Previous studies suggest that granulocyte colony-stimulating factor (G-CSF) drugs may increase the risk of certain cancers, but findings remain controversial. We employed a drug-target Mendelian randomization approach to investigate the causal relationship between G-CSF and 14 cancer types. The target gene of G-CSF drugs was sourced from the DrugBank database. Expression quantitative trait loci data for the target gene (CSF3R) were obtained from the expression quantitative trait loci Gen Consortium. Genome-wide association study data for the 14 cancers were retrieved from the FinnGen dataset. A Bonferroni correction was applied for multiple testing (P < .0036). Analyses were performed using the inverse variance weighted, Mendelian randomization-Egger, weighted median, weighted mode, and simple mode methods. Heterogeneity was assessed using Cochran Q test, and sensitivity analyses were conducted to verify the reliability of the findings. Inverse variance weighted analysis revealed a significant association between genetically proxied G-CSF exposure and an increased risk of lung squamous cell carcinoma (LUSC) [odds ratio: 1.61, 95% confidence interval: 1.20-2.17, P = 1.51 × 10-3] and a potential association with estrogen receptor-negative breast cancer (odds ratio: 1.26, 95% confidence interval: 1.06-1.50, P = 7.31 × 10-3). The association with LUSC remained significant after multiple testing correction. No statistically significant associations were found with the other 12 cancers. Sensitivity analyses indicated no evidence of heterogeneity or pleiotropy. While these results suggest a potential causal role of G-CSF in the development of LUSC and possibly estrogen receptor-negative breast cancer, their clinical implications (particularly regarding long-term G-CSF use) should be interpreted with caution. Further validation in large-scale prospective studies and diverse populations is essential before any clinical recommendations can be made. Our findings highlight the need for continued investigation into the long-term safety profiles of G-CSF and may contribute to a more nuanced understanding of its risk-benefit balance in specific clinical contexts.

Continuous invasive blood pressure monitoring is crucial during the perioperative period, particularly in high-risk and critically ill patients. In patients with Takayasu arteritis (TAK) and severe vascular stenosis, conventional arterial cannulation is often technically challenging because of vessel occlusion or fragile tissue. This case report explores the feasibility of using a central venous catheter instead of an arterial puncture kit for invasive blood pressure monitoring when standard arterial catheterization is impractical.

A 56-year-old female with a history of TAK presented for adrenalectomy.

Medical imaging revealed an adrenal tumor and TAK with multi-territorial vascular involvement (radial, brachial, and dorsalis pedis arteries).

The patient underwent adrenal tumor resection. Continuous invasive blood pressure was monitored under ultrasound guidance using an 18-gauge central venous catheter for femoral artery puncture.

The procedure was completed uneventfully with timely hemodynamic monitoring guided by reliable invasive measurements.

This alternative method has the potential to reduce the risk of intraoperative catheterization and ensure reliable intraoperative blood pressure monitoring when conventional puncture is impossible.

Extracranial metastases of primary brain tumors are rare, and there is no effective treatment. Here, we report a patient with anaplastic oligodendroglioma (AO, WHO grade III) who effectively delayed survival time after receiving temozolomide (TMZ), immunotherapy, and radiotherapy.

A 42-year-old man underwent surgery and chemoradiotherapy for AO, 41 months ago.

The patient developed lower back pain, and Positron emission tomography/computed tomography (PET/CT) did not detect any lesions other than the skeleton. Sacral aspirate smear showed atypic cell nests, and immunohistochemistry and fluorescence in situ hybridization testing supported the diagnosis of WHO grade III AO and IDH mutations.

The patient was treated with TMZ, immunotherapy, and local palliative radiotherapy and was stable for 6 months, but the medication was discontinued due to severe myelosuppression.

After drug withdrawal, the disease progressed further, with intracranial recurrence and metastasis to the liver, supraclavicular and axillary lymph nodes. The time from the diagnosis of extracranial metastasis to death was 10 months.

