Search Results (7,167)

Background and Clinical Significance: Tarui disease, or glycogen storage disease type VII, is a rare autosomal recessive metabolic myopathy caused by muscle phosphofructokinase deficiency. Its manifestations include exercise intolerance, exertional myalgia, muscle cramps, myoglobinuria, rhabdomyolysis, hyperuricemia, and compensated hemolysis. The hematologic phenotype may obscure the underlying metabolic disorder and raise concern for a clonal myeloid neoplasm. Case Presentation: A 23-year-old man was referred for persistent mild thrombocytopenia following evaluation for jaundice and hepatosplenomegaly. He had undergone cholecystectomy at 18 years of age and reported exercise-induced myalgia, muscle cramps, and episodes of dark urine. Laboratory investigations demonstrated mild monocytosis, reticulocytosis, thrombocytopenia, hyperuricemia, elevated lactate dehydrogenase, and predominantly unconjugated hyperbilirubinemia, with a negative direct antiglobulin test. Selected inherited hemolytic disorders, hemoglobinopathies, and paroxysmal nocturnal hemoglobinuria were excluded. Bone marrow examination showed marked erythroid hyperplasia and mild megakaryocytic dysplasia. Testing for JAK2, CALR, and MPL mutations and an extended myeloid next-generation sequencing panel identified no pathogenic variants, and monocytosis resolved during follow-up. Whole-exome sequencing identified a homozygous PFKM missense variant, NM_001354735.1:c.1087A>T, p.(Ile363Phe), classified as a variant of uncertain significance. The patient subsequently developed severe rhabdomyolysis, with a creatine kinase level of 225,000 U/L and recovered after intensive intravenous hydration without renal impairment. Conclusions: Tarui disease should be considered in young patients with compensated hemolysis, hyperuricemia, exertional muscle symptoms, dark urine, or rhabdomyolysis, even when hematologic abnormalities suggest a myeloid disorder. The highly concordant phenotype and homozygous PFKM variant support a clinically probable diagnosis, although pathogenicity remains unconfirmed. Functional and segregation evidence may strengthen causal interpretation and support future variant reclassification. Full article

Objectives: To investigate the rate and predictors of recurrence at second-look ureterorenoscopy (URS) and to assess the adequate timeframe for second-look URS in upper tract urothelial carcinoma (UTUC). Methods: This multicenter retrospective study included 179 patients who underwent endoscopic kidney-sparing surgery (KSS) and second-look URS for non-invasive UTUC between 2004 and 2017. We performed logistic and Cox proportional hazard regression analyses to investigate the association between clinical parameters and second-look recurrence, recurrence-free survival (RFS), and cancer-specific mortality. The optimal duration to second-look URS was extrapolated using restricted cubic splines. Results: Overall, 66 (36.9%) patients experienced recurrence at second-look URS. After second-look URS, further recurrence was observed in 87 (48.6%) patients during a median follow-up of 12 months. Female gender (OR [odds ratio] 2.3, 95% CI [confidence interval] 1.1–4.7, p = 0.026) and tumor size > 1 cm (OR 3.3, 95% CI 1.2–9.5, p = 0.027) were independently associated with recurrence at second look. Second-look recurrence was a strong prognostic factor for RFS (HR 5.0, 95% CI 3.1–8.0, p < 0.001). Second-look URS between 5 and 12 weeks after initial endoscopic laser ablation was an independent favorable factor for RFS (HR 0.5, 95% CI 0.3–0.9, p = 0.014). Conclusions: Early recurrence at second-look URS appears to be one of the strongest predictive factors for RFS in patients undergoing endoscopic KSS. Our results suggest that second-look URS performed within 5 to 12 weeks is associated with a lower probability of further disease recurrence. Given that this interval was derived and tested in the same cohort, this finding should be regarded as hypothesis-generating and requires external validation before being adopted as a clinical standard. Full article

