Spontaneous regression of stage III neuroblastoma: A case report

Occurrence–regression–recurrence of hepatocellular carcinoma without any intervention: A case report

Background

Spontaneous regression of primary liver cancer is a rare event, and currently the exact pathogenesis of spontaneous tumor regression remains unclear.

Case description

Clinical information was collected from a patient with spontaneous regression of liver cancer at our center. The patient was a 41-year-old male. He was admitted to the hospital on 3 May 2019, due to aversion to fatty or greasy food, anorexia, loss of appetite, and abdominal distension. Laboratory examination results included hepatitis B surface antigen positivity, hepatitis B e antigen positivity, and hepatitis B core antibody positivity and tumor marker levels of alpha-fetoprotein 142,938.20 µg/L, abnormal prothrombin 4,599.91 mAU/ml, and carbohydrate antigen 19–9 82.05 U/ml. Upper abdominal enhanced computed tomography indicated right hepatocellular carcinoma with portal vein tumor thrombus formation. The patient declined any treatment. The tumor in the right lobe of the liver completely regressed after 1 year, and the patient is still undergoing follow-up.

Conclusions

We encountered a hepatocellular carcinoma patient who underwent spontaneous regression, but the exact pathogenesis remains unknown. Understanding the pathogenesis of spontaneous regression of hepatocellular carcinoma has the potential to contribute to the development of an effective treatment for hepatocellular carcinoma.

Application of three-dimensional reconstruction with a Hisense computer-assisted system in upper pancreatic lymph node dissection during laparoscopic-assisted radical gastrectomy

BACKGROUND/OBJECTIVE

To investigate the feasibility of three-dimensional (3D) reconstruction with an interactive Hisense computer-assisted system (CAS) for preoperative planning and intraoperative guidance during laparoscopic-assisted upper pancreatic lymph node dissection in distal gastrectomy for gastric cancer.

METHODS

This study included 28 patients who underwent preoperative 3D reconstruction of the upper border of the pancreas using Hisense CAS (3D reconstruction group) for preoperative planning and intraoperative navigation. To determine its efficacy, the clinical data of these patients were compared with those of 28 patients who did not undergo 3D reconstruction (control group).

RESULTS

Fifty-six cases of laparoscopic-assisted distal gastrectomy were performed. Three-dimensional reconstruction was successful in all the patients in the 3D reconstruction group, and real-time navigation was performed during the operation. The rate of correspondence between the 3D reconstruction images and intraoperative findings was 100%. The time taken for upper pancreatic lymph node dissection, number of upper pancreatic lymph node dissections, and number of unnecessary injuries during surgery were superior in the 3D reconstruction group than in the control group. The results of the remaining parameters were not statistically significant.

CONCLUSION

Preoperative planning with interactive Hisense CAS 3D reconstruction technology can improve surgeons' understanding of each patient's individual anatomy and can reveal anatomical variations, which is helpful for accurate preoperative planning and intraoperative navigation. This technique is helpful for the implementation of the precise dissection of lymph nodes at the upper edge of the pancreas and improves the quality and safety of the surgery.

Bottom up proteomics identifies neuronal differentiation pathway networks activated by cathepsin inhibition treatment in neuroblastoma cells that are enhanced by concurrent 13-cis retinoic acid treatment

Neuroblastoma is the second most common pediatric cancer involving the peripheral nervous system in which stage IVS metastatic tumors regress due to spontaneous differentiation. 13-cis retinoic acid (13-cis RA) is currently used in the clinic for its differentiation effects and although it improves outcomes, relapse is seen in half of high-risk patients. Combinatorial therapies have been shown to be more effective in oncotherapy and since cathepsin inhibition reduces tumor growth, we explored the potential of coupling 13-cis RA with a cathepsin inhibitor (K777) to enhance therapeutic efficacy against neuroblastoma. Shotgun proteomics was used to identify proteins affected by K777 and dual (13-cis RA/K777) treatment in neuroblastoma SK-N-SH cells. Cathepsin inhibition was more effective in increasing proteins involved in neuronal differentiation and neurite outgrowth than 13-cis RA alone, but the combination of both treatments enhanced the neuronal differentiation effect. SIGNIFICANCE: As neuroblastoma can spontaneously differentiate, determining which proteins are involved in differentiation can guide development of more accurate diagnostic markers and more effective treatments. In this study, we established a differentiation proteomic map of SK-N-SH cells treated with a cathepsin inhibitor (K777) and K777/13-cis RA (dual). Bioinformatic analysis revealed these treatments enhanced neuronal differentiation and axonogenesis pathways. The most affected proteins in these pathways may become valuable biomarkers of efficacy of drugs designed to enhance differentiation of neuroblastoma [1].