Background/Objectives: Composite hemangioendothelioma (CHE) is a rare vascular endothelial tumor with borderline malignancy. This study presents a case of CHE and an updated systematic review of previously reported cases, providing insights into recurrence patterns and survival outcomes. Methods: A comprehensive electronic search was conducted across PubMed, Scopus, the Cochrane Library, and Web of Science up to 31 December 2024, to identify eligible case reports. Kaplan–Meier curves were used to estimate event-free survival. Results: We report a 61-year-old man with a splenic lesion associated with weight loss and abdominal pain persisting for 1 year. Intraoperative findings revealed an enlarged spleen and multiple hepatic deposits. Splenectomy and liver biopsy revealed a well-demarcated, nodular tumor measuring 160 × 145 × 100 mm, with histological and immunohistochemical findings consistent with CHE, complicated by hepatic metastasis. Of 405 potentially eligible studies, 59 were included in the review, covering cases from 2000 to 2024, with a peak in 2020 and 2023. The median age of patients was 42 years, with the most common tumor sites being the lower extremities (30.48%), followed by the face, head, and neck (20.95%), and upper extremities (18.1%). Surgical intervention was the most common treatment (60.95%). Recurrence-free survival was observed in 42.86% of cases, while 15.24% experienced recurrence with or without metastasis. Two patients (1.90%) died from the disease. The median recurrence-free survival was 48 months (95% CI: 7.3–88.7). Conclusions: CHE exhibits significant morphological variation and can mimic other vascular tumors. Accurate diagnosis is crucial for proper prognosis and avoiding overtreatment due to misdiagnosis as more aggressive neoplasms. Patients with high-risk CHE should undergo closer surveillance to ensure timely detection of progression.

Pancreatic neuroendocrine tumors (PNETs) are uncommon pancreatic neoplasms with malignant potential, heterogeneous clinical behavior, as well as imaging appearance. These tumors represent less than 3% of all pancreatic neoplasms with typical CT presentation as solid, well-circumscribed, hypervascular lesions. Cystic PNET is a rare pancreatic tumor which is nowadays more often detected due to the widespread use of high-resolution cross-sectional imaging. They are mainly solitary lesions most commonly localized in the body and the tail of the pancreas. Due to cystic presentation these lesions often present a diagnostic challenge to both experienced radiologists and pathologists. Herein, we present a rare case of synchronous, multiple cystic and solid pancreatic neuroendocrine tumors, which due to their extensiveness required total dudenopancreatectomy with splenectomy. Histopathological findings confirmed microscopic and macroscopic cystic components as well as typical solid variants of neuroendocrine tumors along the entire pancreas.

Computed tomography (CT) perfusion is a CT examination modality that enables visualization and non-invasive quantitative assessment of tissue perfusion. Application of CT perfusion in oncology enables non-invasive detection and quantification of neo-angiogenesis (i. e., pathological vascularization) in various malignant tumors. Based on the values of CT perfusion parameters, it is possible to distinguish neoplastic from healthy tissue, malignant from benign tumors, highly aggressive from low-aggressive tumors, and good from poor tumor response to oncological therapy. The basic principle of low-dose CT perfusion is to repeatedly scan the selected region where the tumor is located, using reduced tube voltage and current, at short time intervals after intravenous administration of a small bolus of iodine contrast by an automatic injector at a high flow rate. Using different kinetic-mathematical models allows measurement of certain tissue perfusion parameters, including: blood flow (BF), circulating blood volume (BV), mean transit time (MTT), and vascular permeability (PS or K trans). While results from different CT perfusion software are not comparable, the standardized perfusion value (SPV) is a universal semi-quantitative indicator of tissue perfusion that is independent of the CT perfusion algorithm and can be easily calculated without commercial CT perfusion software. While BF, BV, and PS values are significantly higher in the majority of high-grade malignant tumors compared to low-grade or benign tumors or healthy tissue, MTT is often lower in high-grade tumors. A significant decline in CT perfusion parameter values is a marker of a good response of the neoplasm to the oncological therapy.

Background/Objectives: Postoperative urinary tract infections (UTIs), particularly catheter-associated UTIs (CAUTIs), are potentially preventable complications of colorectal surgery. This study evaluated their incidence, timing, microbiology, antimicrobial resistance, and associated factors among patients undergoing colorectal cancer surgery. Methods: This prospective cohort study included 300 patients undergoing colorectal cancer surgery at a Serbian tertiary hospital. Associations with postoperative UTI, defined according to ECDC criteria, were examined using Firth penalized logistic regression and cause-specific Cox regression, with cumulative catheter exposure modeled as a time-dependent covariate. Results: Nineteen patients (6.3%) developed postoperative UTI, including 17 CAUTIs (89.5%) and two asymptomatic bacteriuria. The incidence rates of all UTIs and CAUTIs were 12.0 (95% confidence interval [CI], 7.2–18.8) and 10.8 (95% CI, 6.3–17.2) per 1000 catheter-days, respectively. Seventeen infections occurred by postoperative day 30, and no additional events occurred after day 45. In the multivariable Firth penalized logistic regression model, cumulative catheter exposure per five catheter-days (adjusted odds ratio [aOR], 1.45; 95% CI, 1.17–1.84), operative duration per 30 min (aOR, 1.59; 95% CI, 1.13–2.21), and preoperative leukocyte count (aOR, 1.20; 95% CI, 1.02–1.42) were associated with UTI. In the primary Cox model, cumulative catheter exposure (adjusted hazard ratio [aHR], 2.66; 95% CI, 2.03–3.50) and operative duration (aHR, 1.60; 95% CI, 1.16–2.21) remained associated with postoperative UTI after adjustment for the other covariates included in the model. Gram-negative organisms predominated, with notable third-generation cephalosporin and carbapenem resistance among Klebsiella–Enterobacter isolates. Conclusions: Most surveillance-defined postoperative UTI events were symptomatic and catheter-associated. Greater cumulative catheter exposure and longer operative duration showed consistent associations with UTI across exploratory models. These findings support careful review of catheter necessity but require confirmation in larger cohorts.