Search Results (315)

Background: Oral lichen planus (OLP) is a chronic immune-mediated mucosal disorder frequently accompanied by Candida colonization. However, the polymicrobial interactions and network alterations underlying this association remain poorly understood. This study aimed to characterize bacterial–fungal community changes and interkingdom network dynamics in OLP patients with Candida detection compared to healthy controls. Methods: Unstimulated saliva samples were collected from 24 OLP patients and 31 healthy controls. Bacterial 16S rRNA (V1–V2) and fungal ITS2 regions were simultaneously sequenced using Illumina NovaSeq. Taxonomic profiling, diversity analyses, differential analysis, and intermicrobial correlations were analyzed. Results: Beta diversity analysis revealed distinct community separation between groups (p = 0.001). OLP exhibited increased Bacteroidetes and decreased Firmicutes compared to controls. Health-associated commensals (Streptococcus salivarius, Rothia mucilaginosa, Haemophilus parainfluenzae, Veillonella sp. HMT 917) were significantly depleted, while pro-inflammatory anaerobes (Prevotella, Fusobacterium, Leptotrichia, Selenomonas) were enriched. At the genus level, Candida abundance was modestly higher in the OLP group (1.38%) compared to Healthy (0.94%), and Candida albicans was the most prominent fungal species, with a mean relative abundance of 1.22% in OLP compared to 0.91% in Healthy controls, calculated using the same sample-level denominator as the genus-level values above. Network analysis demonstrated that Candida occupied a central position with expanded connectivity to disease-associated genera. The disease network showed increased negative correlations and dispersed topology, reflecting inversely correlated taxa and reduced modularity (0.206 vs. 0.260 in healthy), consistent with less distinct community compartmentalization. Conclusions: OLP is characterized by compositional dysbiosis and disrupted bacterial–fungal interaction networks. Candida may function as a network hub associated with interkingdom dysbiosis in OLP. These findings suggest that microbiome-targeted adjunctive therapies—including antifungals, selective antimicrobials, and probiotics—warrant investigation for managing Candida-associated OLP. Full article

Human milk is increasingly recognized as a complex biological system that contributes to infant development through nutritional, immunological, and microbial pathways. Simultaneously, antimicrobial stewardship (AMS) has become a global healthcare priority because of rising antimicrobial resistance and concerns regarding the ecological consequences of antibiotic exposure during early life. This narrative review examines current evidence regarding the impact of anti-infective therapies during lactation on the maternal–infant microbiome axis and discusses the role of AMS in supporting appropriate maternal treatment while preserving breastfeeding. While previous reviews have independently described the biological properties of human milk or general antimicrobial resistance, this narrative review uniquely bridges these domains by framing the infant microbiome as a clinical endpoint for pharmacological governance. The primary objective is to synthesize current evidence on the relationships among human milk, the infant gut microbiome, and neurodevelopment, with a novel emphasis on how integrating Antimicrobial Stewardship (AMS) and microbiome-conscious prescribing during lactation actively safeguards these developmental trajectories. This work contributes to the existing literature by shifting the focus from observational biology to an actionable clinical framework for healthcare providers. A structured literature search was conducted in PubMed/MEDLINE, Scopus, and Web of Science. Studies addressing human milk biology, infant gut microbiota development, antimicrobial exposure during lactation, microbiota–gut–brain interactions, and stewardship strategies were reviewed. Available evidence indicates that breastfeeding promotes the establishment of a beneficial gut microbiota and supports immune maturation through the combined action of human milk oligosaccharides, immunological factors, and milk-associated microorganisms. Maternal and neonatal antibiotic exposure may alter microbial colonization patterns; however, the magnitude, persistence, and long-term clinical significance of these effects remain incompletely understood. Although mechanistic studies support biologically plausible links between microbiome alterations and neurodevelopmental pathways, direct evidence connecting maternal antibiotic use during lactation with adverse neurodevelopmental outcomes is limited. Current evidence supports continued breastfeeding during most maternal antibiotic treatments and highlights the importance of microbiome-conscious prescribing. AMS strategies based on diagnostic appropriateness, treatment optimization, and avoidance of unnecessary antibiotic exposure may help minimize microbial disruption while ensuring effective infection management. Full article

