Introduction: The purpose of this paper is to study the type, the clinical presentation, and the best diagnostic methods for pleural solitary fibrous tumors (PSFTs), as well as to evaluate which is the most appropriate treatment, especially as PSFTs represent a rare occurrence in the thoracic pathology. Material and Method: A retrospective study was conducted on a group of 45 patients submitted to surgery between January 2015 and December 2019. In most cases, the diagnosis was established through imaging studies—thoracic computed tomography (CT) scan with or without contrast—but also using magnetic resonance imaging (MRI) or positron emission tomography (PET) scans when data from CT scans were scarce. All patients were submitted to surgery with curative intent. Results: Most patients included in this study were asymptomatic, with this pathology being more common in patients over 60 years of age, and more common in women. The occurrence of malignant PSFT in our study was 17.77% (8 cases). All cases were submitted to surgery with curative intent, with a single case developing further recurrence. In order to achieve complete resection en bloc resection of the tumor with the chest wall, resection was performed in two cases, while lower lobectomy, pneumectomy, and hemidiaphragm resection, respectively, were needed in each case. Postoperative mortality was null. Conclusion: Thoracic CT scan remains the most important imagistic investigation in diagnosing. MRI is superior to thoracic CT, especially in cases that involved the larger blood vessels within the thorax, spinal column, or diaphragm. Complete surgical resection is the gold standard in treatment of PSFT, and the prognosis in benign cases is very good.

Androgenetic alopecia (AGA) is a benign condition with variable psychosocial impact, with some individuals adapting well while others needing therapeutic support. Although 5α-reductase inhibitors like finasteride and dutasteride have proven effective in ameliorating AGA, their use/selection is currently a subject of debate. Areas covered: Treatment of AGA with 5α-reductase inhibitors lead to variable adverse effects and relatively unstable results (therapeutic efficacy ending with treatment cessation), so the choice of optimal therapy is not straightforward. This paper presents a general perspective regarding AGA based on studies listed in PubMed, to better understand/appreciate the opportunity for long term use of medication for a biological condition having non-life threatening implications. Studies focussed on adverse effects suggest that finasteride should be used with caution in AGA, due to considerable and persistent side effects induced in some men. In contrast, efficacy data indicate that dutasteride (a stronger inhibitor) presents superior therapeutic results compared to finasteride. Expert opinion: This paper argues that finasteride should be preferred to dutasteride in the treatment of AGA. Thus, finasteride preserves important physiological roles of dihydrotestosterone (unrelated to AGA) and, in addition, its adverse effects seem to be (at least in part) predictable.

Nowadays, finasteride is a relatively frequently prescribed drug in the therapeutic management of male androgenic alopecia. The reported adverse effects are notable in some patients, consisting in signs and symptoms that are encountered both during finasteride administration and after treatment cessation. Clinical and imagistic data show that cognition and sexuality are two distinct but interrelated environmental functions, most probable due to lateralization process of the brain. Specific for our topic, relatively recent published studies found that frequency and severity of finasteride adverse effects could be interrelated with hand preference and sexual orientation of the respective subjects. This paper tries to explain/support this interrelation through a psychophysiologic approach, to suggest how this premise could be further proved in dermatological practice, and to highlight its relevance in respect to therapeutic approach of male androgenic alopecia. As a possible therapeutic application, subjects having preference for a certain sexual orientation and/or predisposition for a given dominant hand could be advised before finasteride administration, that present an increased risk/sensitivity to develop adverse effects. Finally, even if finasteride and post-finasteride symptoms overlap to a large extent they should be, however, viewed as distinct physiopathologic entities, which could require perhaps different therapeutic approaches.

Abstract. Although gastric metastases have been estimated to occur in less than 2% of cancer patients, an increased use of upper digestive tract endoscopy allows for a higher detection of secondary gastric tumors. We describe the case of a 66-year-old male patient presenting with mild pain in the sternum and upper abdominal area. Physical examination revealed a right parietal skull tumor, with no other significant clinical changes. Upon exclusion of an acute coronary syndrome, upper digestive tract endoscopy was performed, showing the presence of an ulcerated tumor located in the gastric fundus. Histopathologic examination of the biopsy sample and immunohistochemical tests suggested a pulmonary origin of the gastric tumor. Whole body computer tomography showed the presence of tumors in the gastric fundus, left lung, liver, kidneys, bones and brain. Transbronchial biopsy of the lung tumor certified the diagnosis of non-small cell lung cancer, with the same immunohistochemical profile as the gastric tumor. Hence, it was considered the origin of the metastases. Biopsy of the skull tumor also had the identical tumor histology. Whole brain radiotherapy was performed for the brain metastases and subsequent chemotherapy was administered. Although non-specific, gastrointestinal signs and symptoms occurring in lung cancer patients should alert the clinicians as to the possibility of gastrointestinal metastases and prompt endoscopic evaluation.

