A 34-year-old man from Guinea-Bissau presented with a rapidly growing tumor on his right foot over 6 months, arising from a long-standing pigmented papule present for more than 20 years. Clinical examination revealed an exophytic black tumor with ipsilateral inguinal lymphadenopathy. Histopathological analysis showed an epithelioid and fusiform melanocytic proliferation in the dermis with abundant melanin. Immunohistochemical staining demonstrated diffuse positivity for Sox-10, Melan-A, HMB45, and PRAME. A diagnosis of blue nevus-like melanoma (BNM) was confirmed. BRAF V600 mutation testing on a cutaneous metastasis was negative. Staging imaging revealed widespread metastases involving lymph nodes, brain, lungs, liver, stomach, duodenum, colon, adrenal glands, pancreas, gallbladder, and bones. Despite 4 cycles of ipilimumab/nivolumab immunotherapy, the disease progressed, and the patient died 4 months after diagnosis. BNM is a rare melanoma variant, often arising from a pre-existing blue nevus, with aggressive potential and frequent lymph node metastasis. The molecular heterogeneity of BNM and the limited therapeutic options underscore the need for further research into targeted therapies and prognostic biomarkers for this rare melanoma subtype.

Approximately one-third of patients with metastatic triple-negative breast cancer (TNBC) develop brain metastases during their lifetime. Notably, up to 90% of TNBC brain metastases express B7-H3, a molecule that contributes to an immunosuppressive microenvironment-positively correlating with regulatory T cells and negatively with CD8+T cells. We propose that B7-H3-targeted antibody-drug conjugates (ADCs) may help convert these immunologically "cold" tumors into "hot" ones, thereby enhancing the responsiveness of patients with metastatic TNBC and brain metastases to immunotherapy. The ability of ADCs to penetrate a blood-brain barrier that is disrupted by brain metastases and/or associated local therapies generates considerable excitement for this potential approach.We further describe a search of the clinicaltrials.gov website, which yielded eight phase I/II trials examining the efficacy of B7-H3 ADCs, 12.5% (n=1/8) of which exclude patients with brain metastases and 62.5% (n=5/8) of which include patients with asymptomatic brain metastases. Given the natural progression of metastatic TNBC and the high incidence of brain metastases, future studies of B7-H3-targeted therapies should consider the broad inclusion of patients with brain metastases. Additionally, the potential of B7-H3-targeted ADCs to prevent brain metastases warrants investigation in both preclinical models and clinical trials.

This article reports a case of bilateral renal subcapsular hemorrhage in a 51-year-old female patient with lung adenocarcinoma and multiple metastases after receiving four cycles of combination antitumor therapy with pemetrexed, carboplatin, sintilimab, and bevacizumab. The patient had a pre-existing cystic lesion in the right kidney and developed intermittent fever, hypertension, and anemia during treatment. The diagnosis was confirmed by a renal contrast-enhanced CT scan. Management involved immediate discontinuation of bevacizumab, absolute bed rest, hemostasis, antihypertensive therapy, and other comprehensive treatments. The renal hemorrhage was effectively controlled and gradually resolved. Based on the temporal relationship of medication use and clinical manifestations, the renal hemorrhage was considered to be associated with bevacizumab. In recent years, bevacizumab has been widely used in tumor treatment; however, its adverse effects still require further exploration. Hemorrhage induced by bevacizumab primarily occurs in the respiratory tract, digestive tract, and brain, while renal subcapsular hemorrhage has not been reported. This case suggests that bleeding manifestations caused by bevacizumab are diverse and remain a cause for vigilance.

