The natural history of renal oncocytoma (RO) following surgical resection remains unclear. We examined a cohort of post-nephrectomy patients with RO, focusing on the management of synchronous and metachronous tumors and their clinical course under surveillance.

This retrospective, single-institution study analyzed patients from 1990 to 2020 with at least 24 months of follow-up. Patient characteristics and management of synchronous and metachronous tumors were recorded. Cox regression identified risk factors for metachronous tumors, while Kaplan-Meier and log-rank tests assessed metachronous-free survival (MFS).

Among 328 patients (median follow-up: 109 months), 19% (n = 63) had synchronous renal tumors on preoperative imaging. Of these, 27 underwent additional procedures, revealing renal cell carcinoma (RCC)/cortical neoplasm (n = 7), benign lesions (n = 5), or secondary RO (n = 13). Two specimens were unavailable. Metachronous renal lesions developed in 8.5% (n = 28), with 18 undergoing active surveillance. Among 8 patients undergoing biopsy or surgery, 3 had RCC/cortical neoplasm, 4 had RO, and 1 specimen was inconclusive. 5-year MFS were 98.8% in patients with a single lesion at diagnosis and 88% for patients with presence of synchronous renal lesions (P = .004). Higher BMI (HR 1.09, CI 1.01-1.17, P = .026) and synchronous lesions at diagnosis (HR 2.67, CI 1.16-6.14, P = .021) were significant risk factors for metachronous tumors.

Patients with RO have a very low risk of harboring RCC in synchronous or metachronous lesions, supporting active surveillance as a safe strategy. However, those with synchronous kidney tumors at diagnosis face an increased risk of metachronous disease and may require closer monitoring.

Common lymphatic endothelial and vascular endothelial receptor-1 (CLEVER-1) is a multifunctional scavenger receptor expressed on tumor-associated macrophages (TAMs). In a recent study published in the Journal for ImmunoTherapy of Cancer, Yu et al reported that CLEVER-1⁺ TAMs accumulate in advanced gastric cancer (GC), associate with poor prognosis, and contribute to resistance to chemoimmunotherapy. CLEVER-1 blockade using bexmarilimab reprogrammed TAMs toward a pro-inflammatory phenotype by suppressing peroxisome proliferator-activated receptor gamma (PPARγ)-driven lipid metabolism and enhancing antigen presentation and inflammatory cytokine secretion. CLEVER-1 blockade also synergized with anti-programmed cell death protein 1 (PD-1) therapy in ex vivo GC models, particularly in tumors enriched with CLEVER-1⁺ TAM. These findings identify CLEVER-1⁺ TAMs as both biomarker and functional mediator of anti-PD-1 therapy resistance, providing a rationale for combining bexmarilimab with immune checkpoint blockade in GC. In this commentary, we discuss the mechanistic significance, translational potential, and clinical prospects of CLEVER-1 blockade to overcome immunotherapy resistance in GC.

Cutaneous squamous cell carcinoma (cSCC) is the second most common form of skin cancer in Asian, Caucasian, and Hispanic populations and its aggressive form contributes to significant morbidity and mortality. Chronic ultraviolet B (UVB) exposure is a major environmental carcinogen that drives cSCC initiation, progression, and immune evasion. Regulatory T cells (Tregs) are known mediators of UVB-induced immunosuppression; however, their direct involvement in the establishment of cSCC remains elusive.

Flow cytometry was employed to quantify Treg populations in the skin and draining lymph nodes of UVB-exposed and untreated mice. The functional role of Tregs following UVB exposure was examined using a contact hypersensitivity assay, where Treg activity was modulated by anti-cytotoxic T-lymphocyte-associated protein (CTLA)-4, anti-TIGIT, and anti-FR4 antibodies. The capacity of UVB to render mice susceptible to immunogenic cSCC tumor establishment was assessed under different UVB exposure regimens. Treg-modulating antibodies were administered following UVB treatment and prior to tumor implantation to explore whether UV-induced Treg manipulation can prevent cSCC tumor establishment.

UVB irradiation for 5 consecutive days significantly increased the number of CD4⁺ Foxp3⁺ Tregs in both skin and skin-draining lymph nodes. These Tregs were shown to be suppressive in contact hypersensitivity assays. However, suppression was prevented following depletion of Tregs and/or avolition of their function using monoclonal antibodies. Consistently, chronic UVB exposure prior to tumor implantation permitted the establishment and growth of otherwise immunogenic cSCC tumors, which correlated with the expansion and recruitment of Tregs into the skin. Importantly, immunomodulation with anti-CTLA-4 or anti-FR4 after chronic UVB exposure effectively prevented cSCC establishment, indicating that the manipulation of UV-induced Tregs prevented the establishment and growth of immunogenic cSCC tumors.

Our findings show that the manipulation of UV-induced Tregs prevents early cSCC establishment. Thus, strategies aimed at modulating Treg function or abundance in the skin may represent a feasible therapeutic avenue for the prevention of cSCC tumor emergence in patients.

In workplaces where formaldehyde, hydrochloric acid and water vapor coexist, dichloromethyl ether can be produced. Dichloromethyl ether has strong carcinogenicity. Its target organ is the lungs, and the common tissue type of lung cancer is small cell lung cancer. This paper analyzes the cause of a case of occupational tumor (lung cancer caused by dichloromethyl ether) in the electroplating industry. Through the use of on-site occupational health investigation method, engineering analysis method and detection and inspection method, the occupational disease diagnosis is diagnosed in combination with the patient's occupational contact history, clinical symptoms and workplace occupational disease hazard factors. According to GBZ 94-2017 "Diagnosis of Occupational Tumor", the patient in this case was clearly diagnosed with primary lung cancer and was diagnosed as an occupational tumor (lung cancer caused by dichloromethyl ether) .

