Osteosarcoma (OSA) is the most common primary bone tumor in dogs and cats, and accurate diagnosis of OSA has therapeutic and prognostic implications. Immunohistochemistry targeting osterix (Osx), a transcription factor expressed in osteoblasts, was applied to 80 canine samples (40 OSAs and 40 controls (8 chondrosarcomas, 8 fibrosarcomas, 8 hemangiosarcomas, 8 histiocytic sarcomas, and 8 malignant melanomas)) and 40 feline samples (20 OSAs and 20 controls (5 fibrosarcomas, 5 hemangiosarcomas, 5 chondrosarcomas, 3 malignant melanomas, and 2 histiocytic sarcomas)), diagnosed histologically. All 120 samples were assessed blinded using a previously established semiquantitative scoring and classification system. In dogs, 37/40 OSAs (true positives, sensitivity 92.5%) and 2/40 controls (false positives, specificity 95.0%) were classified as OSA. In cats, 14/20 OSAs (true positives, sensitivity 70.0%) and 5/20 controls (false positives, specificity 75.0%) were classified as OSA. Tumors most often "misclassified" as OSAs were chondrosarcomas in both dogs (2/8) and cats (4/5). In 4 cases for which paired decalcified and nondecalcified samples of the same OSA were available, decalcification of OSAs did not affect classification. Quiescent canine, feline, and murine osteoblasts and canine reactive, metaplastic, and non-OSA neoplastic osseous conditions were also tested and demonstrated Osx immunoreactivity; avian and piscine osteoblasts did not. In conclusion, Osx is a highly sensitive and specific marker of canine OSA and a moderately sensitive and specific marker of feline OSA. The diagnostic algorithm applied in this study is a useful adjunctive tool in the diagnosis of canine OSA.
The aim of this study was to ascertain the clinical features that facilitate the differentiation of malignant melanoma of the skin (MM) from suspicious benign skin lesions (SBSLs). From December 2021 to February 2026, a database of 126 excised skin lesions (ESLs) was generated including 106 cases of SBSLs, 13 of non-nodular melanomas (NNMs), and seven of nodular melanomas (NMs). The ESLs were evaluated according to the ABCDE criteria, the 7-PCL scale, and other clinical signs of suspected MM, such as the ugly duckling sign. Fisher's exact test, revealed that, in comparison to SBSLs, all MM cases exhibited a higher propensity for evolution in size, shape or color within six months (p<0.001), firm to touch (p=0.002), rapid growth within six weeks/atypical skin lesion de novo (p<0.001), inflammation (p=0.034), oozing or crusting (p=0.004), and sensory changes including itching (p=0.023). In Firth's penalized logistic regression, for NNMs alone, no clinical feature exhibited a statistically significant higher frequency compared to SBSLs. In multivariate analysis, rapid growth within six weeks/atypical skin lesion de novo was the only clinical feature statistically more frequent in NMs alone than SBSLs [odds ratio (OR)=14.71, 95% confidence interval (CI)=1.02-2583, p=0.049] and in all MM cases compared to SBSLs (OR=4.83, 95%CI=1.04-27.29, p=0.045). Rapid lesion growth within six weeks/atypical skin lesion de novo represents the primary independent clinical feature distinguishing MM from SBSLs. Conversely, standard structural metrics like a diameter greater than 6 mm fail to provide a statistically reliable differentiation between MM and SBSLs during initial clinical inspection in multivariate analysis.
