcinomas: Searching for New Histological Parameters Associated with Lymph Node Metastases.
  10. Plexiform Schwannoma of Digital Nerve.
  11. Spinal Schwannomas; Classification, Management And Outcomes.
  12. Do resected colorectal cancer patients need early chest imaging? Impact of clinicopathologic characteristics on time to development of pulmonary metastases.
  13. Editorial. Nerve sheath tumors and biopsies of the future.
  14. Peptidergic Systems as Antitumor Targets: A Right Direction to Fight Cancer?
  1. Curr Oncol. 2023 Sep 30. 30(10): 8948-8972
    Unraveling the Mysteries of Perineural Invasion in Benign and Malignant Conditions.
    Hisham F Bahmad, Samantha Gogola, Michael Rejzer, Kalin Stoyanov, Aaron S Gomez, Ann-Katrin Valencia, Adonicah Cummings, Timothy Skerry, Ferial Alloush, Abed A Aljamal, Arunima Deb, Sarah Alghamdi, Robert Poppiti.
      Perineural invasion (PNI) is defined as the dissemination of neoplastic cells within the perineural space. PNI can be a strong indicator of malignancy and is linked to poor prognosis and adverse outcomes in various malignant neoplasms; nevertheless, it can also be seen in benign pathologic conditions. In this review article, we discuss various signaling pathways and neurotrophic factors implicated in the development and progression of PNI. We also describe the methodology, benefits, and limitations of different in vitro, ex vivo, and in vivo models of PNI. The spectrum of presentation for PNI can range from diffuse spread within large nerves ("named" nerves) all the way through localized spread into unnamed microscopic nerves. Therefore, the clinical significance of PNI is related to its extent rather than its mere presence or absence. In this article, we discuss the guidelines for the identification and quantification of PNI in different malignant neoplasms based on the College of American Pathologists (CAP) and World Health Organization (WHO) recommendations. We also describe benign pathologic conditions and neoplasms demonstrating PNI and potential mimics of PNI. Finally, we explore avenues for the future development of targeted therapy options via modulation of signaling pathways involved in PNI.
    Keywords:  College of American Pathologists; TNM classification; World Health Organization; perineural invasion; staging
    DOI:  https://doi.org/10.3390/curroncol30100647
  2. Rev Esp Patol. 2023 Oct-Dec;56(4):pii: S1699-8855(23)00046-6. [Epub ahead of print]56(4): 227-232
    The value of SOX10 expression in predicting perineural invasion in gastric cancer.
    Seyed Amir Miratashi Yazdi, Atieh Moghtadaie, Elham Nazar.
       BACKGROUND: SRY-related HMG-box 10 (SOX10) protein has a confirmed role in the regulation of neural cell proliferation and differentiation. It is now suggested that the changes in SOX10 expression may be linked to neural invasion by cancer cells. We aimed to assess the value of SOX10 expression in predicting perineural invasion in gastric cancer.
    METHODS: A cross-sectional study was performed on 40 patients with gastric cancer. To assess perineural invasion, Hematoxylin & Eosin stained slides were examined. The expression of SOX10 was also examined by immunohistochemistry.
    RESULTS: Our study showed higher perineural invasion in those with SOX10 positivity as compared to those without SOX10 expression (64.0% vs. 6.7%, p=0.001). No association was revealed between other baseline variables and SOX10 positivity. The expression of this marker increased the chance of neural invasion up to 17 times as indicated by the multivariable regression modeling. Multivariable regression modeling indicated that the chance of neural invasion increased up to 17 times in cases of SOX10 positivity.
    CONCLUSION: Overexpression of SOX10 is closely associated with the risk of perineural invasion in gastric cancer.
    Keywords:  Cáncer gástrico; Gastric cancer; Invasión perineural; Perineural invasion; Proteína HMG-box 10 (SOX10) relacionada con SRY; SRY-related HMG-box 10
    DOI:  https://doi.org/10.1016/j.patol.2023.05.003
  3. Biomedicines. 2023 Sep 23. pii: 2616. [Epub ahead of print]11(10):
    The Impact of Clinical and Histopathological Factors on Disease Progression and Survival in Thick Cutaneous Melanomas.