Carcinoma of unknown primary origin (CUP) involving the skeletal system is rare in dogs and may closely mimic primary bone neoplasia or multicentric lymphoma, creating substantial diagnostic challenges. A 15-year-old spayed female Jindo-mix dog was referred for rapidly progressive tetralimb lameness and inability to stand following a 2-week history of worsening forelimb lameness. Computed tomography revealed aggressive multifocal osteolytic and osteoproliferative lesions involving the pelvis, distal femur, and lumbar vertebra, accompanied by generalized lymphadenopathy, raising differential diagnoses including osteosarcoma, lymphoma, and metastatic neoplasia. Serial CT examinations demonstrated rapid progression of the dominant left ischial lesion, which was considered most consistent with a primary bone neoplasm and was surgically excised for definitive diagnosis. MRI failed to identify clinically significant neurologic disease. Histopathologic examination of a surgically excised ischial lesion favored poorly differentiated epithelial malignancy, although lymphoma could not initially be excluded. During hospitalization, serial thromboelastography (TEG) and coagulation testing demonstrated a predominantly hypercoagulable profile despite antithrombotic therapy. Following acute clinical deterioration, contrast-enhanced CT identified thrombosis involving the splenic vein and caudal vena cava, pulmonary thromboembolism (PTE), and concurrent multi-organ infarction. Cytology of an enlarged peripheral lymph node suggested metastatic carcinoma, and postmortem immunohistochemistry supported epithelial differentiation, and in the absence of an identifiable primary tumor despite comprehensive diagnostic evaluation, the case was clinically classified as carcinoma of unknown primary origin. This case highlights an unusual diagnostic presentation of skeletal CUP mimicking osteosarcoma or lymphoma and complicated by fatal cancer-associated thrombosis. Rapidly progressive multifocal bone lesions accompanied by hypercoagulability should prompt consideration of metastatic carcinoma, including carcinoma of unknown origin, even in the absence of an identifiable primary tumor. Full article

Background and Objectives: Ménétrier’s disease (MD) is an exceptionally rare hypertrophic gastropathy characterized by foveolar hyperplasia, gastric acid suppression, and protein-losing enteropathy. Congenital gallbladder duplication is a rare biliary anomaly associated with independent pathological risks and surgical complications. Case Presentation: We report the case of a 34-year-old male presenting with chronic epigastric and right hypochondriac pain, alongside persistent, uninvestigated polycythemia. Upper endoscopy and histopathology revealed diffuse foveolar hyperplasia with cystic oxyntic gland dilatation and active Helicobacter pylori infection, confirming MD. Magnetic resonance cholangiopancreatography demonstrated a double gallbladder with independent cystic ducts. Successful H. pylori eradication was achieved, and hematological workup ruled out primary myeloproliferative neoplasm. Conclusions: To our knowledge, this is the first reported case of concurrent MD, and double gallbladder. This report underscores the necessity of a systematic diagnostic approach combining advanced imaging and histopathology to manage complex, overlapping abdominal pathologies. Full article

Colonoscopy is a key screening method for colorectal cancer (CRC), but its effectiveness is limited. Computer-aided detection (CADe) and computer-aided diagnostics (CADx), as part of an artificial intelligence (AI) system, improve the detection and optical characterization of lesions. This review maps and analyzes the evidence on the application of AI in colonoscopy, with a focus on the detection, segmentation, and characterization of colon neoplasms, available platforms, architectural models and implementation. The review was conducted in accordance with JBI and PRISMA-ScR guidelines, using the PCC framework. Meta-analyses, randomized controlled trials, systematic and narrative reviews, observational studies, guidelines, and consensus documents on the use of AI systems in different phases of colonoscopy were searched. CADe significantly improves adenoma detection and reduces the number of missed lesions. CADx, segmentation, depth of invasion assessment, and detection of learned lesions remain limited and heterogeneous. CADe has strong evidence for improving ADR, whereas current evidence for CADx remains insufficient to support a “resect-and-discard” strategy. Further cost-effectiveness studies are needed. Commercial platforms vary in their features and level of clinical validation. Colonoscopy using AI is a current topic with rapid development. This scoping review comprises heterogeneous literature covering clinical applications, technical aspects, the potential benefits and limitations of AI in improving colonoscopy performance and reducing the burden of colorectal cancer. Further trials involving diverse patient populations across different countries are needed to validate and extend the current evidence. Full article

