Yuedong He

Background: Adolescent patients presenting with hyperandrogenic symptoms often receive a diagnosis of polycystic ovary syndrome (PCOS). However, accurate diagnosis is crucial because the symptoms of rare conditions, such as ovarian steroid cell tumor (OSCT), can mimic PCOS. Case summary: An 18-year-old female presented with irregular menstrual cycles, hyperandrogenic symptoms, and obesity. Despite standard treatments for PCOS, symptoms persisted. Exploratory laparoscopic examination revealed an OSCT. Thorough hormonal profiling, imaging, and histopathological analysis confirmed the diagnosis. Literature review: All OSCT and PCOS with their synonyms were searched in Pubmed on March 1, 2025. After limited the topic to tittle/abstract and then screened manually, only one report was found to present similar OSCT-NOS case with the case we report here. Conclusion: This case highlights the need for accurate diagnosis, early evaluation, and timely intervention in adolescents with hyperandrogenism to manage rare conditions like OSCT. Core tip: Adolescent females with hyperandrogenic symptoms are often diagnosed with polycystic ovary syndrome (PCOS). However, the symptoms of rare conditions like ovarian steroid cell tumors can mimic symptoms of PCOS. This case highlights the importance of an accurate diagnosis and a thorough evaluation through hormonal profiling, imaging, and exploratory laparoscopy. If the standard PCOS treatments are unsuccessful, then alternative diagnoses such as ovarian steroid cell tumor should be considered. Early identification and appropriate management are critical for satisfactory patient outcomes and emphasize the need for heightened awareness of rare conditions that present similarly to PCOS in adolescents.

The high incidences of bone metastasis in patients with breast cancer, prostate cancer and lung cancer still remains a puzzling issue. The “seeds and soil” hypothesis suggested that bone marrow (soil) may provide a favorable “niche” for tumor cells (seed). When seeking for effective ways to prevent and treat tumor bone metastasis, most researchers focus on tumor cells (seed) but not the bone marrow microenvironment (soil). In reality, only a fraction of circulating tumor cells (CTCs) could survive and colonize in bone. Thus, the bone marrow microenvironment could ultimately determine the fate of tumor cells that have migrated to bone. Bone marrow adipocytes (BMAs) are abundant in the bone marrow microenvironment. Mounting evidence suggests that BMAs may play a dominant role in bone metastasis. BMAs could directly provide energy for tumor cells, enhance the tumor cell proliferation, and resistance to chemotherapy and radiotherapy. BMAs are also known for releasing some inflammatory factors and adipocytokines to promote or inhibit bone metastasis. In this review, we made a comprehensive summary for the interaction between BMAs and bone metastasis. More importantly, we discussed the potentially promising methods for the prevention and treatment of bone metastasis. Genetic disruption and pharmaceutical inhibition may be effective in inhibiting the formation and pro-tumor functions of BMAs.

Context: Lung cancer still remains the leading cause of cancer-related mortality worldwide. Bone is one of preferred metastatic sites for lung cancer cells. So far, both accurate diagnosis and effective treatment of lung cancer bone metastases are difficult. Objective: This review aimed to evaluate roles of bone turnover markers (BTMs), microRNAs (miRNAs), dickkopf1 (DKK1) and insulin like growth factor binding protein 3 (IGFBP-3) in lung cancer bone metastases. Methods: We searched articles about these four biomarkers in lung cancer bone metastases mainly in PubMed. Result: The levels of bone specific alkaline phosphatase (BALP), cross-linked carboxy-terminal telopeptide of type-I collagen (ICTP) and N-terminal telopeptides of type-I collagen (NTX) were reported to be significantly increased in lung cancer patients with bone metastases. ALP, NTX and bone sialoprotein were thought to be associated with prognosis of lung cancer patients with bone metastases. MiRNA-335, miRNA-33a, miRNA-21, DKK1 and IGFBP-3 were revealed to be novel biomarkers in lung cancer bone metastases. Discussion and conclusion: Current researches have revealed that BTMs, miRNAs, DKK1 and IGFBP-3 may be useful in diagnosis, prognosis evaluation or treatment of lung cancer bone metastases. More studies about these biomarkers in lung cancer bone metastases are needed.