Gastric cancer (GC), a malignant neoplasm originating from the gastric mucosal epithelium, represents one of the most prevalent cancers worldwide. Early detection is critical for improving treatment outcomes and patient prognosis. Recent advances in artificial intelligence (AI), particularly in machine learning, have introduced powerful computational and analytical capabilities that are increasingly being applied in GC research. Machine learning algorithms have shown considerable promise in enhancing the accuracy of GC diagnosis and optimizing therapeutic strategies. This review provides a concise overview of progress in machine learning applications within oncology, examines their current role and clinical utility in GC diagnosis and treatment, and highlights the transformative potential of machine learning in advancing GC management and patient care.

(1) Background: Pancreatic cancer causes significant morbidity and mortality, and guidelines recommend early integration of palliative care alongside active treatment. As access to palliative care is often mediated by oncology clinicians, this survey sought to understand these clinicians' perspectives on barriers and facilitators to clinician palliative care referral and patient palliative care access. (2) Methods: An online survey was distributed via community and academic institutions across Canada to oncology clinicians who were able to refer a pancreatic cancer patient to palliative care (e.g., oncology nurses, medical oncologists). (3) Results: Of 134 clinicians from ten provinces, almost all (97%) believe that palliative care is 'very important' in pancreatic cancer care. The greatest perceived barriers to patient palliative care access included patient-family reluctance to accept palliative care (73%), lack of knowledge about services (50%), and lack of support from other healthcare professionals (40%). Perceived barriers to referring included patient-family reluctance to accept palliative care (57%) and lack of available specialist services (58%). Most providers suggested patient education as a strategy to overcome barriers (85%). (4) Conclusions: Perceptions about public acceptance may preclude oncology clinicians from referring to palliative care, despite nearly universal belief in its importance. The findings highlight service and education gaps for future intervention.

Cystic neoplasms of the hepatoduodenal ligament are exceedingly rare lesions that pose significant diagnostic and therapeutic challenges due to their nonspecific clinical presentation and complex anatomical location. These lesions, which include cystic lymphangiomas, hydatid cysts and benign cystic neoplasms, often mimic other cystic abdominal masses, complicating preoperative diagnosis. We present a case of a 29-year-old male with a cystic lymphangioma located in the hepatoduodenal ligament, highlighting the role of advanced imaging and laparoscopic excision in effective management. This report underscores the importance of high clinical suspicion, comprehensive imaging and meticulous surgical technique in addressing these uncommon cystic neoplasms.

Familial non-medullary thyroid cancer (FNMTC) is defined as non-medullary thyroid cancer occurring in two or more first-degree relatives, without features of known hereditary syndromes. Although familial predisposition is well established, its clinical behavior remains debated. This study aimed at characterizing familial cases compared to sporadic non-medullary thyroid cancer (SNMTC).

FNMTC and SNMTC patients were recruited from the Endocrine Division (SEMPR) of the Federal University of Paraná, Brazil, and private endocrine clinics in Curitiba, Paraná, Brazil (2000-2019). Baseline, histopathological, and clinical data were analyzed using SPSS Statistics 26.0. Statistical comparisons employed chi-square, Student's t test, and Mann-Whitney U test, as appropriate. Post hoc power analysis was performed using G*Power 3.1.9.7, and R 2025.05.0.

We analyzed 39 FNMTC and 119 SNMTC patients. Papillary thyroid carcinoma was the predominant histological type in both groups. FNMTC patients were diagnosed at a younger age (38.5 ± 14.2 vs. 46.6 ± 13.8 years, p = 0.003) and more frequently presented with lymph node metastases at diagnosis (46.2% vs. 21.8%, p = 0.007), with a 4.57-fold increased risk. Despite these differences, long-term outcomes did not differ significantly between groups. An earlier disease onset in subsequent generation suggests a possible anticipation phenomenon.

These findings suggest that FNMTC patients may present with earlier onset and higher rates of lymph node involvement, underscoring the need for thorough preoperative lateral neck evaluation. In view of a possible anticipation phenomenon, cervical ultrasound screening might be considered starting in adolescence.

