Subcutaneous tumors
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Subcutaneous Tumors: Definition and Preclinical Models
Subcutaneous tumors are abnormal growths that develop beneath the skin. In preclinical cancer research, the subcutaneous tumor model is widely used because it is simple to establish and allows for easy monitoring of tumor growth. Researchers inject mouse or human tumor cells under the skin of mice, leading to tumor formation within 1–3 weeks. This model is essential for testing new cancer drugs and understanding tumor biology, but it does not fully replicate the complexity of tumors in their natural locations within the body Stribbling2022Suominen2023.
Imaging and Monitoring Subcutaneous Tumors
Accurate monitoring of subcutaneous tumors is crucial for both research and clinical management. Several imaging techniques are used:
- Mueller Polarimetry: This non-invasive imaging method can track tumor development stages in mice, distinguishing between pigmented and non-pigmented tumors. It can also help outline tumor boundaries, especially in early stages .
- Micro-CT Scanning: Micro-CT provides detailed 3D images of subcutaneous tumors in animal models. Manual annotation of tumor regions is common but time-consuming, highlighting the need for automated segmentation tools. High inter-annotator agreement ensures reliable tumor volume measurements .
- Ultrasound and MRI: For human subcutaneous soft tissue tumors, ultrasound (US) and MRI are standard imaging tools. Contrast-enhanced ultrasound (CEUS) has shown higher sensitivity than MRI in detecting malignancy in small (<5 cm) subcutaneous masses, suggesting that even small tumors can be malignant and should be carefully evaluated .
Diagnosis and Management of Subcutaneous Soft Tissue Tumors
Subcutaneous soft tissue tumors are often noticed early because they are visible and palpable. This allows for easier tracking of growth and physical characteristics. However, early and sometimes inadequate surgical removal without proper imaging or planning (“whoops surgery”) can lead to incomplete excision and the need for more extensive follow-up surgery. Careful imaging and preoperative planning are essential to ensure complete removal and reduce the risk of recurrence. Subcutaneous soft tissue sarcomas can be invasive, requiring wide excision along the fascia to prevent local recurrence .
Subtypes and Prognosis of Subcutaneous Tumors
- Subcutaneous Leiomyosarcoma (LMS): This rare tumor type is more aggressive than its dermal counterpart and has a prognosis similar to deep-seated LMS. Factors such as tumor grade, necrosis, size, and stage are linked to higher risk of metastasis and death, with the lung being the most common site of spread .
- Malignant Peripheral Nerve Sheath Tumors (MPNSTs): These aggressive sarcomas can be cutaneous or subcutaneous. Survival rates do not differ significantly between the two locations, but advanced age, higher tumor grade, and less definitive surgery are associated with worse outcomes .
Subcutaneous Tumors in Drug Development and Therapy
Subcutaneous tumor models are widely used in preclinical drug testing due to their ease of use. However, these models may not fully mimic the tumor environment found in the body’s organs, which can affect drug response. For example, tumor growth rates are much faster in orthotopic (organ-specific) sites compared to subcutaneous sites, suggesting that more sophisticated models may provide better predictions of drug efficacy in humans .
In clinical settings, subcutaneous administration of cancer therapies, such as the anti-PD-L1 antibody envafolimab, has shown to be effective, well-tolerated, and convenient for patients with advanced solid tumors, offering an alternative to intravenous treatments .
Surgical and Immunotherapy Approaches
Protocols for surgical debulking of subcutaneous tumors in mice have been developed to allow for intraoperative delivery of immunotherapy. These models are important for testing new treatments aimed at preventing cancer recurrence after surgery .
Conclusion
Subcutaneous tumors are important in both clinical and research settings. They are easily accessible for monitoring and treatment, but require careful imaging and management to ensure accurate diagnosis and effective therapy. While subcutaneous tumor models are valuable for preclinical drug development, their limitations highlight the need for more complex models to better predict clinical outcomes. Advances in imaging, surgical techniques, and drug delivery continue to improve the diagnosis, management, and study of subcutaneous tumors Varin2021De Marchi2020Jensen2024+7 MORE.
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