Pub Date : 2022-08-01DOI: 10.17650/2222-1468-2022-12-2-79-88
N. Severskaya, A. Ilyin, I. Chebotareva, N. V. Zhelonkina, P. Isaev, V. Polkin, S. A. Ivanov, A. Kaprin
Introduction. The results of the calcitonin (Ctn) study in patients with thyroid nodules are included in the clinical guidelines for the treatment of differentiated thyroid cancer. However, the management of patients with moderately elevated Ctn up to 100 pg/mL is not clearly defined.Materials and methods. The study included 103 patients with thyroid nodules and a Ctn level above the reference, but not more than 100 pg/ml. The Ctn concentration was determined using the Cobas e platform (Roche, Germany) or by the immunoradiometric method (Izotop, Hungary). 45 patients were operated on. The analysis of the incidence of medullary thyroid carcinoma (MTC), other thyroid and nonthyroid pathology in patients with elevated Ctn scan was carried out. The results of additional examination are presented: the serum cancer embryonic antigen, Ctn in wash-out, stimulated Ctn, gene RET mutation testing.The study objective is to evaluate the probability MTC with Ctn level <100 pg/ml, propose management tactics for patients with elevated Ctn and negative cytological results.Results. The incidence of MTC was 22 % (23/103). The maximum probability of mTC was at Ctn above 50 pg/mL (81 %, 13/16), at Ctn 31-50 pg/mL mTC was detected in 38 % (3/8). With Ctn <30 pg/mL and <20 pg/mL, the incidence of MTC was 9 % (7/79) and 6 % (4/64), respectively. In the majority of MTC patients (65 %), the tumor size did not exceed 1 cm. However, 22 % (5/23) had metastases to the neck lymph nodes. postoperative Ctn normalization was achieved in 96 % (22/23). In 26 % (5/19), a RET germ-line mutation was detected, most often p.val804met.Among patients without MTC, other thyroid tumors were found in 35 % (28/80), more often papillary thyroid cancer (25 %, 20/80). 13 % (10/80) had other malignant neoplasms. parathyroid adenoma was detected in 3 % (2/80). The maximum Ctn in this group was in patients with chronic kidney disease and metastatic liver disease with cholestasis and ascites.Cancer embryonic antigen was increased in 53 % of patients with MTC and in 7 % of patients without MTC. Ctn in washout was >2000 pg/mL in mTC and up to 938 pg/mL in patients with histologically confirmed absence of MTC.Conclusion. If the Ctn level is <100 pg/mL and there is no cytological confirmation, the issue of surgery is decided individually, taking into account many factors. After excluding other causes of hypercalcitoninemia (hyperparathyroidism, kidney disease, other tumors), measurement of serum cancer embryonic antigen and Ctn in wash-out is recommended. In some cases, testing for a RET mutation can be helpful.
{"title":"Calcitonin testing in patients with thyroid nodules for screening medullary thyroid carcinoma: a “gray zone”","authors":"N. Severskaya, A. Ilyin, I. Chebotareva, N. V. Zhelonkina, P. Isaev, V. Polkin, S. A. Ivanov, A. Kaprin","doi":"10.17650/2222-1468-2022-12-2-79-88","DOIUrl":"https://doi.org/10.17650/2222-1468-2022-12-2-79-88","url":null,"abstract":"Introduction. The results of the calcitonin (Ctn) study in patients with thyroid nodules are included in the clinical guidelines for the treatment of differentiated thyroid cancer. However, the management of patients with moderately elevated Ctn up to 100 pg/mL is not clearly defined.Materials and methods. The study included 103 patients with thyroid nodules and a Ctn level above the reference, but not more than 100 pg/ml. The Ctn concentration was determined using the Cobas e platform (Roche, Germany) or by the immunoradiometric method (Izotop, Hungary). 