Cutaneous and mucosal melanoma are biologically and clinically distinct malignancies whose epidemiology varies markedly across populations and skin phototypes. In Arab and other Eastern Mediterranean populations, melanoma is comparatively uncommon but is frequently diagnosed at an advanced stage and shows a relatively high proportion of acral and mucosal subtypes. Data describing melanoma in the Palestinian population are scarce. We characterised the clinicopathological profile of cutaneous and mucosal melanoma diagnosed at a large Palestinian diagnostic pathology service and placed the findings in a comparative regional context. We performed a retrospective review of all histopathologically confirmed cases of cutaneous and mucosal melanoma reported at Medicare Diagnostic Laboratories, West Bank, Palestine, between May 2008 and May 2026. Demographic variables (age, sex), anatomical site, melanoma subtype, depth of invasion (Clark level), and, where recorded, Breslow thickness and American Joint Committee on Cancer (AJCC) stage were abstracted from pathology records. Diagnoses were confirmed on haematoxylin-eosin sections supported by immunohistochemistry (S100, SOX10, HMB-45, Melan-A). Repeat specimens were consolidated to the patient level, and findings were compared with published series from neighbouring countries. Fifty-seven patients with primary melanoma were identified, comprising 47 cutaneous (82.5%) and 10 mucosal (17.5%) tumours. The mean age at diagnosis was 59.5 +/- 17.0 years (range 10-87), and there was a slight female predominance (30 women, 52.6%; male-to-female ratio 0.90:1). Acral sites (sole, heel, plantar, and subungual regions) accounted for 15 of 47 cutaneous melanomas (31.9%), the most common single location, followed by the head and neck (14, 29.8%). Among mucosal tumours, the anorectum was the predominant site (6 of 10, 60%). A histological subtype was explicitly recorded in only 19 of 57 cases; within this limited subset the nodular pattern predominated (18 of 19), although the large proportion of cases without a stated subtype precludes firm conclusions about the true distribution of melanoma subtypes in this cohort. The Clark level was documented in 27 patients, of whom 26 (96.3%) had level IV-V (deep) invasion. A further 17 patients presented with metastatic melanoma deposits without a primary tumour in the archive. Melanoma in this Palestinian cohort was characterised by a slight female predominance, a high proportion of acral (31.9% of cutaneous) and mucosal (17.5% of all primary) tumours, a predominantly nodular phenotype among the subset of cases with a recorded subtype, and deep invasion at diagnosis. This profile mirrors patterns reported in neighbouring Arab and Eastern Mediterranean populations and contrasts with more lightly pigmented (Fitzpatrick I-II) Western populations. The findings underline the need for improved melanoma awareness, routine examination of acral and mucosal sites, and strengthened cancer registration in Palestine.
Live-cell imaging (LCI) of modified T cells co-cultured with cancer cells is commonly used to quantify T cell anti-cancer function. Videos captured by LCI show complex multi-cell behavioral phenotypes that go beyond simple cancer cell fluorescence measurements. Here, we develop an unsupervised analysis workflow to characterize LCI data generated using the Incucyte imaging platform. Unlike most LCI analyses, we avoid cell segmentation due to the low spatiotemporal resolution of the LCI videos and high levels of cell-cell contact. Instead, we develop methods that identify global aggregation patterns and local cellular keypoints to characterize the multicellular interactions that determine cancer cell sensitivity to, or escape from, T cell surveillance. We demonstrate our segmentation-free live-cell behavioral analysis (SF-LCBA) methods on TCR T cells from four donors with varying proportions of cells with a beneficial RASA2 knockout and effector-to-target initial concentrations in a co-culture with A375 melanoma cells. We find that different T cell modifications affect the spatiotemporal dynamics of multicellular aggregate formation. In particular, we show that fewer and smaller cancer cell aggregates form with higher proportions of T cells with the beneficial RASA2 gene knockout in co-culture with A375 melanoma cells. Our SF-LCBA method identifies, characterizes, and tracks cellular aggregate formation in datasets that are unsuitable for cell segmentation and tracking, opening the door to more therapeutically-relevant measurements of modified T cell therapy cell behavioral phenotypes from LCI data.
