bims-netuvo Biomed News
on Nerves in tumours of visceral organs
Issue of 2023–12–10
twelve papers selected by
Maksym V. Kopanitsa, The Francis Crick Institute
  1. Targeting beta-adrenergic receptor pathways in melanoma: how stress modulates oncogenic immunity.
  2. Causal associations between schizophrenia and cancers risk: a Mendelian randomization study.
  3. Unusual Clinical Presentation of a Benign Peripheral Nerve Sheath Tumor of the Radial Nerve.
  4. A rare case of a median nerve schwannoma: Case report.
  5. Establishment and validation of a nomogram model for preoperative prediction of the risk of cholangiocarcinoma with perineural invasion.
  6. Risk factors affecting oncological outcomes of surgical resections for middle and lower rectal cancer.
  7. Adjuvant chemotherapy combined with immunotherapy in patients with cholangiocarcinoma after radical resection.
  8. Challenging Diagnosis: Unmasking the Enigma of Imaging Findings with Lung Schwannomas.
  9. Schwannoma and Post-vaccine Changes: A Case Report.
  10. [Thoracoscopic Resection of Schwannoma Using Intraoperative Neurophysiological Monitoring: Report of a Case].
  11. An Unusual Finding of a Neurogenic Tumor of the Trachea: A Tracheal Schwannoma.
  12. Differentiating gastric schwannoma from gastric stromal tumor (≤5 cm) by histogram analysis based on iodine-based material decomposition images: a preliminary study.
  1. Melanoma Res. 2023 Dec 04.
    Targeting beta-adrenergic receptor pathways in melanoma: how stress modulates oncogenic immunity.
    Benjamin Switzer, Igor Puzanov, Shipra Gandhi, Elizabeth A Repasky.
      The intricate pathways of the sympathetic nervous system hold an inherently protective role in the setting of acute stress. This is achieved through dynamic immunomodulatory and neurobiological networks. However, excessive and chronic exposure to these stress-induced stimuli appears to cause physiologic dysfunction through several mechanisms that may impair psychosocial, neurologic, and immunologic health. Numerous preclinical observations have identified the beta-2 adrenergic receptor (β2-AR) subtype to possess the strongest impact on immune dysfunction in the setting of chronic stressful stimuli. This prolonged expression of β2-ARs appears to suppress immune surveillance and promote tumorigenesis within multiple cancer types. This occurs through several pathways, including (1) decreasing the frequency and function of CD8 + T-cells infiltrating the tumor microenvironment (TME) via inhibition of metabolic reprogramming during T cell activation, and (2) establishing an immunosuppressive profile within the TME including promotion of an exhausted T cell phenotype while simultaneously enhancing local and paracrine metastatic potential. The use of nonselective β-AR antagonists appears to reverse many chronic stress-induced tumorigenic pathways and may also provide an additive therapeutic benefit for various immune checkpoint modulating agents including commonly utilized immune checkpoint inhibitors. Here we review the translational and clinical observations highlighting the foundational hypotheses that chronic stress-induced β-AR signaling promotes a pro-tumoral immunophenotype and that blockade of these pathways may augment the therapeutic response of immune checkpoint inhibition within the scope of melanoma.
    DOI:  https://doi.org/10.1097/CMR.0000000000000943
  2. Front Oncol. 2023 ;13 1258015
    Causal associations between schizophrenia and cancers risk: a Mendelian randomization study.
    Kai Zhou, Lin Zhu, Nian Chen, Gang Huang, Guangyong Feng, Qian Wu, Xiao Wei, Xiaoxia Gou.
       Background: Previous observational studies have reported inconsistent findings regarding the incidence of cancer in patients with schizophrenia compared to the general population. The causal relationship between schizophrenia and cancer remains unclear and requires further investigation.
    Objective: To investigate the causal relationship between schizophrenia and cancer.
    Methods: In this study, a two-sample Mendelian randomization (MR) analysis was conducted using publicly available genome-wide association studies to determine the causal relationship. The effect estimates were calculated using the random-effects inverse-variance-weighted method.