45 patients were operated on. The analysis of the incidence of medullary thyroid carcinoma (MTC), other thyroid and nonthyroid pathology in patients with elevated Ctn scan was carried out. The results of additional examination are presented: the serum cancer embryonic antigen, Ctn in wash-out, stimulated Ctn, gene RET mutation testing.The study objective is to evaluate the probability MTC with Ctn level <100 pg/ml, propose management tactics for patients with elevated Ctn and negative cytological results.Results. The incidence of MTC was 22 % (23/103). The maximum probability of mTC was at Ctn above 50 pg/mL (81 %, 13/16), at Ctn 31-50 pg/mL mTC was detected in 38 % (3/8). With Ctn <30 pg/mL and <20 pg/mL, the incidence of MTC was 9 % (7/79) and 6 % (4/64), respectively. In the majority of MTC patients (65 %), the tumor size did not exceed 1 cm. However, 22 % (5/23) had metastases to the neck lymph nodes. postoperative Ctn normalization was achieved in 96 % (22/23). In 26 % (5/19), a RET germ-line mutation was detected, most often p.val804met.Among patients without MTC, other thyroid tumors were found in 35 % (28/80), more often papillary thyroid cancer (25 %, 20/80). 13 % (10/80) had other malignant neoplasms. parathyroid adenoma was detected in 3 % (2/80). The maximum Ctn in this group was in patients with chronic kidney disease and metastatic liver disease with cholestasis and ascites.Cancer embryonic antigen was increased in 53 % of patients with MTC and in 7 % of patients without MTC. Ctn in washout was >2000 pg/mL in mTC and up to 938 pg/mL in patients with histologically confirmed absence of MTC.Conclusion. If the Ctn level is <100 pg/mL and there is no cytological confirmation, the issue of surgery is decided individually, taking into account many factors. After excluding other causes of hypercalcitoninemia (hyperparathyroidism, kidney disease, other tumors), measurement of serum cancer embryonic antigen and Ctn in wash-out is recommended. In some cases, testing for a RET mutation can be helpful.","PeriodicalId":12937,"journal":{"name":"Head and neck tumors (HNT)","volume":"82 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83919792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-01DOI: 10.17650/2222-1468-2022-12-2-71-78
A. Musaelyan, S. Lapin, V. Nazarov, E. S. Kozorezova, S. Vorobyev, S. Orlov
Introduction. Fine needle aspiration biopsy followed by cytological examination is the gold standard in the diagnosis of thyroid nodules. However, up to one third of cases represent an indeterminate result (Bethesda Thyroid Classification, 2017) III—V). Among such cases, category IV is the most common and most difficult to interpret (Bethesda, 2017). The study objective is to determination of the diagnostic and prognostic significance of the molecular genetic study of the fine needle aspiration biopsy material in patients with thyroid nodules with the cytological category Bethesda, IV.Materials and methods. The study included surgical thyroid samples obtained from patients whose cytological examination revealed pathology of cytological category IV according to the Bethesda classification (2017). group 1 included surgical samples from 143 patients with thyroid lesions, and group 2 - cytological material from 45 patients. Determination of the BRAF V600E mutation, mutations in the RAS genes (KRAS, HRAS, NRAS) was carried out using allele-specific polymerase chain reaction, and the RET / PTC1, RET / PTC3 and PAX8 / PPARG translocations were determined using reverse transcription polymerase chain reaction. Sanger sequencing was used to detect mutations in the promoter region of the TERT gene.Results. In group 1, an overall prevalence of the studied mutations in thyroid cancer was 35.1 %: 8.8 % of cases were mutation BRAF V600E, 24.6 % - mutations in the RAS genes, 1.8 % - mutation C228T in the TERT gene. The C228T mutation in the TERT gene was found in 1 case of widely invasive Hurtle cell carcinoma. The prevalence of mutations in benign formations was 4.7 %. mutations in RAS genes were also found in them in group 1, mutation BRAF V600E was associated with the presence of extrathyroid invasion (p = 0.024), vascular invasion (p = 0.018), and lymph node metastases (p = 0.018). In group 2, using the genetic panel sensitivity and specificity were equal: 36.4 and 93.9 %, respectively. positive and negative predictive values were 66.7 and 81.6 %, respectively. No RET / PTC and PAX8 / PPARG translocations were found in groups 1 and 2.Conclusion. The investigated molecular genetic panel, having a high specificity for carcinomas, will make it possible to supplement the cytological diagnostics of material in the category Bethesda, IV. BRAF V600E was associated with an aggressive morphological pattern.
