Background: Spermatocytic tumor (ST) is a rare non-GCNIS-derived testicular germ cell neoplasm that predominantly affects older men and generally follows an indolent course. Its occurrence in a cryptorchid testis is exceptionally uncommon. Methods: A narrative literature review was conducted using the PubMed database, including studies published up to August 2026. The search used combinations of the terms "spermatocytic tumor", "spermatocytic seminoma", "cryptorchidism", "undescended testis", "immunohistochemistry", "molecular features", "magnetic resonance imaging", and "treatment". Results: A 56-year-old man presented with a painless left inguinal mass corresponding to a cryptorchid testis. Serum tumor markers were normal. MRI demonstrated a well-circumscribed heterogeneous lesion with pseudocystic areas and enhancement of the solid component. Radical inguinal orchiectomy was performed. Histopathological examination revealed the characteristic triphasic cellular population without GCNIS, lymphovascular invasion, or sarcomatous transformation. Immunohistochemistry showed SALL4 and CD117 positivity and absence of OCT3/4 and D2-40 expression, supporting the diagnosis of ST and its distinction from classical seminoma. No recurrence or metastatic disease was detected during 12 months of follow-up. Conclusions: ST arising in a cryptorchid testis represents an exceptionally uncommon presentation. Integration of clinical, radiological, morphological, and immunohistochemical findings is essential for accurate diagnosis and distinction from classical seminoma, thereby avoiding unnecessary additional treatment.

Cutaneous malignancies constitute a growing clinical and public health burden, encompassing common keratinocyte carcinomas, melanomas, and a heterogeneous group of rare neoplasms [...].

Background/Objectives: In the operating room, surgical staff are exposed to inhalation of smoke from the combustion of tissues when using electrocautery. By introducing HIPEC/peritonectomy in the treatment of malignant neoplasms of the peritoneum, exposure to smoke is significantly increased. To adequately perform this procedure, high-power monopolar cautery is used. The aim of this study was to assess carbon monoxide exposure associated with surgical smoke generated during peritonectomy procedures and to compare it with exposure during standard colorectal resections. Methods: In this prospective observational study, a total of 360 blood samples were collected and analyzed from surgeons participating in surgical procedures. The study cohort was divided into two groups: the HIPEC/peritonectomy group and the standard resection group. Blood samples were obtained from three surgeons who participated in a total of 30 procedures, comprising 15 HIPEC/peritonectomy procedures and 15 standard resection procedures. Samples were collected at the start of the intervention, at the 20th and 40th minutes, and at the end of procedures. Results: COHb values increased over time, and levels were higher in the peritonectomy group. An increase in MetHb levels was seen in HIPEC/peritonectomy, but not in the standard colorectal resection group. The observed values did not lead to symptoms of acute CO poisoning. Conclusions: The results suggest that the use of electrocautery increases carboxyhemoglobin (COHb) and methemoglobin (MetHb) levels in surgical staff; however, these increases did not reach clinical significance. The long-term health consequences of repeated exposure to surgical smoke, as well as the effectiveness of personal protective equipment and smoke evacuation systems in reducing this exposure, should be investigated in future studies.

Objectives: A percutaneous native kidney biopsy remains the gold standard for diagnosing glomerular, tubulointerstitial and vascular kidney diseases. Although generally safe, it may cause major haemorrhagic complications. Using the French national registry, Kaczmarek et al. developed a simplified bleeding risk score (anaemia, female sex, heart failure, acute kidney injury; range: 0-5), achieving an AUC of 0.755 in native biopsies. We aimed to externally validate this score in a Romanian cohort and to assess whether additional clinically relevant predictors could improve discrimination for major bleeding. Methods: We conducted a retrospective cohort study of all consecutive adults undergoing an ultrasound-guided percutaneous native kidney biopsy at a tertiary nephrology centre in Romania between January 2008 and December 2024. The primary outcome was a composite major bleeding event: clinically significant haematoma or haemorrhage, blood transfusion, angiographic intervention or nephrectomy. The Kaczmarek score was validated using a receiver operating characteristic (ROC) analysis. Candidate predictors were assessed by multivariable logistic regression, and a simplified score was derived from the regression coefficients. Results: Among 3081 patients, 162 (5.3%) experienced major bleeding. The Kaczmarek score showed modest discrimination (AUC: 0.624, 95% CI: 0.585-0.663). In the multivariable analysis (n = 2506 complete cases), anaemia, heart failure, solid neoplasm and fibrinogen were independently associated with major bleeding. An eight-component score (anaemia, heart failure, solid neoplasm, and fibrinogen < 511 mg/dL; female sex, hypertension, liver disease, and eGFR < 30 mL/min/1.73 m²) achieved an AUC of 0.676 (95% CI: 0.631-0.717), outperforming the Kaczmarek score. Conclusions: The French score performed only modestly in our cohort. Adding comorbidities, kidney function and haemostatic parameters, particularly fibrinogen, improved the risk discrimination.