Neuroinflammation within the tumor microenvironment (TME) of central nervous system (CNS) neoplasms, particularly glioblastoma (GBM), is no longer viewed merely as a reactive phenomenon but rather as a major driver of gliomagenesis and malignant transformation. This process involves a shift from acute immune activation to a chronic, sterile state that reshapes the CNS borders and immune niches to favor tumor evasion. This narrative review provides a comprehensive mechanistically focused analysis of the mechanisms governing the inflammatory stroma in primary and metastatic brain neoplasms. It critically examines the ontogeny and transcriptomic profile of myeloid and glial populations, dismantling the binary M1/M2 polarization model in favor of a continuum of functional states determined by metabolic and oxygenation gradients. It also analyzes intracellular signaling cascades, the subversion of innate immunity sensors such as the cGAS-STING pathway, the epigenetic reprogramming of stromal cells, and the role of extracellular vesicles. The electrochemical integration of tumor cells into neuronal circuits via glutamatergic synapses and connexin 43 gap junction coupling is addressed in detail, defining the mitogenic impact of neuronal activity on the tumor. The inflammatory profiles of IDH-wildtype and IDH-mutant gliomas and of secondary brain metastases are contrasted. Finally, the correlates of functional neuroimaging, liquid biopsies, and resistance mechanisms to conventional therapies are analyzed, including the GIANT and SENIPERA clinical trials, CARv3-TEAM-E bivalent cellular immunotherapy preconditioned with the LDC + R regimen, and the accelerated approval of dordaviprone (Modeyso) in H3 K27M-mutant diffuse midline gliomas. Full article

Inflammatory and nested testicular sex cord tumor (IN-TSCT) is a recently recognized, rare testicular sex cord–stromal neoplasm characterized by a recurrent EWSR1::ATF1 fusion and potentially aggressive clinical behavior. Because of its nested epithelioid morphology accompanied by prominent inflammatory infiltrates, IN-TSCT may be mistaken for seminoma, while frequent diffuse CD30 expression further complicates the differential diagnosis with lymphoma. We report a case of IN-TSCT in a 54-year-old man presenting with intermittent left testicular pain. Scrotal ultrasonography demonstrated a well-defined, heterogeneously hypoechoic intratesticular mass with minimally increased internal vascularity. Radical orchiectomy revealed a 1.5 × 1.4 cm epithelioid neoplasm arranged in nests and cords with a prominent inflammatory infiltrate. The tumor cells expressed the sex cord–stromal markers SF-1 and calretinin and showed diffuse CD30 expression. RNA-based next-generation sequencing identified an EWSR1::ATF1 fusion, establishing the diagnosis of IN-TSCT. Unexpectedly, the tumor also demonstrated strong ALK immunoreactivity with both the ALK1 and D5F3 antibody clones, despite the absence of an ALK fusion by RNA sequencing or an ALK rearrangement by fluorescence in situ hybridization. The combined expression of CD30 and ALK may mimic anaplastic large cell lymphoma and represents an important diagnostic pitfall. The patient remained free of recurrence or metastasis 18 months after orchiectomy. This case expands the recognized immunophenotypic spectrum of IN-TSCT and demonstrates that strong ALK immunoreactivity does not necessarily indicate an underlying ALK fusion or rearrangement. Given the potentially aggressive clinical behavior reported in IN-TSCT, long-term oncologic surveillance is warranted. Full article