This case show that immunotherapy, oral low-dose TMZ and local palliative radiotherapy may be effective ways to prolong the survival of patients with extracranial metastasis and severe bone marrow suppression.

Infantile hemangioma (IH) is a noncancerous tumor commonly observed in pediatric patients, characterized by the proliferation of endothelial cells. Despite numerous studies on IH, there is a lack of comprehensive analysis and synthesis of research trends. This study aims to: examine the applicability of slope graphs in bibliometrics; identify the most significantly dominant entities; and determine if the h-indexes are consistent across all IH-related articles and the top 100 cited IH (T100IH) articles.

A comprehensive collection of IH-related publications from 2014 to 2023 was obtained from the Web of Science Core Collection, resulting in a total of 2000 articles. The analysis was conducted in 2 parts: the overall dataset of 2000 publications and a subset of the T100IH articles. An online R platform was used to analyze the data. The study findings were presented using various visual displays, including: performance analytics; trends and spot analyses for entities over the years using slope graphs; and impact beam plots for T100IH. The absolute advantage coefficient >0.70 was applied to identify significantly dominant entities over the next 2 counterparts.

Slope graphs provided more valuable information, demonstrating superiority over traditional spot trend views. The most dominant elements in each aspect were: the United States, Shanghai Jiao Tong University in China, the Dermatology department, author Yi Ji from China, the journal of Pediatric Dermatology, the year 2015, type of article, research area of Dermatology, and the keyword CHILDREN. The overall h-index was 47, slightly lower than the T100IH h-index of 49, as T100IH contains articles with Digital Object Identifier only. The journal of Pediatric Dermatology presented significantly dominant (i.e., absolute advantage coefficient = 0.80 > 0.70). Article type and journal are significantly dominant over time, particularly before 2020.

The use of slope graphs proved to be highly effective in generating insightful research trends and hotspots. This study suggests that slope graphs, which provide superior insights compared to traditional spot trend views, should be embraced as a valuable tool in future bibliometric analyses.

Cutaneous squamous cell carcinoma (cSCC) is the second most common nonmelanoma skin cancer. Treating aggressive cSCC in very elderly patients, especially centenarians with significant health issues, poses a major challenge due to the risks of standard surgical excision under general anesthesia. This report presents a novel palliative approach that combines limited surgical resection, open-wound management, and photodynamic therapy (PDT) for facial cSCC in a centenarian, suggesting it as a safe and effective alternative when conventional treatments are unsuitable.

A 101-year-old female patient presented with a rapidly enlarging cutaneous mass on the left side of her face, characterized by erosive lesions and a malodorous scent. The patient reported no history of trauma or significant sun exposure.

A computed tomography scan of the orbit identified a soft tissue shadow indicative of a mass located in the lateral aspect of the left orbit, whereas the remaining structures of both orbits appeared unremarkable, with intact bony walls. Clinical manifestations were suggestive of squamous cell carcinoma. Histopathological examination of the postoperative lesion tissue, utilizing hematoxylin-eosin staining, revealed a significant presence of squamous cells, along with scaly vortices, keratin pearls, and nuclear atypia, thereby confirming the diagnosis of squamous cell carcinoma.

The patient underwent a surgical resection in combination with PDT. Specifically, a straightforward surgical resection was executed with a 5-millimeter margin. The surgical incision was intentionally left open and not sutured. During the management of the open wound, PDT was administered.

The patient elected to undergo a surgical resection and a single PDT session, after which the wound gradually healed from the edges, drying without infection. Over 2 months, the wound healed by secondary intention, leaving a flat, stable scar. The patient was very satisfied with the cosmetic result and odor resolution. At a follow-up 7 months later, and until the patient's death from unrelated causes, there was no sign of local recurrence.

We suggest that surgery combined with open-wound and PDT could be a safe and effective treatment for squamous cell carcinoma in elderly patients and those with comorbidities who cannot undergo general anesthesia.

