Tuberculosis (TB) remains a major cause of morbidity and mortality worldwide, particularly among patients with human immunodeficiency virus (HIV) infection. Esophageal involvement is an exceedingly rare manifestation of extrapulmonary tuberculosis. Owing to its clinical and endoscopic features, it may mimic neoplastic disease, thereby complicating early diagnosis. We present the case of an immunocompromised patient with constitutional symptoms and dysphagia. Upper gastrointestinal endoscopy revealed a large ulcerated esophageal lesion highly suggestive of malignancy; however, histopathological and microbiological examination confirmed its infectious etiology.

The branching patterns of the facial nerve (FN) vary among individuals, which may affect the risk of surgical complications.

The aim of this study is to examine the relationship between FN branching patterns and clinical variables including facial paralysis in patients undergoing parotidectomy in our clinic and to reveal the region-specific anatomical distribution of the FN.

Data from 39 patients who underwent parotidectomy were analyzed. In all cases, the main trunk of the FN was located at the exit of the stylomastoid foramen and dissected. Intraoperative nerve monitoring was used in all cases. The branching patterns of the FN were categorized according to the Davis and Alomar classifications. The relationship between these two classifications and the variables was statistically analyzed.

Of patients, 53.8% were female and 46.1% were male, with an average age of 47.59 ± 16.12 years. The mean length of the main trunk of the FN was 15.44 ± 3.51 mm. The interbranch anastomosis rate was 74.36%. In the Alomar classification, the most frequent subtype was IB2 (51.28%), while in the Davis classification, Type I (25.64%) and Type III (25.64%) were the most frequent. The rate of facial paralysis (FP) in the early postoperative period was determined to be 33.3%. A significant association was found between malignant tumors and the development of FP ( P = 0.035 ).

Understanding the branching patterns of the FN and regional anatomical variations is critical for improving surgical success during parotidectomy. Among clinical variables, malignant histopathology is the strongest predictor of FP.

Primary retroperitoneal mucinous tumors are rare. In this study, a 19-year-old female with a giant retroperitoneal ovarian mucinous cystadenoma and superinfection was reported, alongside an analysis of 85 cases. The patient had fever and a palpable mass, with imaging showing a 23 cm x 13 cm x 27 cm cystic lesion and elevated levels of CA199 and ferritin. The tumor was fully removed and confirmed as a mucinous cystadenoma with infection. Our review shows that these tumors mainly occur in young to middle-aged adults (86.1%) and vary in size (3-30 cm) and about 17.3% of tumors are giant (>20 cm). High CA125 and CA199 levels may indicate borderline or malignant changes. The pathology is diverse, often with benign, borderline, and malignant areas in the same tumor and benign types can progress to malignancy. Effective treatment relies on complete surgical removal. Although benign and borderline types have good outcomes, malignant mucinous cystadenocarcinomas have a high recurrence rate (33.3%) after tumor removal alone. This risk is greatly reduced with additional hysterectomy and bilateral salpingo-oophorectomy. Our research highlights the importance of early surgery, and provides practical management advice for this rare condition.

The clinical management of gastric cancer is challenged by profound tumor heterogeneity and the emergence of drug-resistant cell populations. Ferroptosis, a regulated form of iron-dependent cell death driven by lipid peroxidation, has exhibited limited clinical efficacy as a monotherapy. Emerging evidence shows that selective autophagy pathways can promote ferroptosis.

In this study, integrated analysis of ferroptosis-associated autophagy genes (FARGs) was conducted to explore their application potential in improving therapeutic outcomes. By leveraging transcriptomic and clinical data from The Cancer Genome Atlas and Gene Expression Omnibus databases, a prognostic model was developed using univariate Cox regression followed by Least Absolute Shrinkage and Selection Operator (LASSO) regression, which identified 11 FARGs exhibiting robust prognostic performance across multiple cohorts.

Functional enrichment analysis revealed distinct pathway activations: extracellular matrix remodeling was enriched in high-risk patients, whereas interferon-mediated immune responses were heightened in low-risk patients. Further tumor microenvironment characterization revealed that high-risk patients displayed an immunosuppressive phenotype marked by M2 macrophage infiltration, upregulation of immune checkpoint molecules, and elevated stromal activity. By contrast, low-risk patients were associated with a higher prevalence of microsatellite instability-high status and increased tumor mutational burden, which are biomarkers predictive of favorable responses to immune checkpoint inhibitors. Investigation into autophagy-ferroptosis crosstalk highlighted the central role of lipid metabolism-related pathways. Aldehyde dehydrogenase 3A2 was also identified as a key biomarker, and functional validation confirmed its involvement in promoting cancer cell proliferation and migration.

Collectively, the FARG-based model developed here shows great application potential in stratifying patient responses to immunotherapy and developing personalized treatment strategies for gastric cancer.

