Merkel cell carcinoma (MCC) is a rare but aggressive carcinoma with rising incidence. This review summarizes key updates in the optimal surgical and medical management of MCC. Surgery remains the cornerstone of treatment for early-stage MCC, and sentinel node biopsy is important for accurate staging. Emerging salvage options represent critical areas of progress. Sensitive surveillance tools enable earlier recurrence detection. Surgeons play a central role in excision, staging, multidisciplinary coordination, and integration of emerging tools.

Hepatic adenomas (HAs) are rare benign liver tumors traditionally associated with young women, yet contemporary epidemiologic trends reveal increasing recognition among men. Historically, universal resection in males has been recommended because of a nearly tenfold increased risk of malignant transformation as reported by Farges et al. in a single-institution surgical series; however, advances in molecular profiling and imaging have challenged this paradigm. β-catenin-activated and inflammatory subtypes account for most cases in men, often associated with anabolic steroid exposure, obesity, or metabolic syndrome. β-catenin-activated adenomas-particularly those harboring CTNNB1 exon 3 mutations-demonstrate the strongest correlation with malignant potential. Magnetic resonance imaging with hepatobiliary contrast agents can suggest subtype but lacks perfect accuracy; biopsy offers improved diagnostic precision and enables molecular confirmation. Current ACG and EASL guidelines still endorse routine resection for all hepatic adenomas in males; however, available retrospective data suggest that malignant transformation appears to be uncommon in small (5 cm) lesions lacking exon 3 CTNNB1 mutations; however, this observation is derived from limited, predominantly retrospective data and does not exclude the possibility of malignant transformation in this subgroup. These data support selective, biopsy-guided surveillance for small, indeterminate tumors within experienced multidisciplinary centers where longitudinal follow-up is reliable. Resection remains the standard recommendation for large or β-catenin-mutated adenomas, with minimally invasive surgery demonstrating excellent outcomes. Modern management of hepatic adenomas in men should be individualized, integrating molecular subtype, size, risk factors, and patient context. A multidisciplinary and molecularly informed strategy is essential to optimize outcomes while avoiding unnecessary intervention.

Patient-reported outcome measures (PROMs) remain underutilized in musculoskeletal oncology, with only 4.9% of tumor-focused articles incorporating them. This review synthesizes current PROM instruments-including Toronto Extremity Salvage Score, PROMIS, and emerging tools such as the Sarcoma Assessment Measure-and identifies barriers unique to this population, including psychological distress, workflow complexity, and disease heterogeneity. Future directions include flexible baseline collection, EHR-integrated dashboards, national registry linkage, wearable technology, and AI-driven processing to increase PROMs utilization.

Rapid intraoperative distinction between malignant and non-malignant tissue may improve resection completeness and reduce reoperation in cancer surgery. The intelligent knife (iKnife) integrates rapid evaporative ionisation mass spectrometry with electrosurgery to provide real-time tissue classification during surgery. This systematic review assessed the diagnostic accuracy and reported clinical outcomes of intraoperative iKnife use in adults undergoing oncological surgery. The review was prospectively registered in PROSPERO (CRD420251049162) and written according to PRISMA 2020 and PRISMA-DTA, given the primary focus on diagnostic test accuracy. PubMed, Embase, Scopus, Web of Science, the Cochrane Library, ClinicalTrials.gov, and the WHO International Clinical Trials Registry Platform were searched to 10 March 2026. Two reviewers independently screened records, extracted data, and assessed risk of bias and certainty of evidence. Nineteen studies across nine tumour types were included, most of which were small prospective observational or feasibility cohorts. Reported sensitivity ranged from 60% to 100% and specificity from 80.7% to 100%, with high point estimates in ovarian, breast, colorectal and soft-tissue sarcoma settings. Downstream clinical outcome data were limited to margin status in 10 studies, reoperation in 3, complications in 4 and recurrence in 1, with no report of survival. The iKnife shows promise as a real-time intraoperative diagnostic adjunct, but evidence that it improves patient outcomes remains limited. Larger prospective multicentre studies with standardised outcomes and follow-up are required.