Thyroid is at the crossroads of immune dysregulation, tissue remodeling and oncogenesis. Autoimmune disorders, nodular disease and cancer of the thyroid affect a large amount of general population, mainly women. We wondered if there could be a common factor behind three processes (immune dysregulation, tissue remodeling and oncogenesis) that frequently affect, sometimes coexisting, the thyroid gland. The long pentraxin 3 (PTX3) is an essential component of the humoral arm of the innate immune system acting as soluble pattern recognition molecule. The protein is found expressed in a variety of cell types during tissue injury and stress. In addition, PTX3 is produced by neutrophils during maturation in the bone-marrow and is stored in lactoferrin-granules. PTX3 is a regulator of the complement cascade and orchestrates tissue remodeling and repair. Preclinical data and studies in human tumors indicate that PTX3 can act both as an extrinsic oncosuppressor by modulating complement-dependent tumor-promoting inflammation, or as a tumor-promoter molecule, regulating cell invasion and proliferation and epithelial to mesenchymal transition, thus suggesting that this molecule may have different functions on carcinogenesis. The involvement of PTX3 in the regulation of immune responses, tissue remodeling and oncosuppressive processes led us to explore its potential role in the development of thyroid disorders. In this review, we aimed to highlight what is known, at the state of the art, regarding the connection between the long pentraxin 3 and the main thyroid diseases i.e., nodular thyroid disease, thyroid cancer and autoimmune thyroid disorders.

Objective: Evaluate the technical development and long-term outcomes of Parenchymal-sparing One-Stage Hepatectomy (POSH) for colorectal liver metastases (CLM). Summary Background Data: For multiple bilobar CLM, two-stage hepatectomy (TSH) is suggested, with liver transplant proposed for unresectable cases. In this context, POSH showed effectiveness. Methods: A prospective cohort of patients with ≥4 bilobar CLM (2004-2023) was analyzed using an intention-to-treat approach. POSH patients were classified by surgical margin. The primary endpoint was the technique evolution in terms of complexity, feasibility and indications; secondary endpoints included POSH oncological validity, safety, and survival. Results: Of 407 patients, 388 underwent POSH, 17 TSH. Resection area-to-tumor number ratio improved from 0.67 (2004-2007) to 0.41 (2020-2023, P=0.024), eliminating TSH after 207 POSH cases. Among POSH cases: 105 (27.4%) were R0, 153 (39.9%) R1p (tumor-parenchymal exposure), 37 (9.7%) R1v (tumor-vessel detachment), and 88 (23.0%) R1vp (vascular/parenchymal exposure). R1v had outcomes comparable to R0, while R1p had worse OS, RFS, and local recurrence (P<0.05). R1vp showed intermediate outcomes. Tumor size (HR 1.071, P=0.002), primary tumor nodal status (HR 1.695, P=0.005), and R1p margin (HR 1.481, P=0.024) predicted OS. Major complications occurred in 9.3%, 90-day mortality was 0.8%. Redo-hepatectomy was feasible in 93 of 122 (76.2%) patients with intrahepatic recurrence, providing a significant 5-year OS benefit. Conclusions: POSH is effective for bilobar CLM. Advancements in tumor clustering eliminated the need for TSH even in complex cases. R1v outcomes confirm the validity of vascular detachment.

Mesorectal lipoma is a rare, usually asymptomatic tumor. The best treatment is R0 resection but the previous literature reports different approaches. Robotic surgery allows for an accurate intervention, with a faster postoperative course, less risk of infection and need for transfusions, a faster return to normal daily activities and the best esthetic result. We describe a case of a 43-year-old female with a large lipoma with dislocation of the vagina, rectum and distal sigmoid colon, potentially malignant, successfully treated by robotic excision, which was safe, effective and well tolerated by the patient.