bims-netuvo Biomed News
on Nerves in tumours of visceral organs
Issue of 2024–05–19
thirteen papers selected by
Maksym V. Kopanitsa, The Francis Crick Institute
  1. Central neural mechanisms of cancer cachexia.
  2. The prognostic and predictive significance of perineural invasion in stage I to III colon cancer: a propensity score matching-based analysis.
  3. Targeting TRPV4 Channels for Cancer Pain Relief.
  4. Local anaesthetics and chemotherapeutic agents: a systematic review of preclinical evidence of interactions and cancer biology.
  5. Chronic kidney disease with malignant peripheral nerve sheath tumor of the ureter: a case report.
  6. Noninvasive prediction of perineural invasion in intrahepatic cholangiocarcinoma by clinicoradiological features and computed tomography radiomics based on interpretable machine learning: a multicenter cohort study: erratum.
  7. An incidental large adrenal schwannoma: A case report.
  8. Incidental Finding of an Asymptomatic Jejunal Schwannoma: A Rare Case Report and Review of Literature.
  9. Low-grade malignant peripheral nerve sheath tumour presenting as retroperitoneal spindle cell neoplasm.
  10. Retroperitoneal pelvic schwannoma: A rare case report and review of the literature.
  11. Schwannoma as Extraspinal Swelling Over the Thoracolumbar Region: A Tumor at a Rare Site.
  12. Clavicular window for brachial plexus schwannoma removal.
  13. Ancient Schawanoma of radial nerve: a rare case report.
  1. Curr Opin Support Palliat Care. 2024 May 15.
    Central neural mechanisms of cancer cachexia.
    Michael S Yule, Leo R Brown, Richard J E Skipworth, Barry J A Laird.
       PURPOSE OF REVIEW: Cachexia is a devasting syndrome which impacts a large number of patients with cancer. This review aims to provide a comprehensive overview of the central mechanisms of cancer cachexia. In particular, it focuses on the role of the central nervous system (CNS), the melanocortin system, circulating hormones and molecules which are produced by and act on the CNS and the psychological symptoms of cancer cachexia.
    RECENT FINDINGS: A growing body of evidence suggests that a central mechanism of action underpins this multi-system disorder. Recent research has focused on the role of neuroinflammation that drives the sickness behaviour seen in cancer cachexia, with emphasis on the role of the hypothalamus. Melanocortin receptor antagonists are showing promise in preclinical studies. There are also new pharmacological developments to overcome the short half-life of ghrelin. GDF-15 has been identified as a core target and trials of compounds that interfere with its signalling or its central receptor are underway.
    SUMMARY: Understanding the central mechanisms of cancer cachexia is pivotal for enhancing treatment outcomes in patients. While emerging pharmacological interventions targeting these pathways have shown promise, further research is essential.
    DOI:  https://doi.org/10.1097/SPC.0000000000000707
  2. World J Surg Oncol. 2024 May 11. 22(1): 129
    The prognostic and predictive significance of perineural invasion in stage I to III colon cancer: a propensity score matching-based analysis.
    Chun-Hui Chu, I-Li Lai, Bor-Kang Jong, Sum-Fu Chiang, Wen-Sy Tsai, Pao-Shiu Hsieh, Chien-Yuh Yeh, Jeng-Fu You.
       BACKGROUND: Colorectal cancer (CRC) presents with varying prognoses, and identifying factors for predicting metastasis and outcomes is crucial. Perineural invasion (PNI) is a debated prognostic factor for CRC, particularly in stage I-III patients, but its role in guiding adjuvant chemotherapy for node-positive colon cancer remains uncertain.
    METHODS: We conducted a single-center study using data from the Colorectal Section Tumor Registry Database at Chang Gung Memorial Hospital, Taiwan. This prospective study involved 3,327 CRC patients, 1,536 of whom were eligible after application of the exclusion criteria, to investigate the prognostic value of PNI in stage I-III patients and its predictive value for node-positive/negative cancer patients receiving adjuvant chemotherapy. Propensity score matching (PSM) was used to minimize selection bias, and follow-up was performed with standardized procedures.