Deoxynivalenol (DON) has been reported to exhibit skin toxicity and carcinogenic potential; however, its effects on melanoma remain unclear. We integrated network toxicology, single-cell transcriptomic analysis, molecular docking, and publicly available Human Protein Atlas immunohistochemical evidence to investigate the potential toxicological effects of DON on melanoma and identify candidate molecular targets. A total of 5283 DON-related genes were identified from the SwissTargetPrediction, CTD, and SEA databases, and 5101 melanoma-related genes were obtained from the GeneCards, TTD, and OMIM databases. Differentially expressed genes from the GSE15605 dataset were used for intersection validation. After further screening with three machine learning algorithms, MYEF2 was identified as a core target potentially involved in DON-induced melanoma. ROC analysis showed that MYEF2 achieved AUC values above 0.75 in both the training and validation cohorts. Single-cell transcriptomic analysis revealed the expression and distribution of MYEF2 across melanoma cell subtypes. Immune infiltration analysis further showed significant associations between MYEF2 and multiple immune cell populations. Molecular docking supported a stable interaction between DON and MYEF2, and HPA validation confirmed its elevated expression in melanoma. These findings suggest that MYEF2 may represent a candidate molecular target involved in DON-associated melanoma progression, providing a theoretical basis for future studies on the mechanisms and risk assessment of DON exposure.
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To evaluate the diagnostic performance of the CT-based Node-RADS score for assessing metastatic lymph node involvement in patients with cutaneous melanoma and to compare it with short axis and roundness index. This retrospective study included patients with histologically confirmed melanoma who underwent contrast-enhanced CT before sentinel lymph node biopsy. A control cohort of trauma patients free from any condition potentially affecting lymph nodes was included to represent physiological lymph nodes and to address class imbalance. Lymph nodes were independently assessed by two radiologists and re-evaluated after one month; inter- and intra-observer agreement were evaluated using Cohen's kappa. Diagnostic performance was assessed using ROC curve analysis, and AUCs were compared with the DeLong test. A total of 123 lymph nodes were analyzed, of which 55 (45%) were metastatic. Inter- and intra-observer agreement was excellent (κ = 0.84-0.97 and 0.85-0.98, respectively). All imaging features differed significantly between metastatic and non-metastatic lymph nodes (p < 0.001). Node-RADS yielded an AUC of 0.72 (95% CI 0.65-0.79), not superior to the short axis (AUC 0.80; p = 0.13) or long axis (AUC 0.71; p = 0.76), but outperforming the roundness index (AUC 0.60; p = 0.008). The short axis showed the highest discriminatory performance. Node-RADS showed high specificity (0.96) but low sensitivity (0.47), with 40% of low-risk nodes resulting metastatic. On multivariable analysis, only shape was independently associated with metastatic involvement (OR 6.69; p = 0.006). Node-RADS does not outperform short-axis measurement and shows limited sensitivity in subclinical nodal disease, highlighting the need for advanced detection approaches.
Keratinocytes, the dominant cell type in the melanoma microenvironment during tumor initiation, exhibit diverse effects on melanoma progression. Using a zebrafish model of melanoma and human cell co-cultures, we observed that keratinocytes undergo an epithelial-mesenchymal transition (EMT)-like transformation in the presence of melanoma, reminiscent of their behavior during wound healing. Surprisingly, overexpression of the EMT-transcription factor Twist in keratinocytes led to improved overall survival in zebrafish melanoma models, despite no change in tumor initiation rates. This survival benefit was attributed to reduced melanoma invasion, as confirmed by human cell co-culture assays. Single-cell RNA-sequencing revealed a unique melanoma cell cluster in the Twist-overexpressing condition, exhibiting a more differentiated, less invasive phenotype. Further analysis nominated homotypic jam3b-jam3b and pgrn-sort1a interactions between Twist-overexpressing keratinocytes and melanoma cells as potential mediators of the invasive restraint. Our findings suggest that EMT in the tumor microenvironment may paradoxically limit melanoma invasion through altered cell-cell interactions.
