Publications by authors named "Agaimy A"

Background: The latest edition of the WHO classification of urinary and male genital tumours was published in 2022. The revision was based on the newest scientific literature. This article summarizes the updated recommendations regarding the classification of histomorphologically defined tumours.

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Calcified amorphous tumor (CAT) is a rare, mostly incidental tumor-like cardiac lesion of unknown histogenesis. Current imaging modalities do not differentiate between CAT and other masses. As it can be a source for embolization, surgical excision of CAT is mandatory.

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  • Adenoid cystic carcinomas (AdCC) of salivary gland origin are primarily defined by the presence of specific gene fusions, notably MYB::NFIB and MYBL1::NFIB, with sinonasal AdCC being particularly aggressive and lacking effective treatments.
  • Researchers conducted an extensive analysis of 88 sinonasal AdCC cases using various techniques like NGS and FISH to identify gene fusions and mutations, finding that the majority harbored canonical fusions while some had noncanonical ones, with a few tumors showing no fusions at all.
  • Mutational analysis revealed that about 68% of AdCCs tested (21 out of 31) had mutations in key oncogenes, highlighting potential areas for targeted
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Introduction: Laryngeal chondrosarcoma (CS) is a rare indolent malignant tumor. High-grade (G3), dedifferentiated (DD), and myxoid (MY) CSs are considered more aggressive subtypes due to their metastatic potential and relatively poor outcomes. The aim of this systematic review is to evaluate treatment modalities and survival outcomes in patients affected by these rarer CS subtypes.

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Histological subtyping of diverse renal cell carcinomas (RCCs) has seen significant changes during the last two decades. This resulted in the introduction of several new phenotypically and genetically defined entities, many which are also listed in the current WHO classification. Some of these well-defined entities may, under certain circumstances, undergo a process of dedifferentiation resulting in loss of their phenotypic and immunohistochemical features, hence adopting a non-descript anaplastic morphology.

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 Cardiac myxomas are the most common primary cardiac neoplasms.  We present a case of a middle-aged lady with cardiac myxoma in her left atrium awaiting semi-elective surgery. During the preoperative period, the patient presented emergently with acute bilateral lower limb ischemia.

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Sclerosing epithelioid fibrosarcoma (SEF) was originally described as a peculiar variant of fibrosarcoma in 1995. Subsequent studies showed that conventional SEF was associated with both immunohistochemical expression of MUC4 and EWSR1/FUS gene rearrangements with CREB3L1 as the predominant fusion partner. Since then, a distinct group of fibrous tumors characterized by YAP1::KMT2A and KMT2A::YAP1 gene rearrangements and SEF-like morphology has been described.

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Head and neck squamous cell carcinoma (HNSCC) is the sixth most common cancer worldwide and is a cause of significant mortality and morbidity. The epidemiology of this cancer varies worldwide due to either genetic differences in populations or differences in carcinogen exposure. The application of massive parallel sequencing-based techniques in HNSCC should provide a helpful understanding of the genetic alterations that eventually lead to HNSCC development and progression, and ideally, could be used for personalized therapy.

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Conventional high-grade osteosarcomas are characterized by aggressive radiologic features, cytologic pleomorphism, and complex genomics. However, rare examples of osteosarcomas remain challenging due to unusual histology, such as sclerosing or osteoblastoma-like features, which may require molecular confirmation of their complex genetic alterations. We have encountered such a case in a 17-year-old man, who presented with a third metatarsal sclerotic bone lesion, found incidentally in the work-up of a foot trauma.

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TFE3 rearrangements characterize histogenetically, topographically, and biologically diverse neoplasms. Besides being a universal defining feature in alveolar soft part sarcoma (ASPS) and clear cell stromal tumor of the lung, TFE3 fusions have been reported in subsets of renal cell carcinoma, perivascular epithelioid cell tumor (PEComa), epithelioid hemangioendothelioma and ossifying fibromyxoid tumors. TFE3 -related neoplasms are rare in the head and neck and may pose diagnostic challenges.

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With the widespread use of diverse modern molecular testing tools, the last two decades have seen significant advances in the classification of soft tissue neoplasms. Specifically, numerous molecularly defined new entities have been introduced and many established older entities have received more insightful molecular studies that have developed their classification further. The discrepant therapeutic and prognostic implications of this evolving complexity of the nosology of neoplastic diseases make the precise subtyping of soft tissue neoplasms unavoidable.

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Article Synopsis
  • This report presents the first documented case of a giant cell tumor in the larynx, diagnosed through molecular genetic analysis.
  • A 50-year-old non-smoking male experienced persistent hoarseness for 3 months, and imaging revealed a sizable tumor on his thyroid cartilage, leading to a total laryngectomy.
  • Detailed microscopic analysis showed a mix of mononuclear cells and osteoclast-like giant cells, with molecular testing identifying a significant mutation in the H3-3A gene.
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Sclerosing mucoepidermoid carcinoma (SMEC) of the salivary glands is a rare variant of low-grade mucoepidermoid carcinoma with scanty cellular atypia characterized by marked fibrosis/sclerosis and a rich inflammatory infiltrate. Herein, we report 25 unpublished cases of SMEC, two of them with prominent eosinophilia (2/25; 8%) and three with abundant IgG4-positive plasma cells (3/25; 12%). In our series of salivary SMEC, molecular analysis using fluorescence in situ hybridization (FISH) and/or next-generation sequencing (NGS) provided evidence of MAML2 gene rearrangement in 18 cases of the 21 analyzable cases tested (86%), while this gene locus was intact in 3 cases (14%).

