Diagnostics最新文献

{"title":"Diagnostic Discordance in a 46,XX Ovarian Dissecting Gonadoblastoma with Dysgerminoma Transformation and Leydig Cell Tumor: Hyperandrogenism, β-hCG Elevation, and CEUS Findings.","authors":"Jiahui Yu, Jiang Zhu","doi":"10.3390/diagnostics16193223","DOIUrl":"10.3390/diagnostics16193223","url":null,"abstract":"<p><p><b>Background and Clinical Significance:</b> The current WHO classification recognizes gonadoblastoma and mixed germ cell-sex cord-stromal tumor, unclassified, as distinct ovarian germ cell-sex cord-stromal tumors. Their heterogeneous components may generate discordant endocrine, biochemical, and imaging findings. <b>Case Presentation:</b> An 18-year-old nulliparous woman with a 46,XX peripheral blood karyotype presented with progressive virilization and an enlarging left ovarian mass. Preoperative total testosterone was >16,000 pg/mL and β-human chorionic gonadotropin (β-hCG) was 192.0 IU/L. Magnetic resonance imaging (MRI) and transrectal contrast-enhanced ultrasound (CEUS) favored an androgen-producing sex cord-stromal tumor; CEUS showed heterogeneous hyperperfusion with mildly disorganized intratumoral vessels. Computed tomography (CT) suggested a mixed germ cell tumor, and frozen section favored a steroid cell tumor while not excluding a focal germ-cell component. Fertility-sparing surgery was performed. Final pathology showed dissecting gonadoblastoma with dysgerminoma transformation and trophoblastic differentiation, combined with a Leydig cell tumor. Serum β-hCG fell to 80.4 IU/L on postoperative day 1 and to <0.2 IU/L by January 2026, accompanied by androgen normalization and resumption of menstruation. At 6.5 months, the patient remained clinically well; ultrasound showed a normal right ovary and no evident left adnexal mass, although contemporaneous endocrine and tumor-marker measurements were unavailable. <b>Conclusions:</b> In a heterogeneous ovarian tumor, the dominant phenotype may represent only one component. Discordance among endocrine findings, tumor markers, and imaging should prompt consideration of mixed histology. β-hCG elevation in an androgen-secreting ovarian tumor may indicate an occult germ-cell or trophoblastic component, whereas CEUS should be interpreted as a vascular phenotype rather than a histology-specific signature.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 19","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mixed Epithelial Stromal Tumour of the Seminal Vesicle Presenting with Recurrent Acute Urinary Retention: A Case Report.","authors":"Daniel Vas, Alessandra Iacono, Tarek Ajami, Silvia Valls, Isabel Trias, Daniel Corominas, Antonio Alcaraz, Carlos Nicolau","doi":"10.3390/diagnostics16193222","DOIUrl":"10.3390/diagnostics16193222","url":null,"abstract":"<p><p><b>Background:</b> Mixed epithelial stromal tumour (MEST) is a rare biphasic neoplasm, most commonly arising in the kidney. Seminal vesicle involvement is exceedingly uncommon, and its clinical and imaging characteristics remain poorly defined. We present a rare case with detailed clinical and urological evaluation, multiparametric MRI characterisation, and radiologic-pathologic correlation. <b>Case presentation:</b> A 34-year-old man presented with recurrent acute urinary retention requiring repeated catheterization and, subsequently, an indwelling urinary catheter. Urological evaluation, including ultrasonography and cystoscopy, demonstrated marked mass effect on the bladder and prostatic urethra without an intravesical lesion. Contrast-enhanced CT and MRI revealed a large retrovesical mass arising from the right seminal vesicle, measuring approximately 11.5 × 9 × 10.5 cm. MRI demonstrated a predominantly multiloculated cystic lesion containing haemorrhagic or proteinaceous material, with an enhancing papillary solid component showing mild diffusion restriction and progressive enhancement. The lesion produced marked mass effect on the bladder, prostate, and rectum, without local invasion. Robotic-assisted resection of the right seminal vesicle was performed. Histopathology demonstrated a biphasic epithelial and stromal proliferation without atypia, necrosis, or increased mitotic activity, consistent with MEST. <b>Conclusions:</b> This case highlights the value of integrating clinical, urological, radiological, and pathological findings in the evaluation of a large complex retrovesical mass. Multiparametric MRI provided detailed characterisation of the solid-cystic architecture, with imaging features correlating with the epithelial and stromal components identified histologically. Recognition of this pattern may raise suspicion for MEST and help guide differential diagnosis and surgical planning, although definitive diagnosis requires histopathological and immunohistochemical evaluation.