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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">oncotomsk</journal-id><journal-title-group><journal-title xml:lang="ru">Сибирский онкологический журнал</journal-title><trans-title-group xml:lang="en"><trans-title>Siberian journal of oncology</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1814-4861</issn><issn pub-type="epub">2312-3168</issn><publisher><publisher-name>Tomsk National Research Medical Сепtеr of the Russian Academy of Sciences</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.21294/1814-4861-2021-20-6-158-163</article-id><article-id custom-type="elpub" pub-id-type="custom">oncotomsk-1999</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>СЛУЧАЙ ИЗ КЛИНИЧЕСКОЙ ПРАКТИКИ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>CASE REPORTS</subject></subj-group></article-categories><title-group><article-title>Сегментарный нейрофиброматоз с компрессией спинного мозга на шейном уровне. Обзор литературы и случай из практики</article-title><trans-title-group xml:lang="en"><trans-title>Segmental neurofibromatosis with compression of the spinal cord at the cervical level. Literature review and case report</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-5509-5612</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Гуляев</surname><given-names>Д. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Gulyaev</surname><given-names>D. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p> доктор медицинских наук, профессор кафедры нейрохирургии института последипломного образования; главный научный сотрудник НИЛ интегративных нейрохирургических технологий  </p><p>SPIN-код: 1612-8261. Author ID (Scopus): 57189367050</p><p> Россия, 197341, г. Санкт-Петербург, ул. Аккуратова, 2</p></bio><bio xml:lang="en"><p> MD, DSc, Professor, Department of Neurosurgery, Head of the Department of Integrative Neurosurgical Technology</p><p>SPIN-code: 1612-8261. Author ID (Scopus): 57189367050 </p><p>2, Akkuratova, 197341, St. Petersburg, Russia </p></bio><email xlink:type="simple">spb.gda@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-2473-2671</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Белов</surname><given-names>И. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Belov</surname><given-names>I. Yu.</given-names></name></name-alternatives><bio xml:lang="ru"><p> кандидат медицинских наук, врач-нейрохирург</p><p>SPIN-код: 1024-1402 </p><p> Россия, 197341, г. Санкт-Петербург, ул. Аккуратова, 2</p></bio><bio xml:lang="en"><p> MD, PhD</p><p>SPIN-code: 1024-1402 </p><p>2, Akkuratova, 197341, St. Petersburg, Russia </p></bio><email xlink:type="simple">spb.gda@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8719-0342</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Низолин</surname><given-names>Д. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Nizolin</surname><given-names>D. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>клинический ординатор, нейрохирург</p><p>SPIN-код: 9141-7638. ORCID: </p><p> Россия, 197341, г. Санкт-Петербург, ул. Аккуратова, 2</p></bio><bio xml:lang="en"><p> Resident Neurosurgery</p><p>SPIN-code: 9141-7638 </p><p>2, Akkuratova, 197341, St. Petersburg, Russia </p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-0735-7822</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Митрофанова</surname><given-names>Л. Б.</given-names></name><name name-style="western" xml:lang="en"><surname>Mitrofanova</surname><given-names>L. B.</given-names></name></name-alternatives><bio xml:lang="ru"><p> доктор медицинских наук, профессор, заведующая НИЛ патоморфологии </p><p>SPIN-код: 9552-8248. Author ID (Scopus): 638012 </p><p>Россия, 197341, г. Санкт-Петербург, ул. Аккуратова, 2</p></bio><bio xml:lang="en"><p> MD, DSc, Professor, Head of the Department of Pathomorphology</p><p>SPIN-code: 9552-8248. Author ID (Scopus): 638012 </p><p>2, Akkuratova, 197341, St. Petersburg, Russia </p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2446-4155</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Примак</surname><given-names>Н. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Primak</surname><given-names>N. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p> кандидат медицинских наук, врач-нейрохирург</p><p>SPIN-код: 2922-1168. Author ID (Scopus): 1014991</p><p> Россия, 197341, г. Санкт-Петербург, ул. Аккуратова, 2</p></bio><bio xml:lang="en"><p> MD, PhD</p><p>SPIN-code 2922-1168. Author ID (Scopus): 1014991 </p><p>2, Akkuratova, 197341, St. Petersburg, Russia </p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Годанюк</surname><given-names>Д. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Godanyuk</surname><given-names>D. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p> врач-нейрохирург </p><p> Россия, 197341, г. Санкт-Петербург, ул. Аккуратова, 2</p><p> SPIN-код: 7449-1824 </p></bio><bio xml:lang="en"><p> MD</p><p>SPIN-code: 7449-1824 </p><p>2, Akkuratova, 197341, St. Petersburg, Russia </p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Курносов</surname><given-names>И. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Kurnosov</surname><given-names>I. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p> врач-нейрохирург</p><p>SPIN-код: 9131-7381 </p><p> Россия, 197341, г. Санкт-Петербург, ул. Аккуратова, 2</p></bio><bio xml:lang="en"><p> MD</p><p>SPIN-code: 9131-7381 </p><p> 2, Akkuratova, 197341, St. Petersburg, Russia </p></bio><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГБУ «НМИЦ им. В.А. Алмазова» Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>V.A. Almazov National Medical Research Center of the Ministry of Health of the Russian Federation</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2021</year></pub-date><pub-date pub-type="epub"><day>13</day><month>01</month><year>2022</year></pub-date><volume>20</volume><issue>6</issue><fpage>158</fpage><lpage>163</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Гуляев Д.А., Белов И.