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Авторами описаний клінічний випадок несправжньої аневризми дуги аорти, що перебігала під маскою пухлинного процесу і медіастиніту. Наведений випадок наочно демонструє необхідність ангіоконтрастування під час проведення комп’ютерної томографії органів грудної порожнини в разі можливої патології середостіння.

The granular cell tumor or Abrikossoff's tumor is a rare tumor, most often benign in evolution. Malignant forms are exceptional. We report, here, a very rare case of granular cell tumor, localized in the perianal region, in a 54-year-old woman with lung metastases. CT and MRI with contrast showed a locally advanced tumor process in the right para-anal region associated with multiple "balloon release" lung lesions. The diagnosis was confirmed by immunostaining after surgical biopsy. Very few cases of malignant granular cell tumors with lung metastasis have been reported in the literature.

Surgical treatment of patients with postoperative ventral hernias is one of the most pressing problems in herniology. Verification of the diagnosis of postoperative ventral hernia is usually not difficult. At the same time, there may be difficulties in diagnosis associated with determining the true size of the hernia orifices, the contents of the hernial sac. These moments are determined by various factors: the location of the hernia on the anterior abdominal wall, the age, sex of the patient, as well as anamnesis of hernia and the volume of surgery previously performed. One of the very rare situations in external abdominal hernias is the situation when the content of the hernial sac is the part of the parenchymal organ, the tumor process, as well as foreign bodies. The study presents the observation materials of three patients admitted for diagnosis and treatment to the surgical hospital clinics of Irkutsk State Medical University. When examined and treated, it was found that in one case the content of the hernia sac included a part of the left lobe of the liver, in another observation, the inguinal hernia sac contained metastatic carcinoma, in the third case – a foreign body was found. All patients underwent surgery (hernioplasty, hernioplasty). Diagnosis of hernia of the anterior abdominal wall was confirmed. A literary search was made for rare clinical examples in herniology. In the world literature, there are only eight observations when the content of the hernia sac was a part of the lobe of the liver; the presence of metastatic carcinoma and a free foreign body we found as single observations described by known specialists in herniology.

The issue of factors that modify the tumor process stays relevant. The effect of unilateral sciatic nerve ligation on the growth of Guerin's transplantable carcinoma and the lifespan of white outbred rats of the same age, which differed in adaptation status and aging rates, was studied.Material and Methods. The motor activity (open field test), the character and tension of the general nonspecific adaptional reactions of the body (AR) according to Garkavi–Kvakina–Ukolova, the dynamics of tumor sizes and the lifespan of rats after Guerin’s carcinoma transplantation were evaluated.Results. The effect of unilateral sciatic nerve ligation differed from the unidirectional negative effects known in tumor-bearing animals after bilateral ligation of the sciatic nerve. In groups with unilateral ligation of the sciatic nerve and a false operation, more than 40 % of animals showed an increase in lifespan compared with the maximum lifespan in the control group. At the same time, in the most cases, the tumor growth rate was similar to the control indicators or exceeded them (more 25 % of cases). A temporary inhibition of tumor growth was observed only in individual animals. There was no direct relationship between tumor growth or lifespan and the degree of decrease in the motor activity of animals 4 weeks after nerve ligation. A correlation between the changes in the ARs and lifespans of animals and, to a lesser extent, the dynamics of tumor growth was observed. The distinct negative effect of increased aging rate, measured by animal weight, on tumor development and lifespan in studied rats was shown, but not in the cases of sciatic nerve ligation. Unilateral sciatic nerve ligation had a multidirectional effect on tumor growth and lifespan in rats with different rates of aging, depending, probably, on the individual pain sensitivity and the individual features of systemic regulation of tumor-bearing animals.Conclusion. The results reflect the complex relationship between processes associated with chronic pain, oncogenesis, aging and features of neuroendocrine and immune regulation of experimental animals. The question of the reasons for the preservation of viability in animals that underwent surgery and ligation of the sciatic nerve, when the tumors reach large sizes, exceeding this indicator in the control group, needs to be clarified.

У пацієнтів на тлі онкологічної патології як результат впливу на кісткову тканину пухлинного процесу та протипухлинного лікування (хіміотерапія, променева терапія, андрогенна або естрогенна депривація) і супутньої терапії нерідко розвивається остеопороз. У статті висвітлені останні дані літератури щодо остеопорозу при онкологічній патології та виділені кілька загальних рекомендацій ведення цієї категорії пацієнтів. Наведений клінічний випадок метастатичного пошкодження хребта в пацієнтки з остеопорозом.

Background. Given the steady and intense increase in the incidence of breast cancer, the problem of the development of early complications of reconstructive operations, depending on the characteristics of surgery, remains urgent.Objective: to analyze the characteristics of the early postoperative period in patients operated on for breast cancer using different surgical techniques.Materials and methods. A comparative analysis of clinical examination data was carried out, as well as laboratory and instrumental diagnostic methods for 353 women with stage I to IIIA breast cancer after various surgical treatment options and 40 patients after mammoplasty.Results and conclusions. It has been shown that neither single-step nor delayed reconstructive operations after radical mastectomy increase the incidence of complications in the early postoperative period. Single-step breast reconstruction with the help of an expander can be used in patients with I–IIIA stages of the tumor process.

