Background: Malignant tumors represent a significant pathology with a profound global impact on the medical system. The fight against cancer represents a significant challenge, with multidisciplinary teams identifying numerous areas requiring improvement to enhance the prognosis. Facilitating the patient’s journey from diagnosis to treatment represents one such area of concern. One area of research interest is the use of various biomarkers to accurately predict the outcome of these patients. A substantial body of research has been conducted over the years examining the relationship between C-reactive protein (CRP) and malignant tumors. The existing literature suggests that combining imaging diagnostic modalities with biomarkers, such as CRP, may enhance diagnostic accuracy. Methods: A systematic review was conducted on the PubMed and Web of Science platforms with the objective of documenting the interrelationship between CRP value and tumor grading for malignant tumors. After the application of the exclusion and inclusion criteria, 17 studies were identified, published between 2002 and 2024, comprising a total of 9727 patients. Results: These studies indicate this interrelationship for soft tissue sarcomas and for renal, colorectal, esophageal, pancreatic, brain, bronchopulmonary, ovarian, and mesenchymal tumors. Conclusions: Elevated CRP levels are correlated with higher grading, thereby underscoring the potential utility of this biomarker in clinical prognostication.

Background: Mucormycosis is a rapidly progressive and often fatal invasive fungal infection requiring immediate suspicion-driven diagnosis and treatment, particularly in immunocompromised patients. We report the first documented case of rhino-sino-orbital mucormycosis in a patient with recurrent intrahepatic cholangiocarcinoma and summarize our single-centre experience with eight cases of mucormycosis in oncohematologic patients. Methods: A 50-year-old woman developed rhino-sino-orbital mucormycosis after multimodal treatment for recurrent cholangiocarcinoma. Because of high clinical suspicion, imaging was performed before microbiological confirmation and antifungal therapy was initiated immediately through multidisciplinary management. Results: The patient survived 16 years after the initial cancer diagnosis, seven years after recurrence, and two years following mucormycosis. Our institutional series included eight cases with rhino-sino-orbital, pulmonary, cutaneous, and urinary tract involvement, most diagnosed after 2020, highlighting heterogeneous presentations and breakthrough infection despite prior antifungal exposure. Clinical experience gained from these cases contributed to early recognition and successful management of the present patient. Conclusions: To our knowledge, this is the first reported case of mucormycosis in cholangiocarcinoma. These findings emphasize that mucormycosis should be considered a medical emergency in patients with hematologic malignancies or solid tumors, and antifungal therapy should be initiated based solely on clinical suspicion without waiting for microbiological confirmation, even in atypical presentations.

Background: The neutrophil-to-lymphocyte ratio (NLR) has been the focus of extensive research in recent years as an inexpensive inflammatory biomarker with prognostic value in oncology, but its relationship with tumor grade across solid malignancies remains uncertain. Methods: This systematic review evaluated original clinical studies reporting the association between peripheral blood NLR and histological tumor grade in solid tumors. PubMed and Web of Science were searched using Boolean strategies, and eligible full-text studies were synthesized qualitatively because of heterogeneity in tumor type, grading system, NLR threshold, and statistical reporting. Results: The qualitative synthesis included 13 retrospective primary studies comprising 5394 patients. Eight studies reported statistically significant associations between higher NLR and higher tumor grade or poorer differentiation, most consistently in bladder cancer and in single studies of prostate cancer, soft tissue sarcoma, renal cell carcinoma, pancreatic cancer, breast cancer, and colorectal cancer with synchronous liver metastases. Four studies reported no statistically significant grade-related association, mainly in heterogeneous breast cancer and ovarian cancer cohorts, whereas a small colorectal adenocarcinoma cohort study showed a non-significant positive trend. Conclusions: The available evidence suggests a possible relationship between systemic inflammation and tumor grade in selected malignancies, but the evidence remains preliminary, tumor-specific, retrospective, and vulnerable to confounding. NLR should not be interpreted as a surrogate for histological grade.