Tumor immunoediting is a dynamic process of interaction between the host immune system and tumor cells and encompasses three sequential phases: elimination, equilibrium, and escape. It plays a central regulatory role in melanoma initiation, progression, and therapeutic response. Currently, increasing attention has been directed toward the complexity of the melanoma tumor microenvironment, in which functional dysregulation of immune cell subsets, imbalance of cytokine networks, and alterations in the metabolic milieu collectively drive the process of immunoediting. However, most existing studies have focused on individual phases or isolated factors, and a comprehensive understanding of the entire immunoediting process and its systematic associations with tumor heterogeneity and resistance to immunotherapy remains insufficient. This review summarizes recent advances in tumor immunoediting within the melanoma tumor microenvironment, with particular emphasis on the regulatory mechanisms through which individual components of the immune microenvironment influence different phases of immunoediting, providing a theoretical basis for optimizing melanoma immunotherapy and identifying novel therapeutic targets.

Solitary fibrous tumor (SFTs) of the head and neck (H&N) are rare mesenchymal neoplasms with varied clinical behavior. Since 2019, advances in immunohistochemistry, particularly nuclear STAT6 expression, have improved diagnostic accuracy. A comprehensive update is needed to reassess clinical presentation, diagnosis, and outcomes.

The aim of this systematic review was to evaluate the clinical presentation, diagnosis, management, and outcomes of solitary fibrous tumor of the head and neck reported between June 2019 upto 10th June 2025. The review includes pooled analysis of demographics, tumor characteristics, histopathologic and immunohistochemical features, treatment approaches, recurrence rates, and follow-up outcomes among patients diagnosed with H&N SFTs.

Eligible studies were English-language case reports, case series, and observational studies that reported solitary fibrous tumor arising in the head and neck region in humans. Exclusion criteria included non-English publications, non-H&N SFTs, editorials, review articles, and studies without individual patient data. Two independent reviewers performed screening and full-text assessment based on PRISMA guidelines, resolving discrepancies by consensus. Of 503 identified studies, 103 met inclusion criteria (36.1%).

The review included 103 studies comprising 281 patients with head and neck SFTs. The median age was 47 years (range: 6 months-84 years); 53% were female. Common sites included the oral cavity (27.5%), orbit (18.5%), and sinonasal region (13.3%). Most patients presented with painless swelling. Histologically, tumor demonstrated spindle cell morphology; 99.1% were STAT6-positive. Surgical excision was the primary treatment in 96.4% of cases, with negative margins achieved in 85%. Recurrence occurred in 10.3%, primarily associated with positive margins, increased mitotic activity, and nuclear atypia. Adjuvant radiotherapy was administered in 5.3% of cases. Distant metastases were rare (<5%). The average follow-up period was 25 months.

Head and neck SFTs exhibit indolent behavior but carry a risk of recurrence, especially in tumors with high-risk histologic features. STAT6 immunohistochemistry is highly sensitive and should be considered the gold standard for diagnosis. Complete surgical excision with negative margins is essential for optimal outcomes. This review underscores the need for long-term follow-up in patients with H&N SFTs to detect late recurrences or metastasis.

The online version contains supplementary material available at https://doi.org/10.1007/s12663-026-02990-1.

Although gestational trophoblastic diseases (GTD) is common, its coexistence with a viable twin pregnancy is a rare phenomenon. The occurrence of such a pregnancy, with reports of prior exposure to M2-tone in early pregnancy, has not been documented before. To the best of our knowledge, this is the first of such a case in Uganda.

A 30 years old, black African Ugandan, gravida 3para 1+1 at 19⁺⁴ weeks of amenorrhoea (WOA) presented at Mbale RegionalReferral Hospital (MRRH) in September 2024. She had had a viable term vaginal delivery 5 years ago, that was followed by secondary infertility, for which, no treatment was sought. She subsequently had two natural conceptions. The second pregnancy was lost at 3 months of amenorrhoea following a spontaneous abortion. During the current pregnancy, she was put on M-2 tone (Ayurveda tablets) for 2 months and oral progesterone 10 mg daily till 12 weeks of amenorrhoea. During her fourth antenatal care (ANC) contact, it was noticed that she had gained excessive weight for the WOA. Further assessment revealed exaggerated symphysio-fundal height (SFH). The obstetric scan requested for showed features of viable foetus coexisting with a molar pregnancy. Three prior ultrasound scans had apparently reported a normal pregnancy. Serum beta human chorionic gonadotrophin hormone was very high for WOA. During the pregnancy and peripartum period, she developed obstetric complications but delivered a viable foetus, with a placenta that showed clinical evidence of molar pregnancy. Follow up has revealed resolution of symptoms and no gestational trophoblastic neoplasia (GTN) sequelae.