Background: Myelodysplastic neoplasms (MDSs) are clonal hematopoietic stem cell disorders associated with ineffective hematopoiesis, chronic inflammation, and increased cardiovascular morbidity. Although metabolic dysregulation has been implicated in MDS pathogenesis, systemic metabolic alterations remain incompletely characterized. Methods: Plasma samples from treatment-naïve patients with MDS or chronic myelomonocytic leukemia (CMML) and age-matched healthy controls were analyzed using quantitative nuclear magnetic resonance spectroscopy and liquid chromatography-mass spectrometry (LC-MS). Metabolomic profiles were compared using unsupervised and supervised multivariate analyses, validated in an independent external MDS cohort, and integrated with re-analysis of publicly available RNA-sequencing datasets from purified CD14⁺ CMML monocytes. Results: Patients with MDS and CMML exhibited broad reductions in circulating lipoprotein-associated metabolites, including HDL-, LDL-, IDL-, and apolipoprotein-associated fractions, indicating disturbed systemic lipoprotein homeostasis. Within the discovery cohort, CMML samples showed higher concentrations of the ketone bodies 3-hydroxybutyrate and acetoacetate, as well as succinate. LC-MS analysis demonstrated selective increases in C18:1 acylcarnitine, oleic and isopalmitic acids, whereas free carnitine abundance remained unchanged. Elevated 3-hydroxybutyrate levels were not associated with mutational burden, hematologic parameters, disease risk, or immunophenotypic features. Re-analysis of public CMML monocyte transcriptomes demonstrated increased expression of genes involved in lipid uptake and intracellular lipid trafficking, including FABP5, APOE, LPL, and SLC27A2, without coordinated activation of fatty acid oxidation pathways. External cohort analysis confirmed the overall MDS-associated plasma metabolomic profile. Conclusions: MDSs and CMML are associated with reproducible alterations in systemic lipid metabolism characterized by reduced circulating lipoprotein-associated metabolites, while CMML showed more pronounced ketone body- and acylcarnitine-associated metabolic phenotype accompanied by changes in lipid-handling transcriptional programs. These findings support altered systemic lipid metabolism and carnitine-dependent fatty acid handling as characteristic features of myeloid neoplasms and provide a rationale for future functional studies investigating lipid metabolism in disease pathogenesis. Full article

Background: Comorbidity is an important determinant of treatment selection and in-hospital complications in patients with head and neck cancer (HNC) and thyroid cancer (TC), yet population-based evidence on this relationship remains limited. Methods: We analyzed nationwide Diagnosis-Related Groups (DRG) data from 1,552,028 inpatient HNC and TC treatments of patients aged ≥30 years in Germany between 2005 and 2021. The aim was to characterize the association of comorbidity and severe treatment-related procedure-coded inpatient events (IEs) with gender, age, tumor subsite, and treatment type. Results: The largest proportion of treatments occurred in patients aged 60–69 years (33.5%). The most frequent tumor subsites were the oropharynx, thyroid gland, oral cavity, larynx, and hypopharynx, with 35.52, 33.84, 33.60, 26.12, and 15.76 treatments per 100,000 population per year, respectively. Overall, 38% of cases had a Charlson Comorbidity Index (CCI) ≥ 1, with the highest mean CCI observed for C14 (other sites of the lip, oral cavity and pharynx) and C12 (piriform sinus). IEs requiring additional in-hospital treatment occurred in 19.3% of cases. After adjustment for age, tumor location, and treatment type, men had a lower risk of IEs than women (OR 0.929; CI 0.919–0.939; p < 0.001). Increasing comorbidity was associated with a higher IE risk, reaching a plateau at CCI ≥ 4 (OR 2.135; CI 2.029–2.246; p < 0.001). IE risk was high during chemotherapy/immunotherapy (OR 29.527; CI 28.897–30.170; p < 0.001), followed by surgery (OR 3.465; CI 3.433–3.498; p < 0.001), whereas radiotherapy showed the lowest risk (OR 1.339; CI 1.313–1.366; p < 0.001). Conclusions: These findings highlight substantial heterogeneity in comorbidity and IE risk among patients with HNC or TC. Full article

