Eccrine syringofibroadenoma (ESFA) is a rare benign adnexal neoplasm characterized by eccrine ductal differentiation within a fibrovascular stroma and poses significant diagnostic challenges due to its variable clinical presentation. It may occur as a solitary lesion, a reactive proliferation in chronically inflamed or traumatized skin, or in association with hereditary syndromes. We report a case of a 47-year-old male presenting with a two-year history of asymptomatic, slowly enlarging nodules forming an annular plaque over the posterolateral aspect of the right foot. Dermoscopy revealed light-brown pigment globules in a cobblestone pattern with yellowish scales and central crusting. Histopathology demonstrated anastomosing epithelial cords with eccrine ductal differentiation embedded in a mucin-rich fibrovascular stroma, confirming ESFA. The lesion was treated with complete surgical excision, resulting in an excellent outcome. This case highlights the importance of clinicopathological correlation, the supportive role of dermoscopy, and the need for awareness of ESFA in chronic acral lesions.

Breast cancer is the most common cause of cancer mortality in females globally, and a significant proportion of patients develop metastatic disease. Common metastatic sites of breast cancer include bone, lung, liver, and brain. Secondary neoplasms (metastases from other primary sites) represent a minority of all malignant bladder tumors In this report, we describe a case of breast cancer metastasis with ureteral obstruction and bladder mass in a 60-year-old African-American female. For over a decade, this patient was asymptomatic and had been under surveillance following bilateral radical mastectomy for invasive ductal carcinoma (IDC) with adjuvant chemoradiotherapy. Unrelated imaging revealed an incidental finding of right hydronephrosis. Subsequent cystoscopy revealed a bladder mass obstructing the right ureteral orifice. Transurethral resection of a bladder tumor and ureteral stent placement were performed, and the pathology findings favored metastatic breast cancer. The details of the case are intended to help further knowledge of urinary bladder metastases. This case is unusual in that the patient was asymptomatic, her breast cancer type is associated with a lower incidence of bladder metastases, and the bladder was the solitary location of metastasis.

This case series reports the first cases of para-aortic lymphadenectomy performed using the hinotori™ Surgical Robot System (Medicaroid Corporation, Kobe, Japan), Japan's first domestically developed robotic surgical platform. Three patients with gynecologic malignancies (two endometrial and one ovarian cancer) underwent curative surgery, including total hysterectomy, bilateral salpingo-oophorectomy, pelvic lymphadenectomy, and para-aortic lymphadenectomy. All procedures were completed robotically without conversion or intraoperative complications. Operative time ranged from 461 to 512 minutes, and blood loss from 10 to 50 mL. A total of 9-38 para-aortic lymph nodes (median 26) were retrieved, comparable to yields from laparoscopic or da Vinci®-assisted procedures, confirming oncologic adequacy. Postoperative recovery was uneventful in all cases. These cases demonstrate that para-aortic lymphadenectomy using the hinotori™ system is technically feasible and safe. Expanding its use from well-established pelvic surgery to advanced oncologic procedures marks an important milestone for robotic surgery in Japan. Further studies are needed to refine protocols and assess outcomes.

Chemotherapy-induced alopecia (CIA) is known to have a significant psychological and quality of life impact. Although cold caps have been shown to prevent CIA, expense and extension of treatment durations are barriers for routine clinical use. Keratinocyte growth factor (KGF) has been shown to have cytoprotective effects on human hair follicles and reduce alopecia in preclinical models. We hypothesized that KGF-hair serum (KGF-HS) will prevent CIA.

We conducted a Simon two-stage, single-arm clinical study in women with early-stage breast cancer (ESBC) scheduled to receive at least four cycles of chemotherapy. The primary outcome was preservation of hair after chemotherapy, whereas secondary measures included patient-reported wig use, comfort, and validated quality-of-life instruments (EORTC QLQ-C30, HADS, and BIS).

