EPIDEMIOGICAL STUDIES
Objective: to analyze cancer statistics in Russia as a whole, as well as in individual regions of the Russian Federation.
Material and Methods. Based on data from the state medical statistics according to the form No. 7 “information on malignant neoplasms for 2022” the crude and standardized rates, standard error of crude and standardized rates, confidence intervals (ci) for 2022, and the qualitative parameters of cancer care were calculated.
Results. in 2022, 624,835 new cancer cases were detected in the Russian Federation (283,179 in men and 341,656 in women), in increase of 7.6 % compared to 2021 (in 2021: 580415), and decrease of 2.4 % compared to 2019 (in 2019: 640391). in 2022, the crude incidence rate was 425.89 ± 0.54 per 100,000 population of Russia (ci: 424.83–426.95 per 100,000 population), which was 7.0 % higher than that in 2021 (in 2021 – 397.91 ± 0.54 per 100,000 population) but 2.4 % lower than in 2019 (in 2019 – 436.34 ± 0.52 per 100,000 population). the standardized incidence rate was 236.47 ± 0.32 per 100,000 population (ci: 235.84–237.10 per 100,000 population), which was 5.2 % higher compared to that observed in 2021 (in 2021 – 224.87 ± 0.32 per 100,000 population) but 5.2 % lower than in 2019 (in 2019 – 249.54 ± 0.33 per 100,000 population). the prevalence rate of cancer in 2022 was 2,742.4 per 100,000 population of Russia, an increase in the prevalence rate over 10 years was 33.9 %.
Conclusion. Сancer care in the Russian Federation in 2022 was provided at the proper level. there is a positive trend in the early detection of cancer, which partly influences the reduction in the one-year mortality rate.
Background. Burden of disease estimation allows analyses to be carried out integrally, including cause and effect assessment. the rate of life years lost due to premature mortality is part of the burden of disease analysis. given that the burden of cancer is steadily increasing, analysis of the number of years lost makes it possible to identify new strategic directions, as well as to adjust decisions already made, in the health care of cancer patients.
Purpose: to estimate the loss of life expectancy as a result of premature mortality from cancer in the population of the Russian Federation.
Material and Methods. the analysis was carried out using international statistical databases for disease burden estimation, databases of the Federal state statistics service (Rosstat). to determine the target groups of priority reduction of mortality from neoplasms in the Russian Federation, an estimation of the lost years of life expectancy as a result of premature mortality in the form of the e† (e-dagger) indicator was carried out. the analyzed period of the study was 2010–2019.
Results. the Russian Federation is characterized by the smallest share of losses from cancer in the structure of losses from all causes of death compared to the analyzed countries (Japan, France, germany, latvia, lithuania, estonia). However, the share of losses has been intensively increasing for 10 years (in 2010 – 14.79 %, in 2019 – 17.54 %). in comparison with the analyzed countries, Russia is more characterised by losses from cancer at a younger age, with the highest value of life years lost in the age group 60–64 years. the age-standardized number of years lost in men in Russia is 67.1 % higher than in women. in the age group from 25 to 49 years of age, the loss of life expectancy due to cancer in women is higher and accounts for 0.4 years (or 19 %) of all losses, which is not typical of other age groups in which losses in men prevail. A significant regional differentiation of mortality in the constituent entities of the Russian Federation has been revealed, which is also reflected in the number of years lost.
Conclusion. the potential of preventive strategies in the Russian Federation has not been fully realized – the loss of life years in young and middle age requires the correction of measures to improve preventive services and oncological care. the revealed regional differentiation allows us to identify regions with high losses for priority solutions.
Background. surgery is the main method of treatment of colon cancer (cc). Radical surgery performed in non-specialized hospitals can lead to the adverse outcomes.
The aim of this study was to assess CC survival after radical surgery performed in state hospitals of the arkhangelsk region (North-West Russia) in 2010–21.
Material and Methods. data on all the 2142 cases of radical surgery of CC were obtained from the arkhangelsk regional cancer registry (ARCR). One- and five-year cancer-specific survival rates were estimated by the survival tables; cumulative survival function was calculated by the Kaplan–meier method. Univariate and multiple cox regression analysis was carried out to identify independent predictors associated with CC death risk after radical surgery in state hospitals (incl. sex, age at the time of diagnosis, topography, morphology and stage of CC).
