Gastroblastoma is an extremely rare stomach tumor that primarily presents in adolescent and early adulthood, with a biphasic cell morphology of epithelioid and spindle cells. In light of its similarity to other childhood blastomas, it has been named gastroblastoma. Few patients showed a potential of metastasis and recurrence, however, most of the reported cases were alive, with no evidence of the disease after surgical treatment. Commonly, MALAT1-GLI1 fusion has been considered to be the most relevant mutation. Herein, we present a case of an asymptomatic 58-year-old man who happened to find a submucosal gastric mass during a gastroscope and received endoscopic submucosal excavation (ESE). He turned out to have a gastroblastoma with a novel PTCH1::GLI2 fusion confirmed by Sanger sequencing. The patient was discharged two days after ESE without any complication and was recurrence-free during his one-year follow-up. According to the previous literature and our own experience, in cases with characteristic histopathology and immunohistochemistry patterns, a diagnosis of gastroblastoma should be considered even without a MALAT1-GLI1 fusion. Gastroblastoma pursues a favorable clinical outcome and endoscopic therapy could be an effective alternative treatment choice.

Background: Rectal neuroendocrine tumors (NETs) ≤ 10 mm are commonly managed by endoscopic resection. However, the optimal technique remains controversial. We aimed to compare the efficacy and safety of a simplified endoscopic mucosal resection (sEMR) technique, performed without submucosal injection, with conventional endoscopic submucosal dissection (ESD) for small rectal NETs. Methods: This retrospective, single-center study included 74 patients with histologically confirmed rectal NETs ≤ 10 mm treated with sEMR (n = 37) or ESD (n = 37) between January 2022 and January 2025. Patients in the ESD group were matched 1:1 by age and gender. Baseline characteristics, procedural outcomes, histopathologic findings, and cost were analyzed. The primary outcome was histological complete resection (R0) rate; secondary outcomes included en bloc resection, intraoperative bleeding, tumor-to-margin distance, operation time, and material costs. Results: The R0 resection rate was significantly higher in the sEMR group compared to the ESD group (91.9% vs. 67.6%; p = 0.019). Tumor-to-margin distance was also significantly greater in the sEMR group [median (IQR): 0.2 (0.1–0.3) mm vs. 0.1 (0–0.2) mm; p = 0.024]. Intraoperative bleeding was less frequent in the sEMR group (2.7% vs. 21.6%; p = 0.028). Median operation time (409 vs. 1469 s; p < 0.001) and material cost (1486 vs. 6390 CNY; p < 0.001) were both significantly lower in the sEMR group. Conclusions: Compared with ESD, the simplified EMR technique without submucosal injection demonstrated higher R0 resection rates, lower bleeding risk, shorter operation time, and lower costs for small rectal NETs. sEMR may offer a safe, efficient, and cost-effective alternative in selected patients.

Rationale: Amebic colitis has been less prevalent in recent times in China, and the similarity of its symptoms to those of inflammatory bowel disease (IBD) results in the difficulty of early identification and diagnosis. Patient concerns: A 31-year-old male who exhibited intermittent diarrhea and hematochezia was highly suspected as IBD initially. Despite the partial relief of symptoms following the administration of mesalamine, the endoscopic ulcers remained largely unchanged. Diagnoses: Two years after the onset of mesalamine therapy, amebic cysts were detected in stool microscopy and trophozoites were found on the surface of cecal ulcers. The patient was then diagnosed with amebic colitis. Interventions: After 2 rounds of standardized metronidazole treatment, amebic colitis remained refractory until diloxanide was administered. Outcomes: The patient remained asymptomatic, and the mucosa of colon was normal during the annual follow-up. Lessons: Individuals newly diagnosed with IBD should undergo essential screening for amebiasis. And the use of steroids should be taken with caution, especially in cases where the effect of mesalamine is limited. For symptomatic intestinal amebiasis, even after the administration of tissue amebicides, the continued use of luminal amebicides is necessary to prevent recurrence.

Background: Primary hyperparathyroidism (PHPT) is an uncommon but clinically significant cause of acute pancreatitis (AP). Its clinical course and prognosis remain inadequately characterized compared to common AP etiologies. Methods: A bibliometric analysis was performed to evaluate global research trends on PHPT-associated acute pancreatitis (PHPT-AP). We conducted a retrospective cohort study at Peking Union Medical College Hospital between 2000–2025. Clinical data were compared with patients with biliary and hypertriglyceridemia-induced AP. Subgroup analyses evaluated differences between PHPT with mild/moderately severe AP and severe AP (SAP), and between AP and chronic pancreatitis (CP). Statistical analyses included logistic regression and Mann–Whitney U tests. Results: The bibliometric results revealed limited literatures but increasing attention to PHPT-pancreatitis. Our cohort showed PHPT-AP patients exhibited worse outcomes compared to non-PHPT-AP, with higher risks of SAP (OR 3.73, 95% CI 1.28–10.86, P = 0.016), intensive care unit admission (OR 3.79, 95% CI 1.17–12.32, P = 0.027), and in-hospital mortality (OR 12.76, 95% CI 1.52–107.3, P = 0.019). Serum calcium (median 4.2 mmol/L vs. 3.5 mmol/L, P = 0.015) and parathyroid hormone (median 1514.0 pg/mL vs. 312.0 pg/mL, P = 0.007) were significantly higher in PHPT-SAP. A three-phase calcium trajectory was observed in SAP: an initial hypercalcemic phase, a plateau under therapy, and eventual normalization after surgical or extracorporeal interventions. PHPT-CP was associated with longer PHPT duration, recurrent AP, and higher diabetes prevalence. Conclusion: PHPT-AP is associated with a worse prognosis and requires proactive management. Serum calcium correlates with severity and should be monitored dynamically. Early surgery or continuous veno-venous hemofiltration may be warranted in severe cases. Prolonged PHPT with recurrent AP and lifestyle risk factors may contribute to CP.

Altered neutrophil infiltration and function are associated with the deterioration of acute pancreatitis (AP) and even AP-associated lung injury. Although CD177 is a marker of neutrophil activation, its role in AP remains largely unknown. To determine whether ablation of Cd177 could deteriorate colonic barrier dysfunction, changes in the gut microbiota, and AP-associated lung injury, Cd177 knock-out (KO), Cd177 conditional knock-out (cKO) in circulating neutrophils and pseudo-germ-free (antibiotic therapy, or ABX-treated) mouse models were used in this study. AP was induced in mice through injection of sodium taurocholate retrogradely into the pancreatic duct, then peripheral blood, pancreas, lung, colon tissues and fecal samples were collected at 24 h after induction, respectively. The mRNA and protein expression of certain genes and gut microbiota of mice were measured. Results indicated that both Cd177 KO and cKO increased serum amylase and lipase levels, exacerbated pathological damage, and impaired the integrity of the colonic mucosal barrier in AP mice, suggesting a protective role of neutrophil-derived CD177 in AP progression. In addition, ABX-treated mice alleviated AP-associated lung injury, demonstrating that gut microbiota dysbiosis may contribute to the deterioration of phenotypes. Moreover, ablation of Cd177 was associated with reduced abundance of gut microbiota species g_Atopostipes, downregulated Nos1ap expression in the lung and Sorbs1 expression in the colon, consequently aggravating the damage of colon and lung of mice with AP. It is concluded that Cd177⁺ neutrophils may ameliorate AP-associated lung injury through protecting colonic barrier and modulating certain gut microbiota and associated genes in mice.