Background. Pseudosarcomas of soft tissues can cause diagnostic and treatment challenges. On the one hand, it is difficult to make a nosological diagnosis based on a biopsy specimen of a tumor; on the other hand, it is difficult to determine the most appropriate treatment strategy based on a histological pattern.The purpose of the study was to analyze available literature data and systematize the histological characteristics of the chondroid lipoma and pseudosarcoma.Case description. We present the case of chondroid lipoma in a 57-year-old female patient with atypical clinical symptoms. This case shows the difficulties of differential diagnosis of soft tissue sarcomas. Using a clinical example of chondroid lipoma, a rare soft tissue tumor, and an analysis of literature data, the authors showed the importance of a detailed study of the obtained material, a qualified description of the morphological picture, in those cases when the diagnostic conclusion cannot be unambiguous about the malignancy of the tumor process. Additional biopsy is not always possible to clarify the histotype of the tumor. The presented observation shows the difficulties of differential diagnosis of soft tissue sarcomas. Minimally invasive biopsy provides no a full appreciation of histological structure; therefore, if there is a suspicion for chondroid lipoma, it is necessary to perform total surgical biopsy followed by a morphological study using the immunohistochemical method.

Colorectal cancer occupies one of the leading positions in the world in the structure of cancer incidence. The vital processes of cancer cells largely depend on the production of growth factors and their receptors. One of these is epidermal growth factor (EGFR), which is a tyrosine kinase receptor for cell membranes. Normally, binding of EGFR ligands and transforming growth factor alpha (TGFα) induces receptor activation, which triggers ERK and PI3K signaling pathways that control cell proliferation, migration, invasion, and many other processes. It was found that in 80% of cases, colorectal cancer occurs as a result of EGFR overexpression, which leads to increased growth and division of tumor cells due to hyperactivation of the RAS-RAF-MEKERK signaling cascade. The RAS-RAF-MEK-ERK cascade is a pathway that regulates cell proliferation, cell cycle, and cell migration. In the development of human cancer, mutations of the RAS/RAF family are most often the cause of dysregulation of signal transduction through this pathway. According to current data, about a third of all malignant neoplasms are associated with mutations in the genes of the RAS family, which include HRAS, KRAS, NRAS, RRAS, and other homologous proteins. Proteins of the RAS family are involved in the activation of tyrosine kinase signaling pathways, which leads to gene mutations. This process determines proliferative activity, ability to differentiate, metastasis, avoidance of apoptosis, induction of angiogenesis. Permanent RAS activation leads to malignant cell degeneration. Thus, the expression and mutation of the EGFR gene are associated with various variants of tumor progression and poor prognosis in malignant neoplasms of various localizations. Over the past decades, significant advances have been made in the treatment of metastatic colorectal cancer. However, the expansion of the spectrum of effective anticancer drugs also creates a number of difficulties in choosing the optimal drug therapy regimens in patients with metastases of colorectal cancer.

Background. The incidence of colon cancer over the past decade has been growing markedly in the Russian Federation, with about 50 % cases detected at stagesIII–IV of the disease, when a clear clinical picture of the disease appears. In this regard, the search for new methods for early diagnosis of RTK is undoubtedly relevant.Objective. To determine the standard composition of the aerobic parietal colon microbiota and the level of cytokines (chemokines and growth factors) in patients with cancer of the left half of the colon and to assess the possibility of using these data in the diagnosis of the tumor process.Materials and methods. Blood tests were performed on the day of the study using two test systems (BioLegend): multiplex kit for determining growth factors, chemokine multiplex kit. The composition of the intestinal microbiota was determined in colon biopsy specimens by the bacteriological method using the standard test systems StaphyTest, StreptoTest, and EnteroTest.Results. There is an increase in the number of Clostridiumspp. and a decrease in Bifidobacteriumspp., E. coli in the colon during the transformation of a healthy person’s mucosa into a malignant tumor (p < 0.05); a clear tendency was revealed for both an increase (EGF, HGF, M-CSF, PDGF-AA, PDGF-BB, IP-10) and a decrease (MCP-1, RANTES) of the level of chemokines and growth factors under colon cancer conditions. In addition to general quantitative changes in the intestinal microbiota, the level of the investigated substances, a statistically significant dependence was established on the sex, age of the patient, as well as the degree of differentiation and form of tumor growth.Conclusion. It was established that changes in the quantitative composition of the intestinal microbiota, the level of some biologically active substances that occur precisely in the conditions of colon cancer, can be interconnected and interdependent, and also serve as an additional diagnostic marker in the detection of a malignant tumor.

Purpose of the study: to review in vivo studies on the relationship and role of various molecular genetic components of the circadian rhythm system in the initiation and development of malignant neoplasms. in contrast to clinical and epidemiological studies, animal models, including transgenic animal models, can model various changes and disturbances in the activity of clock genes and track the results of these changes.Material and Methods. the review includes data from studies carried out over the past 10 years in animal models, studying the mechanisms and effects of disturbances in the system of circadian rhythms related to the formation and development of tumors. the data sources for the review were the Medline, embase and scopus databases.Results. analysis of the literature has shown that interference with the work of the «biological clock» by changing the light cycle, disrupting the expression of clock genes and other manipulations is a factor predisposing to the development of tumors. in tumors of various types, the expression of clock genes is often mismatched, and it is unclear at what stage of their formation this occurs. in addition, the development of tumors disrupts the circadian homeostasis of the body. there are three key areas of research aimed at studying the role of circadian rhythms in tumor development: disturbance of circadian rhythms as a carcinogenic factor, disturbances in the clock gene system in a tumor, disturbances in the clock gene system of the whole organism, provoked by tumor development.Conclusion. the results of studies on animal models demonstrate that the relationship between the disturbance of circadian rhythms and the tumor process is complex since the causal relationship has not yet been studied. in this regard, the prospect of targeted pharmacological correction of circadian rhythms in clinical practice in cancer patients does not seem to be the nearest one.