Molar twin pregnancy with a viable foetus is associated with various maternal and perinatal adverse outcomes and presents management challenges. Whether early pregnancy exposure to M2-tone is a risk factor cannot be elucidated. Close antenatal and postnatal surveillance should be instituted to rule out GTN sequelae.

Head and neck oncologic reconstruction requires adaptable flaps to restore function and esthetics. The systematic review assesses the efficacy and complications of five distant axial pedicled flaps (DAPF): pectoralis major myocutaneous flap (PMMF), supraclavicular artery island flap (SAIF), deltopectoral flap (DPF), trapezius muscle flap (TMF), and latissimus dorsi pedicled flap (LDPF).

Adhering to PRISMA guidelines, we reviewed data from 131 studies encompassing 5481 patients. Inclusion criteria were limited to studies evaluating adult head and neck cancer patients reconstructed with one of the five options. Parameters analyzed included size, location, early and late complications, functional and aesthetic outcomes.

PMMF was the most frequently used flap (77%), covering an average defect size of 67.7 cm², and proved effective for extensive and complex reconstructions. Both SAIF and DPF flaps were advantageous for medium defects, with SAIF showing superior aesthetic satisfaction and low complication rates (2%). PMMF had higher dehiscence rates (9%) and flap necrosis (< 1%).

Pedicled flaps offer reliable reconstructive options when free flaps are contraindicated. PMMF is optimal for large defects, while SAIF is preferred for medium defects prioritizing aesthetics. Other options are rarely contemplated. Future studies should aim to standardize outcome measures and investigate long-term functional outcomes.

Our study aims to explore the types of diseases that may cause eosinophilia and the changes in the disease spectrum of different degrees of eosinophilia.

We retrospectively analyzed patients who were admitted to the First Affiliated Hospital of Soochow University from July 1, 2023 to June 30, 2024, and had at least twice eosinophilia (absolute eosinophil count [ACE] > 0.5 × 109/L, the interval between the two tests was ≥ 3 days). Eosinophilia was classified as mild (1.5 × 109/L ≥ ACE > 0.5 × 109/L), moderate (5 × 109/L ≥ AEC > 1.5 × 109/L), or severe (AEC > 5 × 109/L).

A total of 1821 patients were included, with a median age of 56 years (2-96 years), including 1252 males (68.8%) and a median ACE of 1.02 × 109/L (0.53-41.35). Here, 1679 cases were diagnosed with diseases that may be related to eosinophilia, allergic diseases were the most common (21.7%, 364/1679). Eight cases of clonal eosinophilia were diagnosed as myeloid/lymphoid neoplasms with eosinophilia and tyrosine kinase gene fusions (MLN-TK). Around 91 patients were diagnosed as idiopathic eosinophilia after a series of screening. Here, 71.7% (1305/1821) of the patients showed mild eosinophilia, allergic diseases (21.7%, 283/1305) were still the main secondary factors, 23.6% (430/1821) of the patients showed moderate eosinophilia, hematological malignancies became the most common secondary factors (20.5%, 88/430), and 86 patients had severe eosinophilia, nearly half (40/86) of the patients were secondary to hematological malignancies.

Eosinophilia has a wide range of age, and is more common in males. Allergic diseases are the most common secondary factors. Different levels of eosinophilia have different causes.

Trial Registration: The authors have confirmed clinical trial registration is not needed for this submission.

Juxtaglomerular cell tumor (reninoma) is a rare benign renal neoplasm causing secondary hypertension via autonomous renin over-secretion, which is extremely rare in children and adolescents. Here we report a 13-year-old boy with a two-year misdiagnosis of resistant hypokalemic hypertension, who underwent unnecessary left adrenalectomy based on ambiguous adrenal computed tomography (CT). Biochemical tests revealed hyperreninemic hyperaldosteronism with normal aldosterone-to-renin ratio. Renal artery CT identified a tiny low-density lesion in the upper pole of the left kidney, while contrast-enhanced ultrasound (CEUS) clearly displayed characteristic hypoperfusion of the mass. Selective renal vein sampling (SRVS) failed to demonstrate a lateralized renin gradient, a finding consistent with the known low sensitivity of this test for small juxtaglomerular cell tumors (JGCT). Laparoscopic nephron-sparing tumorectomy was performed, and histopathological and clinical features together supported the diagnosis of reninoma. Blood pressure and serum electrolytes normalized postoperatively without antihypertensive or potassium supplementation, with complete quantitative biochemical and imaging surveillance confirming stable remission over the 3-year follow-up. This case highlights that CEUS acts as a radiation-free auxiliary localization modality for suspected pediatric reninoma and provides complementary functional information when SRVS yields false-negative results; definitive diagnosis requires integrated assessment of clinical manifestations, biochemical markers, multimodal imaging, and pathological findings rather than relying on a single imaging technique. Clinicians should raise vigilance of reninoma in children with refractory hypokalemic hypertension to avoid misdiagnosis and unnecessary adrenal surgery.