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  • Clear cell sarcoma (CCS) and its similar tumor, malignant gastrointestinal neuroectodermal tumor/sarcoma (GINET), often lead to local and distant relapses, with limited success from systemic treatments.
  • A study analyzed data from 43 patients, revealing a 5-year overall survival rate of 42%, with most tumors being EWSR1::ATF1-translocation-positive and showing a high rate of metastasis.
  • The findings highlighted that complete tumor resection significantly improves survival rates compared to incomplete resection, while systemic treatments and radiation were largely ineffective.
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  • * NIFTP is diagnosed through histological examination, avoiding high-risk mutations, and has a low chance of recurrence, leading to less aggressive surgical treatment strategies compared to traditional thyroid cancers.
  • * The review aims to provide a detailed overview of NIFTP, covering its characteristics, diagnosis, management, and future research possibilities while highlighting challenges in improving preoperative diagnostics and follow-up care.
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  • * The tumor, identified as a "calcified chondroid mesenchymal neoplasm" (CCMN) through molecular analysis, was surgically removed, showing extensive changes indicative of its aggressive nature.
  • * Follow-up imaging for over two years showed no residual tumor, but ongoing monitoring is crucial due to potential local recurrences; targeted therapies may be considered for any future recurrences involving the FGFR2 fusion.
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The FGFR3::TACC3 fusion has been reported in subsets of diverse cancers including urothelial and squamous cell carcinomas (SCC). However, the morphology of FGFR3::TACC3-positive head and neck carcinomas has not been well studied and it is unclear if this fusion represents a random event, or if it might characterize a morphologically distinct tumor type. We describe nine FGFR3::TACC3 fusion-positive head and neck carcinomas affecting six males and three females aged 38 to 89 years (median, 59).

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  • - KAT6B/A::KANSL1 gene fusion tumours display similarities with endometrial stromal and smooth muscle tumours, causing debate over their classification as a unique tumour type or variants of existing ones.
  • - Analysis of DNA methylation and genetic variations revealed a distinct subgroup of these tumours that presented with less aggressive histological features, while others exhibited high-grade characteristics linked to poorer clinical outcomes.
  • - The study indicates that KAT6B/A::KANSL1 uterine sarcomas are distinct molecular entities, with significant differences in prognosis, suggesting they should be classified separately from other uterine tumours.
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  • The study investigates the morphomolecular features of high-grade metastasized G3 neuroendocrine tumors (G3NETs) undergoing prolonged systemic treatments, revealing associations with rapid progression and transformation into NEC-like histology.
  • Out of 40 patients, 22% exhibited NEC-like characteristics such as high-grade atypia and a significant increase in Ki67, indicating aggressive tumor behavior compared to non-NEC-like G3NETs.
  • The presence of TP53 mutations was found in all NEC-like tumors, while they still retained some typical NET mutations, suggesting partial histological and genetic features despite their progression and transformation.
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  • Tumors of salivary glands vary widely and can overlap, making them challenging to diagnose, despite advances in molecular testing.
  • A study examined 363 cases of 20 different salivary gland tumors and found distinct DNA methylation patterns that help classify these tumors, achieving high accuracy with a machine learning algorithm.
  • The research identified specific epigenetic signatures, distinguishing certain tumor types, and suggested that DNA methylation could aid in diagnosing and potentially uncovering new tumor classes in the future.
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Background: Local ablative therapies (LAT) are increasingly used in patients with metastatic soft tissue sarcoma (STS), yet evidence-based standards are lacking. This study aimed to assess the impact of LAT on survival of metastatic STS patients and to identify prognostic factors.

Methods: In this retrospective multicenter study, 246 STS patients with metastatic disease who underwent LAT on tumor board recommendation between 2017 and 2021 were analyzed.

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  • - The study highlights the rapid growth in understanding FET::CREB fusion mesenchymal tumors, which now includes aggressive neoplasms not classified by WHO, specifically focusing on newly reported intra-abdominal and extra-abdominal cases with specific fusions like EWSR1::CREM and FUS::CREM.
  • - Nine additional tumors were analyzed, involving various locations and a wide age range for patients, with treatment primarily consisting of radical surgery and some receiving additional chemotherapy or radiation.
  • - The aggressive nature of these tumors is emphasized, with follow-up showing significant disease progression in some patients, while also noting similarities in immunophenotype across tumor subtypes, indicating a broader classification of potentially dangerous neoplasms.
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Adenoid cystic carcinoma (AdCC) is one of the most common salivary gland malignancies and occurs in all major and minor salivary gland and seromucous gland sites. AdCCs of salivary gland origin have long been categorized as fusion-defined carcinomas owing to the almost consistent presence of fusion genes MYB::NFIB, or less commonly MYBL1::NFIB. We collected a cohort of 95 cases of AdCC, which were largely characterized by canonical fusions MYB::NFIB (49 cases) or MYBL1::NFIB (9 cases).

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With the increasing use of innovative next generation sequencing (NGS) platforms in routine diagnostic and research settings, the genetic landscape of uterine sarcomas has been dynamically evolving during the last two decades. Notably, the majority of recently recognized genotypes in uterine sarcomas represent gene fusions, while recurrent oncogene mutations of diagnostic and/ or therapeutic value have been rare. Recently, a distinctive aggressive uterine sarcoma expressing S100 and SOX10, but otherwise lacking diagnostic morphological, immunophenotypic and molecular features of other uterine malignancies has been presented in a scientific abstract form (USCAP, 2023), but detailed description and delineation of the entity is still missing.

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