Background/Objectives: Postoperative intracerebral hematomas (POHs) are a common complication following brain tumor surgery and are typically associated with unfavorable outcomes. While extensive hemorrhages have been studied extensively, smaller, Non-Space-Occupying hemorrhages are frequently detected, yet their clinical relevance and associated risk factors remain insufficiently understood. This study aimed to identify predictive factors for the occurrence of Non-Space-Occupying postoperative cerebral hemorrhages in patients undergoing brain tumor resection. Methods: A total of 1481 patients without a history of anticoagulant or antiplatelet therapy underwent brain tumor surgery at our neurosurgical institute over a ten-year period. Non-Space-Occupying postoperative hemorrhages were diagnosed in 84 patients using cranial computed tomography (cCT) or magnetic resonance imaging (cMRI) performed after the tumor resection. Demographic data, pre-existing comorbidities, and tumor characteristics were collected and analyzed. Results: Non-Space-Occupying POHs occurred in 5.6% of patients. The most frequent tumor type associated with POHs was glioblastoma multiforme (N = 33; 39.3%), followed by metastatic lesions (N = 9; 10.7%) and benign primary intracranial neoplasms (N = 31; 38%). None of the affected patients exhibited new neurological deficits or signs of increased intracranial pressure. A multivariate analysis identified the tumor size as an independent risk factor for Non-Space-Occupying POHs (p = 0.002), with patient age emerging as the strongest predictor (p = 0.001). Conclusions: Non-Space-Occupying POHs after a brain tumor resection are significantly associated with the tumor size, an advanced patient age, and the presence of pre-existing liver disease. The recognition of these risk factors may facilitate targeted perioperative monitoring and guide postoperative management strategies.

Granular cell tumors (GCTs) are rare neoplasms, typically of Schwannian origin, with generally a benign and indolent clinical behavior. However, a small subset exhibits malignant behavior, often without clear histologic features. We report a rare case of a vulvar granular cell tumor in a 21-yr-old woman with subsequent pulmonary metastasis. The patient presented with a slowly growing vulvar nodule and a subcutaneous lesion on the left flank. Imaging studies revealed residual disease in the vulva and a suspicious lung nodule, both of which were surgically resected. Histopathologic examination confirmed features consistent with granular cell tumor in both primary and metastatic sites, despite the absence of cytologic atypia, necrosis, or elevated mitotic activity. Immunohistochemistry revealed positivity for S100, CD68, NSE, and inhibin, with a low Ki-67 index (<1%). Next-generation sequencing identified a CHEK2 p.I200T mutation in both lesions, suggesting a shared clonal origin. This variant lies within the kinase domain of CHK2, a key mediator of the DNA damage response, and is of uncertain but potentially pathogenic significance. No microsatellite instability or homologous recombination deficiency was observed. This case highlights the diagnostic challenges in GCTs, particularly in distinguishing benign from malignant forms in the absence of classic histologic criteria. The presence of metastasis remains the most definitive indicator of malignancy. Our findings underscore the importance of integrating molecular profiling into the diagnostic and prognostic workup of GCTs and raise the question about the potential role of CHEK2 alterations as additional molecular determinants of aggressiveness beyond conventional histology. Long-term follow-up is warranted given the unpredictable clinical behavior of malignant GCTs.

Background: Periodontitis is a chronic inflammatory condition characterized by progressive destruction of tooth-supporting tissues and sustained microbial dysbiosis. Increasing evidence suggests that chronic oral inflammation may be associated with oral and oropharyngeal carcinogenesis, although findings across epidemiological and prognostic studies remain heterogeneous. Objective: To systematically evaluate the epidemiological association between clinically defined periodontitis and the risk of oral and/or oropharyngeal cancer, and to explore, in a distinct analytical component, the prognostic association between tumor-associated periodontal pathogens, particularly Porphyromonas gingivalis, and survival outcomes in affected patients. Methods: A systematic review and meta-analysis were conducted following PRISMA guidelines and registered in PROSPERO (CRD420251273975). Observational studies evaluating periodontitis and oral/oropharyngeal cancer risk (Arm 1) and prognostic studies assessing tumor-associated periodontal pathogens and survival outcomes (Arm 2) were identified through comprehensive database searches. Random-effects meta-analyses were performed to pool adjusted effect estimates. Risk of bias was assessed using the Newcastle-Ottawa Scale and the QUIPS tool. Results: Six observational studies were included in the epidemiological meta-analysis. Periodontitis was significantly associated with an increased risk of oral and/or oropharyngeal cancer (pooled HR = 2.14; 95% CI: 1.53-2.98), with substantial heterogeneity; trial sequential analysis supported the statistical robustness of this association. In the separate prognostic analysis, three studies evaluating intratumoral Porphyromonas gingivalis were included. A higher presence or expression of P. gingivalis was associated with poorer overall survival (HR = 2.89; 95% CI: 1.93-4.32), with no observed heterogeneity. Sensitivity and influence analyses confirmed the stability of these findings. Conclusions: This systematic review and meta-analysis demonstrate a consistent epidemiological association between periodontitis and an increased risk of oral and/or oropharyngeal cancer. In addition, exploratory prognostic evidence suggests that the presence of Porphyromonas gingivalis within tumor tissue may be associated with adverse survival outcomes. These findings should be interpreted as addressing distinct clinical and microbiological constructs, underscoring the need for further well-designed prospective and mechanistic studies.