Results. less than half (42.8 %) of patients underwent surgery at the arkhangelsk clinical cancer center (accc), a single specialized hospital. one- and five-year survival rates of all patients were 86.5 % (95 % CI: 84.9–87.9 %) and 65.1 % (95 % ci: 62.7–67.4 %), respectively. The 5-year survival rate of patients who underwent surgery in the accc was significantly higher than that in patients who underwent surgery in other state non-specialized hospitals (76.0 % (95 % ci: 72.5–79.0 % versus 49.3–73.8 %, p<0.0001). The relative risk of death of CC patients depended on the state hospital where radical surgery was performed and the stage of CC; it did not depend on patients’ sex, morphology and topography of CC.
Conclusion. our results demonstrate the need to search for specific reasons for the relatively low survival in patients after radical surgery performed in non-specialized hospitals.
CLINICAL STUDIES
The purpose of the study was to assess the diagnostic value of endoscopic autofluorescence imaging (AFI) in patients with premalignant lesions and primary laryngeal/hypopharyngeal cancer.
Material and Methods. The diagnostic value of AFI was assessed in 53 patients with chronic hyperplastic laryngeal/hypopharyngeal lesions and 48 patients with laryngeal/hypopharyngeal cancer.
Results. The inclusion of video laryngoscopy with AFI in the algorithm for examining patients with chronic diseases of the upper respiratory tract made it possible to significantly improve the diagnostic efficacy of endoscopic examination in patients with premalignant lesions (high grade dysplasia) of the laryngeal mucosa. Video laryngoscopy with AFI was found to achieve higher sensitivity, specificity and accuracy rates than white light video laryngoscopy (87.5, 96.9 and 92.5 vs 50.0, 96.0 and 71.7 %, respectively, p<0.05). The video laryngoscopy with AFI allowed identification of not only pathological changes in the laryngeal and hypopharyngeal mucosa but also their malignant potential, as well as identification of areas for targeted biopsy. In 9 (18.8 %) laryngeal cancer patients, the standard white light video laryngoscopy demonstrated difficulties in the differential diagnosis of laryngeal cancer (n=4) and in assessing the extent of laryngeal cancer (n=5). In 3 out of 4 diagnostically difficult cases, video laryngoscopy with AFI made it possible to confirm the diagnosis of laryngeal cancer and in 5 cases to accurately determine the extent of hypopharyngeal cancer.
Conclusion. The addition of standard videolaryngoscopy with a hightech technique of autofluorescence endoscopy makes it possible to accurately diagnose premalignant and malignant lesions of the larynx and hypopharynx.
The purpose of the study was to compare the efficacy of regular prolonged inhalation therapy with tiotropium bromide delivered via the Respimat inhaler and short-acting bronchodilator (SAB) therapy with ipratropium bromide/fenoterol in the perioperative period in patients with non-small cell lung cancer (NSCLC) combined with chronic obstructive pulmonary disease (copd).
Material and Methods. The study included 66 patients with Nsclc and copd. The patients received tiotropium bromide, 5 mcg/day (TB group) or a combination of ipratropium bromide/fenoterol 20/50 mcg/dose, 2 doses 4 times a day (SAB group) for 6 weeks before and 6 weeks after surgery. The control group consisted of patients who did not receive bronchodilators before surgery, but they received a combination of ipratropium bromide/fenoterol in the postoperative period. All patients underwent tests of pulmonary function (spirometry, body plethysmography), measurement of lung parenchyma density and emphysematous lung areas (high-resolution computed tomography).
Results. After preoperative preparation with use of tB or saB, there was a significant improvement in FEV1, FVC, VC, RV, ITGV, and. RV/TLC ratio relative to baseline. In the tB and sad groups, a significant reduction in the severity of total respiratory resistance (Rtot) compared to that in the control group was observed. According to the assessment of lung density and the volume of emphysematous areas on expiration, the results in the TB group were significantly better than those in the sad and control groups. six weeks after surgery, all patients showed a significant decrease in post-FeV1, post-FVC, and post-VC relative to the preoperative values. Bronchodilator therapy resulted in the reduction in Rtot in all groups; however, better results were achieved in the TB group (86 %) compared to sad group (93 %, p=0.03) and control (101.5 %, p=0.02). After surgical treatment, a decrease in the volume of emphysematous areas on inspiration was observed: the parameters were better in the TB group than in the sad and control groups (220 cm3 versus 1025 cm3 and 1002 cm3, p<0.001 and p=0.002, respectively).
