rss_2.0Forum of Clinical Oncology FeedSciendo RSS Feed for Forum of Clinical Oncology of Clinical Oncology Feed of patients with localized prostate cancer treated with combined external beam radiotherapy and high-dose-rate brachytherapy boost: A single-center retrospective study<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Background</title> <p>Temporary prostate brachytherapy, in combination with external beam radiotherapy (EBRT), is an established and evolving treatment technique for non-metastatic, intermediate and high-risk prostate cancer. This study aimed to evaluate the outcomes of patients with localized intermediate and high-risk prostate cancer treated with combined EBRT and high-dose-rate brachytherapy boost (HDR-BT) at a single centre.</p> </sec> <sec><title style='display:none'>Patients &amp; Methods</title> <p>A retrospective review of patients who underwent EBRT and HDR-BT treatment between January 2015 and December 2020. Patient and tumor characteristics, treatment outcomes (Kaplan-Meier analysis), and toxicities were analysed.</p> </sec> <sec><title style='display:none'>Results</title> <p>127 patients with intermediate (28.3%) or high-risk (71.7%) prostate cancer were included. Median follow-up was 42 months. Five-year bDFS, CSS and OS rate was 77.5%, 98.1% and 93.0%, respectively, with no significant difference between risk groups. The most frequent toxicity was acute grade 1 urinary obstruction (7.9%). One patient experienced acute and late grade 3 urinary obstruction. No grade ≥4 were observed.</p> </sec> <sec><title style='display:none'>Conclusions</title> <p>Combined EBRT and HDR-BT demonstrated favourable disease control rates and manageable toxicities in patients with localized intermediate and high-risk prostate cancer. The 5-year bDFS rate was consistent with previous studies, supporting the effectiveness of this treatment approach. The low incidence of toxicities highlights the conformality and biological efficiency of HDR-BT boost. This treatment strategy provides an effective, safe and convenient option for this group of patients. To the best of our knowledge, this is the first report of the use of helical tomotherapy based intensity-modulated radiation therapy in combination with prostate HDR-BT (81.1% of cases).</p> </sec> </abstract>ARTICLEtrue as a paraneoplastic event from prostate cancer relapse<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Objective</title> <p>We wish to investigate whether there is a known connection between prostate cancer and glomerulonephritis.</p> </sec> <sec><title style='display:none'>Methods</title> <p>We present a case report of a patient whom we diagnosed with rapidly progressive glomerulonephritis as a result of prostate cancer relapse.</p> </sec> <sec><title style='display:none'>Results</title> <p>In rare cases, prostate cancer is associated with crescentic glomerulonephritis.</p> </sec> <sec><title style='display:none'>Conclusion</title> <p>Every patient with cryptic glomerulonephritis should be screened for cancer.</p> </sec> </abstract>ARTICLEtrue and Clinical Characteristics of Females with Breast Cancer in Iraq with Respect to Age: A Single-Center Study<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Background</title> <p>Breast cancer is a growing concern in Iraq, posing significant health challenges for Iraqi women. The objective of this study was to describe the demographic and clinical characteristics associated with breast cancer among Iraqi women, with a specific focus on age-related differences.</p> </sec> <sec><title style='display:none'>Materials and Methods</title> <p>Medical records of 500 female patients diagnosed with breast cancer between 2017 and 2022 were retrospectively analyzed. Demographic information, clinical history, presentation details, treatment modalities, and outcomes were collected and analyzed.</p> </sec> <sec><title style='display:none'>Results</title> <p>Among the studied cohort, 62.4% of breast cancer cases were diagnosed in women aged 50 and older. Marital status correlated significantly with age, with 89.9% of those diagnosed before 50 being married compared to 74.7% of those diagnosed after 50. Notably, 48% of patients diagnosed before 50 had breastfeeding duration of 1–3 months, contrasting with 28.5% of those diagnosed after 50. Diabetes mellitus, hypertension, hypercholesterolemia, heart disease, and vitamin D deficiency were significantly more prevalent among patients diagnosed after 50. Clinical presentation revealed 67.8% with tumor stage II. Metastasis to lymph nodes occurred in approximately 50% of patients. Among patients who were diagnosed after 50 years of age, 34% had metastasis, compared to 22.9% of those diagnosed before the age of 50. Mortality rates were higher in patients diagnosed after 50 (23%) compared to those under 50 (12.8%).