{"title":"Diagnostic and prognostic significance of detecting mutations in the BRAF, TERT, RAS, RET/PTC, PAX8/PPARG in the material of fine needle aspiration biopsy thyroid nodules in the IV cytological group (Bethesda, 2017)","authors":"A. Musaelyan, S. Lapin, V. Nazarov, E. S. Kozorezova, S. Vorobyev, S. Orlov","doi":"10.17650/2222-1468-2022-12-2-71-78","DOIUrl":"https://doi.org/10.17650/2222-1468-2022-12-2-71-78","url":null,"abstract":"Introduction. Fine needle aspiration biopsy followed by cytological examination is the gold standard in the diagnosis of thyroid nodules. However, up to one third of cases represent an indeterminate result (Bethesda Thyroid Classification, 2017) III—V). Among such cases, category IV is the most common and most difficult to interpret (Bethesda, 2017). The study objective is to determination of the diagnostic and prognostic significance of the molecular genetic study of the fine needle aspiration biopsy material in patients with thyroid nodules with the cytological category Bethesda, IV.Materials and methods. The study included surgical thyroid samples obtained from patients whose cytological examination revealed pathology of cytological category IV according to the Bethesda classification (2017). group 1 included surgical samples from 143 patients with thyroid lesions, and group 2 - cytological material from 45 patients. Determination of the BRAF V600E mutation, mutations in the RAS genes (KRAS, HRAS, NRAS) was carried out using allele-specific polymerase chain reaction, and the RET / PTC1, RET / PTC3 and PAX8 / PPARG translocations were determined using reverse transcription polymerase chain reaction. Sanger sequencing was used to detect mutations in the promoter region of the TERT gene.Results. In group 1, an overall prevalence of the studied mutations in thyroid cancer was 35.1 %: 8.8 % of cases were mutation BRAF V600E, 24.6 % - mutations in the RAS genes, 1.8 % - mutation C228T in the TERT gene. The C228T mutation in the TERT gene was found in 1 case of widely invasive Hurtle cell carcinoma. The prevalence of mutations in benign formations was 4.7 %. mutations in RAS genes were also found in them in group 1, mutation BRAF V600E was associated with the presence of extrathyroid invasion (p = 0.024), vascular invasion (p = 0.018), and lymph node metastases (p = 0.018). In group 2, using the genetic panel sensitivity and specificity were equal: 36.4 and 93.9 %, respectively. positive and negative predictive values were 66.7 and 81.6 %, respectively. No RET / PTC and PAX8 / PPARG translocations were found in groups 1 and 2.Conclusion. The investigated molecular genetic panel, having a high specificity for carcinomas, will make it possible to supplement the cytological diagnostics of material in the category Bethesda, IV. BRAF V600E was associated with an aggressive morphological pattern.","PeriodicalId":12937,"journal":{"name":"Head and neck tumors (HNT)","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76036256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-01DOI: 10.17650/2222-1468-2022-12-2-33-40
Y. Alymov, A. V. Ignatova, I. Romanov
Introduction. Treatment of the oral cavity is an important problem of current oncology due to high morbidity and mortality reaching 43 % in 5-year period after diagnosis. frequency of positive resection margins is 30 % of cases which partially explains unsatisfactory results of therapy of this pathology and promotes investigation of methods increasing radicalness of surgical treatment of the primary lesion.The study objective is to evaluate the effectiveness of fluorescent visualization with 5-aminolevulinic acid for assessment of radicalness of surgical intervention in cancer of the oral mucosa.Materials and methods. In the study, evaluation of the effectiveness of 5-aminolevulinic acid for intraoperative determination of margins of squamous cell carcinoma of the oral mucosa (n = 36) was performed.Results. Comparison of intraoperative results using 5-aminolevulinic acid and results of histological examination showed that the difference in mean distances from the tumor edge to resection margin was 0.07 mm (95 % confidence interval 2.2905-2.4334) and wasn't statistically significant (p = 0.9519). Sensitivity of intraoperative fluorescent visualization with 5-aminolevulinic acid in diagnosis of resection margins was 100 %, specificity was 92.3 %, accuracy was 92.9 %, effectiveness was 96.1 %. Optimal effect of the fluorescent technique was achieved in patients with exophytic and mixed types of tumor growth without previous treatment.Conclusion. Method of intraoperative fluorescent visualization with 5-aminolevulinic acid showed high effectiveness (96.1 %) and can be recommended for intraoperative assessment of tumor margins and increase of radicalness of surgical treatment of cancer of the oral mucosa.