    RESULTS: PNI-positive (PNI+) tumors were associated with higher preoperative CEA levels and more frequent adjuvant chemotherapy. After PSM, PNI + tumors were associated with marginally significantly lower 5-year disease-free survival (DFS) and significantly lower overall survival (OS) rates in stages III CRC. However, no significant differences were observed in stages I and II. Subgroup analysis showed that among PNI + tumors, only poorly differentiated tumors had higher odds of recurrence. PNI did not predict outcomes in node-negative colon cancer. Adjuvant chemotherapy benefited PNI + patients with node-positive but not those with node-negative disease.
    CONCLUSIONS: Our study indicates that PNI is an independent poor prognostic factor in stage III colon cancer but does not predict outcomes in node-negative disease. Given the potential adverse effects of adjuvant chemotherapy, our findings discourage its use in node-negative colon cancer when PNI is present.
    Keywords:  Colon cancer; Perineural invasion; Propensity score matching; Survival
    DOI:  https://doi.org/10.1186/s12957-024-03405-6
  3. Cancers (Basel). 2024 Apr 27. pii: 1703. [Epub ahead of print]16(9):
    Targeting TRPV4 Channels for Cancer Pain Relief.
    Caren Tatiane de David Antoniazzi, Náthaly Andrighetto Ruviaro, Diulle Spat Peres, Patrícia Rodrigues, Fernanda Tibolla Viero, Gabriela Trevisan.
      Despite the unique and complex nature of cancer pain, the activation of different ion channels can be related to the initiation and maintenance of pain. The transient receptor potential vanilloid 4 (TRPV4) is a cation channel broadly expressed in sensory afferent neurons. This channel is activated by multiple stimuli to mediate pain perception associated with inflammatory and neuropathic pain. Here, we focused on summarizing the role of TRPV4 in cancer etiology and cancer-induced pain mechanisms. Many studies revealed that the administration of a TRPV4 antagonist and TRPV4 knockdown diminishes nociception in chemotherapy-induced peripheral neuropathy (CIPN). Although the evidence on TRPV4 channels' involvement in cancer pain is scarce, the expression of these receptors was reportedly enhanced in cancer-induced bone pain (CIBP), perineural, and orofacial cancer models following the inoculation of tumor cells to the bone marrow cavity, sciatic nerve, and tongue, respectively. Effective pain management is a continuous problem for patients diagnosed with cancer, and current guidelines fail to address a mechanism-based treatment. Therefore, examining new molecules with potential antinociceptive properties targeting TRPV4 modulation would be interesting. Identifying such agents could lead to the development of treatment strategies with improved pain-relieving effects and fewer adverse effects than the currently available analgesics.
    Keywords:  CIBP; CIPN; TRP channels; nociception; osmotransducer; tumor microenvironment
    DOI:  https://doi.org/10.3390/cancers16091703
  4. BJA Open. 2024 Jun;10 100284
    Local anaesthetics and chemotherapeutic agents: a systematic review of preclinical evidence of interactions and cancer biology.
    Ahmed Abdelaatti, Donal J Buggy, Thomas P Wall.
       Background: Local anaesthetics are widely used for their analgesic and anaesthetic properties in the perioperative setting, including surgical procedures to excise malignant tumours. Simultaneously, chemotherapeutic agents remain a cornerstone of cancer treatment, targeting rapidly dividing cancer cells to inhibit tumour growth. The potential interactions between these two drug classes have drawn increasing attention and there are oncological surgical contexts where their combined use could be considered. This review examines existing evidence regarding the interactions between local anaesthetics and chemotherapeutic agents, including biological mechanisms and clinical implications.
    Methods: A systematic search of electronic databases was performed as per Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. Selection criteria were designed to capture in vitro, in vivo, and clinical studies assessing interactions between local anaesthetics and a wide variety of chemotherapeutic agents. Screening and data extraction were performed independently by two reviewers. The data were synthesised using a narrative approach because of the anticipated heterogeneity of included studies.