    Dana Antonia Țăpoi, Diana Derewicz, Ancuța-Augustina Gheorghișan-Gălățeanu, Adrian Vasile Dumitru, Ana Maria Ciongariu, Mariana Costache.
      Thick cutaneous melanomas (Breslow depth > 4 mm) are locally advanced tumors, generally associated with poor prognosis. Nevertheless, these tumors sometimes display unpredictable behavior. This study aims to analyze clinical and histopathological features that can influence the prognosis of thick melanomas. This is a retrospective study on 94 thick primary cutaneous melanomas diagnosed between 2012 and 2018 that were followed-up for at least five years to assess disease progression and survival. We evaluated the age, gender, tumor location, histological subtype, Breslow depth, Clark level, resection margins, mitotic index, the presence/absence of ulceration, necrosis, regression, microsatellites, neurotropism, lymphovascular invasion, and the pattern of tumor-infiltrating lymphocytes, and their association with disease progression and survival. By conducting univariate analysis, we found that progression-free survival (PFS) was significantly associated with female gender, the superficial spreading melanoma (SSM) subtype, mitotic index, necrosis, microsatellites, and perineural invasion. Overall survival (OS) was significantly associated with female gender, Breslow depth, SSM subtype, necrosis, microsatellites, and perineural invasion. Through multivariate Cox proportional hazards regression, we found that the only factors associated with PFS were Breslow depth, necrosis, microsatellites, and perineural invasion, while the factors associated with OS were Breslow depth, necrosis, microsatellites, and perineural invasion. Certain histopathological features such as Breslow depth, necrosis, microsatellites, and perineural invasion could explain differences in disease evolution. This is one of the first studies to demonstrate an association between necrosis and perineural invasion and outcomes in patients with thick melanomas. By identifying high-risk patients, personalized therapy can be provided for improved prognosis.
    Keywords:  Breslow; necrosis; perineural invasion; prognosis; survival; thick cutaneous melanoma
    DOI:  https://doi.org/10.3390/biomedicines11102616
  4. Urol Res Pract. 2023 Sep;49(5): 274-279
    Diagnosis and Management of Intrascrotal Nerve Tumors: A Systematic Review of the Literature.
    Ilias Giannakodimos, Alexis Giannakodimos, Afroditi Ziogou, Konstantinos Tzelepis.
      Scrotal tumors of nerve origin are extremely rare and occur mostly in the extratesticular tissues of scrotum, such as the spermatic cord and epididymis. A systematic search of the literature in PubMed, Medline, and Google Scholar databases concerning intrascrotal nerve tumors was performed by 2 independent investigators. The systematic search retrieved 45 male adults, with a mean age of included patients at 43.9 ± 18.8 years. The majority of nerve tumors were extra-testicular (86.7%), and only 13.3% originated from the testis. Out of that, 51.1% of neoplasms were histologically proved as schwannomas, 44.4% as neurofibromatosis, and 4.4% as malignant peripheral nerve sheath tumors. The majority of patients presented with atypical symptoms such as scrotal swelling (51.1%), while only 4.4% of patients were asymptomatic. Ultrasonography is the diagnostic modality of choice (97.2%) for the detection of primary lesion, while magnetic resonance imaging and computed tomography comprise supplementary diagnostic tools. Surgical excision of the mass was the preferred type of surgery performed (75.6%), whereas orchiectomy was performed only in 22.2% of patients. Intrascrotal tumors of nerve origin are extremely rare neoplasms that present mainly in middle-aged males. Increased clinical suspicion is required for accurate diagnosis of this rare entity.
    DOI:  https://doi.org/10.5152/tud.2023.23050
  5. J Neurosurg. 2023 Aug 18. 1-9
    When biopsy goes wrong: a case series of misdiagnoses and complications from biopsies of masses of unknown origin potentially originating from a peripheral nerve.