Twenty patients were evaluable for the primary end point. None achieved meaningful hair preservation. The average duration of treatment of KGF-HS application was 4.6 weeks.

In this study of women with ESBC receiving chemotherapy, using the KGF-HS did not prevent CIA. There was no statistical difference pre- and post-study BIS, HADS, and EORTC-30 scores. Application of the KGF-HS was reported to be easy, with minimal discomfort, and a non-oily appearance. Patients' ease of use and acceptability of a topical agent for CIA further supports the development of new agents for a more practical and affordable alternative to scalp cooling.

clinicaltrials.gov: NCT04554732.

Several cancer potency estimates have been proposed by regulatory agencies to characterize the dose response of cobalt and/or cobalt compounds.   The objective of this research is to investigate whether these proposed cancer potency estimates for certain cobalt substances align with the available epidemiology literature. After review of the epidemiological literature, we identified a study appropriate for our analysis. We established whether our identified study was adequately powered to detect an elevated lung cancer risk. The power analysis assumed a Poisson distribution and used a one-sided significance level of 0.05. Lung tumors in animals served as the basis for cancer potency estimates for several regulatory bodies. The study population from our identified study was used to calculate predicted excess lung cancer deaths using potency values reported by four regulatory organizations, which were then compared to observed lung cancer deaths. Monte Carlo methods were used to estimate sample size and cobalt exposure distribution of the highest exposure group. We determined that the our identified study has ≥ 98% statistical power to detect a 1.5-fold or greater increase in lung cancer due to cobalt exposure in all but the lowest exposure group and all four exposure groups had 100% statistical power to detect a 2.0-fold or greater increase in lung cancer due to cobalt exposure. Cobalt exposure at the estimated median of the highest exposure group resulted in hypothetical standardized mortality ratios (SMR) estimated from the regulatory potency values ranging from 3.54 to 8.61 compared to an observed SMR of 1.15 (95% CI: 0.92-1.43) in our identified study. On the basis of this analysis, the cancer potency estimates proposed by the included regulatory organizations are likely overestimations of excess lifetime human cancer risk after cobalt inhalation exposure.

Transcolonic endoscopic appendectomy is an emerging minimally invasive alternative to traditional appendectomy, offering potential benefits such as reduced postoperative pain, faster recovery, and avoidance of external incisions. The variable anatomical location of the appendix, however, influences both the surgical approach and technical difficulty. The appendiceal stump-defined as the residual portion of the appendix after prior appendectomy-poses a unique challenge, as the main body of the appendix has already been removed. This study aimed to evaluate the feasibility, safety, and efficacy of transcolonic endoscopic appendectomy for the removal of appendiceal stump lesions.

This retrospective study included patients who underwent the procedure between December 2020 and December 2024 after prior appendectomy for appendiceal remnant lesions. The primary outcome was technical success; secondary outcomes included postoperative complications, hospital stay, and recurrence.

Nine patients (mean age 60.7 years; 4 males, 5 females) were included. Lesion size averaged 1.34 cm. Complete en bloc resection was achieved in all cases. Mean operative time was 70 min, with fasting and hospitalization durations of 3.4 and 5.8 days, respectively. No postoperative complications occurred, and 3-month colonoscopy showed no residual lesions or recurrence.

Transcolonic endoscopic appendectomy for appendiceal stump lesions is a safe and effective minimally invasive treatment option within experienced endoscopic centers. Due to their anatomical simplicity, these lesions represent a straightforward indication, making the procedure suitable as an entry-level application for endoscopists. Further investigation and structured training programs are warranted to assess long-term outcomes and broaden the generalizability of this technique.