Neuroendocrine neoplasms (NENs) represent a rare, heterogeneous group of malignancies. Within this tumor entity, primary renal neuroendocrine tumors (PRNETs) are exceedingly rare, with only 160 cases reported worldwide. Due to the absence of native neuroendocrine cells in the renal parenchyma, their cellular origin remains unclear. Clinical and diagnostic challenges are reflected by the low incidence, non-specific clinical presentation, resemblance to common renal neoplasms, and the need for specialized histopathological diagnostic examination. Here, we present the case of a 61-year-old female with an incidentally diagnosed left-sided PRNET in September 2024. This case highlights the diagnostic complexity of PRNET and, importantly, underscores its genomic heterogeneity. It demonstrates a lack of typical renal cell carcinoma (RCC) or common NEN-associated gene alterations, emphasizing their unique molecular landscape.

Colorectal cancer is predominantly a disease of older adults, yet age-related treatment decisions remain controversial. While chronological age is often used as a criterion for surgical eligibility, it remains unclear whether age alone is an independent predictor of surgical and oncological outcomes. This study evaluated whether age is a significant determinant of outcomes in colorectal cancer patients undergoing surgical resection. This retrospective comparative study analyzed 262 patients (193 younger than 70 years, 69 aged ≥ 70 years) diagnosed with colorectal cancer stages I-IV between 2014 and 2021 at a tertiary single center. Survival analysis was conducted using Kaplan-Meier method and Cox proportional hazards regression. Elderly patients had higher ASA classification (p = 0.0270), higher hypertension prevalence (p < 0.0001), higher ICU admission rates (50.7% vs. 21.2%, p < 0.0001), and longer hospital stays (12.6 vs. 7.5 days, p = 0.0016). However, elderly patients presented with earlier-stage disease (Stage I + II: 64.2% vs. 46.1%, p = 0.0108). After adjustment for confounding factors, age did not significantly impact overall survival (HR = 1.33; 95%CI: 0.54-3.26; p = 0.5375) or disease-free survival (HR = 1.61; 95%CI: 0.79-3.29; p = 0.1939). Despite differences in clinical presentation and pathological findings, age itself was not an independent predictor of survival outcomes. These findings suggest that treatment decisions in elderly colorectal cancer patients should be informed by individual patient physiology and disease stage rather than chronological age alone.

Mucoepidermoid carcinoma of the lung is a rare salivary gland-type tumor with heterogeneous clinical behavior and the potential to mimic neoplasms arising in other organs. The purpose of this report is to describe an exceptionally uncommon presentation of pulmonary mucoepidermoid carcinoma manifesting as a breast metastasis in a male patient, a scenario that poses significant diagnostic challenges due to its rarity and its morphological resemblance to primary breast carcinoma. We evaluated the patient through clinical examination, cross-sectional imaging, endobronchial procedures, ultrasound-guided biopsy, immunohistochemistry, and molecular analysis, integrating these data to establish the diagnosis. Imaging revealed a primary lung mass and a second lesion in the left breast infiltrating the pectoralis muscle. Biopsy of the breast mass showed high-grade salivary gland-type mucoepidermoid carcinoma, clinically and radiologically suggestive of pulmonary origin. Because the lesion showed signs of impending ulceration, palliative surgical debulking was performed with good postoperative recovery. The patient subsequently began systemic therapy with gemcitabine. This case underscores the need for careful clinicopathologic correlation when evaluating atypical breast lesions and highlights the diagnostic value of molecular testing in distinguishing primary from metastatic salivary gland-type tumors. Recognizing such rare metastatic patterns is essential for appropriate therapeutic planning.