Melanoma of the mouth is a rare entity of cancer. It has a bad prognosis. We report two cases of mouth melanoma. In the first case, 68 years old man developed a mandibular gingival tumor. Head and neck MRI scans showed an aggressive tumor process in the mouth with bone extension and in the deep spaces. The patient was free of cervical lymph nodes. The second case is a 75-years-old male with heavy tobacco smoke. The man felt a burgeoning mass on the right palate. The neck palpation found a firm mobile non-tender mass at the left upper jugular region. The anatomopathological study of the biopsies assigned both cases to malignant melanoma. Because of the rarity and delays in diagnosis, case reports are an invaluable source of information., Highlights • Melanoma of the mouth is a rare entity of cancer with a bad prognosis. • Tobacco and alcohol use are two of the most important risk factors for oral cavity and oropharyngeal cancers. • Maxillofacial surgeons and physicians who treat oral lesions must be conscious of the need for early diagnosis of melanoma.

Renal cell carcinoma (RCC) diagnosis and management have undergone significant shifts in the recent past. MSCT makes it possible to assess not only the prevalence of the tumor process, but also the calyx-pelvic system and vessels; In the past 10 years, due to the technological advancements, laparoscopic nephrectomy has become the popular and effective method of the treatment and a less traumatic alternative to open radical nephrectomy. Laparoscopy may not be used only for removal of the neoplasm, but also for biopsy of the tumor. Over the past years, cryodestruction of neoplasms has become widespread since it is possible to carry out the procedure in real time under the control of ultrasound, CT or MRI. This review aims to highlight recent evidence that has emerged in the diagnosis and management of this complicated oncologic issue.

One of the main problems of nasopharyngeal carcinoma treatment is the high incidence regional and distant failures. The method of choice in the first line therapy for the primarily diagnosed nasopharyngeal carcinoma is chemoradiotherapy with poor success rate. The main etiological factor in the occurrence of nasopharyngeal carcinoma is the Epstein–Barr virus, which DNA’s copies could be detected in blood samples in patients with nasopharyngeal carcinoma, which may indicate tumor activity. The indicators of these titers reach different values depending on the stage of the tumor process, the presence of distant metastases, individual patient parameters, and the tumor response to the therapy. Given the high specificity of this biological marker, it is necessary to consider the possibility of its use as a prognostic indicator for assessing the success of the selected method of conservative treatment, as well as assessing the prognosis.

This article describes a new affordable diagnostic method of neuroendocrine tumors, shows the basic information on it’s conduction and interpretation of the results. Scintigraphy of neuroendocrine tumors with 99m Tc-Tectro-tyd is a new alternative and more affordable diagnostic method that allows you to determine tumor receptor status, assess the prevalence of the tumor process and plan therapy. This study may also be the first step in planning radionuclide therapy for patients with neuroendocrine tumors. Also there is a short review on teranostics.

The article presents the literature review of modern approaches in the diagnosis and treatment of squamous cell cancer of the oropharyngeal region and larynx. Various views on the treatment of patients with oropharyngeal tumors are presented. Special attention is paid to the ultrasound examination of patients with laryngeal tumors and to the possibilities of ultrasound in assessing the integrity of the laryngeal cartilage. Various ultrasound techniques for assessing the thickness and depth of invasion of oral tumors are highlighted. The features of regional anatomy that affect the informative value of visualization techniques are discussed. In the article presents criteria for assessing the prevalence of the tumor process in the adjacent organs and tissues, metastasis in regional lymph nodes.