Conclusion. In patients with Nsclc and copd, longterm inhaled bronchodilator therapy can significantly improve respiratory function. more beneficial results are achieved after using long-acting drugs (tiotropium bromide).
LABORATORY AND EXPERIMENTAL STUDIES
Background. medullary thyroid carcinoma (mtc) produces serum markers including calcitonin (ct) and carcinoembryonic antigen (cea). The measurement of ct in fine-needle aspirate washout fluid (FNA-CT) improves the cytological diagnosis of mtc. However, no data are available about cut-off values for FNA-CT using currently immunoassay. The measurement of cea in the needle washout fluid (FNa-cea) in mtc has not been studied.
Objective: to assess the diagnostic value and propose cut-off values for FNA-CT and FNacea in the thyroid nodule to diagnose mtc.
Material and Methods. We conducted a retrospective analysis of 164 samples of fine-needle aspirate washout fluid collected from 92 patients with thyroid nodules, who underwent FNa followed by cytological examination and measurement of FNA-CT. seventeen cases with mtc and 41 with non-mtc nodules were histologically verified. one hundred and six nodules identified as non-mtc by cytology were not operated on. FNa-cea was additionally studied in 29 samples. The cut-off value was determined by Roc analysis.
Results. The FNA-CT level was >2000 pg/ml in all mtc nodules, except for one, in which the FNA-CT level was 638 pg/ml. In non-mtc nodules, the FNA-CT levels were <10 pg/ml and <100 pg/ml in 81 % and 90 %, respectively, however, it was >500 pg/ml in 5 %, and >1000 pg/ml in 2 %. At a cut-off value of 590 pg/ml, the sensitivity and specificity of FNA-CT were 100 % and 96 %, and at a cut-off of 1721 pg/ml, the corresponding values were 94 % and 99 %. The false positive FNA-CT values were 3.7 % and 1.2 % at the cut-off values of 590 pg/ml and 1721 pg/ml, respectively. The median levels of FNa-cea in mtc and non-mtc nodules were 59.3 ng/ml and 1.5 ng/ml, respectively. At a cut-off value of 7.5 ng/ml, the sensitivity of FNa-cea was 86 % and specificity was 100 %. Additional measurement of FNa-cea prevented all false-positive results of FNA-CT, but did not detect 2 mtcs with low FNa-cea levels (false-negative rate of 6.9 %). Among samples with FNA-CT value of >590 pg/ml and negative cytology (n=9), FNa-cea differentiated mtc with 100 % sensitivity and specificity.
Conclusion. The maximum sensitivity of FNA-CT in the thyroid nodule was at a cut-off value of 590 pg/ml (100 %), the maximum specificity was at a cut-off value of 1721 pg/ml (99 %). Risk of false positive result is the major challenge of FNA-CT. to reduce false-positive results, we recommend to measure FNa-cea in the nodules with negative cytology and high level of FNA-CT. At a cut-off value of 7.5 ng/ml, FNa-cea allows the false-positive FNA-CT to be excluded.
Objective: to study the features of PD-L1 expression in tumor stromal cells, peritumoral microvessels, and isolated clusters of tumor cells in breast cancer (Bc) tissue and their correlation with the clinical and morphological characteristics of Bc.
Material and Methods. The study included 158 patients with newly diagnosed invasive BC. PD-L1 expression was studied by immunohistochemistry. statistical analysis was performed using statistica 12.0 software.
Results. PD-L1 expression in peritumoral microvessels occurred in 41.4 and 61.7 % of cases with t1–2 and T3–4 (p=0.020), and in 39.8 and 51.7 % of cases with N0–1 and N2–3 (p=0.008), respectively. In isolated clusters of tumor cells, the marker expression was observed in 28.0 and 52.5 % of cases in nodular and diffuse forms of BC (p=0.005); in 25.9, 39.3 and 66.7 % of cases at stages I–IIb, IIIa–IIIc and IV (p=0.011); in 30.3, 26.2, 40.0 and 52.5 % of cases in T1, T2, T3 and T4 (p=0.040); and in 28.2 and 45.5 % of cases in N0–1 and N2–3 (p=0.030), respectively. Nuclear expression of PD-L1 was also detected in stromal cells, and was observed in 28.8 and 55.0 % of cases with nodular and diffuse forms of BC (p=0.003), in 17.6, 52.5 and 75.0 % of cases in early, locally advanced and metastatic BC (p<0.001), in 21.2, 28.7, 80.0 and 55.0 % of cases in T1, T2, T3 and T4 (p=0.002), in 21.7, 35.3, 51.4 and 55.0 % of cases with N0, N1, N2 and N3 (p=0.005), in 49.0 and 29.0 % of cases with negative and positive status of PR (p=0.014), in 30.3 and 52.8 % of cases with HER2-negative and HER2-positive BC status (p=0.014), respectively.
