Aims/Background Probiotics, including Bacillus licheniformis, have been shown to mitigate intestinal inflammation and mucositis by modulating gut microbiota and immune responses; however, their role in radiation-induced gastrointestinal (GI) injury remains unclear. This study aims to investigate the effects of Bacillus licheniformis supplementation on radiotherapy-induced GI dysfunction, inflammation, and survival rates in pediatric patients with medulloblastoma. Methods A total of 205 pediatric patients with medulloblastoma admitted to Jinhua Municipal Central Hospital between March 2015 and March 2020 were divided into an experimental group and a control group based on treatment protocols. All patients received craniospinal irradiation (CSI). Patients in the experimental group received an oral Bacillus licheniformis preparation (one capsule, three times daily) starting one day before CSI and continuing through the completion of radiotherapy, while the control group did not receive the probiotic. Post-radiotherapy adverse reactions were recorded. Serum levels of endothelin (ET), C-reactive protein (CRP), tumor necrosis factor alpha (TNF-α), interleukin 1 beta (IL-1β), and interleukin 6 (IL-6) were measured one day before the first radiotherapy session and one day after the final session. A five-year follow-up was conducted to assess patients' survival rates. Results Most of the pediatric medulloblastoma patients developed varying degrees of gastrointestinal symptoms after CSI, with fewer cases observed in the experimental group compared to the control group (all p < 0.05). Serum levels of ET, CRP, TNF-α, IL-1β, and IL-6 significantly increased post-radiotherapy in both groups, but the rise was markedly attenuated in the experimental group (all p < 0.001). However, no significant differences were found in 5-year progression-free survival (hazard ratio [HR] = 1.060, log rank p = 0.716) or overall survival (HR = 1.275, log rank p = 0.350) rates between the two groups. Conclusion Bacillus licheniformis preparation effectively alleviates CSI-induced gastrointestinal dysfunction and inflammation in pediatric patients with medulloblastoma, but does not significantly improve their survival rates.

Melanoma is the most common malignancy during pregnancy, with incidence rates rising globally. While most studies focus on prognosis, limited data exist on melanoma in the early post-partum period.

This multicentre European study aimed to characterize the epidemiologic and clinicopathologic features of pregnancy-associated melanoma (PAM) and assess whether these tumours differ from melanomas not associated with pregnancy.

We identified 1,270 women of reproductive age (15-49 years) diagnosed with melanoma between 2012 and 2022 across six melanoma centres in five European countries.

Among them, 70 cases (5.5%) were classified as PAM (range: 1.2%-14.3%). Compared to non-PAM patients, women with PAM were younger (mean age 35.7 years; p < 0.001) and more likely to have a high nevus count (p = 0.031). The majority of PAMs (80.0%) were superficial spreading, and mean Breslow thickness was 1.16 mm; 12.9% were ulcerated. Notably, 57.1% developed on a pre-existing nevus. Histopathologic features were similar between groups, except for tumour-infiltrating lymphocytes (TILs): non-PAM tumours exhibited significantly more dense TILs (p = 0.012), possibly indicating a stronger immune response. Median follow-up was 5.5 years. Recurrence-free survival did not significantly differ between groups; the 5-year recurrence-free survival rate was 95%.

Although pregnancy does not appear to adversely impact melanoma prognosis, PAM demonstrates some distinct clinical features that warrant further investigation given the fact that it affects a substantial proportion of women of reproductive age diagnosed with melanoma. The frequent occurrence of PAM on pre-existing nevi highlights the importance of raising public awareness and promoting dermatologic evaluation of suspicious lesions during pregnancy.

There are many benign skin neoplasms encountered in dermatopathology practice that can be associated with underlying genetic disorders. Although benign themselves, these lesions can offer insight into the potential for development of internal malignancies in patients with these hereditary syndromes. An astute dermatopathologist will recognize clues that suggest a syndromic association of these lesions, such as the presence of multiple lesions, distinct histologic growth patterns, and the results of ancillary immunohistochemical testing. The dermatopathologist can then guide the referring clinician to obtain additional clinical and family history and, if appropriate, pursue further screening and genetic testing. This review article will provide an overview of the clinical and histologic features associated with select common and uncommon benign skin neoplasms with syndromic associations.

Feminizing adrenocortical tumors (FATs) are an exceedingly rare subset of adrenal neoplasms, typically affecting adult men and characterized by an excess of estrogen, suppressed gonadotropins, and gynecomastia. Most FATs are malignant, with a poor prognosis and a high risk of recurrence.

We report the case of a 24-year-old male with bilateral gynecomastia, abdominal mass symptoms, and one year of unexplained infertility. A hormonal evaluation revealed elevated estradiol (90.1 pg/mL) and suppressed ACTH (2.6 pg/mL), with inappropriately normal cortisol levels (12.1 µg/dL). Imaging identified a right adrenal mass. The patient underwent open adrenalectomy, and histopathology confirmed stage II adrenocortical carcinoma (T2NxM0) with autonomous estradiol secretion, negative margins, and a Ki-67 index of 10%. Postoperatively, gonadal function normalized, and infertility resolved at two months. The multidisciplinary tumor board considered but did not initiate adjuvant mitotane, given the completely resected low-stage disease.

