HER2 in Bladder Cancer: Molecular Biology, Prognostic Value, and Emerging Therapeutic Strategies| Chapter 3 | Newer Frontiers in Urology, Volume II

 

Introduction: Non-muscle invasive bladder cancer (NMIBC) accounts for nearly 75–80% of newly diagnosed bladder cancers and is marked by frequent recurrence and a variable risk of progression. Human epidermal growth factor receptor 2 (HER2) has emerged as a biologically relevant oncogenic driver in urothelial carcinoma, but its prognostic and therapeutic significance in NMIBC remains incompletely defined.

 

Aim: This review synthesises current evidence on HER2 biology, molecular associations, prognostic relevance, and therapeutic implications in bladder cancer, with a focus on NMIBC.

 

Results: HER2 overexpression and amplification are enriched in high-grade tumours, advanced stages, luminal molecular subtypes, and aggressive histological variants, and are associated with disease progression and resistance to intravesical BCG therapy. Despite strong biological rationale, conventional HER2-targeted therapies have shown limited efficacy in urothelial carcinoma due to heterogeneous expression, discordance between protein overexpression and gene amplification, and complex downstream signalling. In contrast, emerging antibody–drug conjugates demonstrate promising clinical activity, including in tumours with low or heterogeneous HER2 expression.

 

Conclusion: HER2 represents a clinically meaningful biomarker and therapeutic target in bladder cancer. Standardised HER2 assessment integrated with molecular profiling may refine risk stratification and enable precision-guided therapies, particularly for patients with high-risk or treatment-refractory NMIBC.

 

 

Author(s) Details

Vijayanand Mani
Department of Urology and Renal Transplant, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India.

 

Bhavyadeep Korrapati
Department of Urology and Renal Transplant, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India.

 

Velmurugan Palaniyandi
Department of Urology and Renal Transplant, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India.

 

Hariharasudhan Sekar
Department of Urology and Renal Transplant, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India.

 

Sriram Krishnamoorthy
Department of Urology and Renal Transplant, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India.

 

Please see the book here :- https://doi.org/10.9734/bpi/mono/978-93-47485-68-8/CH3

 

Cerebral Vasospasm as a “Hidden Danger” after Craniotomy: A Systematic Review of Case Reports and Case Series | Chapter 3 | Medical Science: Updates and Prospects Vol. 5

 

Background: Cerebral vasospasm following tumour craniotomy (CVACT) is a rarely reported yet potentially devastating postoperative complication with significant neurological consequences. Unlike cerebral vasospasm associated with aneurysmal subarachnoid haemorrhage, which has been extensively studied, CVACT remains poorly understood with respect to its pathophysiology, early detection, and management. This lack of clarity often leads to delayed diagnosis and suboptimal therapeutic strategies. In this chapter, we present a comprehensive synthesis of the current literature, drawing upon published case reports and case series to identify emerging clinical patterns, key risk factors, available diagnostic approaches, and therapeutic responses associated with CVACT. The objective is to consolidate and interpret existing evidence regarding predisposing factors, potential underlying mechanisms, clinical presentation, diagnostic modalities, treatment strategies, and patient outcomes, thereby improving clinical awareness and informing future research directions.

 

Methods: A systematic review was conducted in accordance with the PRISMA 2020 guidelines, utilising the PubMed and ScienceDirect databases. This review employed a Boolean combination of the MeSH terms and keywords "cerebral vasospasm," "craniotomy," and "brain tumour" to identify instances of cerebral vasospasm following tumour craniotomy (CVACT). The study protocol, which outlines the methodologies used in the systematic review, has been registered with the PROSPERO database. The inclusion criteria for this review consisted of case reports and case series published in English and available in full text, with no restrictions on publication year. Furthermore, gray literature was not excluded from the review. The final search was completed in May 2024.