Skin cancer remains one of the most prevalent malignancies worldwide, with increasing incidence rates for both melanoma and non-melanoma subtypes. In this context, nanotechnology-based phototherapies have emerged as promising therapeutic strategies. This systematic review aimed to analyze the therapeutic potential of metallic nanoparticles (MNPs) for photodynamic therapy (PDT) and photothermal therapy (PTT) in skin cancer treatment. Three databases were consulted-Scopus, Web of Science, and PubMed; the studies were transferred to the Zotero software, where they were analyzed by the authors according to the predefined inclusion and exclusion criteria. Most of the studies found focus on melanoma. In vitro findings demonstrated significant reductions in cell viability following combined MNPs and near-infrared (NIR) irradiation, predominantly mediated by apoptosis and associated with increased reactive oxygen species (ROS) levels and temperature elevation (△T). In vivo studies confirmed enhanced tumor suppression with combined therapy compared to isolated treatments. Although temperature increments were lower in vivo than in vitro, therapeutic efficacy remained significant. Safety assessments indicated no relevant changes in body weight or histopathological alterations in major organs, suggesting low systemic toxicity. Collectively, ROS generation and photothermally induced hyperthermia represent key mechanisms driving tumor regression. Therefore, MNPs thus emerge as promising and biocompatible photoactive agents for skin cancer treatment with NIR association.
Skin cancer is the most common malignancy in the United States; however, regional variation in patient demographics, socioeconomic factors, and stage at diagnosis remains incompletely characterized. Defining these disparities is essential to inform targeted prevention and early detection strategies. We performed a cross-sectional analysis of the National Cancer Database (NCDB), including patients diagnosed with skin cancer between 2004 and 2020. Patients were stratified into six United |States geographic regions based on reporting facility location. Demographic, socioeconomic, and clinical variables, including age, sex, race and ethnicity, insurance status, income, urban-rural residence, and American Joint Committee on Cancer (AJCC) stage, were analyzed descriptively. Among 1,048,575 patients (mean age, 70.8 years; 60.3% male), notable regional differences were observed. White patients were 92.5% of the cohort, with the highest representation in the Mountain region (96.2%), whereas Black patients were most prevalent in the Southeast (8.6%). Socioeconomic disparities varied by region; uninsured rates were highest in the Southwest (3.2%) and Southeast (2.1%), while lower-income households predominated in these regions (81.4% and 71.8%). In contrast, higher-income patients were most common in the Northeast (54.7%). The proportion of advanced-stage (III-IV) disease was highest in the Mountain (29.9%) and Pacific (27.6%) regions and lowest in the Midwest (22.0%). Geographic disparities in socioeconomic conditions and healthcare access are associated with variation in stage at diagnosis among patients with skin cancer. These findings highlight the role of structural barriers in delayed presentation and support the need for targeted interventions, including improved insurance coverage, expanded access to dermatologic care, and enhanced early detection strategies, to improve equity in outcomes.
To report a case of benign conjunctival and corneal epithelial hyperpigmentation associated with long-term osimertinib use. observational case report. An incidental finding of bilateral benign hyperpigmentation of the conjunctiva and corneal epithelium was noted in an Asian woman in her sixth decade. Pigmentation involved the caruncle and extended to the lid margins in both eyes. Her medical history is significant for an 8-year history of non-small-cell lung cancer, for which she has been treated with osimertinib for 4 years. An incidental finding of bilateral benign hyperpigmentation of the conjunctiva and corneal epithelium was noted in an Asian woman in her sixth decade. Pigmentation involved the caruncle and extended to the lid margins in both eyes. Her medical history is significant for an 8-year history of non-small-cell lung cancer, for which she has been treated with osimertinib for 4 years. Although rare, recognizing osimertinib-associated hyperpigmentation is clinically important as it needs to be differentiated from primary acquired melanosis, which carries a risk of progression to conjunctival melanoma.
[This retracts the article DOI: 10.1007/s00500-022-07406-z.].