Conclusion. The data indicate the relationship between PD-L1 expression and BC progression. The determination of PD-L1 expression in peritumoral microvessels and isolated tumor cell clusters, as well as nuclear expression of the marker, can be used to clarify the prognosis of the disease.
ONCOLOGY PRACTICE
Background. esophageal cancer (ec) is one of the most aggressive malignancies of the gastrointestinal tract. chemoradiation therapy is the standard of care for locally advanced ec.
The purpose of the study was to evaluate the efficacy of chemoradiation therapy given alone and in combination with surgery in patients with thoracic esophageal cancer.
Material and Methods. From January 1, 2012 to december 31, 2021, a total of 940 patients with thoracic esophageal cancer were registered in the regional cancer registry, of which 178 patients were selected for concurrent chemoradiotherapy (CRT) at clinical stages I–III. thirty seven thoracic esophageal cancer patients who received CRT and required treatment interruption due to complications were not included in our analysis. The final analysis included 141 patients.
Results. 37 (20.7 %) patients were unable to complete treatment due to intolerance and the development of severe complications of CRT. Hematological toxicity of grade 3-4 was noted in 21 patients (14.8 %). Non-hematological complications of grade 2-4 were noted in 109 patients (77.3 %). The 5-year relapse-free survival rates in patients undergoing and non-undergoing to surgery were 23.0 and 25.0 %, respectively (p=0.018). Overall 5-year survival rates were 24 and 27 %, respectively (p=0.020). The rate of pathological complete response (pcR) was 43.5 % (in 20 of 46 patients who underwent surgery after CRT). The median survival time in patients with clinical complete response (ccR) was 24.0 months and the median survival time in patients with pcR was 29.0 months. The 3-year survival rates were 21 and 45 %, respectively (p=0.050).
Conclusion. The combination of chemoradiotherapy and surgery in patients with thoracic esophageal cancer demonstrated an increase in overall survival in our study. if there is a complete clinical response to CRT and contraindications for surgery or the patient’s refusal to undergo surgery, it is advisable to use the “wait & watch” tactic.
REVIEWS
The purpose of the study was to characterize various methods of local physical destruction used in the treatment of patients with aggressive fibromatosis and demonstrate international experience of their use.
Material and Methods. literature search was conducted in the electronic databases Rsci (Russian science citation index) and NcBi (National centre for Biotechnology information) in the interval time between 2002 and 2022. The review was devoted to the thermal ablation modalities (radiofrequency, microwave ablation, cryodestruction, high-intensity focused ultrasound ablations) used in therapy of patients with desmoid fibromas of various locations, as well as their safety and efficacy.
Results. The review presents the current data on safety and efficacy of minimally-invasive and non-invasive methods of hypo- and hyperthermic local destruction in patients with aggressive fibromatosis, gives the characteristics of exposure and biological effects when performing radiofrequency and microwave ablation, cryodestruction, high-intensity focused ultrasound therapy, describes the main limitations of the methods, indications and contraindications for their application, as well as the methods of prevention of the development of desmoid fibromas.
Conclusion. The described methods of local destruction are used in clinical practice mainly for palliative and symptomatic purposes, in case of persistent tumor growth or recurrence, ineffectiveness of other treatment options or contraindications to them due to concomitant somatic pathology or functional status of the patient. Inclusion of these methods in the treatment plan of patients with aggressive fibromatosis can contribute to the reduction of pain syndrome, improvement of functional status of patients as well as long survival with no evidence of tumor progression.
Purpose of the study: to evaluate the feasibility of using functional analogues of protein antibodies – dNa/ RNa aptamers in diagnostics, treatment and prognosis of human brain glial tumors.