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 19","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between HIV-1 RNA Detection Status and HBV DNA Detection: A Patient-Level Retrospective Longitudinal Molecular Study from Istanbul, Türkiye.","authors":"Murat Yaman, Kubra Alay Kara","doi":"10.3390/diagnostics16193214","DOIUrl":"10.3390/diagnostics16193214","url":null,"abstract":"<p><p><b>Background/Objectives</b>: HIV and hepatitis B virus (HBV) share major transmission routes and may coexist in the same individual, making coordinated molecular assessment clinically important. <b>Methods</b>: This retrospective longitudinal laboratory-based study evaluated the patient-level association between HIV-1 RNA detection and HBV DNA detection using routine molecular testing data from a tertiary-care hospital in Istanbul, Türkiye. HIV-1 RNA and HBV DNA results obtained between 1 January 2022 and 1 August 2026 were linked at the patient level. A total of 5303 unique patients had HIV-1 RNA testing and 30,981 unique patient records had HBV DNA testing; these were separate source populations, and 529 individuals with results available for both molecular assays constituted the primary analytical cohort. <b>Results</b>: Among the 529 patients, HIV-1 RNA was detected at least once in 246 (46.5%), while HBV DNA was detected at least once in 147 (27.8%). HBV DNA detection occurred in 83/246 (33.7%) patients with at least one detectable HIV-1 RNA result and in 64/283 (22.6%) patients with no detectable HIV-1 RNA in any available measurement (OR, 1.74; 95% CI, 1.19-2.56; <i>p</i> = 0.005). However, the association was attenuated after adjustment for age and sex and was no longer statistically significant (adjusted OR, 1.28; 95% CI, 0.84-1.94; <i>p</i> = 0.255). HIV-1 RNA magnitude and HIV-1 RNA categories were not significantly associated with HBV DNA detection, and no significant correlation was observed between same-day HIV-1 RNA and HBV DNA levels (Spearman's ρ = 0.161; <i>p</i> = 0.387) or between the nearest quantitative measurements obtained within ±30 days (ρ = 0.171; <i>p</i> = 0.245). Because treatment exposure and adherence information were unavailable, the observed molecular patterns could not be interpreted as direct measures of treatment response or treatment failure. <b>Conclusions</b>: These findings indicate that HIV-1 RNA detection status or magnitude should not be used as a surrogate for HBV DNA detection and support independent, clinically indicated HBV assessment in people living with HIV.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 19","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Handheld Ultrasound: Technical Review and International Expert Consensus Recommendations.","authors":"Christoph F Dietrich, Michael Blaivas, Vito Cantisani, Xinwu Cui, Yi Dong, Ahmed El Kaffas, Adrian Goudie, Ole Graumann, Moritz Herzog, Thomas Karlas, Daniel Merkel, Kathleen Möller, Michael Bachman Nielsen, Christian Pállson Nolsoe, Peter J Snelling, Daniel Wastl, Christian Jenssen","doi":"10.3390/diagnostics16193215","DOIUrl":"10.3390/diagnostics16193215","url":null,"abstract":"<p><p><b>Background</b>: Handheld ultrasound (HHUS) is increasingly used in point-of-care imaging because of its portability, accessibility, versatility, and comparatively low cost. <b>Methods</b>: This structured narrative technical review evaluated current HHUS technology, image quality and functionality, clinical applications, regulatory considerations, and future perspectives using recent literature, comparative studies, technical sources, and previous EFSUMB/WFUMB position papers. A structured SWOT analysis informed draft recommendations, which underwent three rounds of scientific discussion and revision by a 17-member international multidisciplinary expert panel. Each of the seven final recommendations was subsequently voted on separately, with consensus predefined as ≥80% agreement. <b>Results</b>: While HHUS devices are increasingly suitable for routine clinical use, further standardization, clinician training, and regulatory alignment are essential for widespread adoption. <b>Conclusions</b>: HHUS can expand access to focused ultrasound imaging, particularly in point-of-care and resource-limited settings. Its appropriate use requires task-specific device selection, adequate training, quality assurance, and recognition of its limitations compared with comprehensive ultrasound systems.