{"title":"Clinical guidelines and expediency of using 5-aminolevulinic acid for intraoperative visualization of margins of malignant tumors of the oral cavity","authors":"Y. Alymov, A. V. Ignatova, I. Romanov","doi":"10.17650/2222-1468-2022-12-2-33-40","DOIUrl":"https://doi.org/10.17650/2222-1468-2022-12-2-33-40","url":null,"abstract":"Introduction. Treatment of the oral cavity is an important problem of current oncology due to high morbidity and mortality reaching 43 % in 5-year period after diagnosis. frequency of positive resection margins is 30 % of cases which partially explains unsatisfactory results of therapy of this pathology and promotes investigation of methods increasing radicalness of surgical treatment of the primary lesion.The study objective is to evaluate the effectiveness of fluorescent visualization with 5-aminolevulinic acid for assessment of radicalness of surgical intervention in cancer of the oral mucosa.Materials and methods. In the study, evaluation of the effectiveness of 5-aminolevulinic acid for intraoperative determination of margins of squamous cell carcinoma of the oral mucosa (n = 36) was performed.Results. Comparison of intraoperative results using 5-aminolevulinic acid and results of histological examination showed that the difference in mean distances from the tumor edge to resection margin was 0.07 mm (95 % confidence interval 2.2905-2.4334) and wasn't statistically significant (p = 0.9519). Sensitivity of intraoperative fluorescent visualization with 5-aminolevulinic acid in diagnosis of resection margins was 100 %, specificity was 92.3 %, accuracy was 92.9 %, effectiveness was 96.1 %. Optimal effect of the fluorescent technique was achieved in patients with exophytic and mixed types of tumor growth without previous treatment.Conclusion. Method of intraoperative fluorescent visualization with 5-aminolevulinic acid showed high effectiveness (96.1 %) and can be recommended for intraoperative assessment of tumor margins and increase of radicalness of surgical treatment of cancer of the oral mucosa.","PeriodicalId":12937,"journal":{"name":"Head and neck tumors (HNT)","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80499537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-01DOI: 10.17650/2222-1468-2022-12-2-12-24
F. Kamolova, P. A. Zeynalova, R. I. Azizyan, A. Akhundov, I. Zaderenko, M. Bolotin, D. Stelmakh, V. I. Sokorutov, K. D. Ilkaev, V. Tsiklauri, Y. Alymov, I. Gelfand, M. Pak, A. V. Ignatova, A. Batsev, F. М. Abbasbeyli, A. E. Raportinova
Introduction. Lymphomas are a heterogenic group of tumors of the lymphatic and hematopoietic systems, and in many cases tumor process develops in the area of the head and neck including skin and mucosa, orbit, nasal cavity and paranasal sinuses, oral cavity, oropharynx, salivary glands, thyroid, and cervical lymph nodes. Differential diagnosis of lymphomas of the head and neck is complicated because it can be accompanied by another non-tumor pathology. High heterogeneity of lymphomas of the head and neck requires structurization of knowledge on their epidemiological and clinical manifestations.The study objective is to optimize early diagnosis as it allows to significantly increase cancer alertness in local practitioners, oncologists, diagnosis specialists and, in turn, to decrease verification frequency in generalized disease processes. Study of clinical characteristics of lymphoproliferative disorders of the head and neck leads to increased quality of differential diagnosis.Materials and methods. A study of lymphoproliferative disorders affecting head and neck was performed. Study material consisted of data on 174 patients hospitalized at the N.N. Blokhin National medical Research Center of Oncology between 1999 and 2020.Results. Based on the current clinical and morphological classification of lymphoproliferative disorders, data on location of lesions, characteristic signs of extranodal lesions and cervical lymph nodes involvement, as well as methods of diagnosis of lymphomas of the head and neck, are presented.Conclusion. The obtained data helps solve problems of diagnosis of lymphoproliferative disorders affecting the head and neck and serve as a basis for successful, predictable treatment of lymphomas.