Invasive lobular carcinoma (ILC) is the most frequently diagnosed special histological subtype of invasive breast cancer and accounts for 10 - 15% of all cases. The pathognomonic hallmark of ILC is the genetic loss of E-cadherin ( CDH1 ) causing the disruption of adherens junctions and resulting in discohesive, linear growth. To better understand the role of E-cadherin in ILC metastasis, we generated three ILC cell lines, MDA-MB-134-VI, SUM44PE, and BCK4, with inducible E-cadherin expression, resulting in successful restoration of functional adherens junctions. E-cadherin expression reduced growth in 2D culture, and that effect was even greater in 3D ultra-low attachment (ULA) conditions where increased cell death was consistent with the previously described role of E-cadherin in anoikis. E-cadherin expression did not rescue the lack of migration and invasion of ILC cell line models; however, it decreased haptotaxis and increased adherence to Collagen I in SUM44 cells. There was no significant effect of E-cadherin expression on primary orthotopic tumor growth, but spontaneous metastasis to the reproductive tract, brain, and GI tract was reduced. Inhibition of metastasis to the reproductive tract and brain was also seen after tail vein injection of MDA-MB-134 E-cadherin-expressing cells. In summary, overexpression of functional E-cadherin in ILC models has some, but limited, effects on 2D growth in vitro and primary tumor growth in vivo , but there are pronounced effects on 3D ULA growth and metastases in vivo , with stronger effects on metastatic sites enriched in patients with ILC, especially the reproductive and GI tracts.

Ewing sarcoma is the second most common malignant bone tumor in children and adolescents but remains rare and highly aggressive. We present the case of a 31-year-old woman with widespread metastatic disease suggestive of Ewing sarcoma, including lung, spinal, and brain involvement at presentation; however, no dominant primary lesion was identified despite extensive imaging. The patient's clinical course was complicated by neuropathic pain, seizures, and severe treatment-related infections. She was managed with multi-agent chemotherapy and supportive care but ultimately left against medical advice due to socioeconomic constraints. This case illustrates the diagnostic and therapeutic challenges of Ewing sarcoma in low-resource settings and underscores the importance of early detection, molecular confirmation, and multidisciplinary management.

Background: Germline breast cancer susceptibility gene 1/2 (BRCA1/2) variants guide breast cancer treatment, but their clinical relevance in metastatic triple-negative breast cancer (mTNBC) treated with sacituzumab govitecan (SG) remains unclear. The study aimed to evaluate the association between BRCA status and outcomes in SG-treated mTNBC. Methods: We retrospectively analyzed 264 patients with mTNBC and known germline BRCA1/2 (gBRCA1/2) status who received SG between August 2021 and May 2025 across multiple oncology centers in Poland, the Czech Republic and Slovakia. Survival outcomes were compared between patients with gBRCA1/2 mutations (gBRCA1/2m) and those with gBRCA1/2 wild-type (gBRCA1/2wt) using Kaplan-Meier estimates, the log-rank test, and multivariable Cox proportional hazards models. Two-sided p < 0.05 was considered statistically significant. Results: Among 264 patients, 35 (13.3%) were gBRCA1/2m and 229 (86.7%) were gBRCA1/2wt. After a median follow-up of 9.9 months, the median progression-free survival (PFS) was 4.5 months (95% confidence interval [CI] 2.1-6.3) in gBRCA1/2 carriers versus 4.2 months (95% CI 3.5-5.8) in gBRCA1/2wt patients (p = 0.10). Median overall survival (OS) was 9.1 months (95% CI 5.0-15.1) in gBRCA1/2 carriers compared to 11.5 months (95% CI 10.3-13.5) in gBRCA1/2wt patients (p = 0.26). Brain metastases were more frequent in carriers (20% vs. 8.3%, p = 0.06). In multivariable analysis, Eastern Cooperative Oncology Group (ECOG) performance status was the only independent predictor of poorer survival (hazard ratio 1.97, 95% CI 1.42-2.74, p < 0.01), while gBRCA1/2 status showed no independent association. Conclusions: In this large retrospective cohort of mTNBC patients treated with SG, the presence of gBRCA1/2 was not associated with statistically significant differences in PFS or OS.