bims-netuvo Biomed News
on Nerves in tumours of visceral organs
Issue of 2024–02–04
seven papers selected by
Maksym V. Kopanitsa, The Francis Crick Institute
  1. How cancer hijacks the nervous system to grow and spread.
  2. Does CT overestimate extra-pancreatic perineural invasion in patients with pancreatic ductal adenocarcinoma following neoadjuvant chemoradiation therapy?
  3. Heritability of nervous system tumors: a sibling-based design.
  4. Comprehensive evaluation of rare case: From diagnosis to treatment of a sigmoid Schwannoma: A case report.
  5. Survival outcome of patient with pT1N0 biliary tract cancer treated with surgery alone.
  6. An Unusual Case of a Giant Schwannoma of the Sciatic Nerve: A Case Report With a Review of Literature.
  7. Multiple penile and scrotal schwannomas in an adult patient: Case report.
  1. Nature. 2024 Feb;626(7997): 22-24
    How cancer hijacks the nervous system to grow and spread.
    McKenzie Prillaman.
      
    Keywords:  Cell biology; Neuroscience
    DOI:  https://doi.org/10.1038/d41586-024-00240-3
  2. Br J Radiol. 2024 Jan 04. pii: tqae001. [Epub ahead of print]
    Does CT overestimate extra-pancreatic perineural invasion in patients with pancreatic ductal adenocarcinoma following neoadjuvant chemoradiation therapy?
    Yoshifumi Noda, Nisanard Pisuchpen, Anushri Parakh, Shravya Srinivas-Rao, Yuko Kinowaki, Mari Mino-Kenudson, Avinash R Kambadakone.
       OBJECTIVES: To evaluate the diagnostic performance of CT in the assessment of extra-pancreatic perineural invasion (EPNI) in patients with pancreatic ductal adenocarcinoma (PDAC).
    METHODS: This retrospective study included 123 patients (66 men; median age, 66 years) with PDAC who underwent radical surgery and pancreatic protocol CT for assessing surgical resectability between September 2011 and March 2019. Among the 123 patients, 97 patients had received neoadjuvant chemoradiation therapy (CRT). Two radiologists reviewed the CT images for evidence of EPNI using a 5-point scale (5 = definitely present, 4 = probably present, 3 = equivocally present, 2 = probably absent, and 1 = definitely absent). Diagnostic performance for assessing EPNI was evaluated with receiver operating characteristic (ROC) curve analysis.
    RESULTS: The sensitivity, specificity, and area under the ROC curve for assessing EPNI were 98%, 30%, and 0.62 in all patients; 97%, 22%, and 0.59 in patients with neoadjuvant CRT; and 100%, 100%, and 1.00 in patients without neoadjuvant CRT, respectively. False-positive assessment of EPNI occurred in 23% of patients (n = 28/123), and 100% of these (n = 28/28) had received neoadjuvant CRT. There was moderate to substantial agreement between the readers (ĸ = 0.49-0.62).
    CONCLUSION: Pancreatic protocol CT has better diagnostic performance for determination of EPNI in treatment naïve patients with PDAC and overestimation of EPNI is likely in patients who have received preoperative CRT.
    ADVANCES IN KNOWLEDGE: Pancreatic protocol CT has better diagnostic performance for the detection of EPNI in treatment naïve patients compared to patients receiving neoadjuvant CRT.
    Keywords:  computed tomography; extra-pancreatic perineural invasion; pancreatic ductal adenocarcinoma
    DOI:  https://doi.org/10.1093/bjr/tqae001
  3. Front Oncol. 2023 ;13 928008
    Heritability of nervous system tumors: a sibling-based design.
    Giorgio Tettamanti, Ralf Kuja-Halkola, Catharina Lavebratt, Mats Talbäck, Alexander Viktorin, Michael E Scheurer, Maria Feychting, Maral Adel Fahmideh.