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 19","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"BRAF<i>^V600E</i>-Informed TI-RADS Reclassification of Biopsy Eligibility in Thyroid Nodules: A Retrospective Oracle Decision-Simulation Study.","authors":"Jiaojiao Ma, Xuehua Xi, Yang Li, Shanshan Wang, Ruyu Liu, Xuejiao Yu, Wanlin Huang, Mingyu Feng, Yong Cheng, Bo Zhang","doi":"10.3390/diagnostics16193216","DOIUrl":"10.3390/diagnostics16193216","url":null,"abstract":"<p><p><b>Background/Objectives:</b> We evaluated a hypothetical oracle strategy that assumes BRAF<i>^V600E</i> status is known before fine-needle aspiration (FNA), although testing usually requires FNA-derived material. <b>Methods:</b> This retrospective simulation included 4944 nodules from 4560 patients with linked ultrasound and molecular records following FNA evaluation. The cohort was selected for cytology and molecular testing and enriched for BRAF<i>^V600E</i> positivity (42.4%) and TI-RADS 4C nodules (66.7%). The predefined rule combined BRAF<i>^V600E</i>-positive upgrading with one-level downgrading of negative TI-RADS 4A/4B nodules. Outcomes were FNA-actionable classification changes and retention of originally FNA-actionable Bethesda V/VI nodules. Pre-FNA prediction was evaluated with patient-grouped cross-validation and training-fold calibration. <b>Results:</b> Under the hypothetical assumption of pre-FNA knowledge of BRAF<i>^V600E</i> status, the oracle strategy reduced FNA-actionable classifications from 3454 to 2954 (net reduction 500; 14.5%) while retaining 1843/1920 Bethesda V/VI nodules (96.0%). In the selected surgical subgroup (365/4944), malignant-nodule retention was 189/196 (96.4%; 95% CI, 92.8-98.6%), with uncertainty extending below the exploratory 95% reference. Among 97 reclassified Bethesda III/IV nodules, only 2 had surgical pathology, and 1 was malignant. Patient-grouped random forest AUC was 0.693 (95% CI, 0.678-0.707). After calibration, a training-selected high-sensitivity threshold reduced classifications by 10.6%, with Bethesda V/VI retention of 95.6% (95% CI, 94.7-96.5%). <b>Conclusions:</b> This selected-cohort oracle simulation suggests a theoretical reduction in FNA-actionable classifications. Prospective evaluation in an unselected pre-biopsy population is required before clinical use.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 19","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thromboelastographic Assessment of the Differential Sensitivity of Three Contact Activators to Coagulation Factor Deficiencies in Hemocell Environments.","authors":"Weiguo Liang, Mao Xia, Junpo Li, Fuyang Li, Bidou Wang, Haixuan Sun","doi":"10.3390/diagnostics16193217","DOIUrl":"10.3390/diagnostics16193217","url":null,"abstract":"<p><p><b>Background:</b> Thromboelastography (TEG) assesses global coagulation, but its sensitivity for factor deficiencies is reportedly low and may depend on the contact activator. However, the differential TEG sensitivity of contact activators for individual factor deficiencies in whole blood containing platelets and red blood cells remains unclear. This study assessed the relative sensitivity of three contact activators for detecting single coagulation factor deficiencies in reconstituted whole-blood samples using TEG. <b>Methods</b>: Reconstituted whole-blood samples with graded activities of FII, FV, FVIII, FIX, FX, FXI, and FXII were prepared by mixing platelets, plasma, and red blood cells, and analyzed by TEG using kaolin-, ellagic acid-, and colloidal silica-based activators (KL, EA and CS). Relative sensitivity was assessed via: (1) the factor activity at which R time first showed a statistically significant prolongation; (2) a novel metric, Sensitivity for Detecting Factor Deficiencies (SDFD), defined as the normalized relative change in R time, enabling comparison without reference ranges. <b>Results</b>: KL showed the broadest and highest sensitivity, detecting significant prolongation at the mildest deficiency levels for most factors. EA showed intermediate-to-high sensitivity and the highest sensitivity for FXII. CS was the least sensitive except for FV. Notably, the activity threshold of KL for exceeding the reference range was substantially lower than that for statistical significance. <b>Conclusions</b>: The sensitivity of TEG to coagulation factor deficiencies is dependent on the contact activator. KL showed the highest overall sensitivity to factor deficiencies, while EA showed the highest sensitivity for FXII deficiency under the conditions of this study. R time of KL can be significantly prolonged yet still stay within the reference range. This mismatch calls for more sensitive TEG reagents and stricter ranges.