Giant cystic hepatocarcinoma in the absence of cirrhosis.

The diagnosis of hepatocellular carcinoma (HCC) became easier in relation to the improved radiological examinations; however, the neoplasm may occur under atypical presentations mimicking other benign or malignant processes. Several mechanisms for the cystic changes of HCC have been suggested, including arterial thrombosis, inflammation, and rapid tumor growth. This paper reports an uncommon case of a 74-year-old patient, who presented with pain in the upper right abdomen and large cystic mass involving right lobe of the liver. He was diagnosed as cystic HCC, in the absence of cirrhosis, after surgery.

Uncovering Tumour Heterogeneity through PKR and nc886 Analysis in Metastatic Colon Cancer Patients Treated with 5-FU-Based Chemotherapy.

Colorectal cancer treatment has advanced over the past decade. The drug 5-fluorouracil is still used with a wide percentage of patients who do not respond. Therefore, a challenge is the identification of predictive biomarkers. The protein kinase R (PKR also called EIF2AK2) and its regulator, the non-coding pre-mir-nc886, have multiple effects on cells in response to numerous types of stress, including chemotherapy. In this work, we performed an ambispective study with 197 metastatic colon cancer patients with unresectable metastases to determine the relative expression levels of both nc886 and PKR by qPCR, as well as the location of PKR by immunohistochemistry in tumour samples and healthy tissues (plasma and colon epithelium). As primary end point, the expression levels were related to the objective response to first-line chemotherapy following the response evaluation criteria in solid tumours (RECIST) and, as the second end point, with survival at 18 and 36 months. Hierarchical agglomerative clustering was performed to accommodate the heterogeneity and complexity of oncological patients' data. High expression levels of nc886 were related to the response to treatment and allowed to identify clusters of patients. Although the PKR mRNA expression was not associated with chemotherapy response, the absence of PKR location in the nucleolus was correlated with first-line chemotherapy response. Moreover, a relationship between survival and the expression of both PKR and nc886 in healthy tissues was found. Therefore, this work evaluated the best way to analyse the potential biomarkers PKR and nc886 in order to establish clusters of patients depending on the cancer outcomes using algorithms for complex and heterogeneous data.

Paraganglioma gangliocítico en la ampolla de Vater. Una entidad a tener en cuenta en la patología ampular / Gangliocytic paraganglioma in the ampulla of Vater. An entity to be considered in ampullary pathology

El paraganglioma gangliocítico es un tumor infrecuente que se desarrolla casi exclusivamente en el duodeno, aunque puede aparecer en otras localizaciones. Se presenta como una masa polipoide, sésil o pediculada. Atendiendo a su localización y a la tendencia a ulcerarse suele manifestarse con hemorragias digestivas altas, dolor abdominal o anemia. Es un tumor de naturaleza benigna y de pronóstico favorable, si bien hay algunos casos descritos de recidivas y de metástasis ganglionares. Histológicamente se compone de 3 poblaciones celulares de morfología y características inmunohistoquímicas bien definidas y distintivas (AU)

The gangliocytic paraganglioma is a rare tumour that develops almost exclusively in the duodenum although it may also appear in other locations. It presents as a sessile or pedunculated polypoid mass. Depending on location and the tendency to ulcerate, they often present as upper gastrointestinal bleeding, abdominal pain or anemia. It is a benign tumour with a favorable prognosis, although some cases of recurrence and lymph node metastasis have been reported. Histologically it is composed of three cell populations with characteristic, well defined morphological features and immunohistochemistry (AU)

Quiste linfoepitelial pancreático. Caracterización morfológica y dificultades en el diagnóstico radiológico / The morphological characteristics of lymphoepithelial cyst of the pancreas and the problems in its radiological diagnosis

Las lesiones quísticas verdaderas del páncreas son entidades raras que, a pesar de los avances radiológicos y de las técnicas de abordaje quirúrgico, aún siguen mostrando problemas de diagnóstico diferencial. Presentamos el caso de un varón joven con una masa abdominal asintomática, que fue interpretada por TC como una tumoración probablemente sólida localizada en el cuerpo pancreático, y por RM como una neoplasia quística, manejándose diferentes diagnósticos que variaban entre neoplasia papilar y sólida, tumor intraductal papilar mucinoso de páncreas o cistoadenoma/cistoadenocarcinoma mucinoso pancreático. El diagnóstico histopatológico determinó la naturaleza quística benigna linfoepitelial de la lesión. La comunicación entre radiólogos, cirujanos y patólogos es de especial relevancia en este tipo de patología, ya que con procedimientos diagnósticos sencillos puede evitarse una cirugía con excesiva morbilidad(AU)

True lymphoepithelial cysts of the pancreas are rare entities which still pose a diagnostic challenge, despite the latest radiological and surgical advances. We present a case of young male who presented with an asymptomatic abdominal mass. An abdominal CT reported it as a probable solid tumour located in the body of the pancreas, whist the MR showed a cystic neoplasm. Various differential diagnoses were considered, such as papillary neoplasm, solid epithelial neoplasm, intraductal papillary mucinous neoplasm of the pancreas or mucinous cystadenoma/cystadenocarcinoma of the pancreas. However, histopathology revealed its benign, cystic lymphoepithelial nature. Close collaboration between radiologists, surgeons and pathologists is especially crucial for this lesion, since simple diagnostic procedures can prevent high risk surgery(AU)