{"title":"Lymphoproliferative disorders affecting organs of the head and neck","authors":"F. Kamolova, P. A. Zeynalova, R. I. Azizyan, A. Akhundov, I. Zaderenko, M. Bolotin, D. Stelmakh, V. I. Sokorutov, K. D. Ilkaev, V. Tsiklauri, Y. Alymov, I. Gelfand, M. Pak, A. V. Ignatova, A. Batsev, F. М. Abbasbeyli, A. E. Raportinova","doi":"10.17650/2222-1468-2022-12-2-12-24","DOIUrl":"https://doi.org/10.17650/2222-1468-2022-12-2-12-24","url":null,"abstract":"Introduction. Lymphomas are a heterogenic group of tumors of the lymphatic and hematopoietic systems, and in many cases tumor process develops in the area of the head and neck including skin and mucosa, orbit, nasal cavity and paranasal sinuses, oral cavity, oropharynx, salivary glands, thyroid, and cervical lymph nodes. Differential diagnosis of lymphomas of the head and neck is complicated because it can be accompanied by another non-tumor pathology. High heterogeneity of lymphomas of the head and neck requires structurization of knowledge on their epidemiological and clinical manifestations.The study objective is to optimize early diagnosis as it allows to significantly increase cancer alertness in local practitioners, oncologists, diagnosis specialists and, in turn, to decrease verification frequency in generalized disease processes. Study of clinical characteristics of lymphoproliferative disorders of the head and neck leads to increased quality of differential diagnosis.Materials and methods. A study of lymphoproliferative disorders affecting head and neck was performed. Study material consisted of data on 174 patients hospitalized at the N.N. Blokhin National medical Research Center of Oncology between 1999 and 2020.Results. Based on the current clinical and morphological classification of lymphoproliferative disorders, data on location of lesions, characteristic signs of extranodal lesions and cervical lymph nodes involvement, as well as methods of diagnosis of lymphomas of the head and neck, are presented.Conclusion. The obtained data helps solve problems of diagnosis of lymphoproliferative disorders affecting the head and neck and serve as a basis for successful, predictable treatment of lymphomas.","PeriodicalId":12937,"journal":{"name":"Head and neck tumors (HNT)","volume":"2015 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87131155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-31DOI: 10.17650/2222-1468-2022-12-2-108-115
O. A. Saprina
This review presents data on the strategy for the treatment of oropharyngeal cancer associated with human papillomavirus. This pathology occurs mainly in young people without bad habits. Despite the low degree of differentiation, the course of the disease is relatively favorable. In addition, the tumor has a rather high sensitivity to conservative methods of treatment. The article discusses various options for de-escalation of therapy, modern drug regimens, as well as the results of the most significant randomized trials on this issue.
{"title":"Treatment strategy for HPV-positive oropharyngeal cancer: a literature review","authors":"O. A. Saprina","doi":"10.17650/2222-1468-2022-12-2-108-115","DOIUrl":"https://doi.org/10.17650/2222-1468-2022-12-2-108-115","url":null,"abstract":"This review presents data on the strategy for the treatment of oropharyngeal cancer associated with human papillomavirus. This pathology occurs mainly in young people without bad habits. Despite the low degree of differentiation, the course of the disease is relatively favorable. In addition, the tumor has a rather high sensitivity to conservative methods of treatment. The article discusses various options for de-escalation of therapy, modern drug regimens, as well as the results of the most significant randomized trials on this issue.","PeriodicalId":12937,"journal":{"name":"Head and neck tumors (HNT)","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84319565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-30DOI: 10.17650/2222-1468-2022-12-2-132-138
A. Editorial
Рак щитовидной железы (РЩЖ) является самой частой опухолью эндокринной системы, заболеваемость им составляет 7,7 новых случая в год на 100 тыс. населения, а распространенность за счет накопленного контингента — 125 больных на 100 тыс. населения.
