High-grade ovarian cancer associated H/ACA snoRNAs promote cancer cell proliferation and survival

ABSTRACT Small nucleolar RNAs (snoRNAs) are an omnipresent class of non-coding RNAs involved in the modification and processing of ribosomal RNA (rRNA). As snoRNAs are required for ribosome production, the increase of which is a hallmark of cancer development, their expression would be expected to increase in proliferating cancer cells. However, assessing the nature and extent of snoRNAs’ contribution to cancer biology has been largely limited by difficulties in detecting highly structured RNA. In this study, we used a dedicated midsize non-coding RNA (mncRNA) sensitive sequencing technique to accurately survey the snoRNA abundance in independently verified high-grade serous ovarian carcinoma (HGSC) and serous borderline tumour (SBT) tissues. The results identified SNORA81, SNORA19 and SNORA56 as an H/ACA snoRNA signature capable of discriminating between independent sets of HGSC, SBT and normal tissues. The expression of the signature SNORA81 correlates with the level of ribosomal RNA (rRNA) modification and its knockdown inhibits 28S rRNA pseudouridylation and accumulation leading to reduced cell proliferation and migration. Together our data indicate that specific subsets of H/ACA snoRNAs may promote tumour aggressiveness by inducing rRNA modification and synthesis.

Serous borderline tumour of the peritoneum- A rare entity

Serous borderline tumor is a rare entity of peritoneum which can lead to diagnostic dilemma due to its resemblance with reactive lesions of peritoneum and ovarian borderline and malignant neoplasms. Complete clinical details, histopathological evaluation and immunohistochemistry aid in arriving at correct diagnosis. Recognizing this entity is important as it carries good prognosis.

Trousseau’s syndrome associated with an ovarian borderline tumour

A 71-year-old woman was admitted to our hospital because of sudden onset of weakness on the left side of her body. Her medical history was unremarkable, and on physical examination, hemiparesis and hyperreflexia on the left side were found. MRI of the brain showed multiple areas of restricted diffusion in both parietal lobes and in the cerebellum, consistent with embolic shower. Magnetic resonance angiography showed no abnormal findings. A contrast-enhanced CT scan revealed multiple pulmonary emboli. Abdominal MRI showed a 135 mm left ovarian tumour composed of a solid and a cystic component with liquid level formation. After a total hysterectomy and bilateral adnexectomy, the histopathology confirmed a seromucinous borderline tumour. Therefore, the patient was diagnosed with Trousseau’s syndrome associated with an ovarian seromucinous borderline tumour. To our knowledge, this is the first report mentioning a borderline ovarian tumour detected as Trousseau’s syndrome.

Low-grade serous epithelial ovarian cancer: a comprehensive review and update for radiologists

Low-grade serous carcinoma (LGSC) is an infrequent subtype of ovarian cancer, corresponding to 5% of epithelial neoplasms. This subtype of ovarian carcinoma characteristically has molecular features, pathogenesis, clinical behaviour, sensitivity to chemotherapy, and prognosis distinct to high-grade serous carcinoma (HGSC). Knowing the difference between LGSC and other ovarian serous tumours is vital to guide clinical management, which currently is only possible histologically. However, imaging can provide several clues that allow differentiating LGSC from other tumours and enable precise staging and follow-up of ovarian cancer treatment. Characteristically, LGSC appears as mixed lesions with variable papillary projections and solid components, usually in different proportions from those detected in serous borderline tumour and HGSC. Calcified extracellular bodies, known as psammoma bodies, are also a common feature of LGSC, frequently detectable within lymphadenopathies and metastases associated with this type of tumour. In addition, the characterisation of magnetic resonance imaging enhancement also plays an essential role in calculating the probability of malignancy of these lesions. As such, in this review, we discuss and update the distinct radiological modalities features and the clinicopathologic characteristics of LGSC to allow radiologists to be familiarised with them and to narrow the differential diagnosis when facing this type of tumour.

