AIM2 Inflammasome in Tumor Cells as a Biomarker for Predicting the Treatment Response to Antiangiogenic Therapy in Epithelial Ovarian Cancer Patients

Antiangiogenic therapy, such as bevacizumab (BEV), has improved progression-free survival (PFS) and overall survival (OS) in high-risk patients with epithelial ovarian cancer (EOC) according to several clinical trials. Clinically, no reliable molecular biomarker is available to predict the treatment response to antiangiogenic therapy. Immune-related proteins can indirectly contribute to angiogenesis by regulating stromal cells in the tumor microenvironment. This study was performed to search biomarkers for prediction of the BEV treatment response in EOC patients. We conducted a hospital-based retrospective study from March 2013 to May 2020. Tissues from 78 Taiwanese patients who were newly diagnosed with EOC and peritoneal serous papillary carcinoma (PSPC) and received BEV therapy were collected. We used immunohistochemistry (IHC) staining and analyzed the expression of these putative biomarkers (complement component 3 (C3), complement component 5 (C5), and absent in melanoma 2 (AIM2)) based on the staining area and intensity of the color reaction to predict BEV efficacy in EOC patients. The immunostaining scores of AIM2 were significantly higher in the BEV-resistant group (RG) than in the BEV-sensitive group (SG) (355.5 vs. 297.1, p < 0.001). A high level of AIM2 (mean value > 310) conferred worse PFS after treatment with BEV than a low level of AIM2 (13.58 vs. 19.36 months, adjusted hazard ratio (HR) = 4.44, 95% confidence interval (CI) = 2.01–9.80, p < 0.001). There were no significant differences in C3 (p = 0.077) or C5 (p = 0.326) regarding BEV efficacy. AIM2 inflammasome expression can be a histopathological biomarker to predict the antiangiogenic therapy benefit in EOC patients. The molecular mechanism requires further investigation.

An unusual case of primary peritoneal adenocarcinoma

Primary peritoneal adenocarcinoma is sporadic with few cases cited in pre-existing literature. This cancer arises from the peritoneal epithelium lining of the abdomen, which is derived from extra ovarian mesothelium. It generally carries a poor prognosis. The treatment strategies are similar to ovarian serous papillary carcinoma. Report an incidental finding of primary peritoneal adenocarcinoma in a 39-year-old female army personnel, currently undergoing her chemotherapy and thriving. Exploratory laparotomy was done given the incidental finding of a mass on the contrast-enhanced computed tomography scan (CT). The mass was attached to the greater omentum, however, did not invade the mucosa of the transverse colon. Given this, part of greater omentum was removed. The findings of the immunohistochemical studies of the tumour are described within this report. The diagnosis of a primary peritoneal adenocarcinoma, stage II was established as no other primary site were found upon further investigation. The patient was treated with chemotherapy (carboplatin/paclitaxel) which was planned for 6 cycles. Otherwise, the patient had an uneventful postoperative course, is underway her chemotherapy regime and is planned for interim CT study to assess chemotherapy response. To conclude, isolated solitary primary peritoneal adenocarcinoma without peritoneal carcinomatosis, gastrointestinal manifestations and ascites are rare. This case, however, demonstrates the importance of its diagnosis, accurate evaluation and management.

Tubulopapillary Carcinoma: An Aggressive Variant of Invasive Breast Carcinoma With a Micropapillary DCIS-Like Morphology

Tubulopapillary carcinoma is a recently described variant of breast carcinoma characterized by a proliferation of elongated and anastomosing tubular glands exhibiting intraluminal micropapillary and sometimes papillary epithelial projections. We have recently encountered a patient with invasive breast carcinoma displaying a prominent tubulopapillary component. The histomorphology in our case had an uncanny resemblance to micropapillary ductal carcinoma in situ, but the invasive nature of the glands was confirmed not only by the lack of myoepithelial cells but also by the presence of identical metastatic foci within ipsilateral axillary lymph nodes. This case was made all the more intricate by the simultaneous presence of invasive micropapillary carcinoma in the opposite breast and a carcinosarcoma of the uterus with a serous papillary carcinoma component. As noted in the only prior report on tubulopapillary carcinoma of the breast, our case confirms the aggressive nature of this form of invasive carcinoma, the histological features of which appear to be easily identifiable and reproducible.

A Rare Case of Serous Papillary Ovarian Epithelial Type Carcinoma in Testis: A Rare Testicular Neoplasm

Ovarian epithelial type carcinomas of testis are an extremely rare group of tumors, a few cases of which having been reported. We present the case of a 67-year-old man, presented with testicular mass and inflation, who underwent radical orchiectomy and pathological and immunohistochemical assessments revealed serous papillary carcinoma of ovarian epithelial type tumor of testis.