Afatinib, an irreversible pan-ERBB family inhibitor, has demonstrated promising efficacy in non-small cell lung cancer (NSCLC) patients with uncommon EGFR activating mutations. However, besides the acquisition of the secondary T790M mutation, other resistance mechanisms to afatinib remain to be explored.

Lung adenocarcinoma (LUAC) patients with micropapillary (MP) and/or solid (S) generally demonstrate a poorer survival prognosis. In the diagnosis and treatment of stage IA LUAC, precisely establishing personalized treatment strategies for patients is crucial for both clinical practice and scientific investigation. Our study aims to develop a novel prediction model based on machine learning (ML) to predict the probability of MP/S patterns in stage IA LUAC patients.

Synchronous bilateral breast cancer (SBBC) presents significant radiotherapy planning challenges due to complex target volumes near critical organs. This study evaluated RapidArc Dynamic (RAD), a novel technique integrating dynamic arcs with static angle modulated ports (STAMPs) via simultaneous GPU-accelerated optimization, against conventional volumetric modulated arc therapy (VMAT) for SBBC treatment planning and delivery efficiency.

The metastasis of laryngeal squamous cell carcinoma (LSCC) is not only caused by the tumor itself but is also closely related to cancer-associated fibroblasts (CAFs). The epithelial-mesenchymal transition (EMT) serves as a key event during its metastasis. However, the specific mechanisms underlying LSCC metastasis remain uncertain.

A solid pseudopapillary tumor of the pancreas is one of the rare pancreatic tumors. It usually occurs in young women. The common clinical presentation of this tumor is nonspecific abdominal pain and an abdominal mass. Since it has low malignancy potential, with complete surgical resection, the outcome is excellent.

Multifocal micronodular pneumocyte hyperplasia as first manifestation of tuberous sclerosis complex has rarely been reported.

Lymphoplasmacytic lymphoma/Waldenström macroglobulinemia rarely transforms into diffuse large B-cell lymphoma, and there have been no reports of cases proving clonal identity when presenting as primary central nervous system lymphoma. There are many unclear aspects regarding the mechanism by which lymphoplasmacytic lymphoma/Waldenström macroglobulinemia infiltrates the central nervous system and transforms, as well as the treatment methods for the transformed lymphoma.

Myofibroblastic sarcoma (MFS) is a rare malignant tumor of the myofibroblasts (mammary MFS being even rarer but more aggressive). Only 12 cases of mammary MFS have been reported before this. We report a rare case of a 32-year-old lady who had been operated on twice for phyllodes tumor and who came with another recurrence at the same site. Preoperative work-up was suggestive of recurrent phyllodes tumor. Wide local excision with 1 cm margin with type 1 oncoplastic reconstruction was done, considering her age and marital status. Final histology was suggestive of MFS, and margins were clear. Immunostaining was positive for vimentin and weakly positive for smooth muscle actin (SMA). In the existing literature, there exists no clarity on the underlying lesion or cell origin of MFS. One case report highlighted old fibroadenoma and another attributed radiation preceding the MFS. We report a rare case of MFS in a setting of recurrent breast phyllodes in a young unmarried woman.

Histiocytic sarcoma (HS), a rare malignant neoplasm of hematolymphoid origin, belongs to the World Health Organization (WHO) classification of histiocytic and dendritic cell neoplasms. This rare aggressive malignancy occurs predominantly in adults and accounts for less than 1% of all hematolymphoid neoplasms. It arises from the monocytic/macrophage lineage and shares the histomorphologic and immunohistochemical features of mature tissue histiocytes. Its predominant presentation is extranodal, involving the intestinal tract, skin, and soft tissue, and it rarely presents with lymphadenopathy. The diagnosis of HS is entirely based on identifying the histiocytic lineage and the exclusion of other poorly differentiated malignancies with large pleomorphic cells like high-grade lymphomas, carcinoma, melanoma, germ cell tumors, and sarcomas. Herein, we report a case of a 61-year-old female patient who noticed a left supraclavicular swelling of 3 weeks duration, and the biopsy revealed a nodal HS. The clinicopathologic, histomorphologic, immunohistochemical, and molecular features of the disease will be further discussed.

Ewing sarcoma is a highly malignant neoplasm of bone or soft tissues that is predominantly seen in adolescents and young adults. Patients with recurrent and metastasis have poor survival despite aggressive treatment. In Ewing sarcoma, EWS-FLI-1 translocation has been identified as a biomarker for Poly-ADP ribose Polymerase inhibitor (PARPi) sensitivity and olaparib has been shown to enhance the antitumor activity of chemotherapy agents like temozolomide, irinotecan, and trabectedin. We tried the combination of olaparib and temozolomide in an adult patient of Ewing sarcoma who had metastatic disease, and after 4 months of treatment, he showed excellent response to treatment.

Glomus tympanicum is a hypervascular, benign neoplasm with a slow rate of growth. The incidence of this pathology is higher in females than in males and mainly occurs in the fifth to sixth decade of life. Pulsatile tinnitus and hearing loss are the main clinical features. We present the case of a 70-year-old female patient who was admitted to the otolaryngology service with a 1-month history of epistaxis and equilibrium disorder that caused a ground-level fall.

