International Journal of Trends in OncoScience

RARE CASE OF UNANTICIPATED HEPATIC TISSUE IN THE THORAX MIMICKING A PULMONARY MASS IN A 49-YEAR OLD FEMALE

Govindaraj Ganesan — 2026-02-16

Accessory liver tissue (ALL) is a very rare anatomical abnormality that is congenital with autosomal recessive inheritance, though in rare instances it has been reported after diaphragmatic trauma or surgery. Till date, only around 23 cases of ectopic liver tissue have been reported. This results in serious dilemmas in terms of diagnosis and management, with no specific guidelines available. Most cases of intrathoracic ALL end up in surgery and are diagnosed retrospectively. Most common site of ALL is in gall bladder. Intrathoracic accessory lobe of liver is an extremely rare variant of ALL, where autonomous islands of liver parenchyma are found in the thoracic cavity. The clinical significance of this condition is not well understood. It is suggested that intrathoracic heterotopic liver tissue has a higher risk of malignant transformation, due to inflammation resulting from bile and venous stasis. A 49-year-old woman presented to our hospital’s tobacco cessation clinic with a 24-year history of tobacco chewing and family history of malignancy. At initial visits, as she had no complaints or examination findings, only counselling was provided. However, at later visit, patient had complaints of pain in left cheek radiating to the ear and left sided neck pain. Clinical examination was unremarkable. No intraoral growth or precursor lesion was identified. Hence, she was evaluated by imaging studies. Computed tomography (CT) thorax incidentally identified a well-defined, heterogeneously enhancing pleural-based lesion of size 53.5 × 52.6 mm, located in right lower lobe, with no significant mediastinal or axillary lymphadenopathy. In view if her tobacco use and family history, a CT-guided biopsy of lung mass was done to rule out malignancy. Histopathological examination revealed benign hepatocytes arranged in cords and plates with intervening sinusoids. The hepatocytes exhibited mild macro vesicular steatosis and periportal lymphocytic infiltrates. There was no evidence of malignancy or lung parenchyma in the specimen, and deeper sections confirmed these findings. The impression was given as benign hepatic parenchyma with steatosis. The findings were further discussed with the pathologist, who confirmed that the biopsy, taken from lung mass, consisted solely of liver tissue. We confirmed diagnosis of Intrathoracic Accessory Lobe of Liver. In view of risk of malignant transformation, Serum Alpha Fetoprotein was done which was normal. As she is currently asymptomatic, she is planned to be kept on 6 monthly follow-up. Our case report is an extremely rare diagnosis, and highlights the need to keep normal anatomic aberrations in mind when evaluating a seemingly suspicious mass. Management depends on symptoms, anatomy of accessory lobe, and clinical and biochemical suspicion of underlying malignancy. Understanding of this rare condition is pivotal for prompt diagnosis of this infrequent condition and appropriate management and surveillance.

RESPIRATORY FAILURE IN ACUTE ORGANOPHOSPHATE POISONING: MECHANISMS, RECOGNITION, AND MANAGEMENT

Dumpala Pramod Agasteen — 2026-02-14

Organophosphate (OP) poisoning is one of the serious health problems globally, especially in the agricultural regions of low, and middle, income countries, and respiratory failure has been identified as the principal cause of death. This review to summarize the main features of pathophysiology, diagnosis, and treatment of respiratory failure caused by OP poisoning. Respiratory failure is the result of the conjunction of multiple mechanisms, such as muscarinic, neuromuscular junction, and central depression. The clinical manifestations can be ranging from acute cholinergic crisis to intermediate syndrome so that the patient has to be carefully monitored and treated as soon as possible. The therapeutic approach involves immediate airway control, use of mechanical ventilation, and administration of atropine and oximes, which are antidotes. Although the pathophysiology of the disease has been well elucidated, the death rate is still high, so it is critical to make an early diagnosis and to administer intensive treatment without delay. This article presents a management protocol for this life-threatening condition currently supported by the existing scientific literature.