    Results: We determined a causal relationship between genetic predisposition to schizophrenia and cancer, with schizophrenia increasing lung cancer (odds ratio (OR) = 1.0007; 95% confidence interval (CI), 1.0001-1.0013; p = 0.0192), thyroid cancer (OR = 1.5482; CI, 1.1112-2.1569; p =0.0098),colorectal cancer (OR = 1.0009; CI, 1.0001-1.0018; p = 0.0344), ovarian cancer (OR = 1.0770; CI, 1.0352-1.1203; p = 0.0002), breast cancer (OR = 1.0011; CI, 1.0001- 1.0022; p =0.0352) and reduced the risk of malignant neoplasm of the stomach (OR = 0.8502; CI, 0.7230-0.9998; p = 0.0496).
    Conclusions: This study conducted a two-sample MR analysis and discovered a positive causal relationship between schizophrenia and breast, ovarian, thyroid, lung, and colorectal cancers. On the other hand, an inverse causal relationship was found between schizophrenia and malignant neoplasm of the stomach.
    Keywords:  Mendelian randomization; TSMR; cancer; causal association; schizophrenia
    DOI:  https://doi.org/10.3389/fonc.2023.1258015
  3. Eplasty. 2023 ;23 e64
    Unusual Clinical Presentation of a Benign Peripheral Nerve Sheath Tumor of the Radial Nerve.
    Liron S Duraku, George P Esworthy, Mohammad Nassimizadeh, Hadyn Kn Kankam, Dominic M Power.
      Diagnosis of simple benign peripheral nerve tumors (PNT) is usually based on imaging studies and in most cases, surgical excision leads to no significant functional deficit. The clinical presentation is often asymptomatic with incidental imaging findings. We present an unusual clinical presentation of a benign peripheral nerve sheath tumor of the radial nerve.
    Keywords:  Nerve Tumors; Perineuroma; Radial Nerve; Reconstruction
  4. Radiol Case Rep. 2024 Jan;19(1): 479-482
    A rare case of a median nerve schwannoma: Case report.
    Najwa Amsiguine, Salma El Houss, Mohamed Mouhssani, Nabil Moatassim Billah, Nassar Ittimad.
      A median nerve schwannoma is an uncommon type of tumor that develops from Schwann cells in the peripheral nerves. We present a case report of a young prisoner with a rare median nerve schwannoma presenting as a swelling on the anterior aspect of the right wrist along the radial edge, with associated paresthesia and a positive Tinel's sign. The case was diagnosed using MRI which showed the target sign of biphasic contrast enhancement in both the mass's center and periphery as well as distinct encapsulation. The mass was managed with surgical excision which confirmed the mass to be a neurilemmoma. The radiological finding for neurinomas are not specific and the diagnosis cannot be established unless an excision is made, as neurinomas share common radiological signs with other peripheral nerve tumors and vascular tumors. This case highlights the importance of considering nerve sheath tumors, however rare, in the differential diagnosis of wrist masses, even in young patients with no history of trauma.
    Keywords:  MRI; Median nerve; Paresthesia; Schwannoma; Wrist
    DOI:  https://doi.org/10.1016/j.radcr.2023.09.105
  5. Am J Cancer Res. 2023 ;13(11): 5082-5093
    Establishment and validation of a nomogram model for preoperative prediction of the risk of cholangiocarcinoma with perineural invasion.
    Maobing Wang, Zhaowei Sun, Qinlei Wang, Jingyun Guo, Xueliang Li, Jie Chen, Bingyuan Zhang, Dongdong Dai, Yujie Feng.
       OBJECTIVE: To establish and validate a nomogram model for predicting the risk of cholangiocarcinoma with perineural invasion.
    METHODS: We retrospectively collected the clinical data of 356 patients with surgically confirmed cholangiocarcinoma, including 98 cases of extrahepatic cholangiocarcinoma (eCCA), 197 cases of intrahepatic cholangiocarcinoma (iCCA), and 61 cases of perihilar cholangiocarcinoma (pCCA).
