Palliative care can enhance health care outcomes for patients with life-threatening conditions. However, data regarding the prevalence and consequences of palliative care services for end-of-life patients in Vietnam are limited. Therefore, there is an urgent need to assess the efficacy of palliative care. This evidence supports the advancement of these services. To examine changes in mean health outcome scores, measured by the African Palliative Care Association Integrated Palliative Outcome Scale, among cancer patients receiving palliative care, and to assess their health improvements. We conducted a longitudinal study at Oncology Hospital, a tertiary center in Ho Chi Minh City, Vietnam, from July 2020 to January 2022. Patient and caregiver outcomes were measured monthly, within 3 days of admission, and continued until the patient's death or the end of follow-up. The study included 134 newly admitted patients and their caregivers, all of whom were referred to palliative care within 3 days of admission. Notably, patients with cancer showed an overall improvement in health outcomes, as evidenced by a significant monthly reduction in scores of 4.6 points (P < .01). The most significant progress was observed among those with physical symptoms, who experienced an average monthly decrease of 2.7 points. Furthermore, improved patient health outcomes were associated with an initial cancer diagnosis, older age, and caregiver health status. Palliative care can improve health outcomes of patients with cancer over time. Changes in the patients' quality of life are influenced by psychological burden, physical symptoms, initial diagnosis, patient age, and caregiver health. Understanding these changes can help palliative care healthcare professionals achieve optimal patient outcomes at any stage of the disease.

Infantile hemangiomas (IHs) are the most common benign vascular tumors in infancy, often leading to functional impairment, or cosmetic sequelae. While propranolol hydrochloride is the established first-line therapy, formulation differences may influence dosing precision, safety, and therapeutic response. This study aimed to compare the clinical efficacy and safety of oral solution and tablet formulations in infants diagnosed with IH. This single-center retrospective cohort study reviewed medical records of 120 infants (aged 0-12 months) treated with propranolol at Xuzhou Children's Hospital between September 2023 and December 2024. Patients were categorized into an oral solution group (n = 60) and a tablet group (n = 60). Lesion volume was calculated using the ellipsoid formula at baseline and follow-up intervals of 1 week, 1 month, 2 months, and 3 months. Primary outcomes included improvement rate and efficacy grading; secondary outcomes assessed adverse events and subgroup responses. P < .05 was considered statistically significant. Baseline characteristics were comparable between groups (P > .05). While both formulations resulted in progressive reductions in lesion volume, the oral solution group demonstrated greater improvement at all follow-up points. At 3 months, the improvement rate, presented as mean ± standard deviation, was 85.37% ± 10.78 in the oral group vs 69.50% ± 9.78 in the tablet group (median difference: 13.24%; 95% CI: 11.81-15.47%; P < .001). A higher proportion of excellent responses was observed in the oral group (66% vs 40%, percentage difference: 26.7%; 95% CI: 9.5-43.9%; P = .021). No significant differences were found in adverse events (P = .349). Subgroup analyses revealed that lesion subtype and anatomical location did not significantly influence treatment response (P > .05). Both propranolol formulations were effective and well-tolerated. The oral solution demonstrated a greater clinical improvement with a comparable safety profile. Further prospective multicenter studies are warranted to confirm these findings.

Spiritual needs are increasingly recognized as part of supportive cancer care, but they remain underassessed in routine practice. This study examined spiritual needs and associated psychosocial factors among patients with colorectal cancer recruited from 5 hospitals in Guangdong Province, China. A multicenter cross-sectional survey was conducted between July 2024 and June 2025. Patients with colorectal cancer completed validated Chinese questionnaires assessing perceived social support, psychological resilience, anxiety, depression, spiritual well-being, and spiritual needs. Data were analyzed using descriptive statistics, correlation analysis, confirmatory factor analysis, and structural equation modeling. Bias-corrected bootstrapping with 5000 resamples was used to estimate 95% confidence intervals for standardized direct, indirect, and total estimates. In total, 1068 valid questionnaires were included. Spiritual needs were negatively correlated with perceived social support, psychological resilience, and spiritual well-being and positively correlated with anxiety and depression. The structural equation model showed a good fit to the data: χ2/df = 1.434, root mean square error of approximation = 0.020, Tucker-Lewis index = 0.990, comparative fit index = 0.991, and incremental fit index = 0.991. In the hypothesized model, perceived social support, psychological resilience, and spiritual well-being were negatively associated with spiritual needs, whereas anxiety and depression were positively associated with spiritual needs. Overall, spiritual needs were associated with social support, resilience, emotional distress, and spiritual well-being. These findings support the inclusion of spiritual, psychosocial, and emotional assessment in supportive care for this population.