IntroductionPoor diet and excess weight have been linked to increased risk for at least 13 types of cancer. Culinary medicine utilizes experiential cooking skill development to improve individuals' capacity for healthy eating. Digital communication strategies offer pathways for scalable culinary medicine interventions, but little research has explored how online cooking tools could be leveraged for cancer prevention messaging. We conducted a cross-sectional survey study exploring online cooking information-seeking habits and content preferences among participants in four cancer prevention and control cohorts to inform future digital culinary medicine interventions.MethodsA cross-sectional survey study was conducted with a convenience sample of participants from four existing cohort studies being undertaken at the University of Texas MD Anderson Cancer Center. Survey items examined current cooking practices, online cooking information-seeking behavior, digital intervention content preferences, and evaluation of three online cooking videos. Descriptive statistics were used to summarize findings, and open text comments were examined using rapid thematic analysis to add further context.ResultsMost of the 102 respondents were women (99%), with a mean age of 58 years old. Many (78.4%) reported preparing meals at home ≥4 days per week. Search engines were the most common way recipes were identified online and the majority of respondents reported cooking from online videos some or all of the time. Participants gave the highest overall ratings to the 2-4 minute cooking video and highlighted the host personality and video production as important aspects of online cooking video content.ConclusionsThe findings of this study offer insight to inform the development of digital culinary medicine tools for MD Anderson's cancer prevention and control cohorts.

 Adrenal incidentalomas are common, with a detection rate of up to 7% in patients over 70 years of age. Of these, up to 25% are functionally active, leading to the development of severe clinical manifestations. Challenges of insufficient diagnosis and a lack of a personalized approach to the management of such patients persist. To overcome these challenges, the use of CT image analysis is proposed to develop criteria for non-invasive diagnosis, which is a pathway towards improving personalized patient management.

 Analysis of statistically significant correlations between clinical-laboratory parameters and contrast-enhanced (CE) CT imaging features of adrenal adenomas.

 A single-center, non-comparative, cross-sectional retrospective study analyzed preoperative images from four-phase CECT of adrenal adenomas. Hormonal workup included the determination of aldosterone, renin, cortisol levels during an overnight dexamethasone suppression test (DST), adrenocorticotropic hormone (ACTH), 24-hour urinary free cortisol (UFC); potassium and creatinine levels were also assessed. Clinical data included arterial hypertension, impaired carbohydrate metabolism, dyslipidemia, hypokalemia, and renal dysfunction. A comparative and correlation analysis was performed between clinical-laboratory parameters and CECT characteristics.

 The study included 254 patients. Hormonal activity was detected in 226 (89.0%) patients; 28 (11.0%) patients had non-functioning adenomas. Hormonally inactive adenomas were characterized by larger size (43.0 mm [32.7; 51.2] vs. 29.0 mm [20; 36], p<0.001), higher native density (41.0 HU [36.0; 47.2] vs. 25.0 HU [12.0; 37.0], p<0.001), and lower venous phase contrast enhancement (141.6% vs. 283.7%, p=0.001). In primary aldosteronism (PA), adenomas were significantly smaller (20.0 mm [16.8; 25.0]) and had lower native density (14.0 HU [4.0; 24.0]) compared to cortisol-producing tumors (34.0 mm [30.0; 38.0], 35.5 HU [30.0; 44.0], p<0.001). The presence of calcifications was more frequently observed in cortisol hypersecretion compared to PA (p=0.011). Correlation analysis revealed negative associations between adenoma size and levels of aldosterone (r=-0.504, p<0.001) and ACTH (r=-0.419, p<0.001), and positive associations with post-DST cortisol levels (r=0.500, p<0.001), renin (r = 0.454, p<0.001), and potassium (r=0.458, p<0.001).

 CT characteristics of adrenal adenomas vary depending on hormonal activity, type of secretion, and clinical manifestations.

This study aims to develop and validate a nomogram model based on surgical parameters and clinical features for predicting the risk of poor pulmonary rehabilitation outcomes in patients with non-small cell lung cancer (NSCLC) after radical surgery.

