Latest Research
All publications from the Cancer3.AI database, newest first.
Double faces of pheochromocytoma and paraganglioma-a review of integrated pathologic diagnosis.
Kimura N
This review article examines pheochromocytomas (PCC) and paragangliomas (PGL), rare tumors arising from the adrenal medulla and nerve tissue clusters throughout the body, focusing on how pathologists can accurately diagnose and risk-stratify these tumors. A landmark shift occurred with the 2017 WHO classification, which eliminated the traditional benign/malignant distinction and instead established that all such tumors carry some potential for metastasis, requiring a risk-based approach to patient management. The review comprehensively compares three established scoring systems—PASS, GAPP, and COPPS—used to assess metastatic risk, and details the battery of immunohistochemical markers that help identify tumor type, including tyrosine hydroxylase and dopamine β-hydroxylase for sympathetic tumors, as well as GATA3 and Phox2B for broader classification. Special attention is given to hereditary forms of these tumors linked to genetic mutations in genes such as SDHB, VHL, MAX, MEN2, and NF1, each with distinct histological features and clinical implications. Rare variants such as ACTH-producing and dopamine-producing tumors are also discussed, providing clinicians with a practical diagnostic algorithm. This integrated pathologic framework is essential for guiding treatment decisions and surveillance strategies for patients with these complex neuroendocrine tumors.
Endocrine journal
Source →Absent nocturnal cortisol decline in Pheochromocytoma: A retrospective study.
Sun Y, et al
Researchers conducted a retrospective study examining whether pheochromocytoma — a rare tumor of the adrenal gland that overproduces stress hormones called catecholamines — disrupts the normal daily rhythm of cortisol, the body's primary stress hormone. Among 22 patients with confirmed pheochromocytoma who had both morning and midnight cortisol measurements taken, 82% showed an absent nocturnal cortisol decline, meaning their cortisol levels failed to drop appropriately at night as they should in healthy individuals. Patients with elevated midnight cortisol were older and had significantly higher rates of metabolic complications, including diabetes, dyslipidemia, and cardiovascular disease, compared to those with normal nighttime cortisol. Importantly, standard suppression tests suggested this cortisol dysregulation was not due to the adrenal gland independently overproducing cortisol, pointing instead to a so-called pseudo-Cushing state driven by excess catecholamines. These findings suggest that disrupted cortisol rhythms are common in pheochromocytoma patients and may contribute to their metabolic health burdens, even without overt Cushing syndrome. Clinicians may benefit from routinely evaluating cortisol regulation in pheochromocytoma patients to better understand and manage associated metabolic risks.
Steroids
Source →Isolated Myocardial Metastases in a Neuroendocrine Tumor: 68Ga-DOTATATE PET/CT and Cardiac Magnetic Resonance Imaging Findings.
Baltacioglu MH, et al
Researchers report a rare case of a 58-year-old man diagnosed with a well-differentiated neuroendocrine tumor (NET) originating in the terminal ileum, who was found to have cancer spread directly to the heart muscle during routine staging scans. Using 68Ga-DOTATATE PET/CT, a specialized nuclear medicine imaging technique that targets somatostatin receptors commonly overexpressed in NETs, two unexpected areas of intense radiotracer uptake were identified within the heart muscle alongside the primary tumor. Cardiac magnetic resonance imaging (CMR) subsequently confirmed abnormal tissue changes at the same locations, together establishing a diagnosis of isolated myocardial metastases. What makes this case particularly notable is that cardiac involvement was detected at the very first staging evaluation of a low-grade, slow-growing tumor, a finding considered extremely rare in clinical practice. This report underscores the value of combining somatostatin receptor-based PET/CT with CMR imaging to detect subtle and unexpected cardiac metastases that might otherwise be missed. For clinicians managing NET patients, this case serves as an important reminder to consider cardiac involvement even in early-stage, well-differentiated tumors.
Clinical nuclear medicine
Source →A Case of Thyrotropin-Secreting Pituitary Carcinoma With Bone Metastases.
Nagaoka T, et al
Researchers report a rare case of a 65-year-old man whose TSH-secreting pituitary adenoma transformed into a malignant carcinoma with widespread bone metastases over an eight-year period. Despite multiple surgeries and long-term octreotide therapy, the tumor continued to grow, and TSH levels remained dangerously elevated. A critical turning point occurred when radioiodine (I-131) therapy was administered to control thyrotoxicosis, after which TSH levels surged dramatically and MRI revealed multiple spinal metastases confirmed by biopsy as metastatic pituitary carcinoma. Palliative treatments provided temporary relief, but the patient ultimately died of pneumonia, with autopsy confirming extensive bone metastases from the pituitary tumor. This case highlights the importance of correctly diagnosing central hyperthyroidism early and warns clinicians that radioiodine therapy should be avoided before pituitary-directed treatment, as it may trigger dangerous tumor progression.
JCEM case reports
Source →Microprolactinoma (Pituitary Adenoma) as a Cause of Secondary Headache in a Pediatric Patient With Pain and Restricted Mouth Opening: A Case Report.
Draghici R, et al
A new case report published in Case Reports in Dentistry describes a 15-year-old girl who visited a dental clinic complaining of jaw pain, restricted mouth opening, and frontal headaches, symptoms initially attributed to temporomandibular disorder (TMD). After ordering blood tests and an MRI as part of the diagnostic workup, clinicians discovered that her prolactin levels were nearly double the normal range and that she had a small pituitary adenoma — a microprolactinoma measuring approximately 5 mm — located in the lateral pituitary gland. The MRI also confirmed disc displacement in both temporomandibular joints, explaining her jaw symptoms, while the elevated prolactin and the tumor accounted for the secondary headaches. This case highlights the importance of thorough differential diagnosis in dental practice: when patients present with atypical or unusually severe headaches alongside TMD symptoms, further diagnostic testing — including blood work and imaging — can uncover serious underlying conditions. The authors urge dental practitioners to maintain a broad clinical awareness and not limit their assessment solely to orofacial structures, as this case demonstrates that a routine dental visit can be the first point of contact leading to the diagnosis of a systemic or neurological condition.
Case reports in dentistry
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