This is a narrative review that describes the evolution of terminology and classification schemes of neuroendocrine tumors (NETs), neuroendocrine carcinomas (NECs), mixed neuroendocrine–non-neuroendocrine neoplasms (MiNENs), and paragangliomas of the larynx, with the contribution of immunohistochemistry and treatment of neuroendocrine neoplasms of the larynx. Neuroendocrine neoplasms of the larynx comprise both epithelial (NET and NEC) and neural crest-derived (paraganglioma) neoplasms. Their terminology has evolved substantially over time, with current classifications emphasizing biologically and clinically meaningful categories aligned with contemporary WHO frameworks of other organs. These neoplasms may show overlapping clinical presentation and histomorphological features, which can complicate accurate subclassification. However, precise classification is essential, as these entities display markedly different biological behavior, ranging from indolent to highly aggressive with poor prognosis, and their treatment is essentially histology-tailored. Neuroendocrine neoplasms are classified into three categories comprising six tumor subtypes: well-differentiated neuroendocrine tumors (NETs; grades 1, 2, and 3), poorly differentiated neuroendocrine carcinomas (NECs; small-cell and large-cell types), and paragangliomas. An additional, not yet WHO-recognized category is MiNENs (mixed neuroendocrine–non-neuroendocrine neoplasms), defined by the coexistence of neuroendocrine and non-neuroendocrine components. These tumors exhibit distinct biological behavior and clinical significance. Full article

Background: Oral cavity cancer is a clinically relevant subgroup of head and neck malignancies and is associated with substantial treatment burden and healthcare utilization. Hospital length of stay (LOS) is an important indicator of inpatient resource use and complexity of care, yet large multicenter data from Germany are limited. Methods: This retrospective multicenter analysis used anonymized inpatient administrative data from 49 German hospitals; eligible oral cavity cancer hospitalizations were contributed by 34 of these hospitals. Adult inpatient hospitalizations (≥18 years) with malignant neoplasms of the oral cavity, defined using ICD-10-GM codes C00–C06, recorded between January 1 2019 and 31 December 2024 were included. The primary outcome was hospital LOS in days. Multimorbidity was quantified using the van Walraven-weighted Elixhauser Comorbidity Score. Prolonged hospitalization was defined as LOS ≥ 7 days and LOS ≥ 14 days. Associations between demographic, clinical, and treatment-related variables and LOS were examined using multivariable Poisson regression models. Because overdispersion was present, a negative binomial mixed model was additionally fitted as a sensitivity analysis. To account for inter-hospital variability, hospital was included as a random intercept in all multivariable models. Associations with prolonged LOS were analyzed using multivariable logistic regression models. All analyses were performed at the hospitalization level. Results: A total of 3957 inpatient hospitalizations for oral cavity cancer were included. Mean age was 65.6 years, and 66.2% of hospitalizations involved male patients. The median LOS was 6 days (interquartile range [IQR] 3–13; mean 10.2 days, standard deviation 11.8). Overall, 49.4% of hospitalizations had an LOS ≥ 7 days and 23.5% had an LOS ≥ 14 days. Older age, particularly >80 years, and higher comorbidity burden were associated with longer LOS (adjusted Poisson rate ratio [RR] for age > 80 years 1.17, 95% CI 1.13–1.21; high comorbidity burden RR 1.58, 95% CI 1.54–1.63). Several treatment-related variables, including surgical procedures in the oral and facial region, lymphatic system operations, blood transfusions, and complex intensive care treatment, were associated with prolonged hospitalization (e.g., blood transfusion RR 1.80, 95% CI 1.76–1.85; complex intensive care RR 1.70, 95% CI 1.65–1.75). Chemotherapy-related hospitalizations were associated with shorter LOS. Conclusions: LOS varied substantially across inpatient hospitalizations for oral cavity cancer in Germany. Older age, higher comorbidity burden, and markers of more complex inpatient treatment were associated with extended hospital stay. These findings may help identify hospitalizations at increased risk of prolonged LOS and inform inpatient planning and resource allocation. Full article