甲状腺癌是内分泌系统中最常见的肿瘤，每10万人每年有7.7例新病例，每10万人有125例。
{"title":"Resolution of the expert council on the topic “Clinical practice of drug therapy of thyroid cancer”","authors":"A. Editorial","doi":"10.17650/2222-1468-2022-12-2-132-138","DOIUrl":"https://doi.org/10.17650/2222-1468-2022-12-2-132-138","url":null,"abstract":"Рак щитовидной железы (РЩЖ) является самой частой опухолью эндокринной системы, заболеваемость им составляет 7,7 новых случая в год на 100 тыс. населения, а распространенность за счет накопленного контингента — 125 больных на 100 тыс. населения.","PeriodicalId":12937,"journal":{"name":"Head and neck tumors (HNT)","volume":"54 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81991356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-19DOI: 10.17650/2222-1468-2022-12-1-120-127
E. N. Novozhilova, V. Popadyuk, S. Sokolov, I. F. Chumakov, A. I. Chernolev
The study objective – to present a unique clinical observation of the successful treatment of tracheoesophageal fistula using laser exposure.Case report. Patient H., 51 years old, applied to the Moscow City Oncology Hospital No 62, Moscow Healthсare Department on January 22, 2018, with a diagnosis of thyroid cancer (multicentric growth), T3N0M0 (hospital No. 1974 / 43). Thyroidectomy was performed on 03.08.2009, removal of a recurrent tumor with resection of the esophageal wall and trachea – 03.02.2021. Histological examination No. 5589 / 56662–56668 dated 09.02.2021: papillary cancer with invasion of the wall of the esophagus and trachea. Resection within unaltered tissues. A mobilized sternocleidomastoid muscle was used to separate the esophagus and trachea. A nasogastric tube was used for 14 days. The wound on the neck healed by primary intention. The patient began to eat through the mouth. A day after the removal of the probe, facial emphysema began to grow intensively, which was accompanied by a cough. The nasogastric tube is reinserted. With fluoroscopy of the esophagus and with pharyngogastroduodenoscopy, a tracheoesophageal fistula was revealed along the right lateral wall of the trachea, about 0.5 cm in size, 1.5–2 cm below the level of the vocal folds. On endoscopic examination a week later, the fistula was already 1.0 cm in size. Conservative therapy and surgical treatment were carried out. Due to the flexible laser fiber, a phased effect on the fistula wall was carried out, both from the esophagus and from the trachea. Within a week after the first session, the fistulous opening decreased by 2 times. Then 2 more sessions were carried out with an interval of 10 days. During endoscopic examination from 05.05.2021 the fistula between the trachea and the esophagus is not defined. The mucous membrane is epithelized, smooth. Swallowing is free.Conclusion. Thus, the problem of treating patients with tracheoesophageal fistulas is extremely complex and versatile. The localization of the fistula, its size, and the clinic’s capabilities for treating a patient are of great importance.