 

Results: We included 60 inclusion patients from 14 case reports and 13 case series, with 33 (55%) females and 27 (45%) males, with a mean age of 44.05 ± 16.8 years. The most common tumours were pituitary adenomas, which were found in 22 (36.66%). The most common tumour location was the middle cranial fossa (75%), and the most common surgery technique used was transsphenoidal surgery (50%). Most of those who experience vasospasm have a craniotomy with the TSS technique (50%), with complications of intraoperative bleeding. The range of onset of VS symptoms postoperatively was 0–30 days (mean 6.59d). The symptoms included asymptomatic, headache, loss of vision, hemiparesis, diplopia, etc. The vascular involvement was mainly anterior circulation (78.33%). The diagnostic tools most commonly used were angiography and transcranial doppler (TCD). The most common management of VS from the included studies was pharmacology. The survival rate was 61.66%. We found that the tumour location and vascular-affected vasospasm were significantly correlated with mortality rates: p = 0.015 and p = 0.02.

 

Conclusions: Cerebral vasospasm after craniotomy tumour removal (CVACT) frequently arises in tumours situated in the medial cranial fossa, predominantly pituitary adenomas and meningiomas. The minimally invasive surgical approach of TSS may contribute to the mechanism of CVACT incidence. The existence of preoperative vascular pathology, such as encasement or narrowing, appears to be a predictor alongside the incidence of intra- or postoperative haemorrhage. The vascular structures most susceptible to vasospasm are located in the anterior circulation of the Willis circle, which appears to correlate with the vascular problems that typically undergo preoperative encasement of the internal carotid artery (ICA). The most reliable and real-time diagnostic instrument employed is TCD, while imaging continues to be the gold standard. Nimodipine treatment continues to be a viable therapeutic option that can enhance patient outcomes.

 

 

Author(s) Details

Khairunnisai Tarimah
Department of Anesthesiology and Intensive Therapy Subdivision Neuroanesthesia and Critical Care,  Dr Hasan Sadikin Hospital, Padjadjaran University, Bandung 40161, West Java, Indonesia and Department of Anesthesiology and Intensive Therapy, RSUD Kota Mataram, Al-Azhar Islamic University Mataram, Mataram 83127, West Nusa Tenggara, Indonesia.

 

Dewi Yulianti Bisri
Department of Anesthesiology and Intensive Therapy Subdivision Neuroanesthesia and Critical Care, Dr Hasan Sadikin Hospital, Padjadjaran University, Bandung 40161, West Java, Indonesia.

 

Radian Ahmad Halimi
Department of Anesthesiology and Intensive Therapy Subdivision Neuroanesthesia and Critical Care, Dr Hasan Sadikin Hospital, Padjadjaran University, Bandung 40161, West Java, Indonesia.

 

Elvan Wiyarta
Intensive Care Department, University of Indonesia Hospital, Depok 16424, West Jawa, Indonesia and Service Department, Risetku, South Jakarta 12820, Jakarta, Indonesia.

 

Please see the book here :- https://doi.org/10.9734/bpi/msup/v5/6893

Clinical Profile and Management of Oral and Maxillofacial Tumours in HIV-Seropositive Patients | Chapter 5 | Medical Science: Updates and Prospects Vol. 4

 

 

Background: There has been an increased rate of neoplastic diseases in patients with Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS). The survival of patients with Human Immunodeficiency Virus (HIV) has improved considerably with modern medical management. However, oral and maxillofacial tumours occurring in these patients have not received adequate treatment attention.

 

Objectives: To assess the clinical features and treatment modalities of oral and maxillofacial tumours in HIV-seropositive patients.

 

Methodology: This was a retrospective study of HIV-seropositive patients who received treatments for oral and maxillofacial tumours at Barau Dikko Teaching Hospital, Kaduna, Nigeria. The study covered the period from January 2015 to December 2024. The information was extracted from case files of patients, the theatre register, and histopathology records and slides were retrieved for the purpose of the study. Data collected include patient demography, location of tumour, clinical features, histopathology diagnosis, treatment, and complications.

 

Results: This study identified 28 HIV-positive patients with various oral and maxillofacial tumours. The age range of the patients was from 26 years to 58 years. Mean age was 42 years, SD ±9.24 years.  The tumours include: Kaposi sarcoma (KS), non-hodgkin lymphoma, squamous carcinoma of the oral cavity and oropharynx, mucoepidermoid carcinoma of the parotid gland, parotid cyst, who were treated over a period of 10 years with surgery and radiation therapy. Data collected showed that HIV-positive patients with these tumours presented at the third and fourth decades of life, with aggressive disease and worse prognosis. Treatment comprises surgical resection with radiation therapy and chemotherapy. The complications of the treatment include: tumour recurrence, resistance of the tumour to radiotherapy and chemotherapy, rapidity of tumour growth, acute reactions to radiotherapy, distant metastasis, weight loss and death. Highly active antiretroviral therapy (HAART) has not altered the incidence of these malignancies as observed in this study.