Pancreatic neuroendocrine neoplasms (PanNENs) are a heterogeneous group of tumors characterized by variable biological behavior and frequent overexpression of somatostatin receptors, making them ideal candidates for theranostic approaches. Over the past two decades, advances in molecular imaging and peptide receptor radionuclide therapy (PRRT) have fundamentally transformed the diagnosis and management of advanced PanNENs, establishing nuclear medicine as a central component of precision oncology. This review provides a comprehensive overview of the evolving role of theranostics in PanNENs, with particular emphasis on recent developments in nuclear medicine and radiation-based precision medicine. We discuss the biological foundation of molecular imaging, current clinical evidence supporting PRRT, and emerging strategies for personalized radionuclide therapy based on quantitative imaging, patient selection, and individualized dosimetry. Furthermore, we highlight next-generation radiopharmaceuticals, including somatostatin receptor antagonists and α-emitting radionuclides, as well as novel diagnostic tracers that are expanding the scope of theranostic applications. The review also examines the growing impact of artificial intelligence, radiomics, and computational modeling in image analysis, treatment planning, and adaptive radionuclide therapy. Finally, we discuss future perspectives toward adaptive precision theranostics, in which molecular imaging, multi-omics integration, advanced dosimetry, and artificial intelligence converge to support dynamic, patient-specific treatment strategies. Continued technological innovation and multidisciplinary collaboration are expected to further establish theranostics as a cornerstone of personalized management for patients with PanNENs. Full article

Background/Objectives: Male breast cancer (MBC) is a rare malignancy accounting for less than 1% of all breast cancers, and current treatment recommendations are largely extrapolated from studies in women. We aimed to evaluate the clinicopathological characteristics, treatment patterns, survival outcomes, and prognostic factors of male breast cancer patients treated at a tertiary referral center. Methods: We retrospectively reviewed 45 patients with histopathologically confirmed MBC treated between January 2015 and July 2025. Demographic, clinicopathological, treatment, and follow-up data were collected from institutional records. Overall survival (OS) and disease-free survival (DFS) were estimated using the Kaplan–Meier method, and potential prognostic factors were analyzed using univariate Cox proportional hazards regression. Results: The median age at diagnosis was 60 years, and invasive ductal carcinoma was the predominant histological subtype (95.6%). Estrogen and progesterone receptor positivity were observed in 93.0% and 95.2% of patients, respectively, while HER2 positivity was identified in 26.8%. Modified radical mastectomy was performed in 95.6% of patients, adjuvant endocrine therapy in 88.9%, chemotherapy in 73.3%, and radiotherapy in 64.4%. After a median follow-up of 84 months (range, 1–125 months), the estimated 5-year OS and DFS rates were 85.3% and 68.4%, respectively. No locoregional recurrence was observed in the entire cohort; all recurrences were distant metastases. None of the evaluated clinicopathological variables demonstrated a statistically significant association with OS or DFS. Conclusions: This single-center experience demonstrates favorable long-term survival and no observed locoregional recurrence in a contemporary cohort of patients with male breast cancer. These real-world findings are consistent with current treatment strategies and provide additional evidence regarding the management of this rare disease. Larger multicenter collaborative studies are needed to establish robust prognostic models and generate male-specific evidence to further optimize clinical management. Full article