</p> </sec> <sec><title style='display:none'>Conclusion</title> <p>The findings emphasize the need for targeted public health campaigns, early detection initiatives, and treatment optimization to improve patient outcomes and mitigate the burden of breast cancer.</p> </sec> </abstract>ARTICLEtrue of dosing paradigm in oncology<abstract> <title style='display:none'>Abstract</title> <p>Drug dosing based on the body surface area (BSA) has been the mainstay of oncological treatment over the last decades. Although this seems to be an adequate measure of an individual’s appropriate dose for traditional chemotherapeutic drugs according to their somatometric data, it is currently being questioned due to the delivery of novel treatments such as monoclonal antibodies. Most modern regimes require either a flat (fixed)-dosing model, independent of body weight, or a weight-based administration pattern, mainly depending on specific pharmacokinetic data. However, even in this case, some controversy exists about whether this model is sufficient. Given the recent findings from pharmacokinetic studies, perhaps we should reconsider the solid hypothesis that drug efficacy correlates with dose, as many molecules seem to be efficient even in the lowest doses administered, with minimum toxicity.</p> </abstract>ARTICLEtrue of the COVID-19 pandemic on young oncologists: The Greek perspective<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Background</title> <p>The global impact of the Coronavirus Disease 2019 (COVID-19) pandemic on health professionals has been profound. In response to these circumstances, the coordination committee of the Hellenic Group of Young Oncologists (HeGYO) embarked on an investigation into the well-being of its members.</p> </sec> <sec><title style='display:none'>Methods</title> <p>For the purposes of this study, we developed a 44-question questionnaire. The responses were electronically collected and exported into data frames, which were then subjected to statistical analyses.</p> </sec> <sec><title style='display:none'>Results</title> <p>The study cohort comprised 77 oncologists, of whom 81.7% (n=67) were under the age of 40. Survey responses highlighted the profound impact of the COVID-19 pandemic on young oncologists in Greece, with 67.5% (n=52) feeling that their work lives have not returned to pre-pandemic levels, 74% (n=57) experiencing changes in duties, and 74.0% (n=57) reporting increased working hours. Additionally, 82% (n=63) of participants reassessed their work–life balance. Notably, 92.2% (n=71) expressed fears of COVID-19 contamination, unrelated to the perceived quality of protective measures (p=0.291). Time allocated to clinical and pre-clinical research was also decreased, as reported by 36.4% (n=28) and 41.6% (n=32) respectively. Surprisingly, the pandemic did not prompt the initiation of unhealthy habits, but 51.2% (n=40) reported a reduction in physical activity.</p> </sec> <sec><title style='display:none'>Conclusions</title> <p>In summary, this study reveals that the COVID-19 pandemic significantly altered the professional landscape for young oncologists in Greece, impacting work dynamics, research productivity, and overall well-being. These findings underscore the necessity for targeted interventions during emergencies in the healthcare in order to maintain a resilient workforce in oncology.</p> </sec> </abstract>ARTICLEtrue of Fungating Oral Cancer: A Case Report<abstract> <title style='display:none'>Abstract</title> <p>Fungating growths are most distressing causing substantial psychological distress for patients and families. Malodor associated with fungating growth causes social isolation, yet malodor management remains suboptimal. Management of fungating cancer growth of oral cavity is unique and difficult. This paper discusses the management of malodor and infection associated with fungating wound including definitive treatment of fungating growth of an oral cavity cancer patient.</p> </abstract>ARTICLEtrue neoadjuvant therapy in rectal cancer: a review across studies<abstract> <title style='display:none'>Abstract</title> <p>The optimal management of locally advanced rectal cancer (LARC) often presents a therapeutic challenge. Balancing the benefits of treatment against toxicities and reducing the risk for local and distal recurrences are the mainstay of therapeutic approaches. Recently, several studies have compared a more aggressive approach of delivering several cycles of systemic chemotherapy to the established standard of combined chemoradiation. This approach is termed total neoadjuvant therapy and appears to be beneficial, at least for a subset of patients. The results of the main Phase III studies along with their variations in study design are hereby discussed with the goal of extracting useful clinical suggestions for treatment.