 

Conclusions: Oral and maxillofacial tumours in HIV-positive patients occurred irrespective of the commencement of highly active antiretroviral therapy. Kaposi sarcoma is the most common tumour recorded in this study. The treatment comprises surgery, chemotherapy and radiotherapy; nevertheless, the response varied with the kind of tumours being treated. Infection with HIV is not a contraindication when aggressive radiation therapy is needed in selected patients.

 

 

Author(s) Details

O.O Omisakin
Division of Dental/Maxillofacial Surgery, Barau Dikko Teaching Hospital, Kaduna State University, Kaduna, Nigeria.

 

Please see the book here :- https://doi.org/10.9734/bpi/msup/v4/6837

Fascial Planes in Head and Neck Malignancies: Predictors of Tumor Spread and Guides for Surgical Management |Chapter 2| Medical Science: Recent Advances and Applications Vol. 11

 a

Fascial planes in the head and neck play a dual role as barriers and conduits for tumor spread, making them clinically significant in the management of malignancies. This review synthesizes evidence from anatomical, surgical, and imaging studies to highlight their role in predicting invasion pathways, guiding resection margins, and improving oncologic outcomes. Surgical techniques that incorporate fascial boundaries have been shown to increase nodal yield, reduce recurrence, and preserve vital functions. Advances in imaging, including MRI and novel PET tracers, further enhance visualization of tumor margins and perineural spread, supporting more precise planning and intraoperative decision-making. Despite their importance, inconsistencies in nomenclature and classification of fascial planes continue to limit standardization and interdisciplinary communication. Future research should focus on consensus-driven terminology, integration of emerging technologies such as deep learning, and validation of fascial plane-based approaches in large-scale, prospective studies. Integrating fascial anatomy into clinical practice may enhance oncologic outcomes while supporting functional preservation in patients with head and neck cancer.

 

 

Author(s) Details

Shrikrishna B H
Department of ENT, All India Institute of Medical Sciences, Bibinagar, India.

 

Deepa G
Department of Anatomy, All India Institute of Medical Sciences, Bibinagar, India.

 

 

Please see the book here :- https://doi.org/10.9734/bpi/msraa/v11/6214

Mega Prothesis: A Ray of Hope in Tumor Resection | Chapter 8 | An Overview of Disease and Health Research Vol. 4

Megaprostheses consistently produce positive outcomes for as long as patients are alive. Most methods provide instant weight-bearing and replace damaged bone tissue rather than trying to promote bone healing. There is strong evidence to support the use of these systems, which can undoubtedly improve patients' quality of life, even for those with a poor prognosis. Literature shows that not only these prostheses used in tumour patients, but they are also used to treat non-oncologic patients. They have become the most popular reconstruction technique following segmental resection of the long bones in the extremities during the past three decades. These devices are a promising substitute that may lead to quick recuperation, joint function restoration, and, in the worst situations, amputation avoidance. Megaprostheses are comparatively simple to operate, and their highly modular systems enable a wide range of resections to accommodate as many patients as feasible. There are many different kinds of megaprostheses implants available for limb salvage surgery. They differ in their shape, size, make and functioning. An important issue that significantly affects prosthesis survival is prosthetic joint infection. An elevated risk of infection is linked to the usage of megaprostheses.

 

Author(s) Details

Noel Samuel Macwan, PT

College of Physiotherapy, Sumandeep Vidyapeeth (Deemed to be University), Piparia, Waghodia, Vadodara, Gujarat, India.