Due to the ever-increasing use of plastic products, microplastics and nanoplastics (MNPs) have become ubiquitous environmental pollutants, with their highest concentrations found in the soil. These xenobiotics can affect soil properties: pH, water holding capacity, porosity, bulk density, infiltration, cation exchange capacity, electrolytic conductivity, nutrient retention capacity, biodiversity of soil microorganisms, and the fate of other agrochemicals present in the soil. Pesticides may, in turn, influence plastic particles aging, biological colonization, and environmental interactions. The aim of this review was to analyze the impact of MNPs on the fate of pesticides and to assess whether such co-contaminants may pose a threat to the food safety of agricultural crops intended for human consumption. Experimental studies indicate that MNPs can alter pesticide fate and toxicity, although the direction and magnitude of these effects vary substantially with polymer type, particle properties and age, pesticide characteristics, and environmental conditions. Additionally, degradation and fragmentation of biodegradable polymers may increase particle abundance and modify surface properties over time, potentially altering their interactions with pesticides and soil microorganisms. The most important research gap is the lack of studies that simultaneously assess the MNPs influence on pesticide fate in the soil and measure the concentrations of both contaminants in plant tissues. Full article

Polyethylene terephthalate glycol (PETG) is a versatile thermoplastic widely used in food packaging and biomedical applications owing to its excellent mechanical properties, chemical resistance, biocompatibility, and ease of processing. Porosity is a critical design parameter that governs the biological and mechanical performance of 3D-printed PETG structures by influencing cell attachment, nutrient transport, mechanical integrity, and microbial interactions. In this study, PETG scaffolds were fabricated at five nominal infill densities (20%, 40%, 60%, 80%, and 100%) using fused deposition modelling (FDM) to investigate the influence of printing-defined architecture on mechanical performance and bacterial colonization. Tensile testing revealed that decreasing infill density resulted in a progressive reduction in ultimate tensile strength and Young’s modulus, demonstrating the trade-off between reduced material density and mechanical integrity. Bacterial interactions with the scaffolds were evaluated against Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, Staphylococcus epidermidis, and Salmonella typhimurium using optical density (OD) and ATP-based viability assays to quantify both planktonic and adherent bacterial populations. The results demonstrated that the influence of scaffold porosity was species-dependent. The results demonstrated species-dependent responses to scaffold architecture. Higher infill densities were generally associated with reduced attachment and metabolic activity for P. aeruginosa, S. epidermidis, and S. typhimurium, whereas E. coli exhibited relatively stable growth and metabolic activity across the tested infill conditions. S. aureus showed an intermediate response, with bacterial attachment and metabolic activity varying according to scaffold architecture. Overall, infill density exerted a greater influence on scaffold-associated bacteria than on planktonic populations, while simultaneously determining the mechanical performance of the printed structures. These findings demonstrate that controlling PETG infill architecture is important for balancing mechanical properties and bacterial colonization and provide design insights for future PETG-based biomedical and food-packaging applications. Full article

Aims: Understanding how arrival order, nitrogen (N) availability and population density interact to shape plant invasion is critical for predicting and ameliorating biological invasions under global change. Chromolaena odorata is one of the most destructive invasive plants in tropical and subtropical regions, but the multifactorial drivers of its establishment and competitive dominance are not fully resolved. Methods: We constructed artificial communities in a common garden experiment and manipulated the arrival order of C. odorata (early, simultaneous and late arrival relative to native species), species density (high, medium and low), and N addition (0 vs. 10 g N m⁻² yr⁻¹), and then examined their effects on growth performance and competitive dominance. Results: Early arrival did not increase growth performance of C. odorata, but it substantially enhanced the competitive dominance of the invasive species in most communities. However, late arrival caused substantial reductions in height, biomass, and RDI of C. odorata across all communities, with the most severe declines observed in treatment groups that did not receive N addition. N addition disproportionately promoted the growth of C. odorata regardless of arrival order and enhanced its competitive advantage when it arrived later than native species. In low-density C. odorata communities, N addition exhibited the strongest compensatory effect against growth suppression of the invasive species resulting from late arrival. Importantly, when C. odorata arrived later than native species in plots receiving N addition, its height and biomass were comparable to plants that arrived at the same time as native species in groups without N addition across most communities. Conclusions: Arrival order is a critical determinant of C. odorata invasion success, with early arrival conferring competitive advantages and late arrival imposing severe competitive penalties due to competition with established native species. However, N addition can compensate for late-arrival disadvantages, particularly for low-density C. odorata, suggesting that N-enriched ecosystems may remain vulnerable to invasion, even when native communities are established. These results underscore the context-dependent nature of priority effects and highlight that managing colonization timing and nutrient inputs may be effective in similar localized settings, though future field-based, multi-season validation is clearly needed. Full article