Fuzi Lizhong (FZLZ) decoction is renowned for its traditional role in warming the middle jiao and treating spleen-stomach deficiency-cold syndrome, and recent studies have uncovered its novel and promising potential in regulating chronic inflammation and intercepting the critical transition from inflammation to cancer. This review systematically integrates and critically examines the emerging mechanisms through which FZLZ and its active components modulate key cellular signaling pathways in chronic inflammatory environments. By focusing specifically on the decoction's role in blocking "inflammation-cancer transformation"-a frontier area in both traditional and modern medicines-this article not only synthesizes current research advances but also identifies underexplored therapeutic targets and proposes new directions for future translational studies.

Angiogenesis is a crucial step in the growth and metastasis of invasive tumors. Tumor-induced angiogenesis is not due to a single factor; it involves activation of oncogenic signaling pathways and abnormal expression of angiogenesis-related genes within the complex tumor microenvironment (TME). Traditional research has primarily focused on the regulation of angiogenesis by protein-coding genes. In recent years, growing evidence has shown that long non-coding RNAs (lncRNAs) play important roles in angiogenesis. In this study, we systematically elucidate the molecular mechanisms by which lncRNAs regulate tumor-associated angiogenesis, including epigenetic, transcriptional, and post-transcriptional regulation. Furthermore, lncRNAs indirectly influence angiogenesis by regulating the functions of endothelial cells, cancer-associated fibroblasts, and tumor-associated macrophages within the TME. In addition, lncRNA-targeted therapeutic strategies have been summarized with specific emphasis on their potential integration with anti-angiogenic tumor therapy, including oligonucleotide-based silencing, restoration of tumor-suppressive lncRNAs, anti-vascular endothelial growth factor (VEGF)/VEGF receptor (VEGFR) combination strategies, and nanomaterial-mediated delivery systems. This review aims to provide a theoretical foundation for innovative research on vascular targeted therapy for tumors.

BackgroundBreast cancer is the most frequent malignancy among women worldwide. Despite advances in medical treatment, many survivors experience distressing symptoms and therapy-related side effects that impair quality of life. Acupuncture-related therapies are increasingly employed as supportive care strategies, yet their evidence base remains fragmented.ObjectiveTo construct an evidence map of systematic reviews (SRs) and meta-analyses evaluating acupuncture and related therapies for breast cancer-related symptoms.MethodsSearches were performed in PubMed, Embase, and Cochrane Database of Systematic Reviews, China National Knowledge Infrastructure (CNKI), Wanfang, Research Information Service System (RISS), Oriental Medicine Advanced Search Integrated System (OASIS), and Korean Studies Information Services System (KISS) from inception to April 24, 2025. Eligible SRs included breast cancer populations, any acupuncture-related intervention, and reported outcomes relevant to symptom management or treatment side effects. Data extraction included bibliographic details, intervention type, outcomes, number of studies, sample size, effect direction, and methodological quality (AMSTAR-2). Evidence was synthesized descriptively and presented using heatmaps.ResultsA total of 47 SRs with meta-analysis were included, covering 11 distinct symptom domains and 6 categories of interventions. The most frequently studied outcomes were hot flashes (n=9), general supportive care during chemotherapy (n=9), lymphedema (n=7), general side effect management (n=6), and aromatase inhibitor-associated arthralgia (n=4). The most common interventions were acupuncture (n=17), acupuncture combination therapies (n=16), and acupoint injection (n=9). Across the included SRs, 20 reported positive effects, 23 were mixed, and 4 reported no clear evidence of benefit. Only 8 of 47 SRs achieved moderate confidence, and none were rated high, indicating widespread methodological limitations across the evidence base (29 low, 10 critically low).ConclusionAcupuncture and related therapies are widely studied as supportive care strategies for breast cancer-related symptoms with promising evidence. However, the majority of SRs are of low methodological quality. High-quality trials and rigorously conducted systematic reviews are needed to strengthen the evidence base, reduce redundancy, and guide integrative oncology practice.