 

Please see the book here:- https://doi.org/10.9734/bpi/aodhr/v4/5954

Minor Salivary Gland Tumours: A Retrospective Study of Cases Treated in a Teaching Hospital, Kaduna, Nigeria | Chapter 12 | Medical Science: Trends and Innovations Vol. 13

Background: Tumours of the minor salivary glands occurring in the oral cavity are uncommon. The oral cavity has many tiny salivary glands, which occur in the lip, palate, floor of the mouth, cheeks, tongue and pharynx. Tumours could develop from any of these minor salivary glands. The tumours of the minor salivary glands have an insidious onset, oftentimes noticed when the tumour interferes with oral functions such as swallowing, speech, and breathing or when there are associated pains. The incidence of these tumours varies with age, sex and ethnicity.

 

Objective: The objective of this study is to investigate the nature, clinical features, pathology, and treatment of these tumours in North-West, Nigeria.

 

Materials and Methods: This was a retrospective study of all patients with minor salivary gland tumours that were treated at Barau Dikko Teaching Hospital, Kaduna, Nigeria. The study covered a period of eleven years from January 2009 to December 2019. Information was extracted from case files of patients. Data collected includes: age of patient at presentation, sex, location of tumour, clinical features, treatment, complications and histological diagnosis. Data obtained were analyzed using Statistical Package for Social Science (SPSS), version 20.0.

 

Results: The age of the patients ranged from 16 to 70 years, with the mean SD = 43.0 ± 6.6 years and the male-to-female ratio was 1:2. Benign tumours were the most common compared to malignancies. The palate was the commonest site of occurrence; followed by the upper lip. The treatment was surgical excision. Malignant cases received post-surgery chemotherapy and radiotherapy. Palatal fistula was the most common complication of the surgery.

 

Conclusion:  Pleomorphic adenoma was the most common tumour in this study.  Tumours in the palate interfere with oral functions and destroy maxillary bone resulting in untoward debilitating effects.

 

Author (s) Details

 

Omisakin Olatunde Oluleke
Department of Surgery, Dental/Maxillofacial Unit, Barau Dikko Teaching Hospital, Kaduna State University, Kaduna State, Nigeria.

 

Ayuba Iko Godwin
Department of Pathology and Forensic Medicine, Barau Dikko Teaching Hospital, Kaduna State University, Kaduna State, Nigeria.

 

Fomete Benjamin
Department of Dental Surgery, Ahmadu Bello University, Zaria, Kaduna State, Nigeria.

 

Ogunsina Modupe
Department of Medicine, Barau Dikko Teaching Hospital, Kaduna State University, Kaduna State, Nigeria.

 

 

Sannom Yates
Department of Pathology and Forensic Medicine, Barau Dikko Teaching Hospital, Kaduna State University, Kaduna State, Nigeria.

 

Please see the book here:- https://doi.org/10.9734/bpi/msti/v13/4927

Aggressive Angiomyxoma of the Vulva: A Rare Case Report| Chapter 8 | Perspective of Recent Advances in Medical Research Vol. 1

 We present a rare case of 26 years old female who presented to the emergency with frequent urination and mass in perineum. Aggressive angiomyxoma is a rare, locally invasive mesenchymal tumor occurring usually in women of reproductive age, which carries a high risk for local relapse; hence the need to differentiate it from the other mesenchymal tumors occurring in the region. Aggressive angiomyxoma is a rare condition that can look like a bartholin's cyst. Because of its aggressive nature, it infiltrates locally, which must also be determined radiologically.

Author(s) Details:

Harpreet Kaur,
Department of Obstetrics and Gynaecology, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, India.

Sarvjeet Kaur,
Department of Anaesthesiology, Guru Gobind Singh Medical College & Hospital, Faridkot, Punjab, India.

Naveenta Gupta,
Department of Pharmacology, Guru Gobind Singh Medical College & Hospital, Faridkot, Punjab, India.

Deeksha Sharma,
Department of Obstetrics and Gynaecology, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, India

Please see the link here: https://stm.bookpi.org/PRAMR-V1/article/view/9003

A Rare Case Presentation on Inflammatory Myofibroblastic Tumour of the Stomach | Chapter 4 | Recent Developments in Medicine and Medical Research Vol. 2