</p> </abstract>ARTICLEtrue Heterogeneity and Biomarkers FCO 2023 Death-Ligand 1, C-reactive Protein, and Neutrophil/Lymphocyte Ratio as Lymphangiogenesis Markers of Metastasis in Penile Cancer – A Systematic Review<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Introduction</title> <p>The spread of penile cancer cells through lymphatic vessels provides the potential for using compounds involved in lymphangiogenesis, such as programmed death-ligand 1 (PD-L1), C-reactive protein (CRP), neutrophil/lymphocyte ratio (NLR), and Ki-67, in predicting the development of lymphatic metastases in penile cancer.</p> </sec> <sec><title style='display:none'>Methods</title> <p>The systematic review was conducted based on the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement. A literature search was conducted using the medical literature database PubMed, Scopus, ScienceDirect, EMBASE, and EBSCOHost for studies published until February 7, 2023.</p> </sec> <sec><title style='display:none'>Results</title> <p>Among 527 studies identified in the literature, 21 studies met the inclusion criteria and became eligible studies. PD-L1, CRP, and NLR are biomarkers which are proven to be significantly associated with an increased risk of high-grade tumor and lymphatic metastasis in penile cancer.</p> </sec> <sec><title style='display:none'>Conclusion</title> <p>PD-L1, CRP, and NLR are biomarkers that might be used to assess the risk or likelihood of developing lymphatic metastases in penile cancer.</p> </sec> </abstract>ARTICLEtrue ulcers of unusual location: a case report and review of literature<abstract> <title style='display:none'>Abstract</title> <p>Hydroxyurea is a cytotoxic drug that has been used for decades for the treatment of various entities, mostly hematologic, especially polycythemia vera. Its side effects are varied, including dermatological ones, ranging from skin xerosis to hyperpigmentation, lesions like dermatomyositis and shows even a relationship with premalignant processes (actinic keratosis) and non-melanoma cancer (squamous, basal cell, Merkel, and oral tumors).</p> <p>In this paper, we report a clinical case of a relatively frequent adverse effect of hydroxyurea, but of extraordinary localization and clinical presentation.</p> <p>The association of ulcers with taking hydroxyurea is well known. Most of the time, these appear in the lower limbs and in patients with chronic vascular pathology. However, in our patient, the location was both hands and was associated with dermatomyositis-like lesions, nail hyperpigmentation, and skin changes. The therapeutic response with withdrawal was spectacular. Knowledge of this condition is vitally important for the hematologist and dermatologist to ensure adequate care.</p> </abstract>ARTICLEtrue of Carotid Artery Dose in Early-Stage Glottic Cancer Treated with 3D-Conformal, Helical-IMRT and VMAT<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Background</title> <p>The aim of this study was to compare the dosimetry of carotid arteries (CAs) using three radiation therapy (RT) techniques, three-dimensional conformal RT (3D-CRT), helical tomotherapy-intensity-modulated RT (HT-IMRT), and volumetric modulated arc therapy (VMAT), in patients with early-stage glottic cancer.</p> </sec> <sec><title style='display:none'>Patients and Methods</title> <p>A retrospective analysis of 28 patients was performed, and the right and left CAs were delineated. Mean and maximum dose (Dmax) values were compared across the three treatment techniques.</p> </sec> <sec><title style='display:none'>Results</title> <p>The results indicate that 3D-CRT plans had the highest mean and maximum doses to CAs, while VMAT plans had the lowest doses.</p> </sec> <sec><title style='display:none'>Conclusions</title> <p>Our study demonstrates the feasibility of sparing CAs with newer RT modalities. Further clinical studies are needed to determine if these techniques can reduce carotid stenosis-related events.</p> </sec> </abstract>ARTICLEtrue of Neutrophil-to-Lymphocyte Ratio as A Prognostic Marker in Locally Advanced Head and Neck Cancer Treated with Concomitant Chemoradiation<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Background</title> <p>Various experimental and epidemiological studies have been conducted to find the relationship between hematologic parameters like neutrophil-to-lymphocyte ratio (NLR) and prognosis in numerous solid malignancies. We conducted a similar study to assess the role of NLR as a prognostic marker in locally advanced head and neck cancer (HNC) treated with chemoradiation.