    Fernando Guedes, Vinícius M Henriques, Francisco L Torrão, Neder P Haikal, Gabriel E Sanches, Daniel A N Barbosa, Felipe G Marsicano, Livia A N Rosa, Ana C Siquara, Martijn J A Malessy.
       OBJECTIVE: Biopsies of peripheral nerve tumors (PNTs) are often used to plan an efficient treatment strategy. However, performing a biopsy is controversial when the mass is likely to be a benign PNT (BPNT). The aim of this study was to evaluate the side effects of biopsies in patients with potential PNTs.
    METHODS: A retrospective and cross-sectional study was conducted on 24 patients who underwent biopsy of a mass of unknown origin potentially originating from a peripheral nerve (MUOPON), performed in nonspecialty services, and who were later referred to the authors' service for resection of their lesion between January 2005 and December 2022. The patients were evaluated for pain score, presence of a motor or sensory deficit, biopsy diagnosis, and definitive histopathological postsurgical diagnosis.
    RESULTS: The location of the tumor was supraclavicular in 7 (29.2%) patients, in the axillary region in 3 (12.5%), in the upper limb in 7 (29.2%), and in the lower limb in 7 (29.2%). Twenty-one (87.5%) patients were evaluated by MRI before biopsy, and 3 (12.5%) underwent ultrasound. One patient did not have an examination before the procedure. Based on the biopsy findings, 12 (50%) analyses had an inconclusive histopathological result. The preexisting pain worsened, as measured 1 week after biopsy, in all patients and had remained unchanged at the first evaluation by the authors (median 3 months, range 2-4 months). In 1 case, the open biopsy had to be interrupted because the patient experienced excruciating pain. Four (16.7%) patients developed motor deficits. Subsequent surgery was hampered by scar formation and intratumoral hemorrhage in 5 (20.8%) patients. The initial diagnosis obtained by biopsy differed from the final histopathological diagnosis in all patients, of whom 21 (87.5%) had BPNTs, 2 (8.3%) malignant peripheral nerve sheath tumors, and 1 (4.2%) an ancient schwannoma.
    CONCLUSIONS: Biopsies of PNTs are controversial and may result in misdiagnosis, neuropathic pain, or neurological deficit due to axonal damage, and they may also hinder microsurgical resection when if performed when not indicated. Indications for biopsy of an MUOPON must be carefully considered, especially if BPNT is a possible diagnosis.
    Keywords:  BPNT; MPNST; benign peripheral nerve tumor; biopsy; malignant peripheral nerve sheath tumor; soft-tissue neoplasms
    DOI:  https://doi.org/10.3171/2023.5.JNS23385
  6. J Korean Soc Radiol. 2023 Sep;84(5): 1176-1180
    Imaging Findings of Axillary Granular Cell Tumor in a Patient with Breast Cancer History: A Case Report.
    Jeongeum Oh, Ji Yeon Park, Mee Joo.
      Granular cell tumors (GCTs) are rare soft tissue tumor, originating from neural or perineural cells. We present a case of axillary GCT in a 69-year-old woman with breast cancer history and discuss the various radiologic findings. US revealed a circumscribed oval heterogeneous iso- and hyperechoic mass in the left axilla. Chest CT showed a well-defined, oval, and mildly enhancing mass in the left axilla on the lateral aspect of the pectoralis muscle. A final diagnosis of GCT was made through US-guided core needle biopsy. Follow-up US showed no significant changes in the axillary GCT. Familiarity with GCT may facilitate early diagnosis and subsequent management.
    Keywords:  Axilla; Computed Tomography, X-Ray; Granular Cell Tumor; Ultrasound
    DOI:  https://doi.org/10.3348/jksr.2022.0167
  7. Interdiscip Cardiovasc Thorac Surg. 2023 Oct 24. pii: ivad169. [Epub ahead of print]
    Giant intrathoracic cystic schwannoma resected by video-assisted thoracoscopic surgery.