Melanoma remains a highly aggressive malignancy with limited response to current immunotherapies due to its immunosuppressive tumor microenvironment. To overcome this limitation, we developed a radiolabeled coordination polymer, 177Lu-GAMP, through the self-assembly of 177Lu3+ with adenosine monophosphate (AMP) and guanosine monophosphate, exhibiting coordination-feature resemblance to the endogenous STING agonist cGAMP, thereby enabling activation of the STING pathway. We further incorporated 177Lu-GAMP into a dissolvable microneedle patch (177Lu-GAMP@MN) for localized, minimally invasive delivery to melanoma lesions. Our results demonstrate that 177Lu-GAMP@MN effectively penetrated the skin and retained at the tumor site, leading to robust STING activation and Gasdermin E-mediated pyroptosis. This, in turn, promoted dendritic cell maturation and enhanced T cell infiltration. In vivo, 177Lu-GAMP@MN significantly suppressed subcutaneous melanoma growth, prolonged survival, and elicited strong antitumor immune responses. When combined with anti-PD-L1 monoclonal antibodies, the treatment achieved synergistic tumor regression, improved effector T cell function, and induced durable immunological memory, demonstrating significant inhibition of both primary and distant tumors in murine models. Collectively, this work presents a transdermal brachytherapeutic-immunomodulatory strategy for melanoma treatment, offering promising potential for enhanced antitumor immunotherapy.
Cutaneous malignant melanoma (cMM) incidence continues to rise. AJCC staging provides broad prognostic estimates, potentially leading to overtreatment in early-stage disease. AMBLor™ is a validated IHC-based biomarker that identifies non-ulcerated AJCC stage I/II cMM at lower risk of progression. To obtain consensus on clinical and service challenges in early-stage cMM care and how AMBLor™ could be integrated into decision-making at critical points in the care pathway. A four-round modified e-Delphi survey was conducted. Twenty-five UK skin specialist MDT consultants participated in Round 1, with 15 completing all rounds. Rounds 1-2 explored challenges and potential biomarker use cases; Rounds 3-4 assessed the impact of an AMBLor™ low-risk result on key management scenarios including SLNB, adjuvant therapy, imaging, and follow-up. Consensus was defined as strong (≥75%) or moderate (50-74%) agreement. Strong consensus emerged for biomarker utility in: targeting radiological surveillance to higher-risk patients (100%), reducing follow-up for lower-risk patients (100%), prioritising adjuvant therapy for highest-risk cases (95%), and improving SLNB selection (91%). With an AMBLor™ low-risk result, moderate consensus supported not offering SLNB for pT1b melanoma (66%), not offering adjuvant therapy for stage IIB melanoma (72%) and reducing intensity of both CT surveillance for stage IIB melanoma (50%) and clinical surveillance for stages IA-IIA (50-56%). The e-DAM study demonstrates expert consensus that AMBLor™ could augment clinical decision making at key junctures in the cMM care pathway by refining SLNB selection, rationalising adjuvant therapy and imaging, and reducing follow-up burdens - enhancing personalised care, whilst alleviating service pressures.
Extracellular vesicles (EVs) are emerging as promising vehicles for cancer immunotherapy, yet the molecular determinants of their immunogenicity remain poorly defined. While PD-L1 expression on cancer-derived EVs has been shown to suppress immune responses, its role on immunotherapeutic EVs remains unexplored. In this study, we investigated how eliminating PD-L1 from antigen-loaded bone marrow-derived dendritic cell (BMDC) EVs affects the efficacy of EV-based cancer vaccines. We generated and characterized ovalbumin (OVA)-loaded BMDC EVs from wild-type (WT) and PD-L1-/- C57BL/6 mice. EVs were administered intravenously into WT mice in immunization experiments and in therapeutic and prophylactic B16 OVA-secreting melanoma models. Immune responses were assessed by flow cytometry, ELISpot, and ELISA, and tumour growth was monitored. Proteomic analysis confirmed high EV purity and similar protein profiles between WT and PD-L1-/- EVs, with PD-L1 being the major difference. Functionally, PD-L1-/- EVs induced significantly stronger anti-tumour responses in vivo, particularly in the prophylactic setting. Mice treated with PD-L1-/- EVs showed increased CD8+ T cell tumour infiltration, enhanced IFNγ secretion, and higher tumour rejection rates compared to WT EVs (72.7% vs. 37.5%). Additionally, the frequency of tumour-infiltrating, antigen-specific CD8+ T cells was significantly higher in PD-L1-/- EV-treated mice. In summary, BMDC-derived EVs loaded with antigen are potent immune stimulators, and removal of immune checkpoint molecules such as PD-L1 further enhances their immunogenicity. These findings support the development of engineered EVs as improved platforms for cancer immunotherapy.