Aim To present the European Society of Clinical Oncology current recommendations for the gynecological cancer treatment on the background of the COVID-19 pandemic Materials and methods A literature search was carried out for the most modern literary sources available, published in March and April 2020, based on the experience of several European communities of gynecological oncology We have compiled guidelines from several international communities working with oncological patients for consideration and possible practical application during the ongoing COVID-19 pandemic Results Recommendations for sanitary - epidemiological activities aimed at reducing the risk of infection, as well as the sequence of therapeutic and diagnostic actions in oncogynecological patients, depending on the disease and stage of the tumor process, were presented Factors influencing treatment planning were indicated;a system of measures to provide palliative care for this category of patients was developed Conclusion In the face of the ongoing pandemic, these recommendations can help to choose the optimal tactics for gynecological cancer patients management, and also to ensure the safety of both patients and the medical staff involved in treatment process It is necessary to adhere to preventive and protective measures in conditions of a high infection risk for medical personnel and patients at the stage of outpatient and inpatient care It is necessary to reduce or postpone extended, combined or simultaneous surgical interventions that involve a long stay on the ventilator in the intensive care unit Consideration of alternative methods of conservative therapy is possible In addition, the use of remote consultations helps to resolve tactical issues, avoiding additional infection risks Введение В 2019 -2020 гг мир столкнулся с кризисом вследствие нарастающей пандемии, связанной с разрушительным воздействием коронавирусной инфекциии (COVID-19) Цель исследования Представить современные рекомендации европейского общества клинической онкологии по лечению гинекологического рака в условиях пандемии COVID-19 Материалы и методы Проведен поиск доступных самых современных литературных источников, опубликованных в марте и апреле 2020 года в базах PubMed (https://www ncbi nlm nih gov/pubmed/), Научной электронной библиотеки Elibrary ru (https://elibrary ru/) и сайтах нескольких европейских онкогинекологических сообществ профессиональных Поиск в базах данных проводили по ключевым словам «COVID-19», «cervical cancer», «endometrial cancer», «ovarian cancer», «vulvar cancer» и «vaginal cancer» Мы отобрали и объединили рекомендации, подготовленные несколькими международными сообществами, занимающихся лечением пациентов с онкогенитальной патологией, и предназначенные для рассмотрения и возможного применения на практике во время пандемии COVID-19 Результаты Изложены рекомендации по санитарно-эпидемиологическим мероприятиям, направленным на снижение риска инфицирования;последовательности лечебно-диагностических мероприятий у онкогинекологических больных в зависимости от нозологии и стадии опухолевого процесса Подробно описаны рекомендации при лечении больных с раком шейки матки, раком эндометрия, раком яичников, раком вульвы, раком влагалища Обозначены факторы, влияющие на планирование лечения;предложена система мероприятий по оказанию паллиативной помощи данной категории больных Заключение В условиях продолжающейся пандемии данные рекомендации помогут выбрать оптимальную тактику ведения пациенток с гинекологическим раком, обеспечить безопасность как пациентам, так и участвующему в лечении медперсоналу Необходимо соблюдение мер профилактики и защиты в условиях высокого риска инфицирования медицинским персоналом и пациентами на этапе амбулаторной и стационарной помощи Необходимо сократить либо отложить расширенные, комбинированные или симультанные хирургические вмешательства, предполагающие длительное нахождение наискусственной вентиляции легких (ИВЛ) в условиях реанимационного отделения Возможно рассмотрение альтернативных методов консервативной терапии Кроме того, использование дистанционных консультаций в режиме онлайн, помогает разрешить тактические вопросы, избежав дополнительных рисков инфицирования

Three extracts were obtained from the aerial parts of meadowsweet ( Filipendula ulmaria (L.) Maxim.) using water, 40% ethanol, and 70% ethanol as extractants. Comparative assessment of their effect on the development of Lewis lung carcinoma (LLC) in C57Bl/6 line mice showed that, in isolated introduction, development of the metastatic process was inhibited by the extracts prepared in water and 70% ethanol, without influence on the growth of the tumor node. A comparative assessment of the effect of extracts on the antitumor effect of cyclophosphane (CPh) on the primary tumor node showed no changes in effectiveness of the cytostatic agent. When included in the treatment regimen of mice using extracts at a dose of 25 and 50 μg/kg, a significant increase in the antimetastatic action of CPh was detected under the influence of aqueous extract with metastasis inhibition index IMI = 75 and 98%, respectively, and with 70% ethanol extract (IMI = 95 and 96%). The effect of 40% ethanol extract on development of the tumor process in mice with LLC and the effectiveness of CPh therapy were not found.

A retrospective analysis of the immediate and long-term effectiveness of the treatment of the choroidal melanoma using transpupillary thermotherapy (TTT) was carried out. The study included 84 patients with choroidal melanoma (C69.3) who received treatment between 2007 and 2018. Patients were sampled from the Belarusian Cancer Register. The average values of the thickness of the tumor were 2.6±1.3 mm, the diameter of the base - 7.2±3.3 mm. TTT was carried out using a diode laser with a wavelength of 860 nm and radiation power of 200 - 800 mW, the exposure time was 60 s, and the diameter of the laser spot was varied between 1 and 3 mm. The entire surface of the tumor was thermally treated with overlapping fields from the periphery to the top. 75 patients underwent a single session of TTT, while 9 - two sessions with an interval of 3–4 weeks. As a result of the treatment, 51 (60.7%) patients showed complete tumor resorption, 28 (33.3%) patients had stabilization of the tumor process, and 5 (6.0%) patients had no effect. In the group of patients with stabilization of the tumor process, continued growth was recorded in 16 (19.1%) patients with follow-up periods of 3 months to 4 years. In 19 (37.3%) patients from the group with complete tumor regression, relapse was observed 1 to 8 years after TTT. Metastatic disease (disease progression) developed in 5 (5.9%) patients, of which in 1 patient during the first 12 months, in 1 patient - after 4 years, and in 3 patients more than after 5 years of the follow-up observation. Analysis of the effectiveness of TTT of choroidal melanoma showed that an increase in the thickness and diameter of the base of the tumor focus results in the decrease of immediate effectiveness, and the rise of the likelihood of continued tumor growth.

The review article presents an analysis of the literature over the past 10 years on the relationship of menopausal hormone therapy and the risks of developing malignant diseases in women, including risk factors, such as mutations in the BRCA1/2 genes. The main limiting factor in the appointment of menopausal hormone therapy today remains the question: is there a connection between MHT and the development of oncological pathology, due to the high mortality rates from malignant neoplasms, which occupy the 2nd place after cardiovascular diseases. The main localization of the tumor process, which stops the appointment of MHT, is breast cancer. In the structure of the incidence of malignant neoplasms among the female population in Russia, breast cancer occupies a leading place, and this is the main interest in the effect of MHT. The results of large-scale studies are rather ambiguous and do not answer all the questions. Do not forget about other localizations of the tumor process, which MHT can also influence, and about which, there is also no unequivocal answer to the question about the relationship of MHT and the risks of tumor development. As for any therapy, for MHT there are contraindications, which are also covered in the article. The main modes of taking menopausal hormone therapy and their relationship with the risks of tumor development are also presented. The influence of the main components of menopausal hormone therapy on the processes of neoplastic transformation.

