Latest Research

[Wolffian adnexal tumors (FATWO)].

Matylevich OP, et al

This publication presents a rare case of FATWO (Female Adnexal Tumor of Probable Wolffian Origin), a neoplasm arising from embryonic remnants of the mesonephric (Wolffian) duct, which has been documented in fewer than 100 patients worldwide since its first description in 1973. A 57-year-old woman underwent abdominal ultrasound revealing a large right ovarian mass, and intraoperative exploration confirmed extensive tumor dissemination to the parietal peritoneum, sigmoid colon mesentery, greater omentum, and anterior abdominal wall fatty tissue. Radical cytoreductive surgery was performed to remove all identifiable metastatic foci, and subsequent histological examination showed cytological features inconsistent with high-grade malignancy despite the widespread spread. The final diagnosis of FATWO was established through immunohistochemical analysis, which helped exclude more common tumors sharing a similar morphological appearance. The authors emphasize that the extreme rarity and genetic heterogeneity of FATWO, combined with the absence of entirely specific immunohistochemical markers, pose substantial diagnostic difficulties for pathologists. This case highlights the importance of considering FATWO in the differential diagnosis of adnexal masses and demonstrates that aggressive surgical intervention may be warranted even when histological features appear relatively benign.

Arkhiv patologii

Pancreatic Adenosquamous Carcinoma with Direct Gastric Invasion:Preoperative Diagnosis by Endoscopic Biopsy -A Case Report.

Shiba M, et al

Pancreatic adenosquamous carcinoma (PASC) is a rare and highly aggressive subtype of pancreatic cancer that poses significant challenges for preoperative diagnosis due to its unusual histological features combining both glandular and squamous cell components. This case report describes an 82-year-old man presenting with epigastric pain whose imaging revealed a large, necrotic mass in the tail of the pancreas that had directly grown through the posterior wall of the stomach, accompanied by widespread metastases to the liver, lungs, lymph nodes, and peritoneum. Upper gastrointestinal endoscopy identified a large excavated ulcer within a submucosal elevation at the site of gastric invasion, and targeted biopsies from the ulcer margin confirmed squamous cell carcinoma, enabling a definitive histopathologic diagnosis of Stage IV PASC without surgical intervention. This case highlights an underrecognized diagnostic opportunity: when PASC invades the stomach directly, endoscopic biopsy of the affected gastric site can yield a tissue diagnosis that would otherwise require more invasive procedures. Clinicians should consider PASC in the differential diagnosis of pancreatic masses that show direct gastric invasion and prominent internal necrosis on imaging, as early and accurate diagnosis can guide appropriate management decisions.

The journal of medical investigation : JMI

The Vitamin D3 Analog Calcipotriol Attenuates Pancreatic Cancer Malignancy via Downregulating Thrombospondin 1 in Pancreatic Stellate Cells.

Wu Y, et al

Pancreatic ductal adenocarcinoma (PDAC) is among the deadliest cancers in part because dense fibrous tissue surrounding tumors — driven by activated pancreatic stellate cells (PSCs) — shields cancer cells from treatment and promotes their spread. Researchers investigated whether calcipotriol, a synthetic analog of vitamin D3, could suppress this harmful stromal activation and reduce PDAC aggressiveness. The study found that activated PSCs express considerably higher levels of the vitamin D receptor than PDAC cells themselves, making them especially sensitive to vitamin D signaling. Treatment with calcipotriol markedly reduced key activation markers in PSCs, including α-smooth muscle actin and secretion of thrombospondin 1 (THBS1), a protein that normally drives tumor proliferation, migration, and invasion through the THBS1/CD47 signaling axis. By disrupting this axis, calcipotriol effectively dismantled the supportive tumor microenvironment that pancreatic cancers depend on for growth and therapy resistance. These findings identify stromal targeting with vitamin D analogs as a promising new strategy to slow progression of one of the world's most lethal malignancies.

Mediators of inflammation

[Selection of drainage method for resectable cholangiocarcinoma complicated by obstructive jaundice].

Researchers compared two approaches to relieving bile duct obstruction before surgery in patients with perihilar cholangiocarcinoma — a cancer arising at the junction of bile ducts near the liver — complicated by obstructive jaundice: percutaneous transhepatic cholangiostomy (PTCS) and endoscopic biliary drainage (EBD). The study analyzed 76 patients treated between 1999 and 2023, finding that serious procedure-related complications (grade III or higher) occurred significantly more often after EBD (50.0%) than after PTCS (22.4%), and rescue PTCS was required to manage EBD failures in 44.4% of those cases. No statistically significant differences were found between the two groups in major post-surgical complications, postoperative mortality, or rates of peritoneal or implantation metastases, suggesting that the choice of drainage method does not compromise surgical safety or cancer control. Median overall survival was numerically longer in the PTCS group (25 months versus 15 months), though this did not reach statistical significance, and disease-free survival was also comparable. These findings support PTCS as the preferred first-line method for biliary decompression in resectable perihilar cholangiocarcinoma, offering superior immediate procedural safety without negatively affecting long-term outcomes.

Khirurgiia

[Analysis of a population of patients with hip fracture in Argentina].

Tibaldo MC, et al

A retrospective study conducted at the Metabolic Research Institute in Buenos Aires analyzed the clinical profiles of 80 patients diagnosed with fragility-related hip fractures between 2012 and 2022. The vast majority of patients were older women, with a median age of 73 years, and the femoral neck was the most common fracture site, accounting for 92.5% of cases. Notably, nearly 40% of patients had suffered previous fractures, and among those who had undergone bone density testing, roughly half showed osteoporosis while most of the rest showed osteopenia. Despite the availability of treatments, only about one in five patients was actively receiving pharmacological therapy for osteoporosis at the time of their fracture, highlighting a significant gap in preventive care. These findings underscore the urgent need for better identification and long-term treatment of osteoporosis in older adults to reduce the burden of hip fractures, which carry serious risks of disability and death.

Medicina