Inflammatory and nested testicular sex cord tumor (IN-TSCT) is a recently recognized, rare testicular sex cord-stromal neoplasm characterized by a recurrent EWSR1::ATF1 fusion and potentially aggressive clinical behavior. Because of its nested epithelioid morphology accompanied by prominent inflammatory infiltrates, IN-TSCT may be mistaken for seminoma, while frequent diffuse CD30 expression further complicates the differential diagnosis with lymphoma. We report a case of IN-TSCT in a 54-year-old man presenting with intermittent left testicular pain. Scrotal ultrasonography demonstrated a well-defined, heterogeneously hypoechoic intratesticular mass with minimally increased internal vascularity. Radical orchiectomy revealed a 1.5 × 1.4 cm epithelioid neoplasm arranged in nests and cords with a prominent inflammatory infiltrate. The tumor cells expressed the sex cord-stromal markers SF-1 and calretinin and showed diffuse CD30 expression. RNA-based next-generation sequencing identified an EWSR1::ATF1 fusion, establishing the diagnosis of IN-TSCT. Unexpectedly, the tumor also demonstrated strong ALK immunoreactivity with both the ALK1 and D5F3 antibody clones, despite the absence of an ALK fusion by RNA sequencing or an ALK rearrangement by fluorescence in situ hybridization. The combined expression of CD30 and ALK may mimic anaplastic large cell lymphoma and represents an important diagnostic pitfall. The patient remained free of recurrence or metastasis 18 months after orchiectomy. This case expands the recognized immunophenotypic spectrum of IN-TSCT and demonstrates that strong ALK immunoreactivity does not necessarily indicate an underlying ALK fusion or rearrangement. Given the potentially aggressive clinical behavior reported in IN-TSCT, long-term oncologic surveillance is warranted.

This is a narrative review that describes the evolution of terminology and classification schemes of neuroendocrine tumors (NETs), neuroendocrine carcinomas (NECs), mixed neuroendocrine-non-neuroendocrine neoplasms (MiNENs), and paragangliomas of the larynx, with the contribution of immunohistochemistry and treatment of neuroendocrine neoplasms of the larynx. Neuroendocrine neoplasms of the larynx comprise both epithelial (NET and NEC) and neural crest-derived (paraganglioma) neoplasms. Their terminology has evolved substantially over time, with current classifications emphasizing biologically and clinically meaningful categories aligned with contemporary WHO frameworks of other organs. These neoplasms may show overlapping clinical presentation and histomorphological features, which can complicate accurate subclassification. However, precise classification is essential, as these entities display markedly different biological behavior, ranging from indolent to highly aggressive with poor prognosis, and their treatment is essentially histology-tailored. Neuroendocrine neoplasms are classified into three categories comprising six tumor subtypes: well-differentiated neuroendocrine tumors (NETs; grades 1, 2, and 3), poorly differentiated neuroendocrine carcinomas (NECs; small-cell and large-cell types), and paragangliomas. An additional, not yet WHO-recognized category is MiNENs (mixed neuroendocrine-non-neuroendocrine neoplasms), defined by the coexistence of neuroendocrine and non-neuroendocrine components. These tumors exhibit distinct biological behavior and clinical significance.

Background/Objectives: The COVID-19 pandemic disrupted gynecologic care pathways and required stricter prioritization of surgical treatment. We evaluated whether the pandemic restriction period was associated with changes in the characteristics of women with adnexal masses reaching surgery and explored ADNEX discrimination within the histologically verified surgical cohort. Methods: This retrospective single-center study included all consecutive women evaluated for an adnexal mass in a dedicated gynecologic ultrasound clinic during a pre-pandemic baseline period and a COVID-19 restriction period. Ultrasound examinations were performed by the same expert using International Ovarian Tumor Analysis (IOTA) terminology and the IOTA Assessment of Different NEoplasias in the adneXa (ADNEX) score was calculated prospectively at the time of examination. Histological analyses were restricted to surgically managed patients. Results: Overall, 340 women were evaluated in the non-COVID period and 211 during the COVID period; 149 (43.8%) and 40 (19.0%), respectively, underwent surgery. After exclusion of five adolescents from the pre-pandemic group, 144 and 40 operated patients were analyzed. The COVID-era surgical cohort was older (median 52.0 vs. 39.0 years, p = 0.0053), had higher ADNEX scores (median 13.7% vs. 4.4%, p = 0.0010), and had a higher proportion of borderline or malignant histology (32.5% vs. 13.2%, p = 0.0083). In an exploratory pooled logistic model, ADNEX score and COVID-period status were associated with non-benign histology. The AUCs were 0.789 and 0.905 in the COVID and non-COVID surgical cohorts, respectively, without a statistically significant between-cohort difference (p = 0.169). Conclusions: The COVID-19 restriction period was associated with a lower proportion of evaluated women proceeding to surgery and with enrichment of the operated cohort for older patients and lesions with higher sonographic risk and non-benign histology. Because surgical selection itself depended partly on ultrasound findings and outcomes were unavailable for non-operated women, these data should not be interpreted as independent validation of ADNEX or proof that deferred management was safe.