Material and Methods. The relevant literature sources were searched in scopus, Web of science, pubmed, elibrary with inclusion of publications from 2000 to 2023. sixty articles are presented in the review.
Results. The analysis of the literature devoted to classification, diagnostics and therapy of brain glioblastomas was carried out and the feasibility of using for in vivo diagnostics and therapy of this disease aptamers, which are molecular recognition elements based on DNA/RNA oligonucleotides, capable of binding to the given molecular targets and distinguishing even separate functional groups in them, was studied. A list of aptamers to human glial brain tumors and their molecular targets that can be used for diagnostics and therapy of glioblastoma, including tumor imaging by pet/ct, mRi, plasmon resonance, fluorescence and confocal microscopy, etc., is presented. literature data suggest that DNA/RNA aptamers can be used to search for circulating tumor cells in the blood of glioblastoma patients, to target therapeutic drugs to the tumor and to inhibit tumor growth.
Conclusion. Brain glioblastoma is a heterogeneous tumor consisting of cells at different stages of malignancy and, accordingly, with a different set of oncogenes. For this reason, a multitarget strategy that includes combined suppression of angiogenesis, invasion, metastasis, proliferation and survival of tumor cells should be proposed for the therapy of this disease. DNA/RNA aptamers tailored to key proteins involved in oncogenic transformation may be suitable candidates for the implementation of multitarget therapy for brain glioblastoma.
The purpose of the study was to systematize and summarize the literature data on the study of clinical and genetic aspects, molecular pathogenesis, as well as new trends in the diagnosis and treatment of ovarian cancer.
Material and Methods. A literature search was conducted using Web of science, scopus, medline, pubmed, and elibrary databases.
Results. Ovarian cancer is the leading cause of death in women diagnosed with gynecological cancer. ovarian cancer is a heterogeneous disease composed of different types of tumors, each of which has differences in pathogenesis, spectrum and mutation frequencies in characteristic genes, response to therapy and prognosis of the disease. more than 80 % of all malignant ovarian tumors are of epithelial origin (carcinomas) and about 26 % of all cases of ovarian cancer are caused by germline mutations found in the BRCA1/BRCA2 genes. to date, the priority areas in the study of ovarian cancer are the improvement of diagnostic methods, algorithm of examination of women, identification of new biomarkers, study of tumor microenvironment and composition of ascitic fluid to detect cancer at early stages and prescribe appropriate therapy. Recent advances in targeted therapy based on the molecular profile of the tumor have made it possible to personalize treatment and increase its effectiveness. Achievements in molecular genetic, cytological, immunological and biochemical studies contribute to the development of novel approaches to the diagnosis and treatment of ovarian cancer.
Conclusion. With the advent of new novel approaches to the diagnosis and treatment of ovarian cancer, it is becoming increasingly clear that the tumor microenvironment can significantly affect the success of chemotherapy. New biomarkers can help identify the best candidates for ovarian cancer treatment. Further basic and applied research is needed to explore the use of different diagnostic and therapeutic agents in ovarian cancer.
Background. multiple myeloma (mm) is a plasma cell cancer that affects white blood cells. plasma cells from the bone marrow grow abnormally, as a consequence of which patients have high amounts of monoclonal immunoglobulin in their blood and urine, poor renal function, and recurring infections due to this condition. osteolytic bone lesions and immunodeficiency also impact multiple myeloma patients’ longevity and quality of life. The disease accounts for 13 % of all hematological malignancies worldwide, making it the second most common blood cancer.
Material and Methods. The studies investigating mm biomarkers from 2000 to 2021 are collected from various databases. “multiple myeloma”, “biomarkers”, “genetic markers”, “prognostic markers”, “epidemiology of multiple myeloma”, and “risk factors for multiple myeloma” are the key phrases utilized to gather the articles.
Results. The scientific and medical research progressed into mm, and the number of cases increased over time and continues to rise, prompting researchers and clinicians to discover new consequences of the disease and new markers for prognosis, diagnosis, detection, and treatment of cancer in the earliest stages. Prognostic and predictive signs for illness recurrence and response to medication may be detected adequately by innovative potential biomarkers, which are more accurate than current approaches.