This study presents the first documented case suggesting a potential association between prepregnancy administration of 4 doses of mRNA corona virus disease-19 vaccine and the development of postpartum multi-organ nodules, including pulmonary micronodules and thyroid cysts. The purpose of this report is to delineate a clinical scenario involving 3 interrelated factors: vaccine-induced sustained immune activation, inadequately managed moderate anxiety during pregnancy, and significant lifestyle alterations such as a gluten- and dairy-free diet coupled with sleep deprivation. The significance of this case lies in its novel exposure profile and undocumented long-term implications, offering critical insights that may inform future reproductive health guidance and risk counseling.

A 34-year-old women who presented with incidental findings of asymptomatic bilateral diffuse pulmonary micronodules and thyroid cystic nodules (TI-RADS 1) during routine 6-month postpartum imaging.

Chest computed tomography and thyroid ultrasound confirmed multiple pulmonary micronodules coexisting with benign thyroid cystic nodules. Serial investigations ruled out metastasis, granulomatous disease, and classic autoimmune disorders.

A diagnostic monitoring strategy was implemented, including serial pulmonary computed tomography (6-month follow-ups) and thyroid ultrasound surveillance (12-month follow-ups), complemented by lifestyle rebalancing (gradual exercise reintroduction/sleep optimization) and psychological counseling for health-related anxiety. Pharmacological intervention was withheld to observe the natural evolution of nodule regression and immune homeostasis restoration.

During the ongoing follow-up period, there were no other improvements or deterioration developments.

This case suggests prepregnancy vaccine immune imprinting may become activated under gestational stress, potentially triggering subclinical inflammation via the hypothalamic-pituitary-adrenal axis-gut microbiota-cytokine network. Consequently, we propose the "V-SLAM" clinical framework (vaccine history/stress biomarkers/lifestyle factors/autoimmunity screening/multidisciplinary consultation), emphasizing the integration of vaccination records and psychological resilience assessment into preconception counseling, with cross-pregnancy immune-metabolic monitoring for high-risk women.

The incidence of hepatocellular carcinoma (HCC) has risen significantly in recent years, while current diagnostic and therapeutic approaches remain suboptimal. This study aimed to identify novel biomarkers and therapeutic targets to improve early detection and treatment outcomes. We conducted a comprehensive analysis of HCC-related gene expression datasets (GSE101685, GSE14520, and TCGA-LIHC). Differentially expressed genes (DEGs) were identified, followed by weighted gene co-expression network analysis (WGCNA) on the training cohort. A total of 313 shared genes were identified by intersecting 691 DEGs with 1653 genes from the "MEturquoise" module. Functional enrichment analyses, including gene ontology and Kyoto Encyclopedia of Genes and Genomes, were performed to explore the biological roles of these genes. Subsequently, 109 combinations of 12 machine learning algorithms were applied to identify HCC-specific feature genes. Gene set enrichment analysis and CIBERSORT were used to explore functional pathways and immune infiltration, respectively. Functional analyses revealed that the shared genes were primarily involved in cell cycle regulation and cell division. A total of 96 HCC feature genes were identified through 109 combinations of 12 machine learning algorithms. Among them, 5 novel genes (DNAJC12, KBTBD11, SEC24B, PLSCR4, SH3YL1) with no prior association with HCC were found to have significantly lower expression in tumor samples and were validated for their diagnostic value using receiver operating characteristic analysis. Gene set enrichment analysis further showed their association with immune responses, metabolic processes, and cell cycle regulation. Immune infiltration linked DNAJC12, KBTBD11, and SEC24B to the HCC immune microenvironment. Our study identified 5 previously unreported genes as potential diagnostic biomarkers and therapeutic targets for HCC. These findings provide a new perspective for the molecular characterization and clinical management of hepatocellular carcinoma.