       Background: The contribution of genetic and environmental factors to susceptibility to nervous system tumors remains unclear. We performed a quantitative genetic study using a sibling design to estimate the heritability of nervous system tumors, as well as the proportion of the risk of these tumors, which is attributable to environmental factors.
    Methods: We conducted a population-based cohort study using Swedish National Register data. All individuals born in Sweden during 1950-2010 with available information on both biological parents were included. A Multi-Generation Register was used to identify family clusters, including both full- and half-siblings. Initially, one index person was randomly selected from each cluster containing only full siblings and one sibling was randomly assigned to this index person. Subsequently, within each of the remaining clusters of full- and half-siblings, an index person was randomly selected, and a half-sibling was randomly assigned to this index person. Among the randomly selected siblings, cases of nervous system tumors were identified using the cancer registry. Quantitative genetic models were used to estimate the proportion of the variance in nervous system tumors attributable to additive genetic factors, shared environment, and individual-specific environment.
    Results: The heritability of nervous system tumors was estimated to be 29% (95% confidence interval (CI) = 19%-39%), while the contribution of the non-shared environment to the variance of nervous system tumors was estimated to be 71% (95% CI = 61%-81%). The shared environmental parameter was estimated as zero in the full model.
    Conclusion: The variation in susceptibility to nervous system tumors is predominantly attributable to non-shared environmental factors, followed by genetic factors.
    Keywords:  heritability; nervous system tumors; quantitative genetic modelling; registry-linkage study; sibling-based design
    DOI:  https://doi.org/10.3389/fonc.2023.928008
  4. World J Gastrointest Oncol. 2024 Jan 15. 16(1): 244-250
    Comprehensive evaluation of rare case: From diagnosis to treatment of a sigmoid Schwannoma: A case report.
    Jing-Yi Li, Xi-Zhuang Gao, Jian Zhang, Xiang-Zheng Meng, Yi-Xian Cao, Kun Zhao.
       BACKGROUND: Schwannomas are uncommon tumors originating from Schwann cells, forming the neural sheath. They account for approximately 2%-6% of all mesenchymal tumors and are most commonly identified in peripheral nerve trunks, with rarity in the gastrointestinal tract. Among gastrointestinal locations, the stomach harbors the majority of nerve sheath tumors, while such occurrences in the sigmoid colon are exceptionally infrequent.
    CASE SUMMARY: This study presented a clinical case involving a 60-year-old female patient who, during colonoscopy, was diagnosed with a submucosal lesion that was later identified as a nerve sheath tumor. The patient underwent surgical resection, and the diagnosis was confirmed through immunohistochemistry. This study highlighted an exceptionally uncommon occurrence of a nerve sheath tumor in the sigmoid colon, which was effectively managed within our department. Additionally, a comprehensive review of relevant studies was conducted.
    CONCLUSION: The preoperative diagnosis of nerve sheath tumors poses challenges, as the definitive diagnosis still relies on pathology and immunohistochemistry. Although categorized as benign, these tumors have the potential to demonstrate malignant behavior. Consequently, the optimal treatment approach entails the complete surgical excision of the tumor, ensuring the absence of residual lesions at the margins.
    Keywords:  Case report; Gastrointestinal stromal tumors; Schwannoma; Sigmoid colon; Treatment
    DOI:  https://doi.org/10.4251/wjgo.v16.i1.244
  5. Eur J Surg Oncol. 2024 Jan 23. pii: S0748-7983(24)00032-5. [Epub ahead of print]50(3): 107980
    Survival outcome of patient with pT1N0 biliary tract cancer treated with surgery alone.
    Masaaki Kagoura, Shin Kobayashi, Motohiro Kojima, Masashi Kudo, Motokazu Sugimoto, Masaru Konishi, Naoto Gotohda.