This case illustrates the rare presentation of feminizing adrenocortical carcinoma with reversible infertility and highlights the importance of early recognition and close surveillance. In addition, our literature review of 12 male cases reported between 2015 and 2025 emphasizes gynecomastia as the hallmark presentation and discusses emerging evidence supporting active surveillance as a potential alternative to adjuvant mitotane in selected low-risk patients.

Background and Clinical Significance: Adenoid cystic carcinoma (ACC) is a rare neoplasm of salivary glands, accounting for approximately 2-4% of all ACCs of head and neck malignancies. Adenoid cystic carcinoma (ACC) of the larynx is exceedingly rare, accounting for only 0.07-0.25% of all laryngeal tumors. Within the larynx, ACC may arise in various locations; however, the subglottic region is most commonly affected, representing approximately 64% of cases. ACC typically manifests as a slow-growing tumor with a pronounced tendency for perineural invasion and local recurrence. Current treatment strategies primarily involve surgical resection followed by adjuvant radiotherapy. Chemotherapy demonstrates limited efficacy and is generally reserved for advanced, recurrent, or metastatic disease. Given the rarity of this malignancy and the limited number of cases reported in the literature, we aim to contribute to the existing body of knowledge by presenting a clinical case of laryngeal ACC. Case Presentation: A 77-year-old male with a significant smoking history (more than 20 cigarettes per day for over 40 years) presented to our department in October 2023 with persistent dysphonia lasting several months. Endoscopic evaluation of the upper aerodigestive tract revealed an extensive neoplastic lesion involving the larynx. Contrast-enhanced computed tomography (CT) confirmed the presence and extent of the lesion. The patient subsequently underwent surgical resection and was referred for adjuvant postoperative radiotherapy. Unfortunately, the patient died of a myocardial infarction a few days before radiotherapy could be initiated. Conclusions: Due to the rarity of laryngeal adenoid cystic carcinoma, further studies are necessary to define optimal management strategies. Sharing clinical experiences and outcomes is essential, as there is currently no universally accepted treatment consensus for this uncommon malignancy. At the same time, our aim is to highlight the importance of histological subtype and perineural invasion which have to be considered as important prognostic factors when dealing with ACC.

Background and Clinical Significance: Mucinous tubular and spindle cell carcinoma (MTSCC) is an uncommon subtype of renal cell carcinoma, representing 1-4% of epithelial renal tumors. It usually shows a low-grade morphology and indolent behavior, although sarcomatoid variants with an aggressive course have been described. Because of its overlap with papillary renal cell carcinoma (papRCC), sarcomatoid RCC, mesenchymal tumors, and oncocytic neoplasms, diagnosis requires the integration of imaging, histopathology, and immunohistochemistry. Case Presentation: We report a 71-year-old female who presented with a three-month history of right-sided lumbar pain and intermittent hematuria. Her laboratory tests were unremarkable. Contrast-enhanced CT revealed a well-circumscribed nodular lesion in the mid-portion of the right kidney, measuring 50 × 47 × 52 mm. The patient underwent right nephrectomy. Macroscopic findings revealed an encapsulated, yellowish-gray nodule (5.2 × 5 × 4 cm) without renal pelvis invasion. Microscopically, the tumor consisted of cuboidal- to spindle-shaped cells arranged in cords and tubular structures within a mucinous stroma, with focal necrosis and foamy macrophages. Immunohistochemistry showed positivity for CK19, CK7, EMA, PAX8, and AMACR, with a Ki-67 index <10%, while CD117, RCC, CD10, and chromogranin were negative. Together, the low Ki-67 proliferation index, absence of invasion, and low-grade histological architecture confirmed MTSCC of low malignant potential. At a five-year follow-up, the patient remained disease-free. Conclusions: MTSCC is a rare renal neoplasm that can be diagnosed by integrating clinico-radiological, histopathological, and immunophenotypic features. Molecular profiling may further distinguish MTSCC from papRCC and identify aggressive variants. Surgical excision remains the cornerstone of management, supported by vigilant long-term follow-up.

Background: Artificial intelligence tools are increasingly being used to assist literature reviews, but their effectiveness compared to traditional methods is not well established. This study compares Scopus AI with PubMed keyword searches on the topic of primary prepectoral breast reconstruction after radical mastectomy. Methods: On 28 May 2025, two literature searches were conducted on the topic of primary prepectoral breast reconstruction after radical mastectomy-one using Scopus AI and the other using manual keyword searches in PubMed. Both searches were limited to peer-reviewed clinical studies in English, excluding case reports and studies with fewer than 10 patients. Data extracted included study design, sample size, outcomes, and key findings. Results: The Scopus AI search retrieved 25 articles, while the traditional method identified 4. After removing duplicates, non-English texts, and non-relevant sources, 17 articles were included in the final analysis. Scopus AI provided automatic summaries, while manual review was required for the traditional method. No overlap was found between the two methods. Conclusions: AI tools like Scopus AI can enhance the speed and breadth of literature reviews, but human oversight remains essential to ensure relevance and quality. Combining AI with traditional methods may offer a more balanced and effective approach for clinical research.