This retrospective cohort study included 320 patients who underwent radical lung cancer surgery between June 2021 and December 2024. Patients were divided into a development cohort (n = 224) and a validation cohort (n = 96) at a 7:3 ratio. A composite surgical trauma score (STS) was developed to integrate key intraoperative variables. Independent predictors were identified through multivariate logistic regression analysis, including surgical trauma score, operative time, intraoperative blood loss, and other clinical factors. A nomogram model was constructed and validated using the bootstrap resampling (1000 repetitions). Model performance was assessed using the area under the curve (AUC) and calibration metrics.

The incidence of poor pulmonary rehabilitation was 38.4% in the development cohort and 36.5% in the validation cohort. In the development cohort, 11.2% of patients had a forced expiratory volume in 1 second (FEV1) recovery rate <80% alone, 15.2% had a modified Medical Research Council (mMRC) score ≥2 alone, and 12.0% met both criteria. Multivariable analysis predicted five independent variables: high versus low surgical trauma score (odds ratio (OR) = 3.09, 95% confidence interval (CI): 1.71-5.58), preoperative FEV1% predicted <70% (OR = 2.67, 95% CI: 1.53-4.67), operative time ≥180 minutes (OR = 2.52, 95% CI: 1.41-4.50), intraoperative blood loss ≥80 mL (OR = 2.25, 95% CI: 1.27-3.99), and age ≥65 years (OR = 1.92, 95% CI: 1.10-3.35). The nomogram demonstrated good discrimination, with an AUC of 0.84 (95% CI: 0.78-0.90) in the development cohort and 0.79 (95% CI: 0.70-0.88) in the validation cohort. Calibration was satisfactory in both cohorts (p = 0.23 in the development cohort; p = 0.31 in the validation cohort). Decision curve analysis revealed meaningful net benefits across a wide range of threshold probabilities. Predictive performance remained consistent across subgroups defined by age groups, surgical trauma strata, and tumor-node-metastasis (TNM) stages. Furthermore, sensitivity analyses using alternative endpoint definitions and various approaches for handling missing data further confirmed the robustness of the model.

We developed and validated a predictive nomogram for poor pulmonary rehabilitation outcomes after radical lung cancer surgery. This model incorporates readily available clinical and surgical parameters, providing individualized risk assessment that may facilitate personalized rehabilitation strategies and improve postoperative management.

Laparoscopic systematic mesogastric excision (LSME) is an innovative theory and may lead to better outcomes for the treatment of locally advanced gastric cancers (LAGC). The purpose of this study was to compare outcomes after LSME to those after traditional laparoscopic D2 dissection (TLD2) in patients with LAGC.

From January 2018 to December 2020, 675 patients with LAGC underwent LSME and TLD2 at The First Affiliated Hospital of Bengbu Medical University. Of these, 202 conformed to the inclusion criteria and were included in the study after propensity score matching (PSM). The primary endpoints of this study were 5-year disease-free survival (DFS) and overall survival (OS). The secondary endpoints included surgical outcomes and postoperative complications.

The demographic and pathological characteristics of the patients in both groups were well balanced after PSM. The 5-year DFS rates were 25.2% and 39.2% in the TLD2 group and the LSME group (p = 0.044), respectively. The difference in 5-year overall survival between the two groups was not statistically significant (39.1% in TLD2 vs. 43.2% in LSME, p = 0.370). LSME was associated with less intraoperative blood loss (21.3 ± 9.1 mL in LSME vs. 33.3 ± 11.9 mL in TLD2, p < 0.001), more dissected lymph nodes (LNs) (45.0 ± 16.0 LNs in LSME vs. 40.0 ± 14.0 LNs in TLD2; p = 0.019), and fewer lower limb thromboses (LSME: 6.9% vs. TLD2: 17.8%; p = 0.019). The other postoperative morbidities were similar.

LSME is safe for the treatment of LAGC because it results in fewer postoperative complications. Compared with TLD2, LSME may decrease local recurrence rate and improve 5-year DFS, but there is no significant difference in 5-year OS.