Pulmonary artery pseudoaneurysm (PAP) is a rare but life-threatening vascular complication, often associated with infections, trauma, or malignancies. Rupture of PAP can lead to massive hemoptysis with high mortality. Lung cancer-related PAP is exceptionally rare, particularly in adenocarcinoma, and is underrecognized due to its small size and subtle imaging findings.

A 47-year-old woman with low back pain for 3 months was diagnosed with right lower lobe lung adenocarcinoma (cT2bN0M1, IVa). After chemoradiotherapy, the tumor regressed but formed a cavity. She subsequently developed sudden massive hemoptysis (400 mL), leading to airway obstruction and death.

Imaging revealed a soft-tissue mass invading the right lower pulmonary artery, with subsequent formation of a small PAP (0.5 × 0.4 cm). Biopsy confirmed lung adenocarcinoma. Retrospective computed tomography analysis identified the PAP, attributed to tumor invasion and treatment-induced vascular damage.

The patient underwent intensity-modulated radiotherapy (40Gy/20F) followed by 4 cycles of chemotherapy (pemetrexed, bevacizumab, and cisplatin). After hemoptysis, PAP embolization was planned but not performed due to rapid clinical deterioration.

Despite initial tumor stabilization, the patient succumbed to fatal hemoptysis caused by PAP rupture. A posthumous multidisciplinary review confirmed the pseudoaneurysm as the cause.

Enhanced vascular monitoring is essential in lung cancer patients, especially during tumor regression and posttreatment phases. Small PAPs, though subtle, carry lethal potential. Early detection and multidisciplinary intervention are critical to prevent fatal outcomes.

Bronchogenic cysts (BCs) are congenital anomalies typically located in the mediastinum or lung, with ectopic presentations in the neck being exceptionally rare. The potential for compressive symptoms and malignant transformation underscores the need for precise surgical resection.

A 53-year-old female presented with a self-palpable cervical mass and notable dysphagia. Medical imaging revealed a well-defined cystic lesion in the anterior cervical region.

The histopathological analysis post-resection confirmed a bronchogenic cyst lined by ciliated columnar epithelium consistent with ectopic foregut development.

Intraoperative neuromonitoring (IONM) was used to assist the complete resection of the cyst through the transcervical approach.

The cyst was completely excised with preservation of vocal cord function intact. Postoperative follow-up over 12 months revealed no symptomatic recurrence, and imaging studies demonstrated no evidence of residual or recurrent lesions.

This clinical case highlights the criticality of considering BCs in cervical midline masses and demonstrates the efficacy of Magnetic resonance imaging (MRI) in differentiating ectopic BCs from adjacent tissues. Complete surgical resection combined with IONM optimized surgical safety, particularly in anatomically challenging regions near the recurrent laryngeal nerve (RLN).

Cellular angiofibroma (CAF) is a rare benign mesenchymal tumor, which is difficult to diagnose due to its lack of specificity in clinical and imaging manifestations. This case highlights the challenges in the preoperative diagnosis of inguinoscrotal CAF and emphasizes the necessity of histopathologic confirmation.

A 53-year-old male was found to have a mass in the right inguinal area for 2 years, which had consciously increased for over a month. During the course of the disease, the patient did not experience any significant discomfort.

Physical examination showed a mass in the right inguinal area, about 14 cm in length, with a tough texture and good mobility. Imaging examinations (including ultrasound, computed tomography, and magnetic resonance imaging) have confirmed the presence of a mass in the right inguinal region, adjacent to the right spermatic cord. A benign tumor was suspected based on the clinical symptoms and imaging findings.

The patient underwent a complete surgical resection of the tumor under intravenous anesthesia. The tumor is gray-yellow in color, with a capsule, and can be separated from surrounding tissues.

The surgery was successfully completed without any special discomfort to the patient, and the final pathological diagnosis was CAF. At 3 and 6 months, ultrasound examination showed no signs of tumor recurrence.

Accurate histopathological examination and long-term follow-up are key to ensuring a good prognosis for CAF patients.