We have evaluated PBA-0111, a fully human antibody targeting Glycoprotein A Repetitions Predominant (GARP), designed to induce both antibody-dependent cellular cytotoxicity (ADCC) as well as blockage of Transforming Growth Factor Beta 1 (TGF-β1) activation. Functional assessments included in vitro cytotoxicity assays, inhibition of GARP/TGF-β1 complex formation and inhibition of TGF-β1 signaling. PBA-0111 was compared with clinically tested anti-GARP antibodies, including DS-1055a- and ABBV-151-like antibodies. Lack of significant binding to human platelets was confirmed by flow cytometry. Anti-tumor efficacy in vivo was assessed in CD34⁺ human stem cell humanized mice xenograft models, including models where GARP was expressed both on tumor cells and regulatory T cells as well as models where GARP was expressed exclusively on regulatory T cells. The potential of PBA-0111 to stimulate immune cell activation inside tumors was further studied in a placebo-controlled Phase 0 clinical study in soft tissue sarcoma patients receiving intra-tumoral injections.

Our findings demonstrate that PBA-0111 exhibits ADCC activity comparable to DS-1055a-like antibody, which was not observed for ABBV-151-like antibody. PBA-0111 effectively blocks TGF-β1 activation, similar to ABBV-151-like antibody but unlike DS-1055a-like antibody. In contrast to ABBV-151, which blocks TGF-β1 activation within the pre-formed GARP/TGF-β1 complex, PBA-0111 prevents GARP/TGF-β1 complex formation itself. Importantly, PBA-0111 did not demonstrate significant binding to human platelets. In humanized mice, whether GARP was expressed on tumor cells or exclusively on Tregs, PBA-0111 treatment induced robust inhibition of tumor growth, whereas DS-1055a-like antibody did not demonstrate any statistically significant anti-tumor efficacy in these models. Tumor growth inhibition by PBA-0111 was accompanied by cytotoxic T cell activation. A similar trend of T cell activation was observed in soft tissue sarcoma patients receiving intra-tumoral injections of PBA-0111 in the Phase 0 clinical trial.

These results underscore the therapeutic potential of PBA-0111 as a dual-functioning immunotherapy and a promising candidate for the treatment of GARP-positive cancers. This integrated mechanism may amplify anti-tumor immunity, improve synergy with checkpoint inhibitors, and provide more durable reprogramming of the tumor microenvironment than either approach alone.

CBFA2T3::GLIS2-positive myeloid neoplasms occur predominantly in infants and can closely mimic pediatric small round cell sarcomas. We describe a 14-month-old boy who presented with left leg pain, an abnormal gait, and a destructive left ischial mass. Tissue biopsy was initially interpreted as an undifferentiated Ewing-like sarcoma. Bone marrow aspiration contained approximately 2% unclassified large cells, while trephine biopsy demonstrated focal tumor infiltration. Marrow tumor cells showed strong CD56 and weak CD61 expression and were positive for WT1, CD43, ERG, CD117, and BCL2. Lysozyme, MPO, TdT, and CD71 were negative. Diagnostic bone marrow flow cytometry was not performed. Molecular studies on pelvic lesion tissue showed negative results on EWSR1 break-apart fluorescence in situ hybridization (FISH). Broad RNA fusion testing detected CBFA2T3::GLIS2, joining CBFA2T3 exon 11 to GLIS2 exon 3, without a covered Ewing or Ewing-like sarcoma-defining fusion. After one cycle of cyclophosphamide, doxorubicin, and vincristine under the provisional sarcoma diagnosis, treatment was redirected to a 10-day course of cytarabine, etoposide, and daunorubicin. Severe myelosuppression was managed with anti-infective and supportive therapy. Subsequent marrow morphology, trephine biopsy, and flow cytometry showed no evident residual tumor. Follow-up MRI demonstrated marked reduction of the pelvic mass, although residual osseous abnormalities persisted. The patient subsequently continued treatment elsewhere. Available records documented additional targeted therapy and maternal haploidentical hematopoietic stem cell transplantation (HSCT). The first reported post-transplant molecular assessment detected no CBFA2T3::GLIS2 fusion transcript. Detailed post-transfer treatment parameters and long-term outcomes were unavailable. This case highlights the value of integrated tissue and marrow assessment and broad RNA fusion testing in EWSR1-negative infantile small round cell tumors.