Observational studies have suggested that dietary habits may influence ovarian cancer risk, but Mendelian randomization (MR) evidence remains limited. Genetic data for 187 dietary habit phenotypes and ovarian cancer were collected and preprocessed. MR analyses were performed using 2 independent ovarian cancer datasets. Inverse-variance weighted estimates were pooled by meta-analysis, and multiple-testing correction was applied. Reverse MR analyses were conducted for significant dietary phenotypes to assess causal direction. Among the 187 dietary habit phenotypes, only cherry preference (GCST90094731) showed a significant causal association with ovarian cancer risk. In the FinnGen R12 dataset, the inverse-variance weighted estimate was not significant (odds ratio [OR] = 0.902, 95% confidence interval [CI]: 0.703-1.158; P = .419). In the OpenGWAS dataset, cherry preference was associated with reduced ovarian cancer risk (OR = 0.809, 95% CI: 0.691-0.948; P = .0087). Meta-analysis yielded a combined OR of 0.835 (95% CI: 0.730-0.954; P = .0081), and the association remained significant after Bonferroni correction. Reverse MR analysis showed no evidence of reverse causality. Genetically predicted cherry preference was associated with a lower risk of ovarian cancer. These findings provide genetic evidence supporting a potential role of dietary habits in ovarian cancer prevention and may inform precision nutrition and public health strategies.

Clinical and epidemiological evidence has suggested a potential association between kidney dysfunction and bladder cancer (BC). One hypothesis for this comorbidity is the presence of a common genetic etiology. However, little is known about the shared genetics and causality of this association. Thus, we aimed to investigate shared genetic architecture and the causal link between kidney dysfunction and bladder cancer.

Leveraging summary statistics from large-scale genome-wide association studies (GWASs) conducted on European-ancestry populations on eGFRcrea (N = 1,004,040), eGFRcys (N = 460,826), BUN (N = 852,678), UACR (N = 288,649), urate (N = 547,361) and BC (N _cases = 3357, N _controls = 628,027), we conducted a large-scale genome-wide cross-trait study to determine genetic overlap, to identify shared loci, and to infer causal relationships. We evaluated genetic correlation through linkage disequilibrium score regression (LDSC). Integration of single-trait GWAS was accomplished by multi-trait analysis of GWAS (MTAG), which enabled cross-trait meta-analysis to unveil overlapping genetic loci between five kidney function traits and BC. Shared genes were further validated through colocalization analysis and transcriptome-wide association analysis. Bidirectional Mendelian Randomization (MR) was conducted to determine causal inference of kidney function traits on BC.

We found positive correlations between both BUN and urate and BC at the genome-wide level. A total of 157 significant overlapping genetic loci (range 7 to 72) were identified across five kidney function traits and BC. Among them, PSCA was prioritized as the strongest shared gene with support from MTAG, colocalization, and TWAS, whereas ZFHX3, TTC33, and ATP2A1 were considered candidates supported only by MTAG and TWAS. MR provided the most consistent support for a potential positive causal effect of BUN on BC, limited support for UACR, and exploratory evidence for urate.

Our cross-trait analysis demonstrated a shared genetic basis underlying kidney function and BC, providing novel insights into the biological functions and molecular mechanisms underlying these complex traits.