 IMT (Inflammatory Myofibroblastic Tumour) is a rather uncommon disease. The IMT was first discovered in the lungs. IMT can affect any part of the body, although the lungs, liver, and gastrointestinal tract are the most prevalent. It most commonly affects children and young adults, but it can affect anyone at any age. Clinically, IMTs are painless indurated masses/swelling that last for a short time, with signs and symptoms ranging from asymptomatic to nonspecific respiratory symptoms, fever, or discomfort, depending on the location of the tumour. IMTs have an underlying cause that is unknown. IMTs are tumours with an intermediate biological potential, meaning they can recur locally and have a small chance of spreading to other parts of the body. IMT is always debatable as to whether it is an inflammatory tumour or a tumour, and if it is benign or malignant, as well as the adjuvant treatment. Despite the pathologic findings and their apparent prognostic implications, the majority of those affected have had positive clinical outcomes, regardless of the originating site. A case of primary stomach IMT in an adult male is given here, along with a literature evaluation.

Author (S) Details

Manish Gupta

Department of Radiotherapy, All India Institute of Medical Sciences, Bhopal, India.

Bharati Pandya

Department of General Surgery, All India Institute of Medical Sciences, Bhopal, India.

Ravinder Narang

Department of Surgery, Mahatma Gandhi Institute of Medical Sciences, Sevagram, India.

View Book :- https://stm.bookpi.org/RDMMR-V2/article/view/4275

Study on Gynaecological Malignant Tumours at a University Teaching Hospital in Imo State South-Eastern Nigeria | Chapter 14 | New Frontiers in Medicine and Medical Research Vol. 2

 Background: Gynecological malignancies are important components of reproductive health and contribute significantly to morbidity and mortality in women. They may be found all over the world, though the distribution varies depending on the locale.

The goal of this study was to determine the frequency and pattern of gynaecological cancers at a University Teaching Hospital in South Eastern Nigeria.

Methodology: All patients with histologically established genital tract malignancies in the Department of Obstetrics and Gynecology of a University Teaching Hospital in South Eastern Nigeria were retrospectively examined from January 1, 2004 to December 31, 2013.

Cervical cancer accounted for 60.1 percent (131/218) of the 218 cases, followed by ovarian cancer (20.6 percent) (45/218), corpus uteri cancer (10.6%) (23/218), vulval cancer (8.2%) (18/218), and vaginal cancer (0.5 percent) (1/218). Overall, the age range was 30-69, with a large concentration in the 40-49 age group. Cervical and ovarian cancers were the most common cancers among people aged 40 to 49 years old, accounting for 39.7% and 24.5 percent of all cancers, respectively. At the extremes of age (between 20 and 70 years), gynaecological cancers appear to be less common.

Conclusion: Cervical cancer was the most common type of gynaecological cancer in our study. Despite being the most preventable of all gynaecological malignancies and the leading cause of morbidity and mortality in Nigeria, it remains a major cause of morbidity and mortality. To stop this dreadful trend, health education, public awareness, and sound government policies are essential.

Author (S) Details

J. C. Umeobika
Department of Obstetrics and Gynaecology, Chukwuemeka Odumegwu Ojukwu University Teaching Hospital (COOUTH), Awka, Anambra State, Nigeria.

E. C. Ojiyi
Department of Obstetrics and Gynaecology, Imo State University Teaching Hospital (IMSUTH), Orlu, Imo State, Nigeria.

View Book :- https://stm.bookpi.org/NFMMR-V2/article/view/2687

A Rare Case of Lateral Nasal Wall Haemangioma in a Young Female| Chapter 17 | Highlights on Medicine and Medical Science Vol. 10

 Hemangiomas are benign tumours that arise from the body's circulatory systems. They are classified as capillary, cavernous, or mixed histologically. Although it is frequent in the head and neck area, it is uncommon in the nasal cavity, nasopharynx, and paranasal sinuses, accounting for only 10% of all head and neck haemangiomas. The haemangioma in this patient originated from the right nasal cavity's lateral nasal wall. So yet, just a handful similar examples have been described in the literature. This case was described since it had the potential to be misdiagnosed due to radiological abnormalities, as well as to highlight the benefits of embolization in the treatment of such highly vascular nasal tumours.

Author (S) Details

Dr. Ashfaque Ansari
Department of E.N.T, MGM Medical College and Hospital, Aurangabad, India.

Dr. Sanjana U. Nair
Department of E.N.T, MGM Medical College and Hospital, Aurangabad, India.

View Book :- https://stm.bookpi.org/HMMS-V10/article/view/2265