I am delighted to share our recent article published in European Urology (Journal Impact Factor: 29) @EUplatinum - “Hereditary Renal Cancer Syndromes: Redefining Clinical Management in the Era of Precision Medicine” (PMID: 42580957), written by Dr. Fanni Santa, @FV_Santa an arising star in our field. Hereditary renal cancers account for an estimated 3–5% of renal cell carcinomas, yet many affected patients remain unrecognized and never undergo germline testing. Our article highlights the growing importance of identifying hereditary disease and emphasizes that surveillance and treatment should increasingly be guided by tumor biology, molecular classification, and genetic testing. The therapeutic landscape is rapidly evolving. HIF-2α inhibition has established proof of principle for genotype-directed therapy in VHL-associated RCC, while emerging strategies include next-generation HIF inhibition, immunotherapy-based combinations, metabolism-directed therapies for FH- and SDH-deficient RCC, and biomarker-driven approaches to improve risk stratification and treatment selection. Important challenges remain: refining risk-adapted surveillance, optimizing intervention thresholds, developing syndrome-specific systemic therapies, and generating stronger prospective evidence. International registries integrating genotype, tumor growth, treatment history, renal function, and cancer-specific outcomes will be essential for moving the field toward more precise and dynamic management. The future of hereditary kidney cancer care lies in integrating pathology, germline genetics, surveillance, surgery, and pathway-directed systemic therapy to deliver truly individualized precision medicine. Article is available for free download: authors.elsevier.com/a/1nb4Z…

Comprehensive review on diagnostic criteria and classification of malignant glandular lesions of the urinary bladder by Dr. Fanni Santa @FV_Santa and her colleagues, published as the featured cover article @Human_Pathology.   This review provides a practical framework for one of the most diagnostically challenging areas in genitourinary pathology, integrating contemporary morphologic, immunohistochemical, and molecular advances into a unified diagnostic approach.   Dr. Fanni Santa and her colleagues address the classification and differential diagnosis of primary bladder adenocarcinoma, urachal adenocarcinoma, Müllerian-derived tumors, and precursor lesions, emphasizing key diagnostic pitfalls in distinguishing these uncommon neoplasms from more common primary bladder tumors and secondary involvement by tumors from other organs. The review also highlights emerging molecular insights, including recurrent genomic alterations with potential therapeutic implications, and discusses evolving concepts surrounding precursor lesions such as villous adenoma, cystitis glandularis with intestinal metaplasia, and adenocarcinoma in situ.   This comprehensive review is an essential resource for pathologists, urologists, oncologists, and trainees, and hope it will contribute to improved diagnostic accuracy, multidisciplinary communication, and optimal patient management for these rare but clinically significant tumors. Read the full article here: sciencedirect.com/science/ar…

Delighted to share our article published this month in European Urology @EUplatinum (new Journal Impact Factor: 29). Congratulations to our esteemed global multidisciplinary expert panel for making this landmark work possible. We hope these recommendations will improve communications and diagnostic reproducibility, streamline multidisciplinary patient care, and ultimately support earlier intervention and more personalized management of genitourinary diseases. Full article: pubmed.ncbi.nlm.nih.gov/4193… @IntSocUropath

Just published in the May 2027 issue of The American Journal of Surgical Pathology @JLHornick, in  memory of our dear friend, mentor, and exceptional educator and leader, Dr. Sambit Mohanty.   In the largest series to date of ALK-rearranged renal cell carcinoma (ALK-RCC), Drs. Anandi Lobo @LoboAnandi, Mahmut Akgul, Ankur Sangoi @slusagar, Khaleel Al-Obaidy,@KhaleelAlObaidy @Andres_M_Acosta @Aparwani_dpath @DrSeemaKaushal @Williamson_SR and their distinguished colleagues present an integrated clinicopathologic, morphologic, and molecular analysis of this rare aggressive tumor (PMID: 41790060).   ALK-RCC in adults demonstrates significant morphologic heterogeneity and carries important clinical implications. Accurate diagnosis is critical, as patients - particularly those with metastatic disease- may benefit from ALK-targeted therapies. Notably, TFE3 immunoreactivity can be seen in ALK-RCC, making confirmation of ALK gene rearrangement essential through immunohistochemistry and/or molecular methods such as FISH or NGS.   Given its diverse morphology, ALK-RCC can mimic other renal neoplasms, including TFE3-rearranged RCC, clear cell papillary renal cell tumor, and mucinous tubular and spindle cell carcinoma, posing a risk for misclassification. Recognition of key features- such as solid and tubulopapillary architecture, eosinophilic cytology, and ALK/KRT7 expression - combined with confirmatory molecular testing is crucial, especially in younger patients or diagnostically challenging cases.   This study expands our understanding of ALK-RCC, underscoring its rarity, diagnostic complexity, and variable clinical behavior. Accurate diagnosis, facilitated by molecular diagnostics, is essential not only to avoid misdiagnosis but also to identify patients who may benefit from targeted therapy.   Take a look: journals.lww.com/ajsp/fullte…

Free access: onlinelibrary.wiley.com/doi/… I am absolutely delighted to share this state-of-the-art review on “Evolving Landscape of Precision Medicine in Bladder Cancer: From Challenges to Clinical Impact.”, written by Prof. Ting Ye and colleagues – one of most comprehensive and up-to-date review on bladder cancer care. Bladder cancer (BCa) remains one of the most challenging urologic malignancies due to its marked molecular heterogeneity, high recurrence rates, and variable therapeutic responses. However, the rapid emergence of precision oncology is transforming the field and opening unprecedented opportunities for personalized treatment strategies. In this review, we provide an updated synthesis of recent advances in the molecular characterization, diagnostic innovations, and targeted therapeutic strategies for BCa. We discuss the evolving molecular landscape, highlighting recurrent genomic alterations - including FGFR3, TP53, RB1, ERBB2, and PIK3CA - and their differential prevalence in non–muscle-invasive versus muscle-invasive disease. Advances in molecular subtyping using transcriptomic and epigenetic profiling have further refined prognostic and predictive stratification. We also examine the critical role of the tumor microenvironment, including immune cell infiltration, stromal remodeling, and angiogenic programs, in shaping therapeutic response and guiding treatment strategies. On the therapeutic front, we highlight precision approaches involving FGFR inhibitors, HER2-targeted agents, PI3K/AKT/mTOR pathway inhibitors, immune checkpoint blockade, antibody-drug conjugates, and emerging modalities such as RNA therapeutics and oncolytic platforms. Despite these advances, important challenges remain, including intratumoral heterogeneity, clonal evolution, resistance mechanisms, and disparities in access to genomic testing. Emerging technologies - including multi-omics integration, spatial transcriptomics, single-cell profiling, artificial intelligence–driven predictive modeling, and liquid biopsy monitoring - hold great promise for overcoming these barriers and improving clinical decision-making. Looking ahead, the future of precision medicine in BCa will rely on the integration of comprehensive multi-omics datasets, AI-enabled predictive analytics, and minimally invasive monitoring strategies such as circulating tumor DNA (ctDNA) and exosomal RNA profiling. Novel immunotherapeutic strategies - including bispecific antibodies, neoantigen vaccines, CAR-T therapies, and TCR-engineered cells - may further expand treatment options, particularly for patients with checkpoint inhibitor - refractory disease. Ultimately, the convergence of high-throughput molecular profiling, advanced computational analytics, and real-time tumor monitoring is shifting BCa management from a reactive, one-size-fits-all paradigm toward proactive, adaptive, and highly personalized cancer care.