"Lineage switch" is a term used to describe the phenomenon of change of lineage of acute leukemia to a different lineage. It is typically seen during therapy or at the time of relapse. More commonly, it is described in the pediatric population with an incidence of 6-9%. Lineage switches, though uncommon, can occur from acute myeloid leukemia (AML) to acute lymphoblastic leukemia (ALL (B/T)) and vice versa. The present scenario of AML to B-ALL switch is rare in an adult, with only a handful of cases described in literature. We report herein a case diagnosed as AML at 56 years of age, with NPM mutation who relapsed after 18 months post initial diagnosis. The clinicopathological features, flowcytometry, and molecular characteristics are discussed.

Embryonal sarcoma of the liver (ESL) is an aggressive tumor of childhood and rare in adults. Herein, we report an ESL in a 37-year-old female patient, who presented with liver rupture and acute abdomen. ESL was not considered in preoperative clinical differential diagnoses due to its rarity and the diagnosis was not established in the preoperative liver aspirate. This study highlights the fact that ESL should be considered as an uncommon malignant tumor in adults affecting commonly the right lobe of the liver, especially when the serum alpha-fetoprotein level is within normal ranges. Histological examination is essential to establish the diagnosis with ancillary tests. Due to its rarity, although a definitive mode of therapy is not known, postoperative adjuvant chemotherapy is effective in achieving symptom-free recovery. The index patient developed omental metastasis after 9 months of diagnosis and such a presentation is possibly an indicator of aggressive tumor behavior.

Chondrosarcomas are slow-growing malignant tumors of cartilaginous origin. The tumor can be locally aggressive with a risk of recurrence. Less than 10% of these tumors occur in the head and neck region, with most involving the maxilla, skull base, or larynx. Chondrosarcoma arising from the nasal septum is extremely rare. We report a case of a 64-year-old woman who presented with nasal obstruction and was subsequently diagnosed with nasal septal chondrosarcoma. She was treated with wide endoscopic surgical excision and regular follow-up, resulting in a good outcome.

Myeloid sarcoma (MS) refers to an extramedullary collection of immature cells of granulocytic series and occurs either in isolation or in association with myeloid malignancies, particularly acute myeloid leukemia (AML). We report a 16-year old girl with AML who was treated at our hospital with standard "7 + 3" induction chemotherapy and achieved morphological remission. She developed a small nodule below her right eyelid at day 10 of first consolidation chemotherapy with high-dose cytarabine. Eyelid lesion increased in size despite oral antibiotics. Peripheral blood did not show any blasts. However, bone marrow examination was consistent with relapsed AML. She was treated with salvage chemotherapy followed by allogeneic stem cell transplant. However, her disease relapsed 2 months later and she died. This is the first case of eyelid MS from India in which eyelid MS developed during chemotherapy for AML and heralded the subsequent disease relapse. Eyelid MS could be a sinister manifestation of AML. Literature regarding eyelid MS is discussed in brief.

Glioneuronal tumors are a very rare type of central nervous system (CNS) tumors. Due to rarity, even literature is limited. There is inconsistency in literature with respect to prevalence in different age groups, sex predilection, and treatment. Diagnosis of diffuse glioneuronal tumors is based on both radiologic and histopathologic features. Radiologically, they are often large, ill-defined lesions. On immunohistochemistry, the are positive for glial fibrillary acidic protein (GFAP), OLIG2, S100, and synaptophysin and negative for IDH1. Recently, glioneuronal tumors are included in the 2016 World Health Organization (WHO) classification of CNS neoplasms; however, there are many cases of glioneuronal tumors with distinctive morphologic features that are still not formally included in any classification. Similarly, there is vast disparity between treatments in various literature reports, ranging from surgery to chemoradiation to craniospinal irradiation. Here, we are presenting a case of high-grade diffuse glioneuronal tumor in a 28-year-old male. We have described the radiologic and pathologic features in our case. He was treated with volumetric modulated arc technique (VMAT) radiotherapy and concurrent chemotherapy.

Succinate dehydrogenase (SDH) deficient gastrointestinal stromal tumor (GIST) is the most common type of wild type GIST characterized by lack of mutations in proto-oncogene receptor tyrosine kinase (KIT) or platelet-derived growth factor receptor alpha (PDFGR alpha) pathways. It has a unique predilection for females and young adults, with a relatively indolent prognosis and varied treatment modalities. Data regarding SDH GIST from the Indian subcontinent is sparse.

Radiation therapy plays a critical role in head and neck cancer treatment, which can utilize artificial intelligence algorithms for automatic contour segmentation, treatment planning, and the selection of individual treatments. During the planning phase of radiation therapy, organs at risk (OARs), like the parotid gland, must be identified and mapped out to avoid unwanted side effects. Manual contouring of the parotid gland can be time-consuming and error-prone, causing interobserver variability. This study presents an algorithmic framework for the automated delineation of parotid glands using artificial intelligence and deep learning algorithms that interprets image sets to increase the precision and effectiveness of treatment planning, reduce the risk of side effects, and enhance treatment outcomes. Auto contouring increases the consistency and reproducibility of treatment plans and reduces the need for recontouring.

Vascular endothelial growth factor (VEGF) is an angiogenic marker and is implicated in the carcinogenesis and prognostication of cancers. However, its prognostic potential in Ewing sarcoma (ES) merits exploration.

The aim of this study was to investigate the association between serum C-reactive protein-to-albumin ratio (CAR) and the prognosis of multiple myeloma (MM).