    RESULTS: Based on these data, we determined the influencing factors of preoperative perineural invasion risk in patients with cholangiocarcinoma by forward multivariate regression analysis. Based on these variables, we established two nomogram models. The model variables for predicting perineural invasion of eCCA included prothrombin time, high-density lipoprotein and tumor size (all P<0.05). The consistency index (C-index) of internal and external validation was 0.845 and 0.806, respectively. In addition, the model variables for predicting perineural invasion of iCCA included carcinoembryonic antigen, carbohydrate antigen 19-9 and tumor size (all P<0.05). The internal and external validation of the C-index was 0.735 and 0.886, respectively. Both models have considerable results in terms of calibration accuracy and clinical decision-making. Kaplan-Meier survival analysis showed that the survival time of patients with perineural invasion was significantly reduced (P=0.033).
    CONCLUSIONS: We established a predictive model for preoperative perineural invasion in patients with iCCA and eCCA, and this model can provide good predictive value for clinicians. However, we have not obtained relevant predictive variables for predicting perineural invasion of pCCA, and the number of modeling cases was relatively small, so this study needs to be further explored.
    Keywords:  Cholangiocarcinoma; extrahepatic cholangiocarcinoma; intrahepatic cholangiocarcinoma; perineural invasion; preoperative prediction
  6. Turk J Surg. 2023 Sep;39(3): 197-203
    Risk factors affecting oncological outcomes of surgical resections for middle and lower rectal cancer.
    İsmail Tırnova, Özgen Işık, Ahmet Tuncay Yılmazlar.
       Objectives: In our study, it was aimed to evaluate the factors affecting oncological outcomes in resections for rectal cancer.
    Material and Methods: Between January 2010 and December 2014, patients with rectal tumors were analyzed retrospectively. Demographic and pathological data and oncological outcomes were analyzed as disease-free survival, overall survival, and local recurrence.
    Results: A total of 158 patients' data were obtained. Median age was 60 (22-83). Fifty-three patients were older than 65 years of age (138). Ninety-five (60%) patients were males, and 63 (40%) were females. Eighty patients (50.4%) had middle rectal, and 78 (49.6) patients had lower rectal cancer. There was no effect of tumor localization on oncological outcomes. Univariate analyses revealed the effects of age (p= 0.003), operation type (p <0.001), nodal status (p <0.001), malignant lymph node ratio (p <0.001), stage of the disease (p <0.001), distal resection margin (p= 0.047), perineural invasion (p <0.001), lymphatic invasion (p <0.001), venous-vascular invasion (p= 0.025), local recurrence (p <0.001) and distant metastasis (p <0.001) on overall survival rates. Univariate analyses revealed the effects of nodal status (p= 0.007), malignant lymph node ratio (p= 0.005), stage of the disease (p= 0.008), perineural invasion (p= 0.004) and venous-vascular invasion (p <0.001) on disease-free survival rates. Univariate analyses revealed the effects of anastomotic leak (p= 0.015) and venous-vascular invasion (p= 0.001) on local recurrence rates.
    Conclusion: Older age, advanced nodal status, and distant metastasis were detected as independent risk factors for overall survival. Perineural and venous-vascular invasion were detected as independent risk factors for disease-free survival. Lastly, anastomotic leak and venous-vascular invasion were detected as independent risk factors for local recurrence.
    Keywords:  Rectal cancer; local recurrence; rectal surgery; survival
    DOI:  https://doi.org/10.47717/turkjsurg.2023.5946
  7. Cancer Med. 2023 Dec 07.
    Adjuvant chemotherapy combined with immunotherapy in patients with cholangiocarcinoma after radical resection.
    Xiao-Hui Li, En-Liang Zhou, Chong-Yu Zhao, Bo-Kang Cui, Xiao-Yuan Dong, Hang Du, Xiao-Jun Lin.
       BACKGROUND: The malignancy of cholangiocarcinoma is highly pronounced, and it exhibits a propensity for recurrence and metastasis even in the presence of standard chemotherapy. The efficacy of adjuvant chemotherapy combined with immunotherapy in patients with resected cholangiocarcinoma needs to be substantiated.
    METHODS: Data from 101 patients with cholangiocarcinoma treated at the Sun Yat-sen University Cancer Center between 2015 and 2020 were studied.