Chronic oral and maxillofacial diseases are frequently associated with progressive alveolar bone loss, leading to impaired structural integrity of the jaw and increased risk of implant failure, microbial colonization, and microfracture formation. Ceramic scaffolds such as those made of hydroxyapatite (HA) and β-tricalcium phosphate (β-TCP) have attracted considerable attention because of their controlled resorption properties and the promotion of rapid new vital bone formation. The aim of this research is to enhance the performance of scaffolds composed of HA and β-TCP used for guided bone tissue regeneration in oral surgery. HA/β-TCP scaffolds were loaded with simvastatin (SIMV) and coated with multiple layers of alginate (ALG). The proposed strategy was designed to achieve a local and prolonged drug release while simultaneously improving mechanical properties. The scaffolds were characterized in terms of porosity, water absorption, in vitro degradation, in vitro bioactivity, and SIMV release. In addition, microscale mechanical properties were evaluated using Brillouin microscopy before and after the coating process. Cytocompatibility was further evaluated by using murine macrophages as an in vitro cellular model. The results demonstrated that ALG coatings significantly modulated SIMV release, promoting a delayed drug release. Moreover, ALG deposition improved the micromechanical properties of the scaffolds, conferring a dual structure analogous to those of bone tissue. These findings indicate that ALG-coated SIMV-loaded HA/β-TCP scaffolds represent a promising multifunctional platform for the medical field. Full article

Background/Objectives: Cystic fibrosis (CF) care in Romania underwent a major transition in 2022 with the near-simultaneous introduction of newborn screening (NBS) and national reimbursement of CFTR modulator therapies. This study aimed to compare age at diagnosis between screen-detected and symptom-detected patients, describe clinical outcomes according to modulator status, and estimate regional case-detection ratios in Bihor County. Methods: This was a retrospective observational study with cross-sectional assessment of 46 CF patients followed at the National Cystic Fibrosis Centre in Timișoara during 2025. Nonparametric methods were used for exploratory comparisons. Case-to-live-birth ratios were estimated for pre-screening (2008–June 2022) and post-screening (July 2022–2024) periods in Bihor County. Results: Median age was 8.96 years (IQR 7.06–15.25); 58.7% of patients were male. Screen-detected patients (n = 5) were diagnosed earlier than symptom-detected patients (median 0.00 vs. 0.60 years; p = 0.016). F508del was present in 65.2% of alleles, with 22 distinct variants identified. Modulator therapy was received by 84.8% (76.1% elexacaftor/tezacaftor/ivacaftor). Median percent-predicted FEV₁ (ppFEV₁) was 99.0% (n = 38), comparable to ECFSPR 2024 pediatric values, while median BMI Z-score (−0.32) remained below Western European benchmarks. Chronic Pseudomonas aeruginosa and MRSA colonization rates were 11.4% (pediatric) and 15.2% (overall), respectively. ppFEV₁ correlated strongly with BMI Z-score (ρ = 0.625, p < 0.001). The Bihor County case-to-live-birth ratio was 1:7820, with a descriptive 1.45-fold increase post-NBS. Conclusions: CF characterization in western Romania demonstrates rapid modulator uptake and preserved lung function while highlighting persistent gaps in nutritional status, microbiological burden, and case detection relative to Western European populations. Longitudinal nationally representative studies are needed to confirm these findings. Full article

