Menelaos G. Samaras

Background: Primary angiosarcoma of the breast (PAB) is a rare malignancy with no standardized treatment protocol. Objective: To quantify the impact of tumor grade on overall survival (OS) and evaluate the association of adjuvant chemotherapy and radiotherapy with survival in primary angiosarcoma of the breast (PAB). Methods: We systematically searched PubMed, Scopus, and Cochrane Library until 27 June 2025. Two reviewers independently screened studies, extracted data, and assessed risk of bias using the Newcastle-Ottawa Scale. Kaplan–Meier curve digitization was used to reconstruct individual patient data. Random-effects meta-analysis was performed for grade comparisons and therapy associations. Results: Eleven studies (436 patients) were included. Meta-analysis of six studies showed increasing tumor grade significantly predicted mortality, with homogeneous hazard ratios (HRs) of 1.2 (Grade 2 vs. 1) and 3.7 (Grade 3 vs. 1). Analysis of five studies revealed that adjuvant chemotherapy was associated with significantly improved survival (HR = 0.11, 95% CI: 0.02–0.45), while radiotherapy showed no benefit (p = 0.96). Included studies demonstrated low-moderate risk of bias. Conclusions: This first quantitative synthesis establishes histologic grade as a paramount prognostic factor in PAB and shows a strong association between adjuvant chemotherapy and survival benefit. These findings provide crucial evidence for risk stratification and support considering chemotherapy in multimodal treatment for this rare disease.

Clear cell renal cell carcinoma is the most common histological type of renal cancer, which is a common cancer type usually associated with a long clinical course. During this course, various metastatic sites can be observed. In this review, we have focused on metastases to the thyroid gland. We conducted research in three medical databases, including PubMed, Scopus, and Web of Science, using the same search algorithm. Our inclusion criteria focused on case reports and case series studies since 2011, covering therapeutic strategies for the primary and/or metastatic disease, as well as subsequent follow-up data. Studies with insufficient or uncertain data, or written in a language other than English, were excluded. An analysis of 510 articles from PubMed, 1729 from Scopus, and 649 from Web of Science, after application of inclusion and exclusion criteria, resulted in 77 reports, analyzing 189 patients. A description of the clinical, pathological, ancillary, and follow-up data, in the light of recent therapeutic schemes, was attempted. Our results suggest that metastases’ imaging features comprised more commonly a solitary nodule with a median size of 3.5 cm and worrisome features in ultrasonography, such as heterogeneity, hypoechogenicity, partially solid configuration, and variable internal vascularization. Histological and immunohistochemical examination of the lesion is necessary because these findings are not specific. Common non-thyroid metastases are seen in the urogenital system, lungs, and pancreas. We calculated the restricted mean survival from primary diagnosis at 274.6 months (95% CI: 264.3–285.0 months) and the restricted mean survival from thyroid metastases treatment at 93.9 months (95% CI: 65.3–122.4 months). Results regarding how patient characteristics affect these survival numbers were statistically nonsignificant (p > 0.05).

HPV-related head and neck cancers are increasing globally and although they constitute a major public health problem, there are currently no validated screening or early detection methods in widespread clinical use. This review discusses advances in clinical and molecular aspects of prevention, screening, and early detection of HPV-related head and neck cancers (HNCs), such as potential use of HPV blood or saliva seropositivity, RNA biomarkers, liquid biopsy, circulating tumor DNA, and proteomics. In addition to HPV vaccination, public education about vaccination, smoking, and safe sexual practices is warranted. Continued research is warranted to define optimal use and integration of approaches for prevention, screening, and early detection methods of HNCs.

Invasive lobular carcinoma (ILC) is the most common special type of breast carcinoma, accounting for 5–15% of all breast carcinoma cases. Its metastatic pattern differs from that of invasive breast carcinoma of no special type, with ILC metastases to the peritoneum, gastrointestinal tract, and female genital tract being more frequent. This literature review focuses on ILC cases with metastasis to the female genital tract (FGT). Searches were conducted in medical databases including PubMed, Scopus, and Web of Science, using specific keywords. Inclusion criteria centered on studies presenting one or more cases of patients with ILC metastasis to the FGT and English language publications. Exclusion criteria included articles that did not present original research findings, studies with insufficient data, and publications in languages other than English. A thorough analysis of 154 results from PubMed, 56 from Scopus, and 173 from Web of Science after the application of inclusion and exclusion criteria resulted in the inclusion of 54 manuscripts describing 61 cases. The demographic, clinicopathological, and therapeutic aspects of ILC metastases to the FGT were reviewed and the differential diagnosis and prognosis for each anatomic location in the FGT were discussed separately. Our analysis of the data showed that the restricted mean survival time was 186 ± 30.7 months and that a negative ER on a secondary tumor was found to be linked to worse patient survival rates. Also of note is the fact that in 37.7% of cases there was involvement of multiple FGT anatomic locations and in 36% of cases there were metastases in organs or anatomic locations other than the FGT. To our knowledge, our study is the only one to describe the features of patients with secondary FGT involvement from ILC.