{"title":"A case of successful treatment of tracheoesophageal fistula using laser exposure","authors":"E. N. Novozhilova, V. Popadyuk, S. Sokolov, I. F. Chumakov, A. I. Chernolev","doi":"10.17650/2222-1468-2022-12-1-120-127","DOIUrl":"https://doi.org/10.17650/2222-1468-2022-12-1-120-127","url":null,"abstract":"The study objective – to present a unique clinical observation of the successful treatment of tracheoesophageal fistula using laser exposure.Case report. Patient H., 51 years old, applied to the Moscow City Oncology Hospital No 62, Moscow Healthсare Department on January 22, 2018, with a diagnosis of thyroid cancer (multicentric growth), T3N0M0 (hospital No. 1974 / 43). Thyroidectomy was performed on 03.08.2009, removal of a recurrent tumor with resection of the esophageal wall and trachea – 03.02.2021. Histological examination No. 5589 / 56662–56668 dated 09.02.2021: papillary cancer with invasion of the wall of the esophagus and trachea. Resection within unaltered tissues. A mobilized sternocleidomastoid muscle was used to separate the esophagus and trachea. A nasogastric tube was used for 14 days. The wound on the neck healed by primary intention. The patient began to eat through the mouth. A day after the removal of the probe, facial emphysema began to grow intensively, which was accompanied by a cough. The nasogastric tube is reinserted. With fluoroscopy of the esophagus and with pharyngogastroduodenoscopy, a tracheoesophageal fistula was revealed along the right lateral wall of the trachea, about 0.5 cm in size, 1.5–2 cm below the level of the vocal folds. On endoscopic examination a week later, the fistula was already 1.0 cm in size. Conservative therapy and surgical treatment were carried out. Due to the flexible laser fiber, a phased effect on the fistula wall was carried out, both from the esophagus and from the trachea. Within a week after the first session, the fistulous opening decreased by 2 times. Then 2 more sessions were carried out with an interval of 10 days. During endoscopic examination from 05.05.2021 the fistula between the trachea and the esophagus is not defined. The mucous membrane is epithelized, smooth. Swallowing is free.Conclusion. Thus, the problem of treating patients with tracheoesophageal fistulas is extremely complex and versatile. The localization of the fistula, its size, and the clinic’s capabilities for treating a patient are of great importance.","PeriodicalId":12937,"journal":{"name":"Head and neck tumors (HNT)","volume":"189 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77946397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-19DOI: 10.17650/2222-1468-2022-12-1-114-119
A. Polyakov, L. Bolotina, A. Kornietskaya, D. S. Kudashkina, D. Sidorov, A. Troitskiy, A. Gevorkov
Cutaneous melanoma is characterized by an aggressive course associated with a tendency to metastasis. For a long time, the prognosis of patients with metastatic melanoma remained extremely poor. However, the introduction of immunooncological drugs into clinical practice has changed the approaches to the treatment of patients with metastatic melanoma, and fundamentally improved the prognosis and quality of life of such patients, which undoubtedly became a breakthrough in the treatment of this pathology. This article presents a clinical case of the treatment with immunological drugs of a patient with metastatic melanoma of the skin with lymph nodes of rare localization with a complete tumor response.
{"title":"Immuno-oncological drugs application in the treatment of metastatic cutaneous melanoma with lymph nodes metastases of rare localization: a case report","authors":"A. Polyakov, L. Bolotina, A. Kornietskaya, D. S. Kudashkina, D. Sidorov, A. Troitskiy, A. Gevorkov","doi":"10.17650/2222-1468-2022-12-1-114-119","DOIUrl":"https://doi.org/10.17650/2222-1468-2022-12-1-114-119","url":null,"abstract":"Cutaneous melanoma is characterized by an aggressive course associated with a tendency to metastasis. For a long time, the prognosis of patients with metastatic melanoma remained extremely poor. However, the introduction of immunooncological drugs into clinical practice has changed the approaches to the treatment of patients with metastatic melanoma, and fundamentally improved the prognosis and quality of life of such patients, which undoubtedly became a breakthrough in the treatment of this pathology. This article presents a clinical case of the treatment with immunological drugs of a patient with metastatic melanoma of the skin with lymph nodes of rare localization with a complete tumor response.","PeriodicalId":12937,"journal":{"name":"Head and neck tumors (HNT)","volume":"54 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84958767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-18DOI: 10.17650/2222-1468-2022-12-1-99-106
L. Kozhanov, A. L. Kozhanov, E. Romanova
This review discusses current aspects of the diagnosis and treatment of adenoid cystic carcinoma of the trachea and larynx. It describes different variants of surgical treatment, radiotherapy, combination therapy, endotracheal interventions using endoscopic techniques and physical methods, grafting, tracheal transplantation, complications, and oncological and functional treatment outcomes. We also analyze clinical aspects of adenoid cystic carcinoma of the larynx, most common tumor location, difficulties associated with morphological verification, and controversial issues related to surgery volume, considering that this disease is rare and clinical experience is often insufficient.
