IntroductionTwo types of gliomatosis cerebri exist: Type I and Type II. We report the results of a histological and genetic study of two cases of gliomatosis cerebri Type II, correlating these results with therapy and prognosis.Case presentationTwo patients, a 52-year-old man (Patient 1) and a 76-year-old man (Patient 2) with gliomatosis cerebri II were admitted to our institution; they underwent surgical treatment and received radiotherapy and chemotherapy. At the 24-month follow-up, Patient 1 was still alive, while Patient 2 had died. The poor prognosis of Patient 2 was underlined by molecular analysis which showed that the angiogenesis related genes VCAM1 and VEGF were overexpressed, reflecting the high degree of neovascularization.ConclusionGenes involved in drug resistance and metallothioneins were highly expressed in Patient 2 and this, associated with unmethylated O6-methylguanine methyltransferase, can explain the lack of response to chemotherapy.

Pediatric thymomas are extremely rare and slow-growing malignant tumors. The recent publication of the first Union for International Cancer Control (UICC)/American Joint Committee on Cancer (AJCC) Tumor–Node–Metastasis (TNM) stage classification and updated treatment guidelines for thymomas has prompted us to perform a review of the literature on pediatric thymomas. A search of English-language articles in the PubMed, Cochrane, Web of Science, and Embase databases was conducted. Additional articles were identified through reference lists of retrieved publications. Thirty-two articles involving 82 pediatric thymomas were included. Males comprised 60% of patients, and 13% manifested myasthenia gravis (MG). Histotype B1 (45%) and stage I (52% Masaoka–Koga and 71% UICC/AJCC TNM) were the most frequent. Of note is the possibility that the lack of cases with mixed histologies in the reviewed publications might be related to a sampling issue, as it is well known that the more sections are available for review, the more likely it is that the majority of these neoplasms will show mixed histologies. Both staging systems showed a gradual increase in the percentage of cases, with more advanced stages of disease moving from type A to B3 thymomas. Complete surgical resection (R0) was the main therapeutic approach in Masaoka–Koga stage I (89%) and UICC/AJCC TNM stage I (70%) thymomas. Advanced stages of disease and incomplete surgical resection were most often associated with recurrence and death. An association between stage and outcome, and completeness of resection and outcome, was found. Interestingly, though an association between histotype and staging was found, this does not take into account the possibility of mixed histologies which would reduce the clinical impact of histologic subtyping over staging.

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belongs to the pentraxin superfamily, which are essential components of the humoral arm of the innate immune system and play a pivotal role in vascular biology. Like short pentraxins, PTX3 facilitates dysregulation of mitogenic signaling pathways, sustains cellular proliferation, angiogenesis, insensitivity to apoptosis, cancer cell invasion and migration, and tumor escape from immunosurveillance. Unlike short pentraxins, PTX3 is produced by a variety of cell types at the site of inflammation. Considering that chronic inflammation is found in as much as 80% of prostate biopsy (PBx) and that PTX3 seems to be involved in inflammatory-related carcinogenesis, we elected to test the potential correlation between PTX3 and PCa. Aim of the study is to test and internally validate serum Pentraxin-3 (PTX3) levels as a potential PCa biomarker to predict prostate biopsy (PBx) results.METHODS: Serum PSA and serum PTX3 were prospectively assessed in patients scheduled for PBx at our Institution because of increased serum PSA levels and/or abnormal Digital rectal examination. Uni-and multivariable logistic regression analysis, area under the receiver operating characteristic curve (AUC), and decision curve analysis (DCA), were used to test the accuracy of serum PTX3 in predicting anyPCa and clinically significant PCa (csPCa) defined as Gleason Grade (GG) !2.RESULTS: Between the 455 eligible patients, PCa was detected in 49% and csPCa in 25%. At univariable analysis, PTX3 outperformed other variables in predicting both anyPCa and csPCa. The addition of PTX3 to multivariable models based onto standard clinical variables significantly increased each model predictive accuracy for anyPCa (AUC from 0.73 to 0.82; p<0.001) and csPCa (AUC from 0.79 to 0.83; p<0.001). At DCA, PTX3 and PTX3 density showed higher net benefit than PSA and PSA density and increased the net benefit of multivariable models in deciding when to perform PBx.CONCLUSIONS: The present prospective study reports that serum PTX3 significantly outperforming serum PSA in predicting prostate biopsy results. Moreover, the addition of serum PTX3 to statistical models incorporating PSA and standard clinical variables significantly improved the model diagnostic accuracy, thus being of potential value in reducing the number and harms of unnecessary PBxs. Since nonmalignant conditions may increases PSA levels, there is a great quest for an efficient second test, the so-called reflex test, that may reduce the number of unnecessary PBxs. Results of such additional test may be used alone or included in multivariable models that take into account multiple clinical and laboratory variables. Should our findings be confirmed, this novel reflex test could be used to reduce the number and burden of unnecessary prostate biopsies.

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