       INTRODUCTION: Adjuvant chemotherapy (AC) with S-1 or capecitabine monotherapy is now the standard of care for resected biliary tract cancer (BTC) according to the Adjuvant S-1 for Cholangiocarcinoma Trial (ASCOT) and the BILCAP study. Patients selection criteria, especially regarding pT1N0 BTC, differed in both trials. We aimed to clarify the survival outcomes regarding resected pT1N0 BTC without AC.
    METHODS: Among patients with macroscopically complete resection for BTC treated without AC between September 1992 and December 2020, the survival outcomes of those with pT1N0 BTC, except for intrahepatic cholangiocarcinoma, according to the Union for International Cancer Control 7th and 8th edition (TNM7 and 8), were investigated.
    RESULTS: Of 749 patients who underwent curative resection for BTC, 69 were identified as having pT1N0 BTC according to TNM8. Six patients (9 %) developed recurrence during the median follow-up period of 53 months (range: 14-263 months) with only one patient (2 %) being pT1N0 according to TNM7. Based on TNM8, the 5-year recurrence-free survival, disease-specific survival, and overall survival reached 90.7 % (95 % confidence interval [CI]: 80.3-95.7 %), 96.4 % (95 % CI: 86.1-99.1 %), and 85.3 % (95 % CI: 71.2-92.8 %), respectively. Perineural invasion (PNI) was significantly associated with recurrence, and the recurrence rate in patients with PNI reached as high as 40 %.
    CONCLUSIONS: The survival outcomes regarding resected pT1N0 BTC according to TNM7 were excellent without AC; however, those of TNM8 were not, with PNI being associated with recurrence risk.
    Keywords:  Bile duct cancer; Biliary tract cancer; Cholangiocarcinoma; Perineural invasion; T1
    DOI:  https://doi.org/10.1016/j.ejso.2024.107980
  6. Cureus. 2023 Dec;15(12): e51155
    An Unusual Case of a Giant Schwannoma of the Sciatic Nerve: A Case Report With a Review of Literature.
    Ousama Jelti, Oussama El Alaoui, Adnane Lachkar, Najib Abdeljaouad, Hicham Yacoubi.
      Sciatic nerve schwannomas are rare tumors, mainly characterized by sciatic neuralgia rather than sensory-motor deficits. The poorly suggestive clinical presentation of this localization leads to a delayed diagnosis. Here, we describe the case of a 47-year-old female patient with a nine-month history of schwannoma localized in the sciatic nerve, just above the left popliteal fossa. Although magnetic resonance imaging (MRI) is the imaging modality of choice, the final diagnosis rests on the histological examination of the tumor. The schwannoma must be surgically removed without severing the nerve trunk.
    Keywords:  case report; neurilemmoma; schwannoma; sciatic nerve; surgery
    DOI:  https://doi.org/10.7759/cureus.51155
  7. Urol Int. 2024 Jan 30.
    Multiple penile and scrotal schwannomas in an adult patient: Case report.
    Muhammet Şahin Yılmaz, Mahmut Ulubay, Fatih Kuru, Ömer Salih Akar.
       INTRODUCTION: Schwannomas originate from the peripheral nerve sheaths and are mainly detected in the head, neck, or extremities. They are rarely encountered in the penoscrotal region.
    CASE PRESENTATION: Herein, we present a case of a penoscrotal schwannoma diagnosed and successfully treated in our center. A 40-year-old patient with a history of resection of a dorsal penile schwannoma presented with multiple nodular lesions at the scrotum, penile shaft, and radix, which were first noticed five years before his current presentation. He complained about penile pain and dyspareunia. Magnetic resonance imaging was performed for pre-operative diagnosis. All nodular lesions were resected while preserving the neurovascular structures. The histopathological examination revealed benign lesions. The patient's complaints were resolved, and there was no recurrence during the one-year follow-up.
    CONCLUSION: The primary treatment is surgical excision. The patients need close follow-up regarding the risks of recurrence and malignant transformation.
    DOI:  https://doi.org/10.1159/000535093
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