Pub Date : 2020-11-16DOI: 10.17650/2222-1468-2020-10-3-97-110
C. Rahimov, A. Ahundov, G. Hajiyeva, R. Rahimli, D. Safarov, I. Farzaliyev
Background. Reconstruction of subtotal and total defects of maxillofacial region after ablative tumor surgery is a challenging task of reconstructive surgery. The “golden rule” is maintaining of radicalism of ablative surgery as well as appropriate surgical reconstruction and prosthodontic rehabilitation, that allows patient return to normal life. Wherein reconstructive procedure is focusing on restoring of mandibular continuity by the means of different flaps and grafts, while prosthodontic rehabilitation is performing after some period of time (usually around year) by the means of removable and non-removable prosthodontic devices. Non-removable device requiring dental implants insertion into grafted material followed by period of osteointegration, that is requiring some time as well. However, within this period of time one could observe significant soft tissue deformity.The objective is to improve the outcomes of surgical reconstruction of extensive defects of the mandible and to carry out rapid prosthodontic rehabilitation supported by dental implants by application of 3D preoperative planning and navigation devices.Clinical case. Forty-nine years-old female patient with recurrent ameloblastoma, that affects vertical and horizontal ramus of the mandible. Within virtual preoperative planning one performed: resection of the mandible associated with exarticulation of condylar head, virtual plate bending according to contours of the mandible (that were determined by application of “mirror” function of virtual planning software), arthroplasty of temporomandibular joint, determination of donor site on fibula bone, osteotomy of fibula free flap, positioning of dental implants, transferring of composite flap and it’s fixation by reconstructive plate. According to acquiring data one performed fabrication of patient specific navigation guides for both fibula flap segmentation and dental implants positioning. Surgical procedure included single-step tumor ablation and exarticulation of condylar head, reconstruction of defect by the means of osseo-myo-cutaneous fibula free flap, that was pre-implanted by dental implants, total joint reconstruction by titanium condylar head and polypropylene fossa, fixation of the flap and condylar head in recipient site by the means of prebended reconstructive plate, as well as insertion of non-removable bridge prosthodontic device. Postoperative result was asses clinically and radiologically. No significant postoperative complications occurred. Restoration of facial contours, mouth opening, I class occlusion, as well as adequate meal and speech were detected. Postoperative radiological investigation revealed adequate positioning of dental implants within neo-mandible, as well as positioning of artificial joint.Conclusion. In cases of extensive tumors of the jaws single-step ablative surgical procedure, reconstruction of missing anatomical structures of the jaws and simultaneous prosthodontic rehabilitation allows to preve
{"title":"Treatment of extensive tumors of the jaws by hemimandibuloectomy with simultaniouse reconstruction of the mandible, arthroplasty of temporomandibular joint, orthopedic rehabilitation supported by dental implants","authors":"C. Rahimov, A. Ahundov, G. Hajiyeva, R. Rahimli, D. Safarov, I. Farzaliyev","doi":"10.17650/2222-1468-2020-10-3-97-110","DOIUrl":"https://doi.org/10.17650/2222-1468-2020-10-3-97-110","url":null,"abstract":"Background. Reconstruction of subtotal and total defects of maxillofacial region after ablative tumor surgery is a challenging task of reconstructive surgery. The “golden rule” is maintaining of radicalism of ablative surgery as well as appropriate surgical reconstruction and prosthodontic rehabilitation, that allows patient return to normal life. Wherein reconstructive procedure is focusing on restoring of mandibular continuity by the means of different flaps and grafts, while prosthodontic rehabilitation is performing after some period of time (usually around year) by the means of removable and non-removable prosthodontic devices. Non-removable device requiring dental implants insertion into grafted material followed by period of osteointegration, that is requiring some time as well. However, within this period of time one could observe significant soft tissue deformity.The objective is to improve the outcomes of surgical reconstruction of extensive defects of the mandible and to carry out rapid prosthodontic rehabilitation supported by dental implants by application of 3D preoperative planning and navigation devices.Clinical case. Forty-nine years-old female patient with recurrent ameloblastoma, that affects vertical and horizontal ramus of the mandible. Within virtual preoperative planning one performed: resection of the mandible associated with exarticulation of condylar head, virtual plate bending according to contours of the mandible (that were determined by application of “mirror” function of virtual planning software), arthroplasty of temporomandibular joint, determination of donor site on fibula bone, osteotomy of fibula free flap, positioning of dental implants, transferring of composite flap and it’s fixation by reconstructive plate. According to acquiring data one performed fabrication of patient specific navigation guides for both fibula flap segmentation and dental implants positioning. Surgical procedure included single-step tumor ablation and exarticulation of condylar head, reconstruction of defect by the means of osseo-myo-cutaneous fibula free flap, that was pre-implanted by dental implants, total joint reconstruction by titanium condylar head and polypropylene fossa, fixation of the flap and condylar head in recipient site by the means of prebended reconstructive plate, as well as insertion of non-removable bridge prosthodontic device. Postoperative result was asses clinically and radiologically. No significant postoperative complications occurred. Restoration of facial contours, mouth opening, I class occlusion, as well as adequate meal and speech were detected. Postoperative radiological investigation revealed adequate positioning of dental implants within neo-mandible, as well as positioning of artificial joint.Conclusion. In cases of extensive tumors of the jaws single-step ablative surgical procedure, reconstruction of missing anatomical structures of the jaws and simultaneous prosthodontic rehabilitation allows to preve","PeriodicalId":36598,"journal":{"name":"Opuholi Golovy i Sei","volume":"10 1","pages":"97-110"},"PeriodicalIF":0.0,"publicationDate":"2020-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67785097","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 : 2020-11-16DOI: 10.17650/2222-1468-2020-10-3-12-18