    Domenico Pourmolkara, Antonio Giulio Napolitano, Eleonora Coviello, Francesco Puma.
      Schwannoma is a benign tumour originating from the Schwann cells. Patients can remain asymptomatic, as the onset of symptoms usually depends on the compressive effect on adjacent organs; dimensional and morphological variability increase the time for the diagnosis. We report the case of a successful surgical resection, performed by video-assisted thoracoscopic surgery (VATS), on a patient with radiological evidence of a massive cystic intrathoracic neoformation, histologically revealed to be a peculiar Schwannoma.
    Keywords:  Intercostal nerve Schwannoma; VATS; cystic Schwannoma; neurogenic tumour
    DOI:  https://doi.org/10.1093/icvts/ivad169
  8. Cancer Commun (Lond). 2023 Oct 27.
    Targeted STAT1 therapy for LZTR1-driven peripheral nerve sheath tumor.
    Tonci Ivanisevic, Mikhail Steklov, Benoit Lechat, Christopher Cawthorne, Willy Gsell, Greetje Vande Velde, Christophe Deroose, Koen Van Laere, Uwe Himmelreich, Raj N Sewduth, Anna A Sablina.
      
    DOI:  https://doi.org/10.1002/cac2.12490
  9. Medicina (Kaunas). 2023 Oct 02. pii: 1761. [Epub ahead of print]59(10):
    Colorectal Carcinomas: Searching for New Histological Parameters Associated with Lymph Node Metastases.
    Aura Jurescu, Adrian Văduva, Octavia Vița, Adelina Gheju, Remus Cornea, Codruța Lăzureanu, Anca Mureșan, Marioara Cornianu, Sorina Tăban, Alis Dema.
      Background and Objectives: Colorectal cancer (CRC) continues to be an essential public health problem. Our study aimed to evaluate the prognostic significance of classic prognostic factors and some less-studied histopathological parameters in CRC. Materials and Methods: We performed a retrospective study on 71 colorectal carcinoma patients who underwent surgery at the "Pius Brînzeu" County Clinical Emergency Hospital in Timișoara, Romania. We analyzed the classic parameters but also tumor budding (TB), poorly differentiated clusters (PDCs) of cells, tumor-infiltrating lymphocytes (TILs), and the configuration of the tumor border on hematoxylin-eosin slides. Results: A high degree of malignancy (p = 0.006), deep invasion of the intestinal wall (p = 0.003), an advanced stage of the disease (p < 0.0001), lymphovascular invasion (p < 0.0001), perineural invasion (p < 0.0001), high-grade TB (p < 0.0001), high-grade PDCs (p < 0.0001), infiltrative tumor border configuration (p < 0.0001) showed a positive correlation with lymph node metastases. Conclusions: The analyzed parameters positively correlate with unfavorable prognostic factors in CRC. We highlight the value of classic prognostic factors along with a series of less-known parameters that are more accessible and easier to evaluate using standard staining techniques and that could predict the risk of relapse or aggressive evolution in patients with CRC.
    Keywords:  colorectal carcinomas; lymph node metastasis; poorly differentiated clusters; prognostic factors; tumor border configuration; tumor budding
    DOI:  https://doi.org/10.3390/medicina59101761
  10. J Hand Surg Asian Pac Vol. 2023 Oct 25.
    Plexiform Schwannoma of Digital Nerve.
    Yuji Saeki, Yasunori Hattori, Satish Annabhau Mane, Kazuteru Doi.
      Plexiform schwannoma is an uncommon benign tumour that grows in a plexiform pattern. We report a 47-year-old man with a mass on the palmar aspect of the metacarpophalangeal joint of the right index finger that had been growing gradually for more than 10 years. The mass was palpated from the distal carpal tunnel to the ulnar aspect of the proximal interphalangeal joint of the index finger, with tingling and numbness sensation. The tumour was a multinodular tumour involving the first common palmar digital nerve to the ulnar proper palmar digital nerve. It was resected and reconstructed with a sural nerve graft. Plexiform schwannoma is rare in the digital nerve, with only six cases reported. Generally, classic schwannomas can be enucleated without causing neurologic deficits; however, plexiform schwannoma may require nerve resection. There have been reports of recurrence of plexiform schwannoma; definitive resection and long-term follow-up are necessary. Level of Evidence: Level V (Therapeutic).