The present study investigated the role of YWHAH in colorectal cancer (CRC) progression, focusing on its regulation of autophagy via the MAPK/ERK signaling pathway and subsequent effects on cell migration and invasion. Clinical sample analysis revealed that YWHAH was highly expressed in CRC tissues, associating with poor differentiation, advanced TNM stage, lymph node metastasis, vascular invasion and unfavorable prognosis. In vitro experiments showed that YWHAH overexpression promoted proliferation, and epithelial‑mesenchymal transition of CRC cells, while inhibiting apoptosis. Conversely, YWHAH knockdown exerted opposite effects. Autophagy assays demonstrated that YWHAH knockdown enhanced autophagy by upregulating autophagy related 7 and LC3II/I and downregulating P62, whereas overexpression suppressed autophagy. Mechanistically, YWHAH negatively regulated the MAPK/ERK pathway [reducing phosphorylated (p)‑ERK1/2 and p‑ELK‑1 levels] to inhibit autophagy. The ERK inhibitor PD98059 reversed autophagy activation by YWHAH knockdown, while the ERK agonist U‑46619 reversed autophagy suppression by YWHAH overexpression. Additionally, the autophagy inhibitor 3‑methyladenine abrogated the inhibitory effects of YWHAH knockdown on migration and invasion, and the autophagy inducer rapamycin reversed the promoting effects of YWHAH overexpression. In vivo, nude mouse xenograft models confirmed that YWHAH inhibited autophagy via the MAPK/ERK pathway to accelerate tumor growth. These findings underscore the role of YWHAH as a critical regulator of CRC progression and suggest it as a potential therapeutic target. Interventions targeting YWHAH or its downstream factors may provide innovative approaches for treating CRC, particularly by modulating autophagy to inhibit tumor growth and metastasis.

Hepatocellular carcinoma (HCC), the predominant form of primary liver cancer, represents a substantial global health challenge with limited treatment options. The voltage‑dependent anion channel (VDAC), a critical mitochondrial outer membrane protein, has emerged as a pivotal regulator in HCC pathogenesis. Dysregulation of VDAC expression and function disrupts mitochondrial metabolism, confers resistance to apoptosis and promotes tumor proliferation. Mechanistically, VDAC facilitates HCC progression through metabolic reprogramming, evasion of programmed cell death and crosstalk with multiple oncogenic signaling pathways. Current VDAC‑targeted therapeutic approaches, including small‑molecule inhibitors and metabolic modulators, have demonstrated promising preclinical efficacy in inducing apoptosis and suppressing tumor growth. Notably, these agents may overcome therapeutic resistance and exhibit synergistic effects with conventional therapies. However, several challenges persist, particularly in elucidating isoform‑specific functions, optimizing pharmacokinetic profiles and identifying predictive biomarkers for patient stratification. The present comprehensive review critically evaluates the mechanistic involvement of VDAC in HCC progression, assesses emerging targeting strategies and proposes future research directions to establish VDAC as a viable precision medicine target for HCC management.

Liquid‑liquid phase separation (LLPS) contributes to multiple cellular bioprocesses; however, its clinicopathological relevance to oral squamous cell carcinoma (OSCC) remains largely unexplored. In the present study an integrative multi‑omics analysis investigating the prognostic value and molecular functions of LLPS‑related genes (LLPSRGs) in OSCC was conducted by leveraging transcriptomics and clinical data from 302 cases in The Cancer Genome Atlas database and LLPSRGs. A total of two prognostically distinct molecular subtypes were stratified by unsupervised clustering analysis, and a robust prognostic signature comprising seven key LLPSRGs was developed through LASSO regression and multivariate Cox analysis. Functional enrichment analysis highlighted the involvement of this signature in epithelial‑mesenchymal transition (EMT), with PHLDB2 emerging as a core regulator. Notably, the PHLDB2 protein underwent LLPS and formed droplet condensates both outside and in OSCC cells. Moreover, functional experiments revealed that PHLDB2 depletion attenuated the malignant biological behavior of OSCC cells, including cell proliferation, stemness, invasion and migration, and PHLDB2 promoted OSCC progression by regulating the PI3K‑Akt signaling pathway and PIK3CA expression. Retrospective clinical cohort and public dataset analyses validated that high expression of PHLDB2 was significantly associated with lymph node metastasis, higher pathological grade and reduced survival in patients with OSCC. Collectively, the present study established an LLPS‑based prognostic signature for OSCC, and revealed that phase separation of PHLDB2 may drive OSCC progression through regulating EMT and PIK3CA.