{"title":"Current aspects of the diagnosis and treatment of adenoid cystic carcinoma of the trachea and larynx: a literature review","authors":"L. Kozhanov, A. L. Kozhanov, E. Romanova","doi":"10.17650/2222-1468-2022-12-1-99-106","DOIUrl":"https://doi.org/10.17650/2222-1468-2022-12-1-99-106","url":null,"abstract":"This review discusses current aspects of the diagnosis and treatment of adenoid cystic carcinoma of the trachea and larynx. It describes different variants of surgical treatment, radiotherapy, combination therapy, endotracheal interventions using endoscopic techniques and physical methods, grafting, tracheal transplantation, complications, and oncological and functional treatment outcomes. We also analyze clinical aspects of adenoid cystic carcinoma of the larynx, most common tumor location, difficulties associated with morphological verification, and controversial issues related to surgery volume, considering that this disease is rare and clinical experience is often insufficient.","PeriodicalId":12937,"journal":{"name":"Head and neck tumors (HNT)","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89725814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-11DOI: 10.17650/2222-1468-2022-12-1-53-64
Y. Yusef, A. Stoyukhina
Introduction. The frequency of intraocular metastases is 64–67 % of all metastatic tumors of eye, with the choroid being mainly affected (88–90.7 %). In the majority of cases, metastases are localized in the central regions of the fundus (in 80 % between the equator and the macular zone) and, are characterized by rapid growth and rapid symptoms increase. There is practically no information in the literature about choroidal metastases foloww-up during polychemotherapy.The study objective – to analyze changes in the optical coherence tomography (OCT) of the choriodeal metastatic lesion at the end of polychemotherapy.Materials and methods. Three patients with choroidal metastases were under observation. Two of them were examined once after polychemotherapy. One patient was examined in dynamics before and after the end of polychemotherapy.Results. In all cases, there was a decrease in the thickness of the choroidal complex, compaction of its structure, impaired visualization of the choriocapillaries in the area of metastases localization in the choroid, detected by OCT after polychemotherapy, which should be regarded as evidence of the replacement of the metastatic focus with a scar. Optical coherence tomography – angiography indicates the appearance of ishimization in the projection of the inner choroidl layers, which is evidence of pronounced vascular disorders. We believe that the signs of vascular collateral formation at the level of the choriocapillary layer revealed by OCT-angiography indicate a compensatory reaction of the body.
{"title":"Metastatic lesion of the choroid against the background of polychemotherapy","authors":"Y. Yusef, A. Stoyukhina","doi":"10.17650/2222-1468-2022-12-1-53-64","DOIUrl":"https://doi.org/10.17650/2222-1468-2022-12-1-53-64","url":null,"abstract":"Introduction. The frequency of intraocular metastases is 64–67 % of all metastatic tumors of eye, with the choroid being mainly affected (88–90.7 %). In the majority of cases, metastases are localized in the central regions of the fundus (in 80 % between the equator and the macular zone) and, are characterized by rapid growth and rapid symptoms increase. There is practically no information in the literature about choroidal metastases foloww-up during polychemotherapy.The study objective – to analyze changes in the optical coherence tomography (OCT) of the choriodeal metastatic lesion at the end of polychemotherapy.Materials and methods. Three patients with choroidal metastases were under observation. Two of them were examined once after polychemotherapy. One patient was examined in dynamics before and after the end of polychemotherapy.Results. In all cases, there was a decrease in the thickness of the choroidal complex, compaction of its structure, impaired visualization of the choriocapillaries in the area of metastases localization in the choroid, detected by OCT after polychemotherapy, which should be regarded as evidence of the replacement of the metastatic focus with a scar. Optical coherence tomography – angiography indicates the appearance of ishimization in the projection of the inner choroidl layers, which is evidence of pronounced vascular disorders. We believe that the signs of vascular collateral formation at the level of the choriocapillary layer revealed by OCT-angiography indicate a compensatory reaction of the body.","PeriodicalId":12937,"journal":{"name":"Head and neck tumors (HNT)","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73420585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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