</p> </sec> <sec><title style='display:none'>Patients and methods</title> <p>A total of 60 patients of histopathologically proven, previously untreated, locally advanced HNC were included in this randomized, prospective study. They were stratified into five groups according to their NLR values (&lt;2, 2–3, 3–4, 4–5, and &gt;5). All 60 patients received the same concurrent chemoradiation with a radiation dose of 66 Gy in 33 fractions over 6.5 weeks with injection cisplatin 40 mg/m<sup>2</sup> weekly. Treatment-related toxicities were assessed weekly. Association of NLR was assessed with the outcomes as per the World Health Organization (WHO) response criteria. Informed consent was taken from all patients, and approval of institutional ethical committee was obtained.</p> </sec> <sec><title style='display:none'>Results</title> <p>Complete response was observed to be maximum in patients with low NLR value of &lt;2 (73% of patients). Higher percentage of treatment-related toxicities was also observed in groups with higher NLR values, that is, NLR 4–5 and &gt;5. The association of NLR with treatment response was statistically significant on Pearson's chi-square test (<italic>P</italic> = 0.019).</p> </sec> <sec><title style='display:none'>Conclusion</title> <p>Our study was able to establish the relationship between NLR and treatment outcome in HNC patients treated by concurrent chemoradiation. Higher pretreatment NLR values were associated with poorer survival outcomes and increased treatment-induced toxicities.</p> </sec> </abstract>ARTICLEtrue and Temporal Heterogeneity in Clonal Evolution of Nonsmall-cell Lung Cancer: Implications for Therapy<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Introduction</title> <p>Tumoral heterogeneity has been associated with treatment resistance and failure in patients with cancer. Tumoral heterogeneity can be either intertumoral (static variation of cancer cells) or intratumoral (spatial and temporal variation of cancer cells). Nonsmall-cell lung cancer (NSCLC) is considered a model disease for the study of tumoral heterogeneity, given the emerging evidence about the clinical implications of genetic variations among NSCLC subtypes. This review provides an overview of the etiology, detection, and management methods of intratumoral heterogeneity in NSCLC and discusses their clinical implications.</p> </sec> <sec><title style='display:none'>Methods</title> <p>The authors searched biomedical databases (Medline, Scopus, Embase) for studies reporting on intratumoral heterogeneity in NSCLC.</p> </sec> <sec><title style='display:none'>Results</title> <p>Intratumoral heterogeneity occurs in single tumors, multiple tumors in the same organs, primary tumors and metastases, and among distinct metastases. Genetic (selective pressure, clonal evolution, genomic instability) and nongenetic pathways (tumor metabolism, hypoxia) precipitate heterogeneity across the spatial and temporal progression of the disease. Proposed classifications are based either on cancer subtypes or mutations detected and metastasis sites. Liquid biopsies (cell-free DNA, circulating tumor cells) combined with imaging (computed tomographies (CTs), positron emission tomography/computed tomographies (PET/CTs)) have a major potential for the continuous minimally invasive monitoring of intratumoral heterogeneity in comparison to conventional biopsies. Targeted therapies have a higher likelihood to induce heterogeneity and resistance, while PD-L1 immunotherapy represents a promising therapeutic strategy.</p> </sec> <sec><title style='display:none'>Conclusion</title> <p>Spatial and temporal intratumoral heterogeneity within a single patient sets additional challenges to personalized precision medicine, calling for continuous cellular and molecular-level surveillance and adequate adjustment of the treatment plan.</p> </sec> </abstract>ARTICLEtrue in Squamous Cell Carcinoma of the Head and Neck<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Background</title> <p>Re-irradiation as a therapeutic option for locoregional recurrence in patients with recurrent, persistent tumour or second primary malignant neoplasm has great advantages for locally advanced unresectable tumours.</p> </sec> <sec><title style='display:none'>Methods</title> <p>We intended to characterise the patient pool that underwent re-irradiation and to perform a comparative analysis between previously known data related to prognostic factors with an impact on 2 years OS of these patients, and evaluate the therapeutic impact of re-irradiation in patients with recurrent, persistent tumour or second primary malignant neoplasm in the head and neck region, treated at the Radiotherapy Department in Portuguese Institute of Oncology in Coimbra (IPOC), from the year 2016 to 2020.