Mucinous tubular and spindle cell carcinoma is a rare renal neoplasm first classified by the WHO in 2004. It typically consists of low-grade cuboidal cells in tightly packed tubules, merging with spindle cells in a myxoid stroma with basophilic mucin. High-grade features, including sarcomatoid transformation, necrosis, and vascular invasion, are associated with poor prognosis and metastasis. Here, we present the second reported case of mucinous tubular and spindle cell carcinoma metastasizing to bone despite lacking high-grade features.

Host-microbiome interactions regulate immune function, epithelial barrier integrity, and hematopoietic homeostasis. Intestinal microbial communities show consistent disruption in leukemia, particularly during intensive chemotherapy and hematopoietic stem cell transplantation. Reduced microbial diversity, depletion of short-chain fatty acid (SCFA)-producing commensals, and expansion of opportunistic taxa are recurrent findings across cohorts. Such patterns correlate with inflammatory signaling, impaired barrier function, and shifts in immune responses affecting treatment tolerance and hematopoietic recovery. Clinical associations show greater consistency for treatment-related outcomes, including infection risk, mucosal injury, and delayed immune reconstitution, than for leukemogenesis. Evidence supporting a direct causal role of specific microbial taxa in disease initiation remains limited. This review examines microbiome composition, microbial taxa, and mechanistic pathways in leukemia, with emphasis on how microbiome alterations may influence leukemia biology, disease progression, treatment response, and clinical outcomes, while acknowledging that most human evidence remains associative.

The advancement of synthetic biology and the rise of antimicrobial resistance have led to the development of bacteriophage therapy for more than antibacterial applications. This review focuses on applications to multidrug-resistant infections, biofilm diseases, cancer research, veterinary medicine and animal production. Recent research suggests phages can be used in combination with antibiotics to enhance treatment of large multidrug resistant pathogens such as Pseudomonas aeruginosa, Acinetobacter baumannii and Klebsiella pneumoniae. This could also help to restore antibiotic sensitivity by making bacteria change resistance related structures or mechanisms. Despite this, there are several challenges for the use of phage therapy prior to its widespread clinical application, including phage resistance, difference in patient response, unknown pharmacokinetic parameters, immune issues, and unclear regulatory guidelines. Additionally, in some cases, phages could also play a role in horizontal gene transfer, raising further safety concerns. Beyond antimicrobial therapy, phage display platforms derived from M13, T7 and λ phages have enabled the identification of tumor-targeting peptides, the development of immunomodulatory constructs, and targeted delivery of therapeutic molecules. Over 100 clinical cases and 44 registered trials support the generally favorable safety profile of personalized phage therapy, and highlight the need for better treatment standardization, controlled clinical evaluation, and better regulatory processes. Additionally, engineered phages expressing biofilm degrading enzymes represent promising tools for disrupting matrix-embedded bacterial communities associated with chronic infections and medical devices. In summary, CRISPR-based engineering and genome refactoring highlight the potential of phage-based therapeutics as complements to conventional antimicrobial therapy, although their broader use depends on overcoming biological, clinical, and regulatory challenges.

The efficacy of immunotherapy varies between MSI-H and MSS colorectal cancer(CRC) patients. Multiple studies have shown that gut microbiota is closely related to CRC, but the causality of them has yet to be fully established. This study aims to look for differential bacteria and related pathways by collecting feces from patients with different MS of CRC and healthy individuals, providing direction for immunotherapy of MSS CRC patients.

1. Explore the differences in gut microbiota between MSI-H and MSS CRC. 2.Provide new direction for the future clinical treatment of MSS CRC patients and improve their prognosis.

From October 2021 to December 2025, fecal samples and medical records were collected from healthy individuals and patients with different genotypes of MSS and MSI-H CRC admitted to Shandong Cancer Hospital and Institute. 28 fecal samples were collected from MSI-H, MSS CRC patients and healthy individuals respectively. Then 84 fecal samples were analyzed using 16S rDNA sequencing. Finally the differential microbial communities in the fecal samples of MSI-H and MSS CRC patients were analyzed based on the sequencing results, and healthy human fecal samples were used as controls to explore the role of differential microbial communities in CRC immunotherapy.

The collected 84 fecal samples were subjected to 16s rDNA sequencing analysis. Through Venn plot analysis, it was found that there are 1774 same bacterial species in MSS and MSI-H CRC patients, 3951 unique bacterial species in MSS CRC patients, and 2571 unique bacterial species in MSI-H CRC patients. The species richness of intestinal microbiota in MSS was higher than that in MSI-H CRC patients. Through species analysis, differential bacteria were identified among the samples submitted for testing, and further validation was obtained. Finally, based on the test results and comprehensive analysis of relevant literature, this study found that the bacteria with the most significant difference at phylum level between MSI-H and MSS CRC patients are Bacillota(p=0.024), Bacteroidota(p=0.024), Pseudomonadota(p=0.024), Actinomycetota(p=0.026), Verrucomicrobiota(p=0.037), and at genus level are Akkermansia(p=0.022), Alistipes(p=0.032), Anaerostipes(p=0.034), ASF356(p=0.016), Bacteroides(p=0.032), Bilophila(p=0.007), Coprococcus(p=0.037), Culicoidibacter(p=0.031), Enterocloster(p=0.049), Escherichia-Shigella(p=0.045), Faecalibacterium(0.042), Flavobacterium(p=0.037), Mediterraneibacter(p=0.037), Monoglobus(p=0.028), Oscillibacter(p=0.024), Parabacteroides(p=0.038), Ruthenibacterium(p=0.041), Streptococcus(p=0.015), Terrisporobacter(p=0.019), Tyzzerella(p=0.045), UCG-002(p=0.025), UCG-005(p=0.027), UCG-009(p=0.032), Veillonella(p=0.020). Among them, the relationship between Akkermansia, Faecalibactrium, Coprococcus and Bacteroides with immunotherapy is a hot research topic at home and abroad.