    RESULTS: After propensity score matching, there were no significant differences in baseline characteristics between patients in the combined adjuvant chemotherapy and immunotherapy group (AC + IM group) and the adjuvant chemotherapy alone group (AC group) (all p > 0.05). The AC + IM group demonstrated a statistically significant improvement in relapse-free survival (RFS) compared to the AC group (p = 0.032). Likewise, the AC + IM group exhibited a significantly superior overall survival (OS) outcome when compared to the AC group (p = 0.044). Multivariate Cox analysis unveiled perineural invasion (p = 0.041), lymph node metastasis (p = 0.006), and postoperative immunotherapy (p = 0.008) as independent prognostic factors exerting a significant impact on the OS of patients. In the cohort of patients with perineural invasion, the AC + IM group exhibited significantly improved OS compared to the AC group (p = 0.0077). Similarly, within the subset of patients with lymph node metastasis, the AC + IM group exhibited a significantly superior OS outcome when compared to the AC group (p = 0.023).
    CONCLUSION: Combining postoperative adjuvant chemotherapy with immunotherapy extends the RFS and OS of patients with cholangiocarcinoma following radical resection.
    Keywords:  chemotherapy; cholangiocarcinoma; immunotherapy; survival
    DOI:  https://doi.org/10.1002/cam4.6738
  8. Cancer Manag Res. 2023 ;15 1343-1347
    Challenging Diagnosis: Unmasking the Enigma of Imaging Findings with Lung Schwannomas.
    Cui-Ping Li, Lei Li, Lin-Ming Su, Shu-Sheng Zhu, Meng-Jie Li.
      Schwannomas are benign slow-growing tumors arising from the embryonic neural crest cells of the nerve sheaths of peripheral and cranial nerves, and they are a rare type of soft tissue mass that is usually always solitary. Generally, it grows in the head, neck, and flexor portions of the limbs, where many nerves are located. Schwannomas of the lung are extremely rare. Fewer than ten cases of schwannomas in this organ region have been reported in the existing literature. In this case report, a 40-year-old male non-smoker was hospitalized with occasional chest pain. His chest computed tomographic scan revealed a 3.8 cm space occupying lesion in the upper lobe of the right lung. This lesion has clear boundaries and uneven internal density. And it was concluded as a benign lesion possibility, it is preferred to be considered as a haematoma. This space occupying lesion was eventually confirmed as a schwannoma by needle biopsy tissues. Due to the presence in rare locations, such as the lung, the clinical presentation of this space occupying lesion is non-specific, making diagnosis difficult. The data presented in this case report can help clinicians to obtain information on the identification of this disease, which highlighted lung schwannoma as a differential diagnosis for patients with intermittent pain. It can also alert clinicians and radiologists to observe every detail of the radiology imaging findings.
    Keywords:  diagnosis; lung cancer; schwannoma; solitary pulmonary nodule; thoracic radiology
    DOI:  https://doi.org/10.2147/CMAR.S441736
  9. Cureus. 2023 Nov;15(11): e48223
    Schwannoma and Post-vaccine Changes: A Case Report.
    Martha-Lilia Tena-Suck, Steven-Andrés Piña-Ballantyne, Jesús Cienfuegos-Meza, Marco-Antonio Jiménez-López, Andrea Ávalos-Arias.
      Schwannomas are benign sheaths of Schwann cells that can present with degenerative and morphological changes; necrosis or hemorrhage are rare findings in these tumors. We present the case of a 28-year-old man with a C2-C4 cervical Schwannoma who experienced upper limb paresthesia in 2020 while presenting with COVID-19 symptoms. The patient later recovered and came to our institution, where surgery was scheduled one year after the initial diagnosis. One week before surgery, the patient received the first dose of the Moderna vaccine. Despite being asymptomatic, the patient underwent successful total resection of the schwannoma, which was confirmed histologically. However, extensive necrosis with abundant foamy macrophages was observed, suggesting a possible link to post-vaccine effects.