    Results: Initial searches yielded 1225 relevant articles for screening, of which 43 met the inclusion criteria. The interactions between local anaesthetics and chemotherapeutic agents were diverse and multifaceted. In vitro studies frequently demonstrated altered cytotoxicity profiles when these agents were combined, with variations depending on the specific drug combination and cancer cell type. Mechanistically, some interactions were attributed to modifications in efflux pump activity, tumour suppressor gene expression, or alterations in cellular signalling pathways associated with tumour promotion. A large majority of in vitro studies report potentially beneficial effects of local anaesthetics in terms of enhancing the antineoplastic activity of chemotherapeutic agents. In animal models, the combined administration of local anaesthetics and chemotherapeutic agents showed largely beneficial effects on tumour growth, metastasis, and overall survival. Notably, no clinical study examining the possible interactions of local anaesthetics and chemotherapy on cancer outcomes has been reported.
    Conclusions: Reported preclinical interactions between local anaesthetics and chemotherapeutic agents are complex and encompass a spectrum of effects which are largely, although not uniformly, additive or synergistic. The clinical implications of these interactions remain unclear because of the lack of prospective trials. Nonetheless, the modulation of chemotherapy effects by local anaesthetics warrants further clinical investigation in the context of cancer surgery where they could be used together.
    Clinical trial registration: Open Science Framework (OSF, project link: https://osf.io/r2u4z).
    Keywords:  anaesthesia; cancer; cancer recurrence; chemotherapy; local anaesthetics
    DOI:  https://doi.org/10.1016/j.bjao.2024.100284
  5. Front Oncol. 2024 ;14 1368996
    Chronic kidney disease with malignant peripheral nerve sheath tumor of the ureter: a case report.
    Xinyang Yin, Xiaodong Wang, Zhenlin He, Xiaolong Chen, Qing Wang, Kehua Jiang.
      Malignant peripheral nerve sheath tumors (MPNSTs) are a complex group of malignant tumors originating from nerve cells or benign peripheral nerve sheath tumors and are commonly found in major plexus/nerve root sites such as the limbs, head, and neck. Malignant peripheral nerve sheath tumors originating in the ureter are extremely rare. Herein, we report the case of a 63-year-old patient with a malignant peripheral nerve sheath tumor of the right ureter who underwent laparoscopic radical resection of the right kidney and ureter. The patient also had stage 5 chronic kidney disease (CKD). Therefore, chemotherapy and radiotherapy were not considered. No tumor recurrence was observed during the follow-up period.
    Keywords:  MPNSTs; NF1; case report; chemotherapy; chronic kidney disease; malignant tumors
    DOI:  https://doi.org/10.3389/fonc.2024.1368996
  6. Int J Surg. 2024 May 01. 110(5): 3138
    Noninvasive prediction of perineural invasion in intrahepatic cholangiocarcinoma by clinicoradiological features and computed tomography radiomics based on interpretable machine learning: a multicenter cohort study: erratum.
      
    DOI:  https://doi.org/10.1097/JS9.0000000000001624
  7. Radiol Case Rep. 2024 Aug;19(8): 3008-3012
    An incidental large adrenal schwannoma: A case report.
    Ryan C Rizk, Mohammad Yasrab, Linda C Chu, Edmund M Weisberg, Elliot K Fishman.
      Adrenal schwannoma is a rare tumor of Schwann cell origin that represents less than 0.2% of all adrenal tumors. These typically benign tumors are most often found in the head, neck, and limbs. However, schwannomas can also rarely occur rarely in the adrenal gland within the retroperitoneal cavity. In the adrenal gland, these tumors arise from the medulla and are difficult to diagnose, often misdiagnosed as other benign or malignant entities. In this article, we report the case of a 43-year-old female with a large left adrenal mass revealed by biopsy to be a schwannoma. We focus on the use of radiological imaging modalities and immunohistochemical analysis to optimize diagnosis and treatment intervention of this rare tumor.
    Keywords:  Adrenal schwannoma; Case report; Computed tomography; Magnetic resonance imaging; Ultrasound-guided fine needle aspiration
    DOI:  https://doi.org/10.1016/j.radcr.2024.04.036
  8. Am J Case Rep. 2024 May 15. 25 e942881
    Incidental Finding of an Asymptomatic Jejunal Schwannoma: A Rare Case Report and Review of Literature.
