An accurate preoperative diagnosis of parotid tumors is essential for selection and planning of the surgical treatment. Various modern cross-sectional imaging and cytologic investigations can support differential diagnosis of parotid tumors. The aim of this study was to achieve a comprehensive and updated review of modern imaging and cytologic investigations used in parotid tumor diagnosis, based on the latest literature data. This literature review could serve as a guide for clinicians in selecting different types of investigations for preoperative differential diagnosis of parotid tumors. Magnetic resonance imaging (MRI) with its dynamic and advanced sequences is the first-line imaging investigation used in differentiating parotid tumors. Computed tomography (CT) and positron emission tomography (PET)-CT provide limited indications in differentiating parotid tumors. Fine needle aspiration biopsy and core needle biopsy can contribute with satisfactory results to cytological diagnosis of parotid tumors. Dynamic MRI with its dynamic contrast-enhanced and diffusion-weighted sequences provides the best accuracy for preoperative differential diagnosis of parotid tumors. CT allows the best evaluation of bone invasion, being useful when MRI cannot be performed, and PET-CT has value in the follow-up of cancer patients. The dual cytological and imaging approach is the safest method for an accurate differential diagnosis of parotid tumors.

Non-Melanoma Skin Cancer is one of the most common cancer types and the face is the most affected region. The diagnosis of the skin cancer relies on clinical inspection, palpation, dermoscopy followed by incisional or excisional biopsy. When skin cancers are removed from the face, many factors are involved, including aesthetics. In addition, surgical planning with preoperative acknowledgement of the tumour margins is often the key to avoid incomplete excision, the need for reintervention, or in the prevention of functional and aesthetical defects in the treatment of skin tumours. In recent years, the development of new technologies in sonography, including high frequencies transducers can provide a full range of data. It can offer valuable information regarding the size of the tumour including the depth of invasion, the extent of the tumour, histology and subtypes of the lesions which are helpful for the treatment plan. It also may be efficient in detection of positive margins after surgery and it could play a role in the treatment of skin cancer, prevention of local recurrences and overall control of the disease. K

Implementation of precision medicine in lung cancer has benefited from intense research in the past years, developing subsequently an improved quality of life and increased overall survival of the patients. Targeted therapy has become one of the most important therapeutic innovations for the non-small cell lung cancer (NSCLC) category with anaplastic lymphoma kinase (ALK) gene rearrangement. The aim of this review is to provide a through overview of the main molecules of ALK tyrosine kinase inhibitors (TKI) with their general and particular mechanisms of resistance, the main methods of ALK gene detection, each with advantages and limits and the future perspectives currently under research which try to overcome the mechanisms of resistance. We have used two of the most reliable medical databases EMBASE and PubMed to properly select the latest and the most relevant articles for this topic. Encouraged by the promising results, the clinical practice was enriched by the approval of tyrosine kinase inhibitor molecules, three generations being developed, each one with more powerful agents than the previous ones. Unfortunately, the resistance to TKI eventually occurs and it may be induced by several mechanisms, either known or unknown. Crizotinib was the most intensely studied TKI , becoming the first molecule approved into clinical practice and although four other drugs have been broadly used (alectinib, ceritinib, brigatinib and lorlatinib) it seems that even the most recently developed one remains imperfect due to the resistance mutations that developed. There are two types of resistance generally described for the entire class and for the particular drugs, but half of them remain unknown Read more in PDF.

Non melanoma skin cancer (NMSC) is one of the most common types of skin cancer. It has a number of subtypes, which include basal cell carcinoma, cutaneous squamous cell carcinoma and Merkel cell carcinoma. MicroRNAs are short, non-coding RNA (ribonucleic acid) molecules, capable of regulating gene expression at a post transcriptional level. They play a pivotal role in a variety of physiologic cellular functions and pathologies, including malignant diseases. The development of miRNAs represents an important study field, which has been extensively exploited in melanoma for almost a decade with promising results, therefore we consider it a stepstone for further research projects also in non-melanoma skin cancers. The aim of our study was to explore the current literature in order to present the role of the different miRNAs in some of the most frequent types of NMSC pertaining to oncogenesis, evolution and therapy. The most relevant and accurate available data from the literature were evaluated. Our study concluded that there are almost 100 miRNAs which can be upregulated or downregulated and can play a role in oncogenesis. They can be easily identified in circulation, are stable and they can be important diagnosis/prognosis and therapy monitoring markers.

Non-melanoma skin cancer is one of the most frequently diagnosed cancers in the human body and unfortunately the incidence continues to increase. NMSC is represented by the basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs), which are the most prevalent forms, and basosquamous cell carcinomas (BSC) together with Merkel cell carcinoma (MCC), which are rare types but with a very aggressive pattern and poor prognosis. The pathological diagnosis is hard to assess without a biopsy, even by the dermoscopy. Moreover, the staging can be problematic because there is no access clinically to the thickness of the tumor and the depth of the invasion. The aim of this study was to evaluate the role of ultrasonography (US), which is a very efficient imaging method, non-irradiating and cheap, in diagnosis and treatment of non-melanoma skin cancer in the head and neck region. Thirty-one patients with highly suspicious malignant lesions of the head and neck skin were evaluated in the Oral and Maxillo-facial Surgery Department and Imaging Department in Cluj Napoca, Romania. All tumors were measured with three transducers: 13 MHz, 20 MHz and 40 MHz. Doppler examination and elastography were also used. The length, width, diameter, thickness, the presence of necrosis, status of regional lymph nodes, the presence of hyperechoic spots, strain ratio and vascularization were all recorded. After that, all patients were treated by surgical resection of the tumor and reconstruction of the defect. Immediately after surgical resection, all tumors were measured again after the same protocol. The resection margins were evaluated by all three types of transducers in order to detect malignant involvement and the results were compared with the histopathological report. We found that the 13 MHz transducers offered a big picture of the tumor but the level of details, in the form of the presence of the hyperechoic spots, is reduced. We recommend this transducer for evaluation of surgical margins or for the large skin tumors. The 20 and 40 MHz transducers are better for viewing the particularities of malignant lesions and for an accurate measurement; however, in the case of large size lesions, assessing all three dimensions of the tumor can be difficult. The intralesional hyperechoic spots are present in case of BCC and they can be used for differential diagnosis of BCC.