</p> </sec> <sec><title style='display:none'>Results</title> <p>A total of 39 patients were included in this study. All patients were submitted to both primary radiotherapy and re-irradiation with a median time interval between treatment of 20 months (minimum: 8 – maximum: 190). Only the time between irradiations was associated with a decrease in the risk of mortality (HR=0.828; CI 95% 0.731–0.939; p=.03). There were no significant differences in terms of toxicity severity between irradiations.</p> </sec> <sec><title style='display:none'>Conclusion</title> <p>Re-irradiation is an important therapeutic alternative in the treatment of patients with malignant tumours in the head and neck region.</p> </sec> </abstract>ARTICLEtrue Cell Carcinoma of the Breast in a Patient with Previous History of Rectal Cancer: A Case Report<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Background</title> <p>Spindle cell carcinoma of the breast is a very rare subtype of metaplastic breast cancer with aggressive behaviour in comparison with invasive ductal carcinoma, which is the most common histological type of breast cancer. It has a poor prognosis and a controversial response to systemic therapy.</p> </sec> <sec><title style='display:none'>Aim of this study</title> <p>The aim of this study is to shed light on this uncommon but aggressive type of breast cancer.</p> </sec> <sec><title style='display:none'>Case Presentation</title> <p>In this case report, we present a 56-year-old woman with spindle cell carcinoma of the breast with a previous history of treated rectal cancer. She presented with a left breast mass. Ultrasound-guided fine needle aspiration gave results positive for malignancy. A left mastectomy with axillary clearance was done, and the histopathology was spindle cell carcinoma of the breast. The patient refused chemotherapy until five months post-operation when she presented with local recurrence of two small masses at the site of mastectomy. New imaging revealed bilateral pulmonary metastasis. She started on single agent Adriamycin and received a total of six cycles. A CT scan of the chest and abdomen with contrast revealed disease progression. Imaging of the brain showed brain metastasis. The patient refused any kind of further chemotherapy or radiotherapy treatment until she passed away one month later from aspiration pneumonia and its complications.</p> </sec> <sec><title style='display:none'>Conclusion</title> <p>Metaplastic breast cancer is an aggressive subtype of breast cancer with rapid progression, a high tendency for distant metastases, a poor response to treatment, and a short survival time.</p> </sec> </abstract>ARTICLEtrue carcinoma of the breast: Review<abstract> <title style='display:none'>Abstract</title> <p>Apocrine carcinoma of the breast is a rare subtype of breast carcinoma, which only presents as 4% among patients with breast cancer. The percentage varies based on the diagnostic criteria used by each institution to classify apocrine carcinoma. Several confusing terms used in previous studies, including apocrine ductal carcinoma in situ (ADCIS), apocrine morphology in lobular carcinoma in situ (Apocrine LCIS), apocrine-like invasive carcinoma, pure apocrine carcinoma, molecular apocrine tumors (MATs), and triple-negative apocrine carcinoma of the breast (TNAC). The treatment, prognosis, and molecular profiles are also diverse. Pure apocrine carcinoma has stricter criteria for diagnosis, requiring more than 90% of cells showing apocrine morphology and classic IHC characteristics of ER-negative, PR-negative, and AR-positive in at least 10% of tumor cell nuclei. Research related to prognosis is diverse due to the difficulty of unifying the diagnostic criteria. Current evidence of treatment is geared toward the use of neoadjuvant chemotherapy and anti-androgen therapy when AR is present, accompanied by other treatments if biomarkers are present, such as HER2, PI3K, or CDK4/6. This article focuses on clearly summarizing different subtypes and management of apocrine carcinoma of the breast.</p> </abstract>ARTICLEtrue of alpha and gamma Klotho genes in the development of differentiated thyroid carcinoma on top of goiter<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Background</title> <p>Differentiated thyroid carcinoma (DTC) is the most common malignant tumor of the endocrine system. Our study is aimed to investigate the role of the α- and γ-Klotho genes in the development and progression of DTC.