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 19","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case-Based Diagnostic Performance, Challenges and Tool Development in Identifying Orofacial Conditions Among Pediatric Dentists: A Mixed-Methods Study.","authors":"Amani Sait, Nada O Bamashmous, Khlood Baghlaf, Khalid Aljohani, Rahaf Sahhaf","doi":"10.3390/diagnostics16193218","DOIUrl":"10.3390/diagnostics16193218","url":null,"abstract":"<p><p><b>Background/Objectives:</b> This study assessed diagnostic performance, explored diagnostic barriers, and developed an assessment tool for case-based diagnostic performance and associated challenges specific to pediatric OFCs. <b>Methods:</b> An exploratory sequential mixed-methods study was conducted. The qualitative phase included semi-structured interviews with Saudi pediatric dentists, selected using criterion (purposive) sampling until thematic saturation was reached. Findings informed the development and validation of a structured questionnaire, targeting pediatric dentists from various regions of Saudi Arabia. The questionnaire assessed case-based diagnostic performance, appropriate management, and diagnostic barriers. Descriptive statistics were performed using SPSS. Findings from both phases were triangulated. <b>Results:</b> Thirteen interviews were conducted with pediatric dentists (specialists and consultants). Themes and subthemes, including key barriers, were identified. Among 180 pediatric dentists who answered the questionnaire, diagnostic performance was high, with mean diagnosis and management scores of 9.03 ± 1.16 and 8.84 ± 1.32, respectively. Triangulation demonstrated convergence regarding the importance of clinical exposure and interdisciplinary collaboration in improving diagnostic competence. <b>Conclusions:</b> The study developed a valid assessment tool specific to pediatric OFCs in Saudi Arabia, which may have limited generalizability to other countries. Pediatric dentists demonstrated high diagnostic performance and management competency, while key diagnostic barriers highlighted the need for enhanced hands-on training and interdisciplinary collaboration to further support accurate diagnosis and effective management of pediatric OFCs.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 19","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664502/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Communication and the Care That Follows: A Critical Narrative Review.","authors":"Theodoros Xanthos","doi":"10.3390/diagnostics16193211","DOIUrl":"10.3390/diagnostics16193211","url":null,"abstract":"<p><p>An accurate diagnosis does not ensure that a patient understands its implications or receives appropriate care. This critical narrative review draws on purposively selected literature studies on diagnostic labels, explanations of test results, nocebo effects and care after diagnostic revision. Terminology experiments show changes in perceived severity and stated preferences, often in hypothetical settings. Clinical effects on symptoms and healthcare use depend on the intervention, comparator and outcome; explanation is frequently combined with treatment changes. Nocebo experiments demonstrate possible symptom mechanisms, not the cause of an individual patient's continuing symptoms. Studies of diagnostic follow-up identify a separate problem: accurate or revised findings may fail to inform subsequent care. The synthesis distinguishes evidence for changing understanding, relieving symptoms and completing appropriate clinical action. A documented misunderstanding or obsolete instruction can warrant correction while symptom assessment continues. Evaluation should measure accurate understanding, informed choices and care received, with symptoms assessed separately. Truthful disclosure and follow-up remain responsibilities even when symptom benefit is uncertain.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 19","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative White Matter Disease Severity Predicts Intraoperative Cerebral Desaturation During Carotid Endarterectomy.","authors":"Márk Matus, Ágnes Dóra Sándor, Olaf Aleksander Ziółkiewicz, Melissa Pawin-On Brinning, Andrea Varga, Péter Sótonyi, Rita Magyar-Stang, Zsuzsanna Mihály","doi":"10.3390/diagnostics16193212","DOIUrl":"10.3390/diagnostics16193212","url":null,"abstract":"<p><p><b>Objective</b>: Carotid endarterectomy carries the risk of cerebral ischemia during carotid clamping. Traditional risk stratification relies on anatomic factors such as contralateral stenosis, yet these predictors demonstrate limited sensitivity for intraoperative hypoperfusion. White matter hyperintensities (WMH), quantified by the Fazekas scale, reflect chronic cerebral small vessel