Intraoperative Consultation (Frozen Section) in the Diagnosis of Ovarian Tumour

Ovarian cancer is a devastating disease preoperative evaluation of the patients with an ovarian tumour is difficult. So frozen section biopsy of ovarian tumour is important to determine the extent of surgery. This retrospective cross-sectional study was carried out in the Department of Gynaecological Oncology, Bangabandhu Sheikh Mujib Medical University from August 2016 to July 2017 to determine the validity of frozen section biopsy in the diagnosis of ovarian tumour. Fifty cases of ovarian tumour underwent frozen section biopsy were included by purposive sampling. Histopathological finding was taken as the gold standard. Data was analyzed by SPSS version 16. The sensitivity of frozen section in the diagnosis of benign, borderline and malignant were 100%, 100% and 97.67% respectively as well as the specificities were 100%, 97.96% and 100% respectively. Similarly the accuracy, PPV, NPV for the benign, borderline and malignant ovarian tumour were also high except the borderline tumour which had low PPV. Bangladesh Med J. 2019 Sep; 48 (3): 34-38

Kaposiform haemangioendothelioma of duodenum in a neonate

Kaposiform haemangioendothelioma, an endothelial borderline tumour, is typically seen in childhood involving extremities. It has been closely associated with a consumptive coagulopathy state, Kasabach-Merritt phenomenon (KMP). Extracutaneous involvement is uncommon. Intestinal involvement is quite uncommon and can masquerade as an acute abdomen. A 24-day-old neonate presented with bilious vomiting and fever for 5 days. Sections from the resected gangrenous duodenum contained a submucosal tumour composed of infiltrating nodules of slit-like or crescentic CD34-positive spindled-to-flattened endothelial-lined vascular spaces along with zones of fibrosis. No nuclear pleomorphism or necrosis identified. The findings were classic example of kaposiform haemangioendothelioma with an absence of any deranged coagulation profile. The index case raises interest given its congenital incidental presentation at an uncommon site, like duodenum, and absence of coexistent KMP.

Peritoneal Serous Borderline Tumour with Ultra-Mutated NGS Profile Including POLE E, BRAF, RB1, HER2 and P53 Mutations : A Case Report.

Background: Serous borderline tumors of the peritoneum are rare low-grade epithelial proliferation with a tubal-type differentiation occurring in the pelvis or abdomen without underlying tissue invasion that resemble to ovarian serous borderline tumors but by definition without ovrian or tubal involvement. To date, the mutation status in molecular biology of these tumours remains largely unknown.Case presentation: Here we describe the case of a borderline peritoneal serous tumour which occurred in a 48 year old patient in whom an analysis of the mutation status by NGS technique identified a ultra-mutated profile including POLE E, BRAF, RB1, HER2 and p53 mutations.Conclusions: To the best of our knowledge, this particular mutation status has never been described in this type of tumour. It could represent an early event with transient mutations, most of them will not fixate on the genome.

Phyllodes tumours – a retrospective review of 83 clinical cases

Introduction: Phyllodes tumours are rare, accounting for 0.3–1.0% of all primary breast tumours. According to biological behaviour, they are divided into three categories: benign, borderline and malignant. Due to the rare incidence, the requirements for the radicality of surgical treatment are not well known. According to respected foreign recommendations, resection with a free margin of 10 mm or more is desirable. Methods: A retrospective review of patients, who underwent surgical treatment due to phyllodes tumour in the Masaryk Memorial Cancer lnstitute in 2003–2014. Results: 83 patients were evaluated with a median follow-up of 68.0 months. Benign tumours accounted for 62.3%, borderline tumours accounted for 16.9% and malignant accounted for 20.8% of all tumours. Malignant phyllodes tumours reached a bigger average size (84.9 mm) than borderline (41.4 mm) and benign tumours (33.3 mm) and occurred in older patients (mean 56.4 years) than benign (mean 42.5 years). Results from preoperative core-cut biopsy were often inaccurate. In 70 cases, the primary resection was breast preserving, but the free margin above 1 mm was achieved only in 13 cases. The width of the resection edge never exceeded the recommended 10 mm. Nevertheless, there was a relapse in benign tumours in two cases and in the borderline tumours only in one case. Malignant tumours recurred more frequently, even after total mastectomy. Four patients with malignant tumours experienced distant metastases. There has never been a death caused by benign or borderline tumour. Conclusion: The 10 mm resection margin is unachievable in our conditions. However, it seems that such radicality is not necessary in benign tumours, because they rarely recur even with close margins. Conversely, neither total mastectomy of the malignant phyllodes tumours will protect against local progression or distant metastasis.