Recent clinical and imaging studies suggest that sex hormones modulate sexuality according to a psychophysiologic process of lateralization of the brain, with androgens playing a greater role in sexual functioning of left hemibrain/right handedness and estrogens possibly for right hemibrain/left handedness. Based on this perspective, the current study attempted to specify the relationship between hand preference, estrogens, and sexual function in subjects with male breast cancer, taking into account the sexual side effects of tamoxifen as the agent for inhibiting estrogen action. Twenty-eight Romanian men-17 right-handed and 11 left-handed-undergoing treatment with tamoxifen for male breast cancer participated in this study. These men were assessed both prior to and during tamoxifen treatment using the International Index of Erectile Function, a standardized instrument used for the evaluation of various aspects of sexual functioning, including erectile function (EF), orgasmic function (OF), sexual desire (SD), and overall functioning (OF). A main effect for handedness was found on EF, OF, SD, and OS scales, with right-handed men showing higher functioning than left-handed men. Regarding interaction effects, the left-handed group of men showed greater decreased sexual functioning during tamoxifen (on three subscales: OF, SD, OS) compared to right-handed men. Further research should be conducted in order to support and refine this potential lateralized process of sexual neuromodulation within the brain.

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E 2 2 1What ' s known on the subject? and What does the study add? Cerebral lateralization/specialization is a neurophysiological feature that has been documented regarding somatic, psychological and sexual functioning and that may be manifested in differences in hand preference, cognitive style, gonadal hormonal effects and possibly even sexual orientation. In this study we investigated a possible cerebral lateralization effect on sexual response for dihydrotestosterone, using fi nasteride as a hormone-blocking compound.The results of this study differ substantially from other studies examining the effects of fi nasteride on sexual response, presumably due to the greater restrictions we placed on defi ning relevant sexual activity, to our alerting patients to both positive and negative sexual effects and to the fact that we assessed the effects separately in right-handed vs left-handed patients. Handedness, as a proxy for cognitive style and possible lateralization of effect/function, appears to be a relevant factor when considering the sexual effects of specifi c gonadal hormones. OBJECTIVE• To investigate the relationships between pharmacologically induced deprivation of dihydrotestosterone, sexual arousal, libido and hand preference, by comparing the self-reported sexual response prior to and during reception of the anti-androgen fi nasteride in men undergoing treatment for male pattern baldness. PATIENTS AND METHOD• In total, 33 sexually healthy Romanian men participated in this study.• Patients prospectively provided information regarding their sexual functioning (over 4 weeks), as measured by the International Index of Erectile Function (IIEF) prior to and after commencing treatment with 1 mg fi nasteride for male pattern baldness. RESULTS• Overall IIEF scores as well as the erectile function, orgasmic function, sexual desire and overall satisfaction subscales showed group, treatment and group by treatment effects.• The intercourse satisfaction subscale showed group and group by treatment effects.• On most subscales, right-handed men showed no effect or lower sexual function whereas left-handed men reported no effect or improved sexual function, primarily. CONCLUSIONS• These results suggest that the sexual effects of dihydrotestosterone deprivation may depend on handedness -a proxy variable that may represent cognitive style -which lends further support to the idea of two distinct neuroendocrine psychosexual axes.• They further suggest that detection of such sexual effects may be enhanced by using research methodologies and communication strategies that increase patients ' sensitization to such effects. KEYWORDS INTRODUCTIONSexual hormones, sexual orientation, cognitive style and handedness may all be interrelated. For example, sexual hormones may be related to an individual ' s sexual orientation [ 1 ] , with androgens possibly operating in gay men and heterosexual women, and oestrogens operating in heterosexual men and lesbian women [ 2,3 ] . Sexual orientation may also, however, be linked to handedn...

Background/Aim: Association between cervical cancer and uterine prolapse represents a scarce eventuality. This is a case series of 11 patients diagnosed with different stages of cervical cancer in association with uterine prolapse. Patients and Methods: Between 2014 and 2020, 11 patients were diagnosed with cervical cancer on prolapsed uterine cervix. Results: The mean age of patients at the time of uterine cervix diagnosis was 68 years. In six cases, the first intent treatment was surgery, while in the remaining five cases it consisted of radio-chemotherapy, followed by radical surgery. The perioperative and postoperative outcomes were compared to those reported in a similar series of patients diagnosed in similar stages of the disease, but in the absence of uterine prolapse, no significant differences being encountered. Conclusion: Although it represents an unusual situation, malignant transformation of the uterine cervix might be encountered even in cases presenting uterine prolapse. In such cases, the therapeutic strategy should be tailored according to the stage of the disease. Chronic inflammation is widely accepted to be associated with the development of certain malignancies such as skin, liver or lung cancer (1). When it comes to cervical cancer patients, the relationship between chronic inflammation, malignant transformation, viral infection and uterine prolapse is a controversial one. Women presenting a complete uterine prolapse are predisposed to a long process of chronic inflammation and direct mechanical irritation of the prolapsed areas, increasing in this way the risks of cervical cancer development; therefore, in such cases, special attention should be given to this aspect, and the patients should be routinely submitted to more specific investigations, such as colposcopy, endocervical and exocervical examination, in order to achieve an early diagnosis of the neoplastic disease whenever it develops (1). Furthermore, virology studies have underlined the fact that the displacement of the uterine cervix in cases in which 2073 This article is freely accessible online.