Neuroendocrine neoplasms (NENs) are a heterogeneous family of epithelial malignancies that share neuroendocrine differentiation but differ in lineage origin, genomic architecture, immune contexture, and clinical behavior. Pancreatic neuroendocrine neoplasms (PanNENs) are particularly informative because well-differentiated pancreatic neuroendocrine tumors (PanNETs) and poorly differentiated pancreatic neuroendocrine carcinomas (PanNECs) arise in the same organ yet follow distinct evolutionary trajectories. Despite advances in surgery, targeted therapy, chemotherapy, and peptide receptor radionuclide therapy (PRRT), advanced PanNENs remain largely incurable, and immune checkpoint blockade has shown limited and inconsistent benefit. Recent genomic, epigenomic, and immune profiling studies indicate that differentiation state and lineage programs are major organizing principles of PanNEN biology. PanNETs are typically defined by chromatin regulatory alterations, relative lineage stability, and weakly inflamed immune microenvironments, although a subset shows increased tumor-associated macrophage infiltration and other immunoregulatory features linked to aggressive disease. By contrast, PanNECs are characterized by lineage instability, cell-cycle dysregulation, and a more inflamed yet functionally suppressed immune context, with greater immune-cell infiltration and more frequent checkpoint pathway engagement. However, these features do not necessarily indicate effective antitumor immunity, because inflammatory engagement may coexist with impaired antigen presentation, including human leukocyte antigen class I loss, tumor-intrinsic immune evasion, and suppressive myeloid networks. We propose that genomic alterations, epigenetic states, and immune architectures evolve as a coupled system in PanNENs. We discuss how lineage identity shapes antigen presentation defects, immune suppression, and therapeutic vulnerability, and we outline biologically rational, precision-guided strategies, including epigenetic modulation, targeting of immunosuppressive cell populations, and lineage-informed therapies.

BACKGROUND Durvalumab is a humanized monoclonal antibody and immune checkpoint inhibitor used for the treatment of advanced non-small cell lung cancer. Myocarditis, particularly in late-onset cases, is a rare but serious adverse event associated with durvalumab. This report describes a 79-year-old woman with non-small cell lung cancer who developed late‑onset myocarditis requiring differentiation from direct pericardial invasion. CASE REPORT A 79-year-old woman with stage IIIB lung squamous cell carcinoma developed myocarditis after 11 cycles of durvalumab maintenance therapy (5 months after initiation) following chemoradiation. She presented with reduced cardiac function, pericardial effusion, and elevated high-sensitivity troponin T, initially raising concern for pericardial invasion because the primary tumor was in direct contact with the myocardium. Urgent myocardial biopsy confirmed immune checkpoint inhibitor-related myocarditis, showing mononuclear lymphocyte and macrophage infiltration. Her condition improved after discontinuation of durvalumab and initiation of high-dose corticosteroids and intravenous immunoglobulin. Cardiac function recovered within 3 weeks, and biomarkers normalized. Notably, she has maintained a complete oncologic response for more than four years without further cancer treatment or recurrence of myocarditis, suggesting a durable antitumor effect despite early discontinuation of immunotherapy. CONCLUSIONS This case highlights the diagnostic challenge of distinguishing immune checkpoint inhibitor‑induced myocarditis from direct cardiac invasion in patients with lung cancer, particularly in late‑onset presentations. Early myocardial biopsy enabled prompt diagnosis and treatment, leading to a favorable long‑term outcome. Careful cardiac monitoring is essential, and immune-related adverse events should be considered even when tumor invasion is suspected.

Primary intravascular large B-cell lymphoma (IVLBCL) is a rare and aggressive extranodal lymphoma that rarely affects the prostate. Its nonspecific clinical and laboratory features often lead to misdiagnosis as benign prostatic hyperplasia (BPH) or prostatitis, delaying appropriate treatment. We report a case of primary prostatic IVLBCL initially misdiagnosed as BPH, highlighting the diagnostic challenges and the importance of comprehensive pathological evaluation.

A 75-year-old male presented with a 1-year history of a weakened urinary stream, dribbling, increased nocturia, and urinary urgency. Symptoms transiently improved with self-medication of the α1-blocker tamsulosin but later recurred.