Fruit production represents a major agricultural sector worldwide; however, it is severely affected by pests that reduce fruit yield, quality, and marketability. The intensive use of chemical insecticides has generated environmental contamination, resistance in pest populations, and risks to human health, increasing the demand for sustainable alternatives. In this context, endophytic fungi (EF) have gained relevance as biological control agents due to their ability to colonize plant tissues and produce bioactive metabolites that affect agricultural pests. This systematic review aimed to evaluate the current scientific knowledge regarding EF as biological control agents against pests in fruit crops and to analyze the tripartite interactions among fungi, plants, and pests. The review was conducted following PRISMA guidelines using the databases Web of Science, Scopus, PubMed, and OpenAlex. Studies were selected according to predefined exclusion criteria focused on the simultaneous presence of endophytic fungi, fruit crops, and agricultural pests. A total of 24 fruit species, 51 endophytic fungi, and 33 agricultural pest species were identified. The most frequently reported fungal genera were Penicillium, Cladosporium, Fusarium, Aspergillus, Gnomoniopsis, and Trichoderma, while a broad diversity of pest species affected by these fungi was recorded. Interaction analyses revealed complex and highly interconnected tripartite relationships, in which some fungi exhibited strong host specificity whereas others displayed broader interaction ranges. The findings demonstrate that EF possess significant potential as sustainable biological control agents in fruit production systems. However, research in this field remains limited and fragmented, highlighting the need to develop standardized models, validate their efficacy under field conditions, and conduct studies focused on the commercial scalability of EF-based management strategies. Full article

Background: Loss of epithelial integrity leaves the wound bed open to opportunistic bacterial colonization, and the risk of secondary infection persists for as long as the defect remains unclosed. Wound dressings must therefore provide an immediate external barrier while accelerating restoration of the skin’s own barrier. This study aims to develop and evaluate a bioactive nanotechnological platform comprising dexpanthenol (Dxp)-engineered extracellular vesicles (EVs) embedded within cross-linked hyaluronic acid hydrogels (HA@Dxp-engineered EVs) for targeted wound treatment and protection against external contaminants. Methods: EVs were engineered via exogenous (extrusion; Exo EV) and endogenous (co-incubation; Endo EV) strategies to encapsulate Dxp. The physicochemical properties of the HA@Dxp-engineered EV systems were characterized, and their therapeutic efficacy was validated through in vitro assays, including fibroblast migration and endothelial tube formation, and in vivo using a full-thickness excisional wound model in mice. Results: Both engineering strategies successfully encapsulated Dxp while preserving the structural integrity of the EVs. The HA hydrogel enabled sustained EV release and provided a physical barrier. In vitro, HA@Endo EVs significantly promoted fibroblast proliferation, migration, and the formation of mature capillary-like networks in HUVECs compared to controls. In vivo, the HA@Endo EV group demonstrated accelerated wound closure, achieving 99.88% healing by day 10, and promoted tissue remodeling with upregulated expression of COL1A1, VEGF, and HIF-1α. Conclusions: The HA@Endo EV system provides a dual-action strategy against secondary infection risk. It supplies an immediate physical barrier over the wound bed and simultaneously accelerates re-epithelialization, thereby shortening the interval during which the tissue remains exposed. Full article

Tumor-draining lymph nodes (TDLNs) are important immune organs linking primary tumors with systemic immune responses. They support tumor antigen presentation, T-cell priming, and effector immune responses, but under sustained tumor influence they can also be remodeled into microenvironments that promote immune escape and metastatic colonization. Conventional methods, including flow cytometry, bulk RNA sequencing, and routine immunohistochemistry, have advanced our understanding of TDLN immunity but cannot simultaneously preserve tissue architecture, cell identity, and spatial cell–cell relationships. Recent advances in spatial transcriptomics, spatial proteomics, and multiplexed imaging enable in situ analysis of immune cells, stromal cells, vascular structures, and their interactions within TDLNs. Emerging evidence suggests that TDLNs are not immunologically homogeneous organs, but gradually develop spatially distinct immune-activation and immunosuppressive regions during tumor progression. Activation regions are associated with HEV-mediated lymphocyte entry, DC–T-cell priming, B-cell follicles, and germinal-center reactions, whereas suppressive regions are enriched in Treg cells, exhausted T cells, suppressive myeloid cells, tumor-reprogrammed FRCs, and myeloid–CAF niches. This review summarizes spatial multi-omics studies of TDLN functional compartmentalization and discusses the potential value of TDLN spatial immune states in predicting immunotherapy response, assessing metastatic risk, and guiding precision treatment, thereby providing a reference for future spatial multi-omics studies of TDLNs. Full article