disease and impaired cerebrovascular reactivity. Whether baseline WMH burden predicts intraoperative cerebral oxygen desaturation during carotid clamping remains unknown. <b>Methods</b>: This prospective, single-center cohort study enrolled patients undergoing carotid endarterectomy with continuous bilateral near-infrared spectroscopy (NIRS) monitoring. The primary outcome was the maximum contralateral regional cerebral oxygen saturation (rSO₂) decrease within 2 min after carotid clamp placement compared with the pre-clamp baseline. The primary predictor was the contralateral hemisphere Fazekas score assessed on preoperative brain MRI. Multivariable linear regression adjusted for age, contralateral carotid stenosis, clamping time, and shunt use. <b>Results</b>: Of 173 patients screened, 58 with complete data were included in the final analysis. Th average age was 69. 2 ± 7 years, 37.9% were female, significant contralateral stenosis was present in four cases, and the average exclusion time was 30.1 ± 9.7 min. In multivariable regression, a higher contralateral Fazekas score was independently associated with greater contralateral rSO₂ desaturation during carotid clamping (unstandardized β = 0.008, standardized β = 0.287, <i>p</i> = 0.035). The association remained statistically significant after adjustment for all covariates. The overall model explained 8.8% of variance in contralateral desaturation (R² = 0.088). <b>Conclusions</b>: Contralateral white matter disease severity, quantified by Fazekas score, was independently associated with greater contralateral cerebral oxygen desaturation during carotid clamping. This finding supports the concept that baseline microvascular disease modifies acute ischemic tolerance independent of large-vessel anatomy. Preoperative Fazekas scoring may enhance risk stratification and inform individualized neuromonitoring strategies during carotid endarterectomy.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 19","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Skene's Gland Malignancy from Imaging Diagnosis to Management: A Narrative Review.","authors":"Roxana-Denisa Capraș, Teodora Telecan, Lucas Tellier, Miana Gabriela Pop, Adriana Ioana Gaia-Oltean","doi":"10.3390/diagnostics16193213","DOIUrl":"10.3390/diagnostics16193213","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Skene's gland malignancies are extremely rare tumors of the female paraurethral region, known almost exclusively from case reports and small case series. Their diagnosis is often delayed because symptoms are nonspecific and may mimic benign periurethral disorders, urethral diverticula, primary urethral carcinoma or anterior vaginal wall tumors. This narrative review focuses on the role of imaging, particularly pelvic magnetic resonance imaging (MRI), in the diagnosis, differential diagnosis, staging and treatment planning of Skene's gland malignancies, distinguishing evidence from confirmed Skene's gland cases from evidence extrapolated from female urethral carcinoma. <b>Methods:</b> PubMed/MEDLINE, Scopus and Web of Science were searched on 27 September 2026 (publication years 2015-2026) and supplemented by reference-list screening; an explicit case definition was applied. <b>Results:</b> Of 191 records (93 after de-duplication), 17 reports of Skene's gland malignancy were included (15 case reports or series and 2 systematic reviews); fewer than thirty cases have been published overall. Patients were mostly postmenopausal (median age about 70 years, range 45-91), presenting with an asymptomatic periurethral nodule, hematuria or vaginal bleeding, or lower urinary tract symptoms; no uniform staging system has been applied. Most tumors were prostatic-type adenocarcinomas treated by local excision alone; radiotherapy, chemotherapy or androgen deprivation were used mainly for nodal, metastatic or recurrent disease. After examination, ultrasonography can detect and characterize a paraurethral mass, whereas MRI best defines tumor epicenter, urethral, periurethral and anterior vaginal wall involvement and regional spread, and should precede cystourethroscopy and biopsy; CT and PET/CT are complementary for systemic staging. No single immunohistochemical marker establishes Skene's gland origin. <b>Conclusions:</b> MRI is central to localizing and staging suspected Skene's gland malignancy and thus to guiding biopsy and the choice between local excision and radical surgery, but most imaging recommendations are extrapolated from female urethral carcinoma and require validation in pooled multicenter data.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 19","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}