    Keywords:  cervical schwannoma; covid-19 vaccine; hemorrhages and macrophages; necrosis; secondaries changes
    DOI:  https://doi.org/10.7759/cureus.48223
  10. Kyobu Geka. 2023 Oct;76(11): 989-992
    [Thoracoscopic Resection of Schwannoma Using Intraoperative Neurophysiological Monitoring: Report of a Case].
    Emi Sakai, Kazuki Nakahara, Satsuki Kina, Shigeki Miyanaga.
      A 28-year-old right-handed woman had been diagnosed with a tumor of 30 mm in a diameter at the right first intercostal space adjacent to brachial nerve plexus. It was incidentally detected by medical checkup examination five years ago. Because the tumor enlarged to 36 mm in five years without any symptoms, thoracoscopic tumor resection was planned for diagnosis. Intraoperative neurophysiological monitoring (IONM) was performed to prevent brachial plexus nerve injury. The tumor was totally removed via thoracoscopic approach without postoperative neurological deficit. Histopathological diagnosis was schwannoma. In order to reduce the risk of neural injury, IONM is useful in thoracoscopic removal of the peripheral nerve tumor.
  11. Cureus. 2023 Nov;15(11): e48172
    An Unusual Finding of a Neurogenic Tumor of the Trachea: A Tracheal Schwannoma.
    Juan D Botero, María Pérez Restrepo, Mauricio A Murillo, Felipe Campo, Luis Correa.
      We report a rare case of a 57-year-old female patient with intraluminal tracheal obstruction caused by a benign schwannoma. She underwent successful bronchoscopic resection under general anesthesia, with no complications observed during the post-procedure follow-up. Tracheal schwannomas are exceedingly uncommon, and while conventional treatment involves surgical resection, bronchoscopic techniques, such as laser ablation, can be a valuable alternative, particularly for high-risk patients. Further studies are needed to explore the full potential of bronchoscopic interventions in managing tracheal schwannomas.
    Keywords:  argon laser; bronchoscopy; interventional pulmonology; schwannoma; tracheal neoplasms
    DOI:  https://doi.org/10.7759/cureus.48172
  12. Front Oncol. 2023 ;13 1243300
    Differentiating gastric schwannoma from gastric stromal tumor (≤5 cm) by histogram analysis based on iodine-based material decomposition images: a preliminary study.
    Gang Wang, Xianwang Liu, Junlin Zhou.
       Objective: This study aims to investigate the value of histogram analysis based on iodine-based material decomposition (IMD) images obtained through dual-energy computed tomography (DECT) to differentiate gastric schwannoma (GS) from gastric stromal tumor (GST) (≤5 cm) preoperatively.
    Methods: From January 2015 to January 2023, 15 patients with GS and 30 patients with GST (≤5 cm) who underwent biphasic contrast-enhanced scans using DECT were enrolled in this study. For each tumor, we reconstructed IMD images at the arterial phase (AP) and venous phase (VP). Nine histogram parameters were automatically extracted and selected using MaZda software based on the IMD of AP and VP, respectively, including mean, 1st, 10th, 50th, 90th, and 99th percentile of the iodine concentration value (Perc.01, Perc.10, Perc.50, Perc.90, and Perc.99), variance, skewness, and kurtosis. The extracted IMD histogram parameters were compared using the Mann-Whitney U-test. The optimal IMD histogram parameters were selected using receiver operating characteristic (ROC) curves.
    Results: Among the IMD histogram parameters of AP, the mean, Perc.50, Perc.90, Perc.99, variance, and skewness of the GS group were lower than that of the GST group (all P < 0.05). Among the IMD histogram parameters of VP, Perc.90, Perc.99, and the variance of the GS group was lower than those of the GST group (all P < 0.05). The ROC analysis showed that Perc.99 (AP) generated the best diagnostic performance with the area under the curve, sensitivity, and specificity being 0.960, 86.67%, and 93.33%, respectively, when using 71.00 as the optimal threshold.
    Conclusion: Histogram analysis based on IMD images obtained through DECT holds promise as a valuable tool for the preoperative distinction between GS and GST (≤5 cm).
    Keywords:  gastric neoplasms; histogram analysis; iodine-based material decomposition map; schwannoma; stromal tumor
    DOI:  https://doi.org/10.3389/fonc.2023.1243300
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