Ю., Низолин Д.В., Митрофанова Л.Б., Примак Н.А., Годанюк Д.С., Курносов И.А., 2022</copyright-statement><copyright-year>2022</copyright-year><copyright-holder xml:lang="ru">Гуляев Д.А., Белов И.Ю., Низолин Д.В., Митрофанова Л.Б., Примак Н.А., Годанюк Д.С., Курносов И.А.</copyright-holder><copyright-holder xml:lang="en">Gulyaev D.A., Belov I.Y., Nizolin D.V., Mitrofanova L.B., Primak N.A., Godanyuk D.S., Kurnosov I.A.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.siboncoj.ru/jour/article/view/1999">https://www.siboncoj.ru/jour/article/view/1999</self-uri><abstract><sec><title> </title><p> </p></sec><sec><title>Актуальность</title><p>Актуальность. Нейрофиброматоз относится к достаточно редким заболеваниям (1/3000) и представлен несколькими клиническими вариантами. В 1992 г. V. Riccardi описал семь типов нейрофиброматоза. Сегментарный нейрофиброматоз (cH), также известный как V тип нейрофиброматоза, является крайне редким вариантом, для которого характерно развитие типичных кожных проявлений или нейрофибром, ограниченных одним сегментом тела. Описание клинического случая. В литературе описано около 100 наблюдений СН, из которых всего один – с компрессией спинного мозга. Нами представлен первый случай такой нозологической формы с компрессией спинного мозга у российского пациента. Больной, 70 лет, в связи с нарастанием пареза в левых конечностях по рекомендации невролога выполнил МРТ шейного отдела позвоночника, на которой были выявлены опухоли солидного типа, расположенные экстрамедуллярно интра-экстрадурально на уровне Сii–iii с выраженной компрессией спинного мозга. На момент госпитализации неврологическая картина заболевания представлена глубоким спастическим тетрапарезом (1–2 балла), нарушением всех видов чувствительности с уровня СiV по проводниковому типу, нарушением функции тазовых органов по типу задержки. Индекс Карновского 50 %, 2 балла по шкале Fim. В качестве доступа к патологическому образованию выполнена стандартная ламинэктомия на уровне Сii–iii. Первым этапом устранена компрессия спинного мозга за счет удаления интрадурально расположенных опухолей. В последующем поэтапно удалены экстрадуральные части новообразований. При гистологическом исследовании опухоли были представлены переплетающимися пучками вытянутых шванновских клеток с волнистыми ядрами, имеющими заостренные концы, и коллагеновыми волокнами. Присутствующий в строме муцин разделял клетки и волокна. Заключение. СН относится к редкому типу нейрофиброматоза. Однако с точки зрения генетики относить его к отдельному типу нейрофиброматоза, по всей видимости, неправильно, поскольку причина развития – мозаицизм соматических клеток вследствие мутации гена NF 1. СН достаточно редко проявляется развитием множественных нейрофибром спинномозговых нервов, однако при развитии таковых может сопровождаться грубым неврологическим дефицитом, вызванным компрессией спинного мозга. Хирургическое лечение основано на базовых общих и специальных хирургических принципах, которые определяются анатомо-морфологическими характеристиками области вмешательства, соблюдение которых позволяет добиться хороших результатов лечения.</p></sec></abstract><trans-abstract xml:lang="en"><p>Background. Neurofibromatosis is a fairly rare disease (1/3000). In 1992, V. Riccardi described seven types of neurofibromatosis. Segmental neurofibromatosis (sh), also known as type V neurofibromatosis, is an extremely rare variant characterized by the development of typical cutaneous manifestations or one body segment neurofibromas. Clinical case. Currently, the literature describes about 100 cases of sh and only one of them with compression of the spinal cord. We present our first case of this nosological form with spinal cord compression in a Russian patient. A 70-year-old patient, due to an increasing paresis in the left extremities, underwent mri of the cervical spine, which revealed solid tumors located extramedullary intra-extradurally at the level of c2-c3 vertebrae with pronounced compression of the spinal cord. At the time of hospitalization, clinical presentation was characterized by deep spastic tetraparesis (1–2 points), impairment of all types of sensitivity from the c4 level by the conductive type, and dysfunction of the pelvic organs by the type of delay. Karnofsky index was 50 %, 2 points on the Fim scale. Standard c2-c3 vertebrae laminectomy was performed. Spinal cord compression was eliminated due to the removal of intradural tumors. Subsequently, extradural tumors were removed step by step. On histological examination, tumors were represented by intertwining bundles of elongated schwann cells with wavy nuclei with pointed ends and ileogenic fibers. Mucin present in the stroma separated cells and fibers. Conclusion. Sn is a rare type of neurofibromatosis. However, from the point of view of genetics, it is most likely incorrect to attribute it to a separate type of neurofibromatosis, since the cause of its development is mosaicism of somatic cells due to mutation of the NF 1 gene. Sn is rarely manifested by the development of spinal nerves multiple neurofibromas, however, it can be accompanied by a gross neurological deficit caused by compression of the spinal cord such neurofibromas. Surgical treatment is based on basic and special surgical principles that determine the anatomical and morphological characteristics of the area of intervention, the compliance of which allows for good treatment results.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>нейрофиброматоз</kwd><kwd>сегментарный нейрофиброматоз</kwd></kwd-group><kwd-group xml:lang="en"><kwd>neurofibromatosis</kwd><kwd>segmental neurofibromatosis</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Wagner G., Meyer V., Sachse M.M. Segmental neurofibromatosis. Hautarzt. 2018 Jun; 69(6): 487–490. doi: 10.1007/s00105-017-4078-1.</mixed-citation><mixed-citation xml:lang="en">Wagner G., Meyer V., Sachse M.M. Segmental neurofibromatosis. 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