Nested stromal-epithelial tumor(NSET) is a nonhepatocytic and non-biliary tumor of the liver consisting of nests of epithelial and spindled cells with associated myofibroblastic stroma and variable intra-lesional calc...Nested stromal-epithelial tumor(NSET) is a nonhepatocytic and non-biliary tumor of the liver consisting of nests of epithelial and spindled cells with associated myofibroblastic stroma and variable intra-lesional calcification and ossification, which represents a very rare and challenging disease. Most of the reported cases have been treated with surgery, obtaining a long survival outcome. Here, we report the case of a 31-year-old Caucasian man who underwent surgery at our institution for a large, lobulated, multinodular mass of the right hemi-liver. The histological exam confirmed the diagnosis of NSET. After 6 mo from surgery, a liver recurrence was described and a chemoembolization was performed. After a further disease progression, based on the correlation between the histological features of the disease and those of the hepatoblastoma, a similar chemotherapy regimen(with cisplatin and ifosfamide/mesna chemotherapy, omitting doxorubicin due to liver impairment) was administered. However, infection of the biliary catheter required a dose modification of the treatment. No benefit was noted and a progression of disease was radiologically assessed after only four cycles. The worsening of the clinical status prevented further treatments, and the patient died a few months later. This case report documents how the NSET might have an aggressive and non-preventable behavior. No chemotherapy schedules with a proved efficacy are available, and new data are needed to shed light on this rare neoplasm.展开更多
Colorectal cancer(CRC)represents the second most common cancer in Europe with marked differences in prognosis and response to treatments.In the past years research showed emerging interest in genomic and immunologic f...Colorectal cancer(CRC)represents the second most common cancer in Europe with marked differences in prognosis and response to treatments.In the past years research showed emerging interest in genomic and immunologic fields.The clinical heterogeneity,that occurs during the pathogenesis of CRC,is driven by chromosomal alterations and defective function of DNA mismatch repair genes.CRC is classified in four consensus molecular subtypes(CMS)with different immunogenic characteristics and prognosis.CMS1 microsatellite instable(MSI)-like and CMS4,both characterized by high levels of immune infiltration,are recognized as the most immunogenic subtypes,even though functional characteristic leading to different prognosis are reported.In particular,MSI tumors have been identified as the best candidates for immunotherapy treatment and a number of studies have evaluated the efficacy of anti-programmed cell death ligand-1(PDL-1)and anti-cytotoxic T-lymphocyte-associated protein 4(CTLA4)in this setting.However,literature data show that the majority of patients with CRC have microsatellite stable(MSS)tumors and this status seems related to lower response to PDL-1/programmed cell death-1 or CTLA4 blockade.The aim of this paper is to investigate the role of immunotherapy in MSI and MSS CRC.展开更多
文摘Nested stromal-epithelial tumor(NSET) is a nonhepatocytic and non-biliary tumor of the liver consisting of nests of epithelial and spindled cells with associated myofibroblastic stroma and variable intra-lesional calcification and ossification, which represents a very rare and challenging disease. Most of the reported cases have been treated with surgery, obtaining a long survival outcome. Here, we report the case of a 31-year-old Caucasian man who underwent surgery at our institution for a large, lobulated, multinodular mass of the right hemi-liver. The histological exam confirmed the diagnosis of NSET. After 6 mo from surgery, a liver recurrence was described and a chemoembolization was performed. After a further disease progression, based on the correlation between the histological features of the disease and those of the hepatoblastoma, a similar chemotherapy regimen(with cisplatin and ifosfamide/mesna chemotherapy, omitting doxorubicin due to liver impairment) was administered. However, infection of the biliary catheter required a dose modification of the treatment. No benefit was noted and a progression of disease was radiologically assessed after only four cycles. The worsening of the clinical status prevented further treatments, and the patient died a few months later. This case report documents how the NSET might have an aggressive and non-preventable behavior. No chemotherapy schedules with a proved efficacy are available, and new data are needed to shed light on this rare neoplasm.
文摘Colorectal cancer(CRC)represents the second most common cancer in Europe with marked differences in prognosis and response to treatments.In the past years research showed emerging interest in genomic and immunologic fields.The clinical heterogeneity,that occurs during the pathogenesis of CRC,is driven by chromosomal alterations and defective function of DNA mismatch repair genes.CRC is classified in four consensus molecular subtypes(CMS)with different immunogenic characteristics and prognosis.CMS1 microsatellite instable(MSI)-like and CMS4,both characterized by high levels of immune infiltration,are recognized as the most immunogenic subtypes,even though functional characteristic leading to different prognosis are reported.In particular,MSI tumors have been identified as the best candidates for immunotherapy treatment and a number of studies have evaluated the efficacy of anti-programmed cell death ligand-1(PDL-1)and anti-cytotoxic T-lymphocyte-associated protein 4(CTLA4)in this setting.However,literature data show that the majority of patients with CRC have microsatellite stable(MSS)tumors and this status seems related to lower response to PDL-1/programmed cell death-1 or CTLA4 blockade.The aim of this paper is to investigate the role of immunotherapy in MSI and MSS CRC.