Nutritional therapy is an essential component of comprehensive care for cancer patients, playing a vital role in preventing malnutrition, improving treatment tolerance, and maintaining quality of life. In recent years, there has been growing interest in the ketogenic diet as a potential strategy to support cancer therapy. This diet, based on a significant reduction in carbohydrate intake and an increase in fat intake, leads to a state of ketosis that mimics the metabolic changes that occur during starvation. Consequently, the body utilizes ketone bodies as an alternative source of energy. The potential application of the ketogenic diet in oncology stems from the distinct metabolism of cancer cells, which often exhibit an increased demand for glucose. Although the results of preclinical studies suggest a possible anticancer effect of this dietary intervention, clinical evidence remains limited, and its routine use is not currently recommended as a standard of care in oncology. The aim of this study was to analyze the current literature on the use of the ketogenic diet in oncology, with a particular focus on breast cancer. The study assessed the impact of this intervention on metabolic parameters, body composition, and patients' mental well-being, and analyzed the potential metabolic risks associated with its use. The study discusses the molecular basis of oncogenesis and metabolic adaptation in cancer cells, the mechanisms of action of the ketogenic diet, and the results of preclinical and clinical studies as well as meta-analyses. Importantly, the current evidence base should be interpreted with caution. Most mechanistic evidence supporting ketogenic diet in breast cancer derives from preclinical models, whereas clinical studies remain limited by small sample sizes, short intervention periods, heterogeneous ketogenic diet protocols, substantial attrition, and differences in concomitant anticancer treatment. Therefore, mechanistic plausibility and promising preclinical findings should not be interpreted as evidence of clinical anticancer efficacy.

Postbiotics derived from beneficial bacteria have emerged as promising bioactive ingredients owing to their enhanced stability, safety, and functional versatility relative to live microorganisms.

The present study was structured in two complementary stages: (i) biological characterization of liquid microfiltrates obtained from Lactiplantibacillus plantarum and Bacillus mojavensis fermented in aguamiel, and (ii) technological stabilization of these postbiotics through microencapsulation by spray drying, with a view to their potential incorporation into food matrices. Results&Conclusions: In the first stage, biological activity was assessed in vitro using MDA-MB-231 human breast cancer cells and in vivo in C57BL/6J mice, in order to evaluate safety and gastrointestinal effects. Both postbiotics significantly reduced cell viability relative to controls, consistent with antiproliferative activity. In vivo, no macroscopic intestinal damage was observed, supporting their safety profile. Histomorphometric analysis revealed preserved intestinal architecture, with elongation of villi and crypts and increased mucin 2 production, indicating strengthened mucosal barrier integrity; these effects were more pronounced in the Bacillus mojavensis-treated group. In the second stage, the spray-dried powders exhibited adequate physicochemical stability, supporting their potential application as functional food ingredients. The spray-dried powders exhibited adequate physicochemical stability, supporting their potential application as functional food ingredients.

Background: The dynamic advancement of pediatric hemato-oncology and intensified therapeutic protocols have significantly increased survival rates while simultaneously highlighting the challenge of long-term treatment complications. Within the cohort of adolescent and young adult (AYA) survivors, delayed neurocognitive deficits, often manifesting as the chemobrain phenotype, and psychosocial disorders constitute a particularly substantial burden. Contemporary neurogastroenterological evidence indicates a fundamental role of persistent dysbiosis and gut-brain axis dysfunction in the pathogenesis of these alterations. This review aims to critically synthesize translational evidence elucidating the impact of iatrogenic gut microbiota damage and modifiable dietary patterns on the development of long-term neurocognitive sequelae in survivors of early childhood cancer. Methods: A systematized narrative review was conducted in accordance with the SANRA guidelines by integrating data from in vivo models and observational studies. A comprehensive literature search across the PubMed, Embase, Cochrane Central, Scopus, and Web of Science databases up to June 2026 was performed utilizing the Population, Exposure, and Outcomes (PEO) framework. Results: Oncological therapies, including myeloablative conditioning and broad-spectrum antibiotic therapy, induce a microbial scar phenomenon characterized by the depletion of commensal Firmicutes in favor of resistant pathobionts. The subsequent decline in the synthesis of neuroprotective short-chain fatty acids (SCFAs) alongside the pathological activation of the kynurenine pathway disrupts central nervous system homeostasis. Translocation of lipopolysaccharides (LPSs) across the compromised intestinal barrier generates systemic inflammation recognized as inflammaging, which, in turn, stimulates neurotoxic microglial hyperreactivity. This pathophysiological cascade is accelerated by a pro-inflammatory Western diet, whereas anti-inflammatory interventions such as the MIND diet and postbiotics demonstrate measurable restorative potential. Conclusions: The pathophysiology of delayed neurotoxicity is largely a consequence of systemic neuroinflammation driven by intestinal dysbiosis. Implementing individualized dietary and microbiome-targeted strategies into survivorship care protocols constitutes a crucial direction for clinical prophylaxis. Validating their clinical efficacy in the AYA population necessitates prospective randomized controlled trials integrated with shotgun metagenomic sequencing.