The purpose of this study was to evaluate the intra-fractional motion (IFM) in stereotactic body radiation therapy (SBRT) for metastatic spinal tumors according to different irradiation site groups. We analyzed IFM during SBRT in 31 patients (32 lesions) treated at our institution from January 2022 to April 2023. IFM was evaluated in 3 groups according to the targeted spinal regions as follows: the cervical and upper thoracic, the lower thoracic, and the lumbar-sacral (L-S). IFM was defined as the displacement measured by acquired with the orthogonal kV-kV imaging system (ExacTrac; BrainLab, Munich, Germany) before and after irradiation. Correlations between IFM and treatment time were examined. The planning target volume (PTV) was determined by adding a 2 mm margin to the clinical target volume. The results showed that IFM for three groups was within 2 mm/2° for more than 95% of all fractions. There was no strong correlation between IFM and treatment time. The correlation coefficient between IFM and treatment time was up to 0.43 in the anterior-posterior direction of the L-S group. In conclusion, the IFM of SBRT for spinal metastases at our institution was within 2 mm for more than 95% of all fractions, which was encompassed by the PTV.

Retinoic acid receptor-related orphan receptor gamma (RORγ) is a key transcriptional factor that plays a crucial role in the differentiation and activation of Type 17 cells, such as interleukin-17 (IL-17)-producing CD4⁺ T (Th17) cells and CD8⁺ T (Tc17) cells, which are known to boost antitumor responses. Although a RORγ agonist (LYC-55716) has been under clinical evaluation, the precise effects of RORγ agonists on immune cells within tumor environments remain unclear. In our study, we investigated the role of tumor-infiltrating immune cells in the MC38 syngeneic mouse model of colorectal cancer using Compound-34, a novel orally available RORγ-selective agonist we discovered. Our findings revealed that Compound-34 exerts its antitumor efficacy by modulating immune cell activity rather than directly targeting tumor cells. Specifically, Compound-34 increased the infiltration of effector T cells, including Th17 and Tc1 (interferon [IFN]-γ⁺ CD8⁺ T) cells, as well as innate immune cells like natural killer (NK) and natural killer T (NKT) cells, within the MC38 tumor tissue. Following the administration of Compound-34, there was an increase in IFNγ and Granzyme B within the MC38 tumor tissue, accompanied by an increase in the infiltration of cytotoxic immune cells. Moreover, the addition of Th17-derived cytokines to MC38 cells stimulated the release of CXCL10, a chemokine crucial for immune cell recruitment. These results offer valuable insights into the immunomodulatory and therapeutic potential of RORγ agonists in cancer immunotherapy, highlighting their role in enhancing immune cell infiltration and activity within tumors.

Classic rotationplasty technique uses femoral and tibial osteotomies to resect portions of the distal femur and proximal tibia, most commonly in the setting of malignancy. The procedure involves rotating the lower extremity 180° to transform the ankle into a new hinge (knee) joint. This case describes an example of rotationplasty as a limb salvage option following a failed distal femoral reconstruction in a paediatric patient with osteosarcoma. Additionally, to reduce the likelihood of revision for malalignment, a tibial osteotomy was not performed, and the intramedullary nail was kept in a dynamically locked position, preserving the potential for growth through the proximal tibial physis in the rotated limb. This modification demonstrates that sacrificing the proximal tibial physis is not always necessary when performing rotationplasty, offering young patients both disease control and gradual growth of the operative limb with less importance on speculative growth calculations preoperatively.

Dermatomyositis (DM) is an autoimmune inflammatory myopathy characterised by proximal muscle weakness and distinctive cutaneous findings, frequently linked to malignancy. Lambert-Eaton myasthenic syndrome (LEMS) is a paraneoplastic disorder of neuromuscular transmission, most commonly associated with small-cell lung carcinoma. We describe a woman in her early 70s presenting with progressive proximal muscle weakness, dysphagia and a characteristic rash. Initial evaluation confirmed DM according to the 2017 European League Against Rheumatism/American College of Rheumatology classification criteria, based on clinical, serological and MRI findings. Persistent weakness and atypical facial involvement prompted further evaluation, revealing electrophysiological evidence of presynaptic neuromuscular junction dysfunction and positive P/Q-type voltage-gated calcium channel antibodies, confirming coexisting LEMS. Chest imaging identified a left upper lobe lesion, and positron emission tomography-computed tomography confirmed metastatic lung adenocarcinoma. This case illustrates the diagnostic complexity of overlapping paraneoplastic syndromes.

Juvenile granulosa cell tumours (JGCTs) are rare ovarian neoplasms with aggressive potential and limited responsiveness to chemotherapy. We present a case of a female in early adolescence with chemoresistant JGCT and extensive peritoneal recurrence following initial surgery and systemic therapy. The patient underwent cytoreductive surgery followed by hyperthermic intraperitoneal chemotherapy (HIPEC) with cisplatin, resulting in a favourable postoperative course. This report highlights the role of aggressive surgical management combined with HIPEC as a promising approach for selected cases of chemoresistant peritoneal JGCT. Further studies are needed to establish standardised treatment protocols.

Renal cell carcinoma (RCC) during pregnancy is rare and presents a unique clinical dilemma, requiring the simultaneous optimisation of maternal oncological outcomes and fetal safety. Management decisions must balance the urgency of treating a potentially aggressive malignancy against the physiological and obstetric risks of intervention. We present the case of a large, incidentally detected clear cell RCC in a pregnant patient, managed successfully with laparoscopic radical nephrectomy during the second trimester. This case underscores the importance of multidisciplinary collaboration and tailored surgical planning in achieving favourable outcomes for both the mother and fetus.