[Primary pulmonary rabdomyosarcoma: clinical-pathological and immunohistochemical findings]

Pulmonary rhabdomyosarcona is a rare entity and the histopatological differential diagnosis can be difficult. We report on a case of a 48-year-old male patient with a neoplasm located at the hilum of the right lung. The histological study of the lobectomy specimen allowed the diagnosis of embryonal rhabdomyosarcoma to be made. Given the absence of tumor lesions in other sites, it was classified as primary pulmonary neoplasm. The patient underwent chemotherapy and subsequently a completion pneumonectomy for recurrence of the tumor. One year after the initial surgery, he presented a metastasis in the right adrenal gland. He died 20 months after the original diagnosis. The importance of immunohistochemistry in the diagnosis is emphasized and the different theories that attempt to explain the histogénesis of these tumors in unusual sites are analyzed.

The tale of TILs in breast cancer: A report from The International Immuno-Oncology Biomarker Working Group

The advent of immune-checkpoint inhibitors (ICI) in modern oncology has significantly improved survival in several cancer settings. A subgroup of women with breast cancer (BC) has immunogenic infiltration of lymphocytes with expression of programmed death-ligand 1 (PD-L1). These patients may potentially benefit from ICI targeting the programmed death 1 (PD-1)/PD-L1 signaling axis. The use of tumor-infiltrating lymphocytes (TILs) as predictive and prognostic biomarkers has been under intense examination. Emerging data suggest that TILs are associated with response to both cytotoxic treatments and immunotherapy, particularly for patients with triple-negative BC. In this review from The International Immuno-Oncology Biomarker Working Group, we discuss (a) the biological understanding of TILs, (b) their analytical and clinical validity and efforts toward the clinical utility in BC, and (c) the current status of PD-L1 and TIL testing across different continents, including experiences from low-to-middle-income countries, incorporating also the view of a patient advocate. This information will help set the stage for future approaches to optimize the understanding and clinical utilization of TIL analysis in patients with BC.

Ovarian thecoma: clinicopathological analysis of 50 cases

The clinicopathological findings of 50 thecoma cases were studied to establish the most useful diagnostic criteria helpful in characterizing this ovarian stromal tumor. Patient age ranged from 21 to 77 years (median, 57.5 years). In this study, thecoma appears to be associated with endometrial diseases (15 patients) as an incidental finding in a gynecologic routine examination (14 patients) and in a cesarean delivery (1 patient). Arteries, veins, lymphatics, and mast cells are normally present in the ovarian medulla and are absent in the cortical area. The 50 thecomas studied showed proliferation of stromal cells and presence of arteries, lymphatics, and mast cells. Thecoma tumoral growth appeared to cause atrophy or compression of the cortical area. These findings are significant for diagnosis; thus, thecoma is proposed as a tumor originating in the ovarian medulla. Fibroma and thecoma seem to be different neoplasms and should be considered distinct, separate entities because they have different origin, morphology, and potential functionality.