Conclusion. treatment for multiple myeloma includes a variety of chemotherapeutic medicines, including immune modulators and proteasome inhibitors; however, most patients still experience recurrence after completing treatment. There have been numerous novel techniques for managing multiple myeloma, and this review summarises the most commonly used and the new ones that have appeared in the previously published articles.
The main aim of the study is to analyze modern knowledge on endocrine disruptors, non-genotoxic carcinogens, contributing significantly to the total level of contamination of the biosphere by anthropogenic blastomogens.
Material and Methods. For the review preparation, we analyzed articles on molecular mechanisms of the effects of endocrine disruptors, available at biomedical literature databases sciVerse scopus, pubmed, Web of science, Rsci. The review cited 65 recent publications, 21 of them being published over the past three years, 3 papers being the official documents on hazards associated with the use of endocrine disruptors, and 10 papers presenting a background to separate endocrine disruptors into the group of compounds with specific functional activity.
Results. The role of endocrine disruptors involves the development of the tumors of reproductive organs. They may reveal the properties of strong agonists or antagonists disrupting the hormonal balance by inhibition of the synthesis of natural hormones, their secretion, transport, metabolism, binding or degradation. In addition, they activate alternative proliferation signaling pathways by activating g-proteincoupled receptors, estrogen-bound eRRγ or/and β-adrenergic receptors. The main mechanism of action of endocrine disruptors is the induction of epigenetic modifications, in particular, methylation/demethylation of cpg dNa islands, histone modifications and changes in expression of non-coding RNa. since the effects of endocrine disruptors are nonlinear, they can be caused by concentrations corresponding to the real content in the biosphere and detected in the umbilical blood and breast milk. In addition, they contribute to the metabolic activation of the procarcinogens, the main component of air pollution, by activation of the cytochrome p450 isoforms.
Conclusion. Endocrine disruptors can underlie the development of tumors of hormone-dependent organs both at direct and transplacental exposure.
CASE REPORTS
Background. takotsubo cardiomyopathy (tcm) occurs more frequently in cancer patients than in the general population. The triggers for tcm in cancer patients include not only the inflammatory state of the cancer itself, but also the significant emotional stress of a cancer diagnosis and the physical stress associated with invasive diagnostic and treatment procedures.
Case presentation. We describe the case of a 54-yearold woman with histologically verified rectosigmoid junction cancer (cT4bcN2M0) complicated by acute intestinal obstruction. In the early postoperative period, a sudden drop in blood pressure, t-wave inversion and Qt-interval prolongation on ecg, decrease in the left ventricle contractility and presence of wall motion abnormalities on echocardiography (ecHo), as well as an increase in biomarkers of myocardial damage were initially regarded as acute coronary syndrome, which was subsequently excluded according to the findings of coronary angiography, which did not reveal coronary artery obstruction. taking into account the rapid and complete inverse dynamics of changes, acute myocardial infarction without coronary artery obstruction and acute myocarditis were excluded. Ultimately, the diagnosis of takotsubo cardiomyopathy was established.
Conclusion. this case report indicates that cancer can be a trigger for the development of tcm; therefore, the assessment of cardiological status and timely detection of cardiac complications in cancer patients during cancer treatment is extremely important and is aimed at increasing the overall survival in this category of patients.
Background. Bone metastasis is very common in the advanced stage of numerous carcinomas. In penile carcinoma, lymph nodes metastasis is somehow common but it is very rare reported to be secondary from penile cancer. till the date, there are only few cases of penis carcinoma reported bone metastasis in literature worldwide.
Case Presentation. Herein, We presented a 51-year-old Nepalese male with squamous cell carcinoma of penis. computed tomography (ct) scan of the patient revealed that there was carcinoma involving glans penis and precure with bilateral external & internal inguinal lymphadenopathies. After then, the patient was under gone for partial penectomy and bilateral inguinal lymphadenectomy and complete 6-cycle chemotherapy. After one year of treatment, patient developed thigh pain and headache and he advised to have magnetic Resonance imaging (mRi) of brain, 99mTc-MDP whole body bone scan and ct scan of pelvis and thigh. The examination report reveals that there was a sclerotic change in vertex of skull bone and moderate 99mTc-MDP uptake in right proximal shaft of femur just below the neck d/d metastasis. The histopathological examination of the true cut biopsy taken from the lesion of the femur showed metastatic keratinizing squamous cell carcinoma which is rare case of femoral shaft bone metastasis secondary from penile carcinoma. Then patient was sent for surgical reconstruction of femur. Based on the case studies review femur shaft bone metastasis from penile cancer is extremely rare.