There are differences in the species composition of gut microbiota between MSI-H and MSS CRC patients, which may provide new directions for further research.

Lymph node metastasis (LNM) critically influences prognosis in colorectal cancer (CRC), yet the mechanisms driving this process, particularly the contribution of the intratumoral microbiota, remain insufficiently defined.

We performed 16S rRNA sequencing on tumor tissue from a discovery cohort of 122 CRC patients, followed by validation in one internal and one external validation cohort. Immunohistochemistry (IHC), fluorescence in situ hybridization (FISH), and transcriptomic deconvolution were used to explore tumor immune-contexture features and tissue-associated Phascolarctobacterium-like signals. Bulk RNA-seq data were analyzed using Weighted Gene Co-expression Network Analysis (WGCNA) and pathway enrichment to explore host transcriptomic modules and molecular pathways associated with microbial abundance.

Higher tumor tissue-associated Phascolarctobacterium abundance showed a modest positive association with lymph node metastasis and was associated with worse overall survival in the discovery cohort (HR = 3.892, 95% CI = 1.441-10.513, P = 0.007). These tumors showed exploratory immune-contexture differences, including lower CD8+ T-cell-related signals and higher macrophage/M2 macrophage-related signals. WGCNA identified exploratory abundance-associated modules enriched in keratinocyte differentiation, epithelial development, and MAPK signaling, whereas low-abundance-associated modules were linked to lipid metabolism and redox regulation.

Tumor tissue-associated Phascolarctobacterium abundance showed exploratory associations with lymph node metastasis, poorer overall survival in the discovery cohort, and immune-contexture features in CRC. These findings are exploratory and require validation in larger independent cohorts and functional studies.

Prostate adenocarcinoma commonly metastasises to the axial skeleton, but skull base deposits with acute cranial nerve palsies as the first clinical sign are unusual. We report a 68-year-old man admitted with one month history of dyspnoea and weakness, who was found to have severe microcytic anaemia (haemoglobin 6.5 g/dL) with stool positive for occult blood; upper gastrointestinal endoscopy showed only mild antral gastritis. During the first week he developed left-sided ptosis, progressing over three days to complete ophthalmoplegia with binocular diplopia. Gadolinium-enhanced MRI of the brain showed a destructive clival deposit with heterogeneous enhancement extending into the left cavernous sinus. On directed questioning the patient admitted to a five-month history of lower urinary tract symptoms (LUTS) dismissed as age-related. Serum prostate-specific antigen was 754 ng/mL. Cross-sectional imaging and multiparametric prostate MRI confirmed a Prostate Imaging Reporting and Data System (PIRADS) 5 lesion with widespread pulmonary, mediastinal nodal, pelvic nodal and skeletal metastases. The hospital course was complicated by severe hyponatraemia with a high urine sodium (43 mEq/L), supporting the syndrome of inappropriate antidiuresis. Transrectal ultrasound-guided biopsy confirmed prostatic adenocarcinoma. The case is a reminder that cranial nerve palsies in an elderly man can be the first visible sign of silent disseminated prostate cancer, and that asking directly about urinary symptoms at every clinical encounter matter, even though such symptoms are not themselves a reliable indicator of early disease.

Differentiated high-grade thyroid carcinoma (DHGTC) is a newly defined pathological subtype introduced in the 5th edition of the World Health Organization (WHO) Classification of Thyroid Tumors in 2022. This study aimed to analyze its clinicopathological characteristics and improve the understanding of this entity among clinicians and pathologists.

A total of 19 patients with DHGTC from three tertiary medical centers were retrospectively included. Clinical manifestations, histopathological morphology, immunohistochemical findings, and molecular pathological features were analyzed. Postoperative follow-up data were reviewed to evaluate prognosis, and relevant literature was also reviewed.

Among the 19 patients, 9 were male and 10 were female, with a median age of 61 years (range, 24-78 years). The tumors showed marked invasiveness, with 11 cases involving adjacent structures and 13 cases presenting with lymph node metastasis. All cases exhibited high-grade pathological features, characterized by increased mitotic activity and/or tumor necrosis. The Ki-67 proliferation index was ≥10% in all cases, including 10 cases with a Ki-67 index ≥20%, with the highest value reaching 30%. BRAF abnormalities were identified in 9 cases by molecular testing and/or immunohistochemistry, including aberrant immunohistochemical expression and/or molecular confirmation of the BRAF V600E mutation. In addition, two cases harbored a TERT promoter mutation, and one case showed abnormal p53 expression. During follow-up, 4 patients developed recurrence or metastasis, and 2 patients died.