The World Health Organization has announced the coronavirus infection pandemic (COVID-19), associated with a high risk of severe complications requiring intensive care. The following is a possible algorithm for the choice of treatment tactics for prostate cancer during the COVID-19 pandemic, aimed at achieving 3 main goals: reducing the risk of life-threatening complications of the tumor process, minimizing the risk of “crossing” the profiles of adverse events associated with prostate cancer treatment and viral infection, and diminishing the risk of COVID-19 contamination for prostate cancer patients. The proposed algorithm is a personal view of the authors and is not an official recommendation.

Despite the rapid development and improvement of diagnostic capabilities in oncology and endocrinology, the diagnosis of neoplastic hypercorticism syndrome remains one of the most complex and unresolved issue of modern medicine. The aim — to find out the possibility of dependence of the level of adrenocorticotropic hormone of the peripheral blood on the localization and spread of neuroendocrine tumors of the chest accompanied by ectopicCushing’s syndrome at an early, pre-visual stage of diagnosis. Material and methods. The literature data, which contained information about the change in the level of adrenocorticotropic hormone and the degree of spread of the tumor process of 71 patients with neuroendocrine tumors of the chest, were analyzed. According to the localization of tumors, patients were divided into 3 clinical groups. The first group (bronchopulmonary carcinoid) consisted of 30 patients, including 23 patients with a local tumor process; second group (small cell lung cancer) — 4 patients, all with spread process; the third group (carcinoid/thymus carcinoma) — 37 patients, including 17 patients with local process. The indicator of the level of adrenocorticotropic hormone in the peripheral blood of patients is presented as the ratio: the level of adrenocorticotropic hormone of the patient / value of the upper limit of normal. Results. The highest level of adrenocorticotropic hormone was identified in the group of small cell lung cancer — an increase of 11.2±9.89 times, on the contrary, in the group of thymomas — 7.4±7.7 times (p

Organ-preserving methods for surgical treatment of uveal melanoma include transscleral tumor resection and endosurgical tumor resection. There are several approaches to vitreoretinal intervention worldwide. In particular, endoresection can be performed before or after radiation treatment, and can also be used as the only method. Material and methods. The article presents the results of the treatment of two patients with uveal melanoma T3N0M0. In both cases, endosurgical excision of the choroid tumor with brachytherapy in the neoadjuvant mode was performed. Results. In both cases surgical treatment was carried out after stabilization of the tumor process. In one patient stabilization occurred after the initial brachytherapy, in the second after brachytherapy and four sessions of transpupillary thermotherapy due to continued tumor growth. Prior to treatment, patients underwent delimiting laser coagulation of the tumor focus. In both cases, post-radiation complications were observed in the form of maculopathy and opticoneuropathy, for which conservative therapy was carried out. Tumors were removed within healthy tissues. Conclusion. Diagnosis and treatment of uveal melanoma requires an integrated, multidisciplinary approach. Large tumors often require a combination of techniques. Vitreoretinal surgery allows to remove a tumor site, while, according to the literature, it shows the best results in combination with radiation treatment methods. By eliminating the toxic effects of destroyed tumor cells, it is often possible to stop the manifestations of post-radiation complications. However, due to the small size of the tumor tissue fragments obtained during endoresection, the histological evaluation of the tumor pathomorphism and the immunohistochemical study are difficult.

Emergencies in oncology are acute exacerbations of the patient's condition that can be fatal and are caused by a tumor process or antitumor treatment. Can affect different organs or organ systems, generally are classified as: obstructive syndromes, metabolic disorders, and hematological or immunological disorders. The nurse is an important member of the team involved in the treatment of cancer patients and their interventions can contribute to reducing the rate of mortality and successful treatment of emergencies. As she spends most of her time with the patient, the nurse must be educated to recognize the symptoms and signs of emergencies, in order to provide first aid in time and inform the doctor. Nurse interventions are aimed at performing diagnostic procedures in patients, applying appropriate therapeutic measures, monitoring patients and providing health care.

The analysis of long-term results of treatment of 88 primary patients with colon adenocarcinoma at various stages of tumor process is presented, taking into account the TNM system criteria, and serum IGF-1, IGF-2, IGFBP-1, IGFBP-2, IGFBP-3, VEGF, and MMP-7 levels. The overall survival rate assessed by Kaplan-Meier method and Cox multivariate regression model was used as the criterion of prognosis. It was established that IGF-1, IGFBP-2 and VEGF serum levels along with the stage of colorectal cancer might be considered as statistically significant independent predictors of overall survival in patients.

The objective: to study the long-term results of organ-preserving surgeries when removing cystic kidney tumors of category III – VI according to Bosniak.Materials and methods. The study was carried out with the participation of 16 patients with verified cystic renal tumors of the category III – VI according to Bosniak. Indications for surgery were: clinical manifestations, laboratory, ultrasound, Doppler and radiation methods (MSCT with bolus contrast or MRI). The diagnosis of renal tumor process was also confirmed using histological and histochemical research methods.Results. Long-term studies after 18 and 36 months showed no signs of recurrence of cysts or tumor process in the kidneys. Signs of a tumor process in the lymph nodes or in other organs during these periods of the study were also not found. Removal of cysts and tumors in the long term after surgery leads to a significant improvement in blood circulation in the kidneys.Conclusion. Organ-preserving resection of a part of the kidney affected by Bosniak category III–VI cystic tumors is a modern effective method of treatment and should be an alternative to surgical removal of affected kidneys in such patients.