    Konstantina Katsiafliaka, Eleni Karlafti, Georgios Tzikos, Patroklos Goulas, Apostolos Zatagias, Angeliki Vouchara, Elisavet Psoma, Anastasia Tsakona, Georgios Petrakis, Daniel Paramythiotis.
      BACKGROUND Schwannomas are tumors that arise from Schwann cells that surround and support nerve cells. Most common sites for presentations are head, neck, and extremities. Schwannomas of gastrointestinal tract are rare, slow-growing tumors, usually benign, arising from gastrointestinal tract's neural plexus. They are histologically distinguishable from conventional schwannomas that arise in soft tissue or the central nervous system. Preoperative diagnosis of gastrointestinal schwannoma is challenging, requiring immunohistological confirmation of the nature of the tumor. Here, we report a case of 57-year-old woman with an incidental finding of an asymptomatic submucosal jejunal schwannoma. CASE REPORT A 57-year-old woman with a medical history of hematological disorder underwent a contrast abdominal computed tomography as part of medical follow-up. The imaging revealed the presence of a jejunal mass. The patient underwent laparoscopic surgical resection of the lesion, followed by side-to-side jejuno-jejunal anastomosis with 4-cm clear surgical margins. The final pathologic study revealed the presence of jejunal schwannoma, as tested positive for S-100 protein. The patient was discharged home on the fourth postoperative day, having an uneventful recovery. CONCLUSIONS Jejunal schwannoma are usually benign and asymptomatic, and they are often discovered incidentally during diagnostic tests for other conditions; therefore, it should be included in the differential diagnosis of gastrointestinal tumors. Surgical treatment appears to be necessary to achieve a definitive diagnosis through a biopsy of the tumor tissue. Benign jejunal schwannomas have a good prognosis.
    DOI:  https://doi.org/10.12659/AJCR.942881
  9. J Int Med Res. 2024 May;52(5): 3000605241255504
    Low-grade malignant peripheral nerve sheath tumour presenting as retroperitoneal spindle cell neoplasm.
    Mitesh Karn, Basant Kumar Mahato, Liladhar Ojha, Yeshika Thapa, Suman Bhatta, Sushil Sharma, Sachita Chapagain, Sunita Ranabhat, Bhoj Raj Neupane, Deependra Man Shrestha.
      Retroperitoneal spindle cell neoplasms are diagnostically challenging. Malignant peripheral nerve sheath tumours (MPNSTs) can sometimes present as sporadic primary retroperitoneal tumours. MPNSTs are usually high-grade and highly aggressive tumours and are associated with a poor prognosis. Low-grade MPNSTs are very rarely described. This current case report describes a case of sporadic primary low-grade MPNST presenting as retroperitoneal spindle cell neoplasm. The diagnosis, imaging and immunohistopathological findings, as well as its successful surgical management, are presented.
    Keywords:  MPNST; low-grade; retroperitoneal; spindle cell neoplasm
    DOI:  https://doi.org/10.1177/03000605241255504
  10. Radiol Case Rep. 2024 Aug;19(8): 3028-3032
    Retroperitoneal pelvic schwannoma: A rare case report and review of the literature.
    Benbrahim Fatima Zohra, Naggar Amine, Zebbakh Hajar, Omor Youssef, Latib Rachida, Khmou Mouna, El Khannoussi Basma, Amalik Sanae.
      Schwannoma, typically a non-cancerous tumor originating from Schwann cells, seldom occurs in the retroperitoneal area. Its clinical manifestation varies, often remaining asymptomatic for an extended period until it enlarges, exerting pressure on neighboring organs. This article presents a unique instance of retroperitoneal pelvic schwannoma in a 75-year-old woman, initially presenting with unusual lower back discomfort. Imaging was used to characterize the tumor, and anatomopathological examination established the preoperative diagnosis of pelvic schwannoma and its benign nature. The clinical, imaging, and anatomopathological aspects of this pelvic schwannoma case are elucidated herein.
    Keywords:  Anatomopathology; Benign schwannoma; Giant tumor; Imaging; Retroperitoneal
    DOI:  https://doi.org/10.1016/j.radcr.2024.03.075
  11. Cureus. 2024 Apr;16(4): e58157
    Schwannoma as Extraspinal Swelling Over the Thoracolumbar Region: A Tumor at a Rare Site.