Conclusion. The best of our knowledge; this is the first early detected bone metastases to shaft of the femur in a patient with penile cancer. early diagnosis helps to radical treatment as well as palliative treatment. surgery is the preferred option of the treatments, especially for metastatic foci in the long bones.
lymphangitic carcinomatosis is characterized by the spread of cancer cells through pulmonary lymphatic vessels, which results in secondary interstitial inflammation. The diagnosis of lymphangitic carcinomatosis is challenging due to nonspecific clinical symptoms and radiological findings that similar to those of interstitial lung disease.
The purpose of the study was to demonstrate difficulties in the diagnosis of lymphangitic carcinomatosis with a systemic dissemination from unknown primary site. Case presentation. We report on a case of lymphangitic carcinomatosis from cancer of unknown primary origin with systemic involvement of internal organs imitating pulmonary disease caused by coVid-19. patient K., 58 years old, was treated for 12 bed-days in therapy departments with the diagnosis of bilateral viral coVid-19 pneumonia. clinical, laboratory and instrumental data were nonspecific. despite treatment, heart failure and kidney disease progressed to terminal stages, leading to the death of the patient. Autopsy revealed systemic lymphangitic carcinomatosis from cancer of unknown primary origin with involvement of the lungs, heart, liver, pancreas, spleen, kidneys and adrenal glands. lymphangitic carcinomatosis mimicked interstitial lung disease in a novel coronavirus infection coVid-19. metastasis to the heart mimicked coronary disease, and metastases to the kidneys led to acute kidney failure, which along with acute respiratory and heart failure caused the death of the patient.
Conclusion. lymphangitic carcinomatosis, which does not have specific clinical manifestations, is able to mimic interstitial lung diseases, including a new coronavirus infection. cancer of unknown primary and multiple visceral metastases in this case confirm the concept of the independence of different types of tumor progression.
Background. The incidence of HpV-associated oropharyngeal squamous cell carcinoma (oscc) is steadily increasing. given the better prognosis in patients with HpV-positive cancer compared to HpV-negative cancer, attempts were made to reduce the therapeutic effect in patients with early-stage oscc to improve the quality of life of these patients. early-stage oscc can currently been treated with radiation therapy or surgery used alone or in combination. Currently, the concept of transoral surgery includes both transoral laser microsurgery and robot-assisted surgeries (da Vinci, medrobotics Flex system). Case description. We report a case of using the da Vinci robot-assisted system in the combined modality treatment of oropharyngeal cancer. The patient underwent surgery followed by chemoradiotherapy. At a follow-up of 10 months, no evidence of disease progression was found. The patient experienced no any pain on swallowing.
Conclusion. The use of the da Vinci robot-assisted surgical system in the combined modality treatment of oropharyngeal cancer, especially in such a hard-to-reach area as the root of the tongue, makes it possible to better visualize and determine the boundaries of the lesion, followed by en block resection, as well as to improve functional and aesthetic results. However, careful selection of patients for this type of treatment is necessary.
Introduction. triple negative breast cancer is an aggressive clinical phenotype characterized by poor prognosis. immune system plays an important role in the development, treatment response, and progression of solid tumor. The search for immune-related markers associated with the prediction of treatment efficacy and disease prognosis, and based on the use of high-resolution molecular techniques, is a promising area of research, the results of which can be translated into clinical practice. Case description. The molecular profile of blood mononuclear cells in a 48-year-old female patient with histologically proven triple negative breast cancer (estrogen Receptor – 0; progesteron Receptor – 0; Her2/neu – 0; gata-3 – 0, androgen Receptor – 0 and Ki67 – 70 %) was described. The patient did not response to neoadjuvant chemotherapy with 4 cycles of paclitaxel + carboplatin followed by 2 cycles of adriamycin + cyclophosphamide. The patient underwent surgery. disease progression (pelvic bone metastases) occurred 2 months after surgery. The features of blood lymphocytes and monocytes associated with a lack of response to neoadjuvant chemotherapy and disease progression were described.
Conclusion. This clinical case demonstrates that sequencing of peripheral blood mononuclear cells can be used as a method for identifying predictive markers of therapy efficacy and developing personalized treatments for patients with triple negative breast cancer.
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