Histopathological examination revealed clusters of atypical tumor cells within the prostatic vasculature. Immunohistochemistry showed positivity for leukocyte common antigen, Vimentin, CD20, and CD79a, with a Ki-67 index > 90%. A final diagnosis of primary intravascular large B-cell lymphoma of the prostate was established.

Following diagnosis, the patient and his family declined any antitumor therapy (including chemotherapy) and opted for best supportive care and were discharged against medical advice.

The patient died 5 months after diagnosis without receiving any subsequent antitumor therapy.

Prostatic IVLBCL is a diagnostic mimic of BPH and requires a high index of suspicion. Immunohistochemistry and molecular studies are essential for accurate diagnosis. Early recognition and appropriate chemotherapy can improve outcomes in this rare malignancy.

Synchronous primary malignancies involving solid tumors and aggressive lymphomas, such as extranodal NK/T-cell lymphoma, nasal type (ENKTL-NT), are exceedingly rare and pose significant diagnostic and therapeutic challenges. To our knowledge, no previously reported case of synchronous rectal adenocarcinoma and ENKTL-NT has been identified in the available literature.

A 64-year-old man presented with malaise, loss of appetite, toothache, gingival swelling, and a persistent facial sinus with purulent discharge.

Colonoscopy and histopathological examination confirmed moderately differentiated rectal adenocarcinoma with liver and sacral bone metastases. Histopathological and immunohistochemical analysis of the facial tissue confirmed ENKTL-NT, which was positive for Epstein‑Barr virus‑encoded small RNA, CD3, CD56, and T‑cell intracellular antigen-1.

The patient received 2 cycles of CHOP (cyclophosphamide, hydroxydaunorubicin/doxorubicin, Oncovin/vincristine, and prednisone) chemotherapy before a definitive diagnosis was established. Owing to rapid disease progression and poor nutritional status, no further lymphoma-specific therapy was feasible.

The patient died 3 months after diagnosis, underscoring the aggressive nature of ENKTL-NT and the risks associated with empirical chemotherapy.

This case highlights the critical need for early and accurate histopathological diagnosis in suspected lymphoma cases and emphasizes a multidisciplinary strategy to optimize management when synchronous aggressive malignancies are present. Anthracycline-based regimens should be avoided in ENKTL-NT.

Good syndrome (GS) is a rare acquired immunodeficiency disorder characterized by thymoma, hypogammaglobulinemia, and peripheral B-cell lymphopenia. Because of its rarity and complexity, the diagnosis and treatment of this condition remain inadequately reported in clinical practice. Therefore, we report a typical case of GS in a patient who developed chronic diarrhea and recurrent pneumonia several years after thymectomy, with the aim of improving the understanding and early recognition of this disease.

A 55-year-old Chinese woman presented with chronic diarrhea and recurrent severe pneumonia, which developed 3 and 6 years, respectively, after thymectomy for a mixed-type (B2/B3) thymoma.

Laboratory examination results revealed severe hypogammaglobulinemia (immunoglobulin G = 3.9 g/L), peripheral blood B-cell lymphopenia (B lymphocytes 12 cells/μL), and cellular immune dysfunction (CD4+/CD8+ ratio 0.31, CD(16 + 56): 0.23%, CD19: 3.31%). The diagnosis was confirmed based on the combination of clinical manifestations, laboratory findings, and imaging examinations. GS was diagnosed based on the triad of thymoma history, humoral and cellular immunodeficiency, and recurrent opportunistic infections.

The patient received long-term intravenous immunoglobulin (IVIG) replacement therapy, prophylactic antibiotics, and aggressive management of acute infections.

Despite regular IVIG therapy, the patient's condition progressively deteriorated over 8 years, and the patient ultimately died at home, likely due to respiratory failure secondary to severe pulmonary infection (the family declined an autopsy).

This case highlights that GS can manifest several years after thymectomy, necessitating sustained clinical vigilance. This case also highlights the limitations of conventional IVIG therapy and underscores the need to enhance clinicians' awareness of GS.