Adila Adilli

Leptomeningeal carcinomatosis (LMC) is a rare and highly fatal complication of solid malignancies and is extremely uncommon in gastric cancer, particularly as an isolated metastatic lesion. This study presents a rare case of LMC in a patient diagnosed with gastric signet-ring cell carcinoma and reviews cases reported in PubMed over the last 10 years. n METHOD: We present a 43-year-old male patient diagnosed with poorly differentiated gastric signet-ring cell carcinoma and elevated CA19-9 levels. His initial staging was consistent with locally advanced disease (CT4aN2M0). The patient received neoadjuvant FLOT chemotherapy, followed by total gastrectomy. In addition, articles published in PubMed over the last 10 years were systematically reviewed to identify cases of LMC associated with gastric cancer. The final pathology from the gastrectomy revealed ypT3N3 disease. Three weeks after surgery, the patient developed new-onset headaches and progressive confusion, with a Mini-Mental State Examination score of 23/30. Contrast-enhanced brain MRI did not reveal any mass lesion but showed subtle hyperintensity in the cerebral peduncle region. CSF cytology confirmed LMC, demonstrating malignant signet-ring cells. After detailed consultation, the patient declined targeted therapy and transitioned to home palliative care, passing away two weeks after the diagnosis. The literature review identified 18 cases of LMC associated with gastric cancer. Clinical presentations were largely non-specific, including headache, nausea/vomiting, and confusion. Outcomes were uniformly poor, with survival typically measured in weeks. In patients with gastric cancer, clinicians should maintain a high index of suspicion for LMC when new neurological symptoms are detected, even in the absence of other metastatic disease on systemic workup. Cerebrospinal fluid cytology remains as an important test for confirming the diagnosis.

Gastric cancer (GC) is a leading cause of cancer-related mortality globally, with a 5-year survival rate remaining below 50% despite advancements in treatment. The standard care for locally advanced GC includes curative gastrectomy combined with perioperative chemotherapy. Different factors may influence chemotherapy responses, underscoring the need for biomarkers to tailor treatment. GP73, a Golgi-associated protein, has been implicated in cancer progression and prognosis, though its role in GC remains poorly understood. This study aimed to evaluate the association between pretreatment GP73 expression and overall survival (OS) and chemotherapy response in locally advanced GC patients. This was a retrospective study of 92 locally advanced GC patients who received neoadjuvant chemotherapy and underwent surgery between 2017 and 2024. GP73 expression was assessed in pretreatment biopsy samples via immunohistochemistry. Clinicopathological data were analyzed, and the correlation between GP73 expression and survival, as well as chemotherapy response, was evaluated. Tumor regression was graded using the Mandard Tumor Regression Grade scale. Continuous variables were demonstrated as median and interquartile range. High GP73 expression was observed in 64% of patients and correlated with poor tumor differentiation and reduced likelihood of radical surgery. Univariate analysis revealed that high GP73 expression was significantly associated with poorer overall survival (p < 0.001). Multivariate Cox model identified high GP73 status as an independent prognostic factor for poor OS (HR 4.53, p < 0.001). However, no significant correlation was found between GP73 expression and chemotherapy response (p = 0.32). This study suggests that high pretreatment GP73 expression is a marker of poor prognosis in locally advanced GC, linked to poorer survival and less favorable tumor characteristics. These results highlight the need for personalized treatment strategies incorporating GP73 and other clinicopathological factors to optimize outcomes for GC patients. The online version contains supplementary material available at 10.1186/s12876-026-04713-9.

Background: Desmoid tumor is a locally aggressive fibroblastic/myofibroblastic neoplasm frequently arising in deep soft tissues. Although it can be well circumscribed, a desmoid tumor generally infiltrates surrounding tissues and tends to recur locally without metastasizing. While commonly arising in the extremities and abdominal wall, primary hepatic involvement is exceedingly uncommon. Case Report: We report the case of a 20‐year‐old woman presenting with progressive jaundice, pruritus, weight loss, and abdominal pain. Imaging revealed a 3 × 3 cm hepatic hilar mass with bile duct dilation, initially suggestive of cholangiocarcinoma. Histopathological examination following a tru‐cut biopsy demonstrated features consistent with desmoid‐type fibromatosis, confirmed by nuclear β‐catenin positivity. Due to clinical deterioration, the patient underwent a left hemihepatectomy. The postoperative course was uneventful. Adjuvant tamoxifen therapy was administered, and follow‐up imaging showed no recurrence. Despite the hormonal changes of a subsequent pregnancy, no disease progression was observed. Conclusion: This report highlights an extremely rare presentation of desmoid tumor in the hepatic hilum, mimicking malignancy. It underscores the importance of histopathological confirmation, multidisciplinary management, and individualized follow‐up strategies, especially in women of reproductive age.

Aim: Testicular germ cell tumors (TGCT) are solid neoplasms common in young adult men and an important cause of cancer-related deaths during this period. Revisions in histopathological classification and staging affect prognosis and treatment. The aim of this study was to analyze our TGCT cases, to review prognostic parameters, and their relationship between germ cell neoplasia in situ (GCNIS), intratubular and intertubular tumors.Material and Methods: In this study, Hematoxylin&Eosin-stained sections of 77 TGCTs were re-evaluated. The presence of GCNIS, intratubular and intertubular germ cell tumors were recorded. Histopathological classification and staging were revised based on the changes in the 8th edition of American Joint Committee on Cancer (AJCC).Results: The majority of the patients were diagnosed as seminoma (n=42), followed by mixed germ cell tumors (n=33) and spermatocytic tumors (n=2). Rete testis invasion in 30 cases, epididymal invasion in 6 cases, hilar soft tissue invasion in 10 cases, tunica vaginalis invasion in 1 case, spermatic cord invasion in 4 cases, and lymphovascular invasion in 22 cases were detected. Intertubular seminoma in 25 cases, intratubular carcinoma in 16 cases, and GCNIS in 73 cases were detected.Conclusion: The major criteria to determine treatment choices are histopathological diagnosis, pathological tumor stage, serum tumor markers and presence of metastasis. According to AJCC 8th edition, addition of hilar soft tissue invasion to staging has increased the number of our pT2 cases. Moreover, assuming discontinuous tumor invasion of spermatic cord by vascular invasion as pM1 has also increased the number of metastatic testis tumors.