Invasive lobular carcinoma (ILC) is the most common special type of breast carcinoma, accounting for 5-15% of all breast carcinoma cases. It exhibits several unique features in morphology, clinical behavior, radiological features, molecular characteristics, and metastatic pattern. The latter differs from that of invasive breast carcinoma of no special type with ILC metastases to the peritoneum, gastrointestinal tract, and female genital tract being more frequent. We herewith review the demographic, clinicopathological, and therapeutic aspects of ILC metastases to the female genital tract and discuss separately the differential diagnosis and prognosis for each anatomic location of the female genital tract.

This case report describes the clinical presentation, diagnosis, and management of a 52-year-old Greek male with unilateral tonsillar swelling and concomitant syphilis, emphasizing the key histopathological differentials. The patient presented with a longstanding unilateral right tonsillar enlargement, and further evaluation revealed syphilis as the underlying disease. The management included intramuscular penicillin therapy and close follow-up with dermatology and otolaryngology specialists. This report aims to raise awareness among healthcare providers, particularly pathologists, about considering tonsillar syphilis in the differential diagnosis of tonsillar abnormalities, especially in patients at increased risk for syphilis infection.

Ewing sarcomas are rare tumors arising mainly in the bones and the surrounding soft tissues. Primary extraosseous Ewing sarcomas have also been described in several other organs and locations other than bones, including the pancreas. These tumors have well-defined histological, immunohistochemical, and molecular characteristics. In this manuscript, we present a case of primary Ewing sarcoma of the pancreas in a 29-year-old patient, and we systematically review the literature on both primary and metastatic Ewing sarcomas of the pancreas, describing their clinicopathological characteristics. We also discuss the differential diagnosis and the treatment of this rare entity.

Breast carcinoma is the most common cancer in women. Nineteen different subtypes of breast carcinomas are recognized in the current WHO classification of breast tumors. Except for these subtypes, there are a number of carcinomas with special morphologic and immunohistochemical features that are not included in the 5th WHO classification, while others are considered special morphologic patterns of invasive breast carcinoma of no special type. In this manuscript, we systematically review the literature on four different subtypes of invasive breast carcinoma, namely lymphoepithelioma-like breast carcinoma, breast carcinoma with osteoclast-like giant cells, signet-ring breast carcinoma, and metaplastic breast carcinoma with melanocytic differentiation. We describe their clinicopathological characteristics, focusing on the differential diagnosis, treatment, and prognosis.

Background: Malignant Brenner tumors are rare ovarian tumors, accounting for less than 1% of malignant ovarian neoplasms. The aim of this manuscript is to systematically review the current literature concerning malignant Brenner tumors. Methods: We searched three medical databases (PubMed, Scopus, and Web of Science) for relevant articles published until 15 September 2023. Results: After applying inclusion and exclusion criteria, 48 manuscripts describing 115 cases were included in this study from the English literature. Conclusions: We analyzed the demographic, clinical, pathological, and oncological characteristics of 115 patients with malignant Brenner tumors. The statistical analysis showed that recurrence was marginally statistically significantly related to tumor stage and was more common in patients with ascites and in women with abnormal CA-125 levels; patients that were treated with lymphadenectomy had better disease-specific survival.

Background: Axillary lymph node metastasis is a rare stage IV ovarian carcinoma manifestation. This manuscript aims to systematically review the literature regarding axillary lymph node metastasis from ovarian carcinoma. Methods: We searched three medical internet databases (PubMed, Scopus, and Web of Science) for relevant articles published until 22 July 2023. Cases describing supraclavicular or intramammary lymph node metastases and concurrent metastasis to the breast were excluded. Results: After applying eligibility/inclusion and exclusion criteria, twenty-one manuscripts describing twenty-five cases were included from the English literature. Data were collected and analyzed regarding demographic, clinical, laboratory, radiological, histopathological, and oncological characteristics. Conclusions: We analyzed the clinical and oncological characteristics of patients with axillary lymph node metastasis from ovarian carcinoma, presented either as an initial diagnosis of the disease or as a recurrent disease. The analysis we performed showed a significant difference only in the serum CA-125 level (p = 0.004) between the two groups. There was no observed difference in womens’ survival.