Aim. To study the capabilities of 18F -FDG PET/CT in the differential diagnosis of colorectal liver metastases. Materials and methods . A retrospective analysis of 18F -FDG PET/CT data of 126 patients with colorectal cancer was carried out. The final diagnosis of colorectal cancer was established based on the analysis of morphological material obtained from the primary tumor. The metastatic or benign origins of the liver foci was confirmed by histological examination or by the results of radiation examination (dynamic observation). Sensitivity and specificity of this method were determined using ROC analysis using the SUV as a numerical classifier. Results . Colorectal liver metastases were detected in 51 (40.5%) patients. Advanced extrahepatic tumor process was detected in 25 (19.8%) cases. There were no progression in 50 (39.7%) patients. Benign tumors were detected in 22 patients with colorectal cancer: in 10 cases coupled with liver metastases, in 12 – without them. Totally 166 focal liver lesions were found: 125 (75.3%) metastases and 41 (24.7%) benign tumors. According to ROC analysis, sensitivity and specificity of 18F -FDG PET/CT with SUV ≥ 3.0 in the diagnosis of liver metastases were 84.8% and 97.6% respectively, the area under the ROC curve – 0.893 (95% CI 0.836–0.936 , p < 0.0001), positive predictive value and negative predictive value were – 99.1% and 67.8%, respectively. Conclusion. 18F-FDG PET/CT is a highly informative imaging method in the differential diagnosis of colorectal liver metastases larger than 10 mm. The use of quantitative data processing with a threshold value SUV ≥ 3.0 allows to achieve high sensitivity and specificity of the method.

This article systematizes and analyzes objective difficulties in the diagnosis of precancerous and primary vulva cancer, such as: constant changes in classification and long-term coordination, long-term systematization of clinical manifestations. It also reflects the current data and achievements of virology and molecular biology, which again led to a change in the classification and approaches to the diagnosis and management tactics of patients with squamous cell lesions of the vulva. New predictor markers, currently available for use in conventional routine morphological practice, gave new data on the development of pre-tumor and tumor process of the external genitals. Also in this article, the new clinical classification of vulva diseases is analyzed in detail, a comparison of standard and new diagnostic methods is carried out, which in clinical practice helps to correctly diagnose, determine the extent of the lesion and, depending on the molecular factors of the prognosis, choose an individual modern treatment tactics.

The treatment of common forms of squamous cell carcinoma of the organs located on the head and neck that are not subject to surgical treatment is limited to the use of chemoradiotherapy with platinum derivatives or drug therapy with platinum-containing regimens. With the progression of the disease, ineffective 2‑line cytostatics were prescribed that did not fundamentally change the course of the tumor process. The introduction into clinical practice of drugs of the original mechanism of action has significantly increased the effectiveness of drug therapy during progression after platinum-containing chemotherapy. The article presents two clinical observations that demonstrate the relevance of the strategy of using inhibitors of immune response control points after platinum preparations.

Introduction. The fundamental strategic objective of the national health care was to increase the life expectancy of Russians including the early detection and treatment of cancer, remaining in recent years the leading cause of mortality, and therefore ensuring the availability of diagnostic studies for patients conducted for early diagnosis and control of treatment was extremely urgent. The objective of the study was to assess the volume and economic indicators of the availability of studies by computer tomography and magnetic resonance imaging (CT, MRI) for patients.Material and methods. The basis for the study – all cases of CT and MRI studies in patients under the program of state guarantees of free medical care for citizens in St. Petersburg in the dynamics of 5 years. The data were statistically processed using the methods of variation statistics.Results. Over the last 5 years in St. Petersburg, the number of medical organizations conducting CT and MRI in patients under the program of state guarantees has been doubled (CT: 37 medical organizations in 2013, 63 – in 2018; MRI: 32 medical organizations in 2013, 65 – in 2018), and there was a significant increase in the number of studies by these methods. In 2017, the number of CT scans was 106028, MRI – 107503 that was more than 2 times higher the number of studies conducted in 2013: 44799 and 56090, respectively. The role of these studies for the diagnosis of tumor process was significant: 67.3 % of CT and 46.6 % of MRI were performed for this purpose. The increase in the number of studies was accompanied by the increase in tariffs and costs of the system of compulsory health insurance for their implementation.Conclusion. In St. Petersburg, sufficient conditions was created to ensure the volume and financial indicators of access to medical care for patients with cancer (suspected cancer) in need of CT and MRI. At following planning for the development of this type of care, it was advisable to take into account the research needs of residents of certain districts in St. Petersburg.

—A mathematical model is proposed to describe and solve problems of medical diagnostics and forecasting based on a risk criterion. Within the framework of the model, problems with ranked diagnoses are considered, whose solution benefits from taking medical preferences into account. A diagnostic algorithm, which is the implementation of this model, is used to solve the problem of predicting the clinical status of prostate cancer. A comparative analysis of the quality of the prediction for four model options was carried out, informative prognostic indicators were revealed, and the results were interpreted. Taking medical preferences into account increases the accuracy of prediction for patients with more frequent and aggressive tumor process due to loss of accuracy for patients with less frequent and aggressive tumor process.