    Keywords:  Digital nerve; Nerve graft; Plexiform neurofibroma; Plexiform schwannoma; Resection
    DOI:  https://doi.org/10.1142/S2424835523720190
  11. J Pak Med Assoc. 2023 Oct;73(10): 2118-2120
    Spinal Schwannomas; Classification, Management And Outcomes.
    Ayesha Sohail, Anam Tariq, Qurat-Ul-Ain Virani, Hafiza Fatima Aziz, Muhammad Shahzad Shamim.
      Schwannomas are benign tumours of the peripheral nerve sheath. When they occur in spine, they are most commonly found in intradural-extramedullary location. Surgery is the mainstay of treatment. Radiation has a limited role in the management of residual or recurrent lesions not suitable for surgery. Here we discuss the existing literature on the outcomes of spinal schwannoma after surgery.
    DOI:  https://doi.org/10.47391/JPMA.23-75
  12. J Surg Oncol. 2023 Oct 24.
    Do resected colorectal cancer patients need early chest imaging? Impact of clinicopathologic characteristics on time to development of pulmonary metastases.
    Nathaniel Deboever, Erin M Bayley, Michael A Eisenberg, Wayne L Hofstetter, Reza J Mehran, David C Rice, Ravi Rajaram, Jack A Roth, Boris Sepesi, Stephen G Swisher, Ara A Vaporciyan, Garrett L Walsh, Brian K Bednarski, Van K Morris, Mara B Antonoff.
       BACKGROUND AND OBJECTIVES: For patients with colorectal cancer (CRC), the lung is the most common extra-abdominal site of distant metastasis. However, practices for chest imaging after colorectal resection vary widely. We aimed to identify characteristics that may indicate a need for early follow-up imaging.
    METHODS: We retrospectively reviewed charts of patients who underwent CRC resection, collecting clinicopathologic details and oncologic outcomes. Patients were grouped by timing of pulmonary metastases (PM) development. Analyses were performed to investigate odds ratio (OR) of PM diagnosis within 3 months of CRC resection.
    RESULTS: Of 1600 patients with resected CRC, 233 (14.6%) developed PM, at a median of 15.4 months following CRC resection. Univariable analyses revealed age, receipt of systemic therapy, lymph node ratio (LNR), lymphovascular and perineural invasion, and KRAS mutation as risk factors for PM. Furthermore, multivariable regression showed neoadjuvant therapy (OR: 2.99, p < 0.001), adjuvant therapy (OR: 6.28, p < 0.001), LNR (OR: 28.91, p < 0.001), and KRAS alteration (OR: 5.19, p < 0.001) to predict PM within 3 months post-resection.
    CONCLUSIONS: We identified clinicopathologic characteristics that predict development of PM within 3 months after primary CRC resection. Early surveillance in such patients should be emphasized to ensure timely identification and treatment of PM.
    Keywords:  chest surveillance; colorectal pulmonary metastasis; colorectal resection
    DOI:  https://doi.org/10.1002/jso.27490
  13. J Neurosurg. 2023 Aug 18. 1-2
    Editorial. Nerve sheath tumors and biopsies of the future.
    Suganth Suppiah, Rajiv Midha.
      
    DOI:  https://doi.org/10.3171/2023.6.JNS231103
  14. Cancers (Basel). 2023 Oct 13. pii: 4975. [Epub ahead of print]15(20):
    Peptidergic Systems as Antitumor Targets: A Right Direction to Fight Cancer?
    Francisco D Rodríguez, Rafael Coveñas.
      Undoubtedly, much progress has been made in treating cancer over the past few years, but unfortunately, 28 [...].
    DOI:  https://doi.org/10.3390/cancers15204975
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