    Manu Srinivas, Prabhat Nichkaode, Bijay Sharma, Shriya Haval.
      This case report describes an unusual presentation of schwannoma, a typically benign and solitary tumor originating from Schwann cells in peripheral nerves. While the literature on extraspinal schwannomas is limited, this report discusses the case of a 21-year-old female with complaint of a back swelling persisting for two years, causing discomfort during sleep. The oval-shaped swelling, measuring 7x6 cm, was located over the T11-T12-L1 vertebrae, with normal overlying skin, pinchable hardness, and fixation to the vertebrae. The patient had no history of pain or weakness in the lower limbs. Fine-needle aspiration cytology (FNAC) yielded inconclusive results. X-ray imaging of the thoracolumbar spine revealed a soft tissue shadow over the T11-T12-L1 vertebrae. The patient underwent complete surgical excision through a vertical incision, emphasizing the importance of preoperative imaging for accurate diagnosis, optimal surgical planning, and ensuring procedural safety.
    Keywords:  extraspinal swelling; fine-needle biopsy; imaging analysis; schwannoma; thoracolumbar region
    DOI:  https://doi.org/10.7759/cureus.58157
  12. Surg Neurol Int. 2024 ;15 135
    Clavicular window for brachial plexus schwannoma removal.
    Mary K Carbullido, Paul Samuel Page, Amgad Hanna.
       Background: Schwannomas are benign nerve sheath tumors that can either be sporadic or part of neurofibromatosis type 2 (NF2). Tumors of the brachial plexus (BP) with both supra- and infraclavicular components are uncommon and represent a challenge to complete surgical resection. There are few reports on single clavicular osteotomies for BP exposure; however, there are currently no reports of utilization of a clavicular window for a large schwannoma resection.
    Case Description: We report a case of a patient with a schwannoma spanning the BP roots to the cords, with the majority involving the retro clavicular inferior trunk in the setting of NF2. The patient underwent previous subtotal resection and had postoperative enlargement of the residual mass. A gross total resection was made possible by the creation of a clavicular window to expose the BP. A 2 cm segment piece of the mid-clavicle was removed, allowing for roughly 6 cm of mediolateral exposure through clavicular distraction. This clavicular window facilitated complete exposure of the BP schwannoma underneath the clavicle as well as unobstructed exposure of supraclavicular and infraclavicular tumor. The segment was then refixed with a plate after resection of the tumor.
    Conclusion: The use of a clavicular window allowed for extensive exposure of the trunks and divisions of the BP to achieve a gross total resection in this case. The clavicular window approach may provide a benefit for optimizing exposure in the setting of lesions involving the trunks and divisions that the clavicle would traditionally obstruct.
    Keywords:  Brachial plexus; Clavicle window; Neurilemmoma; Neurofibromatosis; Schwannoma
    DOI:  https://doi.org/10.25259/SNI_824_2023
  13. J Pak Med Assoc. 2024 Apr;74(4): 804-806
    Ancient Schawanoma of radial nerve: a rare case report.
    Abdul Malik Mujahid, Asma Binte Saad, Iftikhar Alam, Husnain Khan.
      Soft tissue swellings on the forearm can present with a range of clinical and histopathological diagnosis. Ancient Schawanoma is a rare benign condition that can develop over the flexor surface of the forearm as a cystic swelling and can involve the median or the ulnar nerve. However, the presentation of this condition on the extensor surface with involvement of the radial nerve is an extremely uncommon diagnosis. A 69 year old female presented at the outpatient department with a swelling on the extensor aspect of her right forearm for the past 2 years. Ultrasound examination showed a mixed cystic solid mass and MRI report revealed a complex predominantly cystic mass in the extensor compartment of the forearm, measuring 4.3 x 5.3 x 7.2 cm size. After obtaining informed consent, the patient was operated under tourniquet control and the mass was removed sparing the radial nerve that was adherent to its capsule. The final histopathological report confirmed the diagnosis as Ancient Schawanoma.
    Keywords:  Ancient Schawanoma, Forearm swelling, surgical treatment, Histopathology, MRI.
    DOI:  https://doi.org/10.47391/JPMA.9610
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