Species of the genus Streptococcus constitute important pathogens in human and veterinary medicine, being responsible for a wide spectrum of infections ranging from mild illnesses to severe invasive pathologies. Although β-lactams continue to be effective against most species, the global increase in resistance to macrolides, lincosamides, tetracyclines, and, in some cases, reduced susceptibility to penicillin represents a growing challenge for antimicrobial therapy. This review synthesizes the clinical and epidemiological landscape of antimicrobial resistance in the main Streptococcus species, including Streptococcus pyogenes, Streptococcus agalactiae, Streptococcus pneumoniae, Streptococcus dysgalactiae, and other species of clinical and veterinary relevance, addressing their epidemiological profiles, molecular mechanisms of resistance, and virulence factors. The main genetic determinants involved in resistance are discussed, namely the erm, mef, and tet genes, as well as the impact of alterations in penicillin-binding proteins, horizontal gene transfer, and biofilm formation on the persistence of infections and decreased therapeutic efficacy. Simultaneously, the main virulence factors are analyzed, including polysaccharide capsules, adhesins, toxins, extracellular enzymes, and immune response evasion mechanisms that contribute to the colonization, dissemination, and severity of infections. The importance of epidemiological and genomic surveillance, particularly through whole-genome sequencing, in monitoring the spread of resistant clones and identifying determinants of resistance and virulence is also highlighted. Taken together, the data highlight the need to strengthen programs for the rational use of antimicrobials, to promote integrated surveillance strategies from a One Health perspective, and to deepen knowledge about the interaction between antimicrobial resistance and virulence, in order to improve strategies for the prevention, diagnosis, and treatment of infections caused by Streptococcus spp. Full article

Staphylococcus aureus frequently colonizes the skin and upper airways and produces a broad repertoire of immunomodulatory molecules. In asthma, the most consistent evidence concerns staphylococcal enterotoxins (SEs), which can act both as superantigens and as allergens, and IgE sensitization to SEs (SE-sIgE). SE-sIgE is associated with severe asthma, type 2 inflammation, chronic rhinosinusitis with nasal polyps (CRSwNP), exacerbations, and, in some longitudinal studies, persistent airflow obstruction. However, this relationship is not necessarily causal: SE-sIgE may reflect exposure, an immune response, or a biologically active endotype, whereas colonization, local toxin production, and systemic sensitization are not equivalent. SEs simultaneously bind class II MHC molecules and Vbeta regions of the T-cell receptor, activating large fractions of T lymphocytes; they also promote IL-4, IL-5, and IL-13 production, polyclonal B-cell activation, local IgE synthesis, mast-cell degranulation, eosinophilia, and IL-8/neutrophil circuits. Alpha-toxin (Hla) and SEB can damage the epithelial barrier, facilitating allergen penetration and alarmin signalling. These observations support an interaction model in which dysbiosis, barrier dysfunction, and type 2 immunity mutually reinforce one another along the nasobronchial axis. Corticosteroids and antibiotics may modify selected nodes in this circuit, but current evidence is insufficient to recommend decolonization or antitoxin therapy in stable asthma. Biologics interrupt downstream pathways potentially fuelled by toxins: omalizumab neutralizes free IgE; mepolizumab and benralizumab reduce the eosinophilic axis; dupilumab blocks IL-4/IL-13 signalling; and tezepelumab acts upstream on TSLP. Nevertheless, randomized trials stratified by SE-sIgE are lacking, and no evidence demonstrates that these treatments eliminate colonization or toxin production. SE-sIgE therefore appears to be a promising biomarker, particularly in severe asthma with CRSwNP, but it is not yet an autonomous criterion for biologic selection. A broader barrier-organ analysis also identifies nasal, cutaneous, and intestinal colonization as distinct ecological states; atopic dermatitis as a complementary model of toxin-amplified type 2 inflammation; and biofilms and extracellular vesicles as candidate mechanisms of persistent toxin delivery. These data increase biological plausibility but remain indirect for asthma. Full article