Melanoma is one of the most lethal cancers in the clinic; cationic peptides have shown great potential in the treatment of melanoma. The large pore volume and high specific surface area of mesoporous silica nanoparticles (MSNs) allow for efficient loading of drugs, while surface-functionalized MSNs can further improve drug stability and carrier targeting. Polydopamine (PDA) coating is an effective surface modification method that provides an additional protective layer to prevent premature drug release during delivery and can prolong the treatment time. Hyaluronic acid (HA) is a commonly used tumor-targeting molecule that binds to HA receptors on the surface of tumor cells, thereby facilitating drug internalization and enhancing the therapeutic effect of the drug. In this paper, the cationic short peptide RKIIIRW, which can effectively inhibit B16F10 cells, was successfully screened by solid-phase synthesis combined with MTT assay and cell membrane chromatography. By combining the cationic short peptide RKIIIRW with MSNs and further surface modification with PDA coating and HA targeting molecules, a nanodrug delivery system with targeted and controllable release characteristics was prepared. This drug-delivery system enhances the efficacy of cationic short peptides while minimizing side effects, offering a more effective therapeutic strategy for melanoma.
Radiotherapy is a cornerstone of cancer therapy but is often undermined by tumor radioresistance arising from insufficient generation of reactive oxygen species (ROS) and limited DNA damage. Cuproptosis-a newly identified form of copper-dependent cell death-offers an innovative, yet untapped, approach to enhance radiosensitivity. Here, we report a first-of-its-kind copper-doped metal-organic framework nanoplatform, based on a ZIF-8 framework and loaded with the copper ionophore elesclomol, to concurrently induce cuproptosis and amplify radiotherapy. This nanoplatform (Cu-MOF@ELS) efficiently shuttles copper into cancer cell mitochondria, triggering excessive reactive oxygen species (ROS) production and mitochondrial dysfunction that synergize with radiation to promote extensive DNA damage. We demonstrate that Cu-MOF@ELS strongly induces cuproptosis in tumor cells and significantly boosts radiotherapeutic efficacy in vitro and in vivo, with treated mice showing pronounced tumor regression and minimal systemic toxicity. Our work pioneers a novel therapeutic paradigm by integrating cuproptosis induction with radiotherapy, establishing Cu-MOF@ELS as a groundbreaking radiosensitizer that exploits metabolic cell-death mechanisms to overcome tumor radioresistance.
Hypopigmentation disorders are characterized by impaired melanogenesis and remain challenging to manage due to limited efficacy of current interventions and insufficient mechanistic insights. Natural products represent a valuable source of bioactive phytoconstituents capable of regulating key pathways involved in melanin synthesis. Despite its extensive traditional use and diverse pharmacological activities, Tinospora cordifolia and its major bioactive constituent tinosporide remain unexplored for their role in melanogenesis. The present study aimed to evaluate the melanogenesis-promoting potential of bioactive phytoconstituents isolated from Tinospora cordifolia, and to elucidate their underlying molecular mechanisms. Four phytoconstituents-columbin, tinosporide, 8-hydroxy tinosporide and ecdysterone-were isolated and structurally characterized from T. cordifolia. Their melanogenic potential was evaluated in murine (B16F10) and human (SK-MEL-2) melanoma cells by assessing melanin content, tyrosinase activity, and expression of melanogenesis-associated genes. Intracellular cAMP levels and associated signalling pathways were further analysed to investigate the mechanism of action. Among the isolated compounds, tinosporide exhibited the most pronounced melanogenic activity, significantly increasing melanin synthesis and tyrosinase activity. Tinosporide promotes nuclear localization of the microphthalmia-associated transcription factor (MITF), leading to upregulation of MITF-target genes, including Trp1, Tyr, Dct, Pmel, and Mlana. Furthermore, mechanistic studies revealed that tinosporide elevated intracellular cAMP levels and induced the phosphorylation of PKA and CREB, thereby activating cAMP/PKA/CREB signalling pathway. Pharmacological inhibition of PKA and CREB markedly attenuated tinosporide-induced melanogenesis, confirming the essential role of the cAMP/PKA/CREB-MITF axis. Collectively, these findings identify tinosporide as a promising natural melanogenic agent derived from Tinospora cordifolia and highlight its potential relevance in the development of plant-based interventions for hypopigmentation disorders.