NANOTECHNOLOGY-DRIVEN APPROACHES TO OVERCOME CHEMORESISTANCE IN CANCER THERAPY

Prashanthi Evangelin M — 2026-02-28

Chemoresistance remains a major obstacle to effective cancer therapy, accounting for over 90% of therapeutic failures in advanced malignancies. It arises through multidimensional mechanisms, including the over expression of ATP-binding cassette (ABC) efflux transporters (P-gp, MRPs, and BCRP), enhanced DNA repair, anti-apoptotic signaling, epithelial–mesenchymal transition (EMT), cancer stem cell (CSC) persistence, and a hostile tumor microenvironment (TME) characterized by hypoxia, acidosis, and dense stroma. Conventional chemotherapy fails to address these complexities owing to poor selectivity, toxicity, and limited tumor penetration. Nanotechnology offers a transformative approach that enables targeted and controlled drug delivery through carriers, such as liposomes, polymeric nanoparticles, dendrimers, mesoporous silica nanoparticles, and gold nanostructures. These systems leverage passive (EPR effect) and active targeting mechanisms to bypass efflux pumps, co-deliver therapeutics with P-gp inhibitors, siRNA, or CSC-targeting ligands, and modulate the TME via stimuli-responsive release (pH, redox, enzymes, or light). Preclinical and clinical investigations-such as with Doxil®, Abraxane®, and CRLX101 have demonstrated enhanced drug accumulation, restored chemosensitivity, and reduced systemic toxicity. Despite promising outcomes, challenges persist in terms of EPR variability, large-scale reproducibility, immune clearance, and long-term safety. Emerging innovations,such as biomimetic and exosome-mimetic nanocarriers, AI-assisted nanodesign, CRISPR-loaded nanoparticles, and precision diagnostics,hold promise for personalizing and optimizing future cancer nanotherapeutics. Collectively, nanotechnology-driven strategies hold immense potential for overcoming chemoresistance, improving clinical outcomes, and redefining the landscape of cancer treatment through integrated, intelligent, and patient-tailored approaches.

ANTICANCERACTIVITYOFDRUGSFROM AZADIRACHTA INDICA [NEEM] PLANT

Prashanthi Evangelin M — 2026-03-07

Azadirachta indica (Neem), a cornerstone of traditional Indian medicine, has emerged as a promising source of anticancer agents due to its rich repertoire of bioactive limonoids, including nimbolide, azadirachtin, and gedunin. These compounds exhibit potent cytotoxic, antiproliferative, anti-angiogenic, and anti-metastatic effects across diverse cancer models. Nimbolide, the most extensively studied neem constituent, induces apoptosis through both intrinsic and extrinsic pathways, modulates Bcl-2 family proteins, and causes cell-cycle arrest by regulating cyclins and cyclin-dependent kinases (CDKs). Neem limonoids suppress angiogenesis by inhibiting VEGF- and IGF-1R-mediated PI3K/Akt/HIF-1α signaling, while also reducing metastatic potential through the downregulation of matrix metalloproteinases and epithelial-to-mesenchymal transition markers. Gedunin disrupts Hsp90 chaperone function, destabilizing oncogenic proteins and triggering endoplasmic reticulum stress. Neem extracts further enhance antitumor immunity by promoting dendritic cell maturation, boosting CD8+ T-cell responses, and inhibiting immunosuppressive cells such as regulatory T cells (Tregs) and myeloid-derived suppressor cells (MDSCs). Additionally, neem demonstrates chemopreventive effects by elevating antioxidant defenses and activating detoxification enzymes. Despite compelling preclinical evidence, translational progress is hindered by poor solubility, limited bioavailability, and insufficient clinical data. Therefore, standardized formulations and rigorous clinical trials are essential to validate neem-derived compounds as effective anticancer therapeutics.