Background: The highly heterogeneous and dynamically evolving tumor microenvironment leads to the development of drug resistance and recurrence in traditional therapies. Although immunotherapy demonstrates unique advantages, its clinical utility remains constrained by the suboptimal immunogenicity and the limited effect of monotherapy. Herein, a hybrid drug delivery system based on a spatiotemporal hierarchical controlled-release strategy was proposed to achieve dual immunotherapy with immune checkpoint blockade (ICB) and immunogenic cell death (ICD) to promote synergistic anti-tumor therapy. Methods: A liposome–micelle hybrid drug delivery system (RUT-RPP-LP) was constructed using a lipid bilayer composed of dioleoyl phosphatidylethanolamine/hemisuccinyl cholesterol to encapsulate rutin (RUT) and to form an inner cavity-encapsulated resveratrol micelle (RPP). RUT-RPP-LP was characterized, and its pH sensitivity and release behavior were investigated. Subsequently, a colon cancer tumor-bearing mouse model was constructed to evaluate the in vivo targeted anti-tumor effect and biological safety. On this basis, the combined mechanism of ICB and ICD was preliminarily explored. Results: RUT-RPP-LP possessed excellent formulation characteristics, stability, and biocompatibility, achieving graded controlled release of drugs via responding to the TME and lysosomal acidity, respectively. Obviously, RUT-RPP-LP could specifically target the tumor site, induce the occurrence of ICD, and simultaneously block the PD-1/PD-L1 immune checkpoint signaling pathway, thereby enhancing the function of T cells and inducing apoptosis of tumor cells. Conclusions: The RUT-RPP-LP based on the hierarchical controlled-release strategy exerted a spatiotemporally coordinated enhancement of anti-tumor immunity, and may provide a novel combinatorial approach to overcome the low response of immunotherapy in solid tumors. Full article

The ecological adaptations of insect pests, such as multi-niche colonization and physiological resistance to conventional chemicals, pose severe challenges to the sustainable production of sweet potato (Ipomoea batatas). The tobacco whitefly, Bemisia tabaci (Hemiptera: Aleyrodidae), and the sweet potato weevil, Cylas formicarius (Coleoptera: Brentidae), form a highly destructive, spatially separated pest complex. In this study, we evaluated the dual-niche pathogenicity of a Beauveria bassiana (Hypocreales: Cordycipitaceae) isolate, BbCF-2, generated via spaceflight mutagenesis, against C. formicarius and B. tabaci under controlled laboratory conditions. The mutated strain exhibited enhanced colony expansion and a high sporulation capacity (2.72 × 10⁸ conidia/mL). Bioassays revealed that BbCF-2 possesses significantly increased virulence compared to the wild-type strain, capable of overcoming the distinct physiological and physical barriers of both targeted pests. Against the highly sclerotized subterranean C. formicarius adults, BbCF-2 achieved 92.68% mortality at 15 days post-inoculation at 1 × 10⁸ conidia/mL, with an LC50 of 8.452 × 10³ conidia/mL and an LT50 of 6.305 days. Concurrently, against the canopy-dwelling B. tabaci, the isolate demonstrated rapid lethal mycosis with an LT50 of 6.718 days, effectively reducing the adult vector population prior to their typical dispersal timeframe. These results demonstrate that the spaceflight-mutated BbCF-2 strain exhibits broad pathogenicity. By simultaneously targeting both foliar and soil-dwelling pests, this single-agent biological control strategy shows potential for integrated pest management, pending greenhouse and field evaluation. Full article

Background and Clinical Significance: The primary occurrence of low-grade endometrial stromal sarcoma (LG-ESS) at extrauterine sites, termed extrauterine ESS (EESS), is exceedingly rare. Case Presentation: A 49-year-old female, gravida 2 para 2 (all deliveries by cesarean section), presented with a 1-month history of epigastric and left upper quadrant abdominal pain. Abdominal computed tomography revealed a lobulated mass, measuring 4.6 cm, in the left upper quadrant with focal attachment to the splenic flexure of the colon. She underwent a laparoscopic partial gastrectomy and colectomy at a referral institution. Surgical pathology identified a 6.0 × 5.0 × 4.0 cm lobulated tumor involving the stomach with colonic invasion, diagnosed as LG-ESS (pT3N0). Immunohistochemistry showed a CD10-reactive lesion. The patient was referred to our institution for definitive gynecological surgery. After prophylactic ureteral double-J catheter insertion, she underwent laparoendoscopic single-site (LESS) total hysterectomy with bilateral salpingo-oophorectomy. The final histopathological examination of the hysterectomy specimen revealed intramural leiomyomas and benign ovarian cysts, with no evidence of ESS within the uterine corpus or adnexa. These findings confirmed a true primary EESS of nonuterine origin, consistent with AJCC stage 3 disease. The patient recovered uneventfully and was discharged during outpatient follow-up. Conclusions: This case represents one of the very few reported instances of primary LG-EESS involving the stomach and colon, simultaneously managed with a staged multidisciplinary surgical approach, including gastrointestinal resection followed by LESS hysterectomy and bilateral salpingo-oophorectomy. Full article