DHGTC is a highly aggressive thyroid malignancy with a poor prognostic tendency. Increased mitotic activity, tumor necrosis, elevated Ki-67 index, and molecular abnormalities such as BRAF alterations are important for diagnosis and prognostic assessment.

Adrenocorticotropic hormone (ACTH)-secreting pituitary adenomas are rare endocrine neoplasms. Pituitary apoplexy, caused by acute hemorrhage or infarction within the tumor, is an uncommon complication. Pediatric cases of ACTH-secreting adenomas with apoplexy are exceptionally rare, with limited understanding of their clinical and imaging manifestations. This report aims to enhance diagnostic awareness through a detailed case analysis.

A 13-year-old boy presented with acute-onset severe headache, anuria, hypertensive crisis (180/120 mmHg), and rapid weight gain (20 kg over 2 months). Biochemical evaluation revealed elevated ACTH (190 pg/mL), disrupted cortisol rhythm, and hypokalemia (2.16-3.0 mmol/L). Pituitary magnetic resonance imaging (MRI) demonstrated a 6mm×5 mm cystic lesion in the left adenohypophysis with mixed T1/T2 signals and no post-contrast enhancement, consistent with apoplexy. Histopathology confirmed an ACTH-secreting adenoma. Transsphenoidal resection and hormone replacement achieved stable remission at the 3-year follow-up.

Pediatric ACTH-secreting pituitary apoplexy presents diagnostic challenges due to nonspecific symptoms and atypical imaging features. MRI remains pivotal for initial evaluation, though histopathology is confirmatory. Early surgical intervention and hormonal management are critical for favorable outcomes.

Adrenocortical carcinoma (ACC) is a rare and aggressive malignancy of the adrenal glands, characterised by high recurrence rates and poor survival outcomes. Living with ACC is associated with significant uncertainty and psychological burden. This study aimed to explore the experiences, impacts, and perceptions of people living with ACC to inform the development of comprehensive, person-centred care.

A qualitative study underpinned by Van Manen's hermeneutic phenomenological methodology was undertaken. Semi-structured interviews were conducted, informed by Mullan's concept of survivorship, Bowen's Family System Theory, and the concept of resilience. These frameworks guided both data collection and analysis.

Twenty-one participants (12 women, 9 men; mean age 50, range 28-74) from the USA, Canada, UK, Europe, Nigeria, and Australia took part in interviews totalling 19 hours and 34 minutes. Five themes and 11 subthemes emerged. Living with ACC was described as an existential challenge, as participants navigated the reality of limited survival alongside demanding, life-prolonging treatments. The pursuit of survival was likened to a rollercoaster, requiring sustained support and continuous adaptation. For some, these challenges became overwhelming and led to thoughts of suicide. Participants highlighted a strong need for hope, understanding, and compassionate, ongoing care to help them cope, adapt, and rebuild their lives.

ACC is a complex and life-altering condition that requires careful balancing of treatment burden with quality-of-life considerations. Current healthcare systems do not adequately meet the needs of this population. Future research should focus on developing and evaluating interventions to better support individuals living with ACC and mitigate the psychological and practical impacts of the disease.

Imprecision in breast-conserving surgery results in re-excision in 20% of cases, delaying adjuvant therapy and increasing patient anxiety and financial burden. Fluorescence-guided surgery (FGS) enables real-time tumor visualization and may improve surgical precision. This systematic review evaluates fluorophores investigated for intraoperative navigation in breast cancer. Medline, Embase, Scopus, and Web of Science were searched using "breast cancer," "surgery," "fluorophore," and "near-infrared." Eligible studies investigated in vivo fluorophores for invasive breast cancer in animals or humans. Of 1946 studies, 65 met the inclusion criteria. Extracted data included fluorophore administration, mechanism, optical properties, imaging systems, safety, and diagnostic accuracy. Dual-modality studies were excluded. 58 fluorophores were evaluated across 761 human and 520 animal subjects. Most agents emitted within the near-infrared-I (NIR-I) window (74.1%), while 11 utilized NIR-II imaging for deeper penetration. Indocyanine green (ICG) was the most widely studied fluorophore, demonstrating a pooled clinical tumor-to-background ratio (TBR) of 2.25 ± 0.74 (95% CI 2.10-2.39); sensitivity 80.8% (95% CI 72.5-89.2%); specificity 93.3% (95% CI 88.1-98.6%). IRDye800CW-trastuzumab demonstrated higher pooled TBRs of 4.83 ± 1.77 (95% CI 4.27-5.40). Nanoparticle-based fluorophores showed high contrast but remained preclinical. FGS is rapidly evolving, but no fluorophore has demonstrated optimal performance across translational endpoints; standardized reporting remains essential.