Gastric cancer (GC) is closely associated with microbial dysbiosis; however, the spatial-temporal characteristics of the gut, paracancerous, and intratumoral microbiomes, as well as their interrelationships during tumor progression, remain insufficiently defined. This study aimed to characterize these microbiomes in 85 GC patients from Northwest China using shotgun metagenomic sequencing and functional annotation. Clinical samples included feces, tumor tissues, and paratumor mucosal tissues (≥5 cm from the tumor margin), enabling comprehensive profiling of microbial composition at the phylum, genus, and species levels, as well as functional pathway analysis. The results showed that the microbial community was dominated by Firmicutes and Bacteroidetes (combined relative abundance >75%), maintaining structural stability across tumor stages II-IV (Stage I n=2 is only descriptively reported and excluded from formal statistical testing), thereby supporting the "core microbiota resilience" hypothesis. PERMANOVA revealed that tumor stage had a statistically significant yet modest effect on community structure (R² = 0.039, P = 0.032). MaAsLin2 identified stage-associated differential genera: Roseburia and Megamonas decreased with advancing stage, whereas Lactobacillus and Enterobacter were enriched in advanced stages (III/IV). Functional pathway analysis revealed stage-specific metabolic remodeling: Stage II was enriched in DNA repair, glycolysis, aromatic amino acid, and nucleotide biosynthesis pathways; Stage IV showed enrichment in protein deamination/demethylation, pyruvate fermentation, and coenzyme metabolism pathways. Correlation analysis further revealed a characteristic pattern of "pathogen enrichment and beneficial bacteria depletion." Fusobacterium nucleatum and Helicobacter pylori exhibited strong positive correlations with GC, whereas short-chain fatty acid-producing bacteria such as Roseburia and Faecalibacterium prausnitzii showed significant negative correlations, particularly in paracancerous tissues. We established multi-layered taxonomic correlation profiles based on intra-cohort microbial shifts, in which Bacteroides stercoris and Bifidobacterium pseudocatenulatum exhibited the most pronounced stage-related abundance changes in the fecal microbiota across tumor stages. Overall, this study systematically delineates the structural stability, stage-specific functional remodeling, and interrelated dynamics of gut, paracancerous, and intratumoral microbiomes in gastric cancer. These findings provide descriptive baseline data of cross-compartment microbiome variation within gastric cancer patients across tumor stages, which only deliver preliminary correlative clues of GC-related microbial shifts and require further multi-cohort verification with non-cancer control populations.

Carbonic anhydrase IX (CAIX)-targeted PET/CT is an emerging molecular imaging approach for clear cell renal cell carcinoma (ccRCC). This systematic review aimed to summarize the clinical evidence on CAIX-targeted PET/CT for ccRCC detection and characterization.

PubMed/MEDLINE, Embase, and the Cochrane Library were searched on March 29, 2026, according to PRISMA 2020. Original clinical studies evaluating CAIX-targeted PET/CT in adult patients with suspected or confirmed renal masses or metastatic/recurrent renal cell carcinoma were included. Study selection, data extraction, and QUADAS-2 quality assessment were performed independently by two reviewers. Because of substantial clinical and methodological heterogeneity, a narrative synthesis was performed.

Twenty studies were included, with a summed sample size of 902 patients. Antibody-based tracers, mainly ¹²⁴I- and ⁸⁹Zr-girentuximab derivatives, provided the most established evidence for localized or indeterminate renal masses, showing high specificity and encouraging diagnostic accuracy for ccRCC. Small-molecule tracers enabled same-day imaging and showed promising results in metastatic disease assessment, particularly for extra-renal lesions. Performance was influenced by tracer class, imaging timing, renal background activity, lesion site, endpoint definition, and completeness of histological verification. The main methodological concerns involved patient selection, reference standard, and flow/timing domains.

CAIX-targeted PET/CT is a promising imaging strategy for ccRCC, with antibody-based tracers currently better supported for indeterminate renal masses and small-molecule tracers emerging for metastatic disease assessment. Further prospective multicenter validation and standardized endpoints are required. The review was not registered and received no external funding.