To evaluate the clinical performance of ultra-widefield swept-source optical coherence tomography (UWF-OCT) in the assessment of choroidal tumors and to compare it with ultrasonography (US), spectral-domain (SD)-OCT, and magnetic resonance imaging (MRI). Retrospective diagnostic comparison. Thirty-nine eyes from 39 patients diagnosed with choroidal tumors at a single tertiary referral center. This retrospective diagnostic comparison evaluated patients diagnosed with choroidal tumors at a single tertiary referral center between January 2023 and August 2025. All patients underwent UWF-OCT imaging at diagnosis. Tumor measurements obtained with UWF-OCT were compared with US, SD-OCT, and MRI. Comparative analysis among imaging modalities and predictors affecting UWF-OCT applicability was performed. Tumor thickness (mm) and largest basal diameter (LBD, mm) measurements, and complete measurability rate across different tumor size categories. Thirty-nine eyes from 39 patients (mean age 59.2±16.9 years) were analyzed, including 27 choroidal melanomas (69.2%), 5 metastatic tumors (12.8%), 4 hemangiomas (10.3%), 2 osteomas (5.1%), and 1 (2.6%) indeterminate choroidal melanocytic lesion. UWF-OCT successfully measured both tumor thickness and largest basal diameter (LBD) in 100% (31/31) of small and medium choroidal tumors, substantially outperforming SD-OCT (complete measurement achieved in 63.6% of small tumors, and 0% of medium or large tumors). UWF-OCT measurements were systematically smaller than ultrasonography (thickness: -32.3%, P<0.01; LBD: -11.1%, P<0.01) and MRI (thickness: -29.2%, P<0.01). Mushroom-shaped tumor morphology was the strongest negative predictor of UWF-OCT quality (OR=0.015, 95% CI 0.001-0.196, P<0.01). UWF-OCT's complete measurability was limited in large tumors (12.5%, 1/8). UWF-OCT provides precise, noninvasive, single-scan assessment of small-to-medium choroidal tumors with detailed structural visualization. It may be particularly useful for dome-shaped tumors, while multimodal imaging with US and MRI remains optimal for complex morphologies. Overall, UWF-OCT represents a valuable tool for diagnosis and treatment planning, with potential utility for longitudinal follow-up in choroidal tumor management.
Immune checkpoint inhibitors (ICIs) improve outcomes across multiple cancers but may cause immune-related adverse events, including ICI-induced diabetes (ICI-D). ICI-D typically presents abruptly with severe insulin deficiency, and published cases have largely described irreversible loss of endogenous insulin secretion. We report a novel case of clinical and biochemical recovery of ICI-D. Following melanoma treatment with ipilimumab plus nivolumab, then nivolumab monotherapy, the patient developed abrupt-onset symptomatic hyperglycemia with mild ketosis and positive GAD and insulin autoantibodies, consistent with ICI-D. The patient subsequently received infliximab for ICI-related arthritis. Insulin requirements progressively declined, allowing discontinuation of insulin therapy. GAD antibodies normalized within ∼2 months and later became undetectable. Urine C-peptide-to-creatinine ratios increased over time, consistent with endogenous insulin secretion. Recovery from ICI-D may occur. The temporal association suggests infliximab may have contributed, warranting further study as a potential disease-modifying therapy.