Purpose: Although machine learning-based prediction of overall survival (OS) in palliative radiotherapy for bone metastases has been investigated, explainable deep learning (DL) models remain underexplored. This study aimed to develop and validate an explainable DL model to predict OS in this setting, and to examine whether this flexible model provides predictive value beyond a standard Cox model based on routinely collected baseline variables. Methods and Materials: We analyzed all 472 eligible patients who received palliative radiotherapy for bone metastases between January 2013 and August 2024; patients alive with less than one year of follow-up were retained as right-censored observations. The primary endpoint was OS over a fixed 1-year horizon. A DeepSurv model using 14 baseline predictors, including the planned prescribed dose (biologically effective dose, BED10), was developed with repeated 5-fold cross-validation (K = 5, R = 10) and compared with standard and ridge-penalized Cox models fitted on identical splits. Performance was assessed by the time-dependent concordance index (C-index), integrated Brier score (IBS), time-dependent area under the curve (AUC) at 90, 180, and 365 days, and a calibration analysis at one year; 95% confidence intervals (CI) were obtained by patient-level bootstrapping of the pooled out-of-fold predictions. Shapley Additive Explanations (SHAP) and SurvLIME were computed on the held-out test sets. Results: Within one year, 242 patients (51.3%) died; median OS was 225 days (95% CI: 189–287). The DeepSurv model achieved a pooled time-dependent C-index of 0.779 (95% CI: 0.751–0.807), an IBS of 0.135 (95% CI: 0.122–0.149), and AUCs of 0.892 (0.857–0.925), 0.862 (0.822–0.895), and 0.856 (0.814–0.895) at 90, 180, and 365 days, with an observed/expected ratio of 0.94 and a calibration slope of 1.02; discrimination was comparable to the Cox model (C-index 0.763, 95% CI: 0.737–0.789). SHAP identified poor performance status as the dominant predictor (mean |SHAP| 0.178), followed by male sex (0.067), high-risk primary tumor type (0.063), multiple bone metastases (0.047), and planned dose (0.033), the latter being the only leading feature associated with lower predicted mortality; SurvLIME gave consistent results. In multivariable Cox analysis, performance status (hazard ratio [HR] 2.21 per standard deviation [SD], p < 0.001) and planned dose (HR 0.71 per SD, p < 0.001) were independently associated with OS. Conclusions: The explainable DL model predicted OS after palliative radiotherapy for bone metastases with discrimination and calibration comparable to those of a well-specified Cox model, and its feature attributions agreed with the Cox coefficients, suggesting that the prognostic information in these baseline variables is essentially additive and can therefore be delivered at the bedside as a simple score, without dedicated AI infrastructure and without loss of predictive performance. The combined use of SHAP and SurvLIME verified that the model relies on established clinical factors, most prominently performance status, and provides patient-level explanations. Pending external validation, such prediction may support individualized decisions on treatment goals and radiation schedules. Full article

Background: Spermatocytic tumor (ST) is a rare non-GCNIS-derived testicular germ cell neoplasm that predominantly affects older men and generally follows an indolent course. Its occurrence in a cryptorchid testis is exceptionally uncommon. Methods: A narrative literature review was conducted using the PubMed database, including studies published up to August 2026. The search used combinations of the terms “spermatocytic tumor”, “spermatocytic seminoma”, “cryptorchidism”, “undescended testis”, “immunohistochemistry”, “molecular features”, “magnetic resonance imaging”, and “treatment”. Results: A 56-year-old man presented with a painless left inguinal mass corresponding to a cryptorchid testis. Serum tumor markers were normal. MRI demonstrated a well-circumscribed heterogeneous lesion with pseudocystic areas and enhancement of the solid component. Radical inguinal orchiectomy was performed. Histopathological examination revealed the characteristic triphasic cellular population without GCNIS, lymphovascular invasion, or sarcomatous transformation. Immunohistochemistry showed SALL4 and CD117 positivity and absence of OCT3/4 and D2-40 expression, supporting the diagnosis of ST and its distinction from classical seminoma. No recurrence or metastatic disease was detected during 12 months of follow-up. Conclusions: ST arising in a cryptorchid testis represents an exceptionally uncommon presentation. Integration of clinical, radiological, morphological, and immunohistochemical findings is essential for accurate diagnosis and distinction from classical seminoma, thereby avoiding unnecessary additional treatment. Full article