</p> </sec> <sec><title style='display:none'>Methods</title> <p>The expression of the α- and γ-Klotho genes was assessed by quantitative real-time polymerase chain reaction (RT-qPCR) in thyroid tissues of 40 DTC patients and 40 age- and sex-matched subjects diagnosed as goiter and included as a control group. The demographic, laboratory and clinicopathological data of the subjects were reviewed to detect their association with the Klotho genes.</p> </sec> <sec><title style='display:none'>Results</title> <p>The α-Klotho gene expression was statistically significantly lower in DTC tissues compared to goiter tissues (<italic>p</italic> &lt; 0.001). However, there was no statistically significant association between the γ-Klotho gene expression and DTC (<italic>p</italic> = 0.643). Receiver operating characteristic (ROC) curve analysis showed the diagnostic value of the α-Klotho mRNA levels, by providing an AUC of 0.954 value (95% CI = 0.910–0.999; <italic>p</italic> &lt; 0.001). Lower α-Klotho gene expression associated significantly with higher stages of DTC (<italic>p</italic> = 0.026). Logistic regression analysis declared that low α-Klotho mRNA expression was demonstrated to be a significant predictor for the likelihood of DTC on top of goiter (<italic>p</italic> = 0.001).</p> </sec> <sec><title style='display:none'>Conclusions</title> <p>Our study showed the role of the α-Klotho gene as a potential novel biomarker for discrimination between DTC and goiter tissues. Low α-Klotho mRNA expression was found to be a significant predictor for the likelihood of DTC on top of goiter, as well as higher stages of this tumor.</p> </sec> </abstract>ARTICLEtrue of lymph node adequacy in patients with colorectal cancer: Results from a referral center in Iran<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Background</title> <p>The presence of lymph node metastasis is one of the most important prognostic factors for long-term survival of patients with colorectal cancer. Therefore, thorough pathologic examination of at least 12 lymph nodes is essential for accurate staging of this disease, as well as for choosing the best adjuvant treatment. The aim of this study is to assess the adequacy of lymph node harvest in patients with colorectal cancer.</p> </sec> <sec><title style='display:none'>Methods</title> <p>This observational, cross-sectional study was performed on 584 patients with colorectal adenocarcinoma who had undergone surgery from 2012 to 2017. Thereafter, the relevant demographic, pathological, and surgical data were extracted from the patients’ medical records; and a relationship between the number of evaluated lymph nodes and other variables was also assessed.</p> </sec> <sec><title style='display:none'>Results</title> <p>Among 584 studies cases in this study, 336 (57.5%) subjects had fewer than 12 evaluated lymph nodes. Mean and median number of the evaluated lymph nodes were calculated as 10.7 (±5.6) and 10, respectively. The patients aged 60 years old and older and the cases with tumors located in descending colon and rectum were observed to have a higher likelihood of inadequate lymph node retrieval. After an average follow-up of a 60-month period, 63% of the patients were alive. For the patients in whom fewer than 12 lymph nodes had been assessed, the median survival was estimated to be 48 months. For the patients in whom the number of evaluated lymph nodes was ≥12, median survival was calculated to be 54 months.</p> </sec> <sec><title style='display:none'>Conclusion</title> <p>The number of lymph nodes evaluated in our study was less than the standard number in more than half of the patients. Among various other factors, older age and tumor location in descending colon and rectum are found to be associated with suboptimal assessment of lymph nodes. The number of lymph nodes dissected is also associated with survival.</p> </sec> </abstract>ARTICLEtrue pararenal dedifferentiated liposarcoma with epithelioid/neuroendocrine features, somatostatin-positive.<abstract> <title style='display:none'>Abstract</title> <p>Liposarcomas are malignant mesenchymal neoplasms that, although derived from adipocytes, may dedifferentiate to other cell types. We present an exceedingly rare case of epithelioid/neuroendocrine dedifferentiation with somatostatin expression of a pararenal retroperitoneal liposarcoma.</p> <p>Based on the immunomorphological features, the diagnosis was possible with the support of the molecular FISH investigation: it showed amplification of the MDM2 gene, which is present in most liposarcomas, even in dedifferentiated ones.</p> </abstract>ARTICLEtrue