The study objective is to evaluate the results of using the Petrov Thyroid Cancer Score (PTCS) in 2018 and assess the diagnostic value of the original PTCS and modified PTCS. Materials and methods. PTCS, proposed in the N.N. Petrov National Medical Research Center of Oncology in early 2018, was tested in this institution in 310 patients, 99 of whom underwent surgery, mainly due to suspected malignancy of thyroid nodules or at the request of patients. Results. According to the standard histological evaluation, in 35 cases the process was considered benign (group Д ), while in 61 cases — after exclusion of 3 medullary carcinomas — regarded as highly differentiated (according to previous classification) thyroid cancer (group Р ). The average values of such components of PCTS as BethesdaScore, TI-RADSScore, ElastoScore and body mass index (BMI) in group Р were significantly higher than in group Д . The sum of the scores of the used four parameters was not only higher in group Р , but also at a magnitude of ≥ 5.0 (62.3 % of observations in this group) it always corresponded to the diagnosis of thyroid carcinoma. At the same time, a similar histological conclusion was made, in particular, in respect of 14 patients (23 % of the group Р contingent) with the value of the mentioned sum

Surgical treatment is leading in the treatment of malignant tumors of the salivary glands. The complexity of the anatomical areas, the severity of the tumor process, the close location of the facial nerve branches lead to frequent complications in the postoperative period. The technique of elimination of paresis of mimic muscles with the use of a complex of therapeutic measures, including a course of physiotherapy with the appointment of a magnetolaser and SCENAR therapy developed at the Cancer Research Institute, Tomsk National Research Medical Center of the RAS and the prospect of its use in this pathology. The clinical case of application of this material is described.

Among complications of malignant neoplasms of the heart, tumor exudative pericarditis requires emergency surgical measures with the development of chronic tamponade. At the frst stage, puncture drainage of the pericardial cavity is advisable. In case of a common tumor process and the impossibility of radical surgical treatment by the second stage, it is advisable to perform video assisted thoracoscopic pericardial fenestration with biopsy and pleurodesis, if necessary. This tactic improves the quality of life in patients and complies with modern standards of treatment of this disease.

Teratoma is a tumor consisting of several types of tissues derived from one, two or three germ leaves, the presence of which is not peculiar to those organs and anatomical areas of the body in which the tumor develops. According to the WHO classification definition, immature teratomas are those containing embryonic tissues along with definitive, mature tissue structures. In histological WHO classification immature teratomas belong to germ cell ovarian tumors and are in­cluded into the group of teracomas. The prognosis is determined by the variant of the histological structure, the primary localization of the tumor, timely and adequate treatment.This article presents a clinical case of treatment of a young female patient with persistently recurrent pelvic teratoma.The presented observation demonstrates, on the one hand, the unpredictability of the course of the tumor process in embryonic tumors. On the other hand, there were demonstrated the possibilities of surgical treatment of another re­lapse of teratoma in a young patient with a massive tumor of the pelvic cavity in a situation where the hopes for a radical operation according to previous abdominal revisions seemed vague.

Objective:study of components of an insulin-like signaling pathway in kidney tissues in local and advanced clear cell renal cell carcinoma depending on the gender of patients.Materials and methods:the object of the study was conditionally intact kidney tissue and tumor and perifocal tissues obtained during the surgical treatment of 100 patients with histologically confirmed clear cell kidney cancer (local cancer (Т1-2N0М0) n=50, advanced cancer (Т3-4N0М1) n=50). Levels of the IGF-1, IGF-2, IGFBP-1 and IGFBP-2 growth factors (Mediagnost, Germany) and STH-releasing (Peninsula Laboratories International, USA) were determined by ELISA using standard test systems. The results were analyzed using Statistica 6.0 (Stat-Soft, 2001).Results:levels of IGFВР-2 and STH-releasing in conditionally intact tissues in women were 44% and 40% lower than in men, respectively. The IGFВР-2 level in perifocal tissues of women was 38% higher than in men, while STH-releasing was lower by 1.9 times. Tumor tissues of local kidney cancer in women showed significant decrease in IGF-1 by 25%, IGFВР-1 by 29% and IGFВР-2 by 2 times. Levels of IGFBP-1 and IGFBP-2 in conditionally intact tissues of women with advanced cancer were 2 and 2.7 times lower, respectively, compared to men. IGFBP-2 and STH-releasing in perifocal tissues of women were increased by 43.8% and 44.6%, respectively. In tumor tissues of women with advanced kidney cancer, levels of IGF-1 were 1.7 times higher, IGF-2 – 31% lower, IGFBP-2 – 2.8 times lower and STH-releasing – 36% lower, compared to men.Conclusions:IGFBP-2 in all studied kidney tissues in local and advanced cancer was an identically variable index characterizing gender differences in the body’s reaction to the tumor process.

Currently, intraosseous dental implantation is one of the most widely used methods to eliminate various defects of the dentition. Despite the achievements of modern medicine, the frequency of inflammatory complications, such as peri-implantitis, in patients after dental implantation remains relatively high. Some authors suggest the presence of similarity of peri-implantitis with squamous cell carcinoma of the oral cavity at the level of pathogenesis, as well as cases of mimicry of these different nosological units are described. In this review, we study the pathogenetic mechanisms of the emergence and development of chronic inflammatory processes on the example of dental peri-implantitis, squamous cell carcinoma of the oral cavity and periodontitis, as well as the comparison of pathogenetic patterns of these processes with the study of the possible relationship. The objective of the review was to provide readers with knowledge about the common pathogenetic mechanisms of different nosological units. First of all, the data are necessary for dentists, who must remember the principle of cancer alertness, carefully carry out differential diagnosis, change the tactics of treatment of peri-implantitis with suspected tumor process.