Non-small cell lung cancer (NSCLC) remains a major cause of cancer-related mortality, and treatment efficacy is frequently limited by acquired resistance and systemic toxicity. Glutathione-responsive abasic site-trapping prodrugs have shown selective anticancer activity in prior experimental studies, but whether their released metabolites also show meaningful interactions with cancer-relevant proteins remains to be established. Here, an integrated in silico workflow combining network pharmacology, molecular docking, molecular dynamics (MD), and molecular mechanics Poisson-Boltzmann surface area (MM-PBSA) analysis was used to prioritize testable protein-interaction hypotheses for two glutathione-responsive prodrugs (Compound 1 and Compound 2), their aminooxy-containing products (Compound 4 and Compound 5), and a matched non-trapping control pair (Compound 3 and Compound 6). Twenty-one intersecting compound- and disease-associated targets were identified, and AKT serine/threonine kinase 1 (AKT1), epidermal growth factor receptor (EGFR), tumor necrosis factor (TNF), matrix metalloproteinase 9 (MMP9), and SRC proto-oncogene non-receptor tyrosine kinase (SRC) were prioritized by protein-protein interaction topology. Compound 5 produced the most favorable single AutoDock Vina score with MMP9 (-8.418 kcal·mol⁻¹) and showed comparatively persistent docking-derived poses across the MMP9 and SRC MD trajectories. However, the top-ranked MMP9 pose did not show direct coordination of the catalytic Zn²⁺ ion or direct engagement of His401, Glu402, His405, or His411, so it cannot be assigned a canonical MMP9 inhibitory binding mode. MD and MM-PBSA analyses characterize only trajectory behavior and the relative energetic ranking of these complexes; they do not demonstrate intracellular target engagement, enzyme inhibition, or pathway regulation. The established abasic-site-trapping activity and the newly predicted protein interactions are therefore treated as separate, potentially parallel hypotheses rather than a demonstrated mechanistic chain. Overall, the results prioritize specific compound-target pairs for future testing but do not establish a multi-target anti-NSCLC mechanism.

Incidental thyroid nodules (ITNs) detected on nonthyroid imaging contribute to thyroid cancer overdiagnosis, largely through downstream evaluation initiated by thyroid ultrasound (TUS). However, TUS follow-up rates for ITNs and their drivers in routine practice remain unclear. We quantified TUS utilization after ITN detection and identified patient, imaging, nodule, and reporting factors associated with this first step in the diagnostic cascade.

We conducted a retrospective cohort study of adults without prior thyroid disease who underwent imaging that incidentally captured the thyroid at Mayo Clinic sites (2017-2023). A validated natural language processing pipeline identified ITNs and extracted nodule characteristics from radiology reports across multiple imaging modalities. The main outcome was the rate of TUS within 180 days after ITN detection. Clinical outcomes, including thyroid biopsy, thyroidectomy, and thyroid cancer diagnosis, were compared between patients who underwent TUS and those who did not. Factors associated with TUS utilization were assessed using multivariable logistic regression with penalized variable selection.

Among 115,683 patients who underwent thyroid-capturing imaging, 8426 (7.3%) had an ITN. These patients were predominantly female (64.6%) and White (89.7%), with a mean age of 61.7 years (standard deviation 15.2). Most nodules were detected on computed tomography (80.8%), most commonly from chest imaging (52.3%). Overall, 1677 patients with ITNs (19.9%) underwent TUS. In multivariable analysis, TUS use was independently associated with higher body mass index (odds ratio [OR], 1.20 per 10-unit increase; confidence interval [CI] [1.08-1.33]), nodule size ≥1.5 cm (OR, 1.79; CI [1.52-2.10]), and a radiologist recommendation (OR, 2.51; CI [2.12-2.98]), whereas older age was associated with lower odds of TUS (OR, 0.89 per 10-year increase; CI [0.84-0.93]). Patients undergoing TUS had higher rates of thyroid biopsy, partial thyroidectomy, and total thyroidectomy compared with those without it. All detected thyroid cancers (103 cases) occurred in the TUS group, representing 6.1% of that cohort.

One in five patients with ITNs underwent TUS, representing a critical gateway to downstream diagnostic procedures and thyroid cancer detection. Factors associated with TUS utilization highlight opportunities to better define appropriateness of ultrasound after incidental nodule detection and to reduce unnecessary testing and treatment.

Intimal sarcoma is a malignant mesenchymal tumour arising in large blood vessels of systemic and pulmonary circulation, depicted as undifferentiated and aggressive. Clinical presentation of these cardiac masses is often subtle, making misdiagnosis possible. We discuss the case of a 27-year-old woman with a recent history of delivery, admitted for dyspnoea and signs of right-heart failure. A diagnosis of pulmonary embolism was made on a computed tomography angiogram and transoesophageal echocardiography basis. Emergency surgery was performed due to haemodynamic instability. Pulmonary arteriotomy revealed a large solid polylobate mass instead of a thrombus. Surgical debulking, with reconstruction of the right ventricle outflow tract, and pulmonary valve replacement were therefore necessary. Partial pulmonary annulus reconstruction was furthermore performed with a strip of heterologous pericardium with a 'sandwich technique'. Prompt diagnosis of intimal sarcoma was made, permitting initiation of timely treatment with anthracycline. Surgical resection of malignancies involving either the heart or great vessels is uncommonly performed because of the potential morbidity and mortality and the unknown probability of significant cure. Preoperative imaging is then of paramount importance in determining the diagnosis and planning for surgery. In this specific case, the haemodynamic instability, the high suspicion of a thrombotic nature of the mass, and young age precluded the performing of any second-level examination, leading surgeons to an unexpected reconstruction.