Scientific evidence indicates the stabilization of indicators of morbidity and mortality from breast cancer in women in Ukraine and the existence of a number of models for predicting the breast cancer risk with the consideration of life style factors, detectable mutations of BRCA1 and BRCA2 genes, family history, as well as predicative and prognostic factors (clinical, molecular-biological) to determine the possible ways of the tumor process and the survival of breast cancer patients.

Introduction: The discovery of the major role of the immune system in the tumor process has led to the development of therapeutic strategies with immunotherapy. The potential systemic role of radiotherapy, (RT) used for a long time for its local action, based on its impact on immunity, is now better understood. The combination of immunotherapy and radiation therapy is currently a field of sustained research programs and has shown successful results, in non-small cell lung cancer, for example. Breast cancer (BC) was wrongly considered poorly immunogenic and put aside during accelerating progress in this new area of treatment.Areas covered: This review provides an overview of pre-clinical and clinical rationales to associate immunotherapy with radiation therapy in the management of breast cancer.Expert opinion: Immunotherapy has been used only recently in breast cancer, but clinical trials have yet to determine the place of this treatment. RT may be useful to enhance the response of breast tumors to immunotherapy. This new approach in breast cancer management is currently based on limited data but should be further investigated, especially in triple-negative breast cancer and in the neoadjuvant setting.

The article is devoted to the study of the regulatory mechanisms dynamics of skin carcinoma on the basis of the firmly established facts and theoretical positions in the field of biology, biophysics and regulation. The developed equations for the regulatory mechanisms of skin cells transformation into abnormal cancer cells have a functional-differential type. Implementation of the developed equations for the epidermis cellular communities number regulation in squamous cell carcinoma on a computer and a series of computational experiments have shown that these equations have stable stationary, self-oscillating solutions typical for the normal functioning of the skin; have chaotic solutions and the “black hole” effect, which makes it possible to diagnose the onset of the phase of unpredictable changes in the skin epidermis regulation and the beginning of the transition into tumor cells. Mathematical and computer models of the skin epidermis regulation at the norm and at the tumor process can be used to improve the methods of early diagnosis, prevention of skin diseases, as well as to choose treatment tactics.

The article deals with results of comparative analysis of the dynamics and trends of the incidents of malignant neoplasms in the population of the Moscow region. The Central Federal district and the Russian federation as a whole according to Rosstat data for 2009-2018. It was established that in Moscow region in comparison with other territories, the level and growth rates of the incidence of malignant neoplasms were lower. In the structure of the incidence of malignant neoplasms, the first rank places are occupied by breast, skin, lung, colon and prostate cancer. Attention is drawn to the fact that over the entire period of observation, the indicator of the number of people under medical supervision in the Moscow region was consistently higher than in the Russian Federation and the Central Federal district. Over the period of 2012-2018, the share of malignant neoplasms of the first stage of the spread of the tumor process increased by 23.4% in the region, and the share of stages III and IV decreased (by 16.9% and 12.3%, respectively).The increase in the number of newly detected malignancies seems to be due to increased diagnostic capabilities in recent times.

We report the case of a patient with recurrent pterygo-palatal angiofibroma and its treatment. A 21-year-old male patient had a long history of recurrent epistaxis with progressive nasal obstruction. He was diagnosed with an angiofibroma centered in the right pterygo-palatine fossa. Initially, he underwent surgical excision with removal of the entire tumor. The evolution was clinically good with no signs of recurrence on the cervico-facial scan of control (CT). Nine months after, he presented a reappearance of epistaxis. A cervico-facial MRI was performed and showed a recurrence of the tumor process, which this time was considered inextirpable, hence the decision to opt for radiotherapy with intensity modulated radiation therapy (IMRT). He has improved clinically with a clear reduction in tumor mass on CT scan. This technique represents an interesting alternative to overcome anatomical complexity of the region, cover the tumor and preserve the organs at risk.

In the Kabarda-Balkar Republic during last decades, stable dynamics of increasing rates of primary breast cancer morbidity is established. The gaining rate of indicator made up to 40.7% over last 10 years. The prevalence indicator of breast cancer is characterized by high growth intensity twice higher than the national level. In the structure of malignant neoplasms morbidity, breast cancer (23.3%) takes position of leading oncologic pathology. The most of patients with breast cancer (33.0%) are in the age group of 50-59 years. However, higher oncologic alertness of medical personnel concerning young women, especially 20-29 years old is required since their percentage among patients with breast cancer is increasing. Noteworthy is the low indicator of active case finding of patients with breast cancer: only 31.8% of cases is diagnosed during prevention examinations. At the early stage of development of tumor process (stage I-II), the rate of identified patients with breast cancer is lower than in the Russian Federation. Especially low is the level of early diagnosis of the disease at stage I. The data testifies existing problems of organization of oncologic medical care in the Kabarda-Balkar Republic and indicates the need of strengthening preventive measures at the primary health care level. Their effectiveness will be assessed by the level of early diagnosis of breast cancer in women and by corresponding appropriate treatment.