A. Polyakov, P. Rumyantsev, P. Nikiforovich, A. V. Mordovsky, E. A. Chistyakova
Background. Approximately 10 % of patients with well-differentiated thyroid cancer (WDTC) develop distant metastases. Of them, only 23 % have bone metastases. Complications associated with metastatic lesion in the skeleton significantly affect overall condition of patients and their quality of life. Surgery and pharmacotherapy are highly traumatic and toxic. Bisphosphonates are stable structural analogues of pyrophosphate that inhibit osteoclast activity, thereby reducing bone resorption, which increases the time to development of bone complications, improves patient’s quality of life, and reduces pain.The study objective is to assess performance status and pain severity in WDTC patients with distant bone metastases after bisphosphonate therapy.Materials and methods. We analyzed clinical experience in using bisphosphonates in WDTC patients treated in P.A. Herzen Moscow Oncology Research Institute between 2016 and 2020. This study included 41 patients with WDTC and bone metastases of various locations. Pain severity was evaluated using a 5-point verbal scale; performance status was evaluated using the Eastern Cooperative Oncology Group scale.Results. We observed an improvement in patients’ performance status (from score 2 to 0 according to the Eastern Cooperative Oncology Group scale) in response to therapy. We also found a decrease in pain intensity (from score 4 to 1.5).Conclusion. The inclusion of bisphosphonates into the treatment scheme for WDTC patients with bone metastases can reduce pain intensity and improve performance status.
{"title":"Current opportunities of comprehensive therapy for bone metastases from thyroid cancer","authors":"A. Polyakov, P. Rumyantsev, P. Nikiforovich, A. V. Mordovsky, E. A. Chistyakova","doi":"10.17650/2222-1468-2020-10-3-12-18","DOIUrl":"https://doi.org/10.17650/2222-1468-2020-10-3-12-18","url":null,"abstract":"Background. Approximately 10 % of patients with well-differentiated thyroid cancer (WDTC) develop distant metastases. Of them, only 23 % have bone metastases. Complications associated with metastatic lesion in the skeleton significantly affect overall condition of patients and their quality of life. Surgery and pharmacotherapy are highly traumatic and toxic. Bisphosphonates are stable structural analogues of pyrophosphate that inhibit osteoclast activity, thereby reducing bone resorption, which increases the time to development of bone complications, improves patient’s quality of life, and reduces pain.The study objective is to assess performance status and pain severity in WDTC patients with distant bone metastases after bisphosphonate therapy.Materials and methods. We analyzed clinical experience in using bisphosphonates in WDTC patients treated in P.A. Herzen Moscow Oncology Research Institute between 2016 and 2020. This study included 41 patients with WDTC and bone metastases of various locations. Pain severity was evaluated using a 5-point verbal scale; performance status was evaluated using the Eastern Cooperative Oncology Group scale.Results. We observed an improvement in patients’ performance status (from score 2 to 0 according to the Eastern Cooperative Oncology Group scale) in response to therapy. We also found a decrease in pain intensity (from score 4 to 1.5).Conclusion. The inclusion of bisphosphonates into the treatment scheme for WDTC patients with bone metastases can reduce pain intensity and improve performance status.","PeriodicalId":36598,"journal":{"name":"Opuholi Golovy i Sei","volume":"10 1","pages":"12-18"},"PeriodicalIF":0.0,"publicationDate":"2020-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67784136","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 : 2020-11-16DOI: 10.17650/2222-1468-2020-10-3-19-26
N. Severskaya, A. Ilyin, I. Chebotareva, N. V. Zhelonkina, V. Polkin, P. Isaev, D. N. Derbugov, S. Podvyaznikov
Background. Parathyroid cancer (PC) is extremely rare, usually diagnosed after surgery, there are no clinical recommendations for the treatment of metastatic PC.The study objective is to present the results of a clinical examination and treatment of patients with PC.Materials and methods. Retrospective analysis of 15 PC patients treated from 2001 to 2019. The results of laboratory tests, the surgical approach, the results of treatment, the rate of metastasis and relapse within 19 months (3 months – 11.6 years) after surgery are presented.Results. Tumor size is 35 mm (20–45 mm). Lymph node metastases – 1 (6.7 %), distant metastases – 2 (13 %). The median initial parathyroid hormone (PTH) is 735 pg/mL, calcium 3.22 mmol/L. Severe hyperparathyroidism with osteitis fibrosa cystica – in 6 (40 %). The surgical approach was parathyroidectomy in 10 (67 %), en bloc resection in 5 (33 %). Normalization of PTH and calcium after surgery – 13 (87 %). In two patients with distant metastases, the PTH and calcium remained high. A patient with Th6 vertebral metastasis was successfully operated on, with normalization of PTH and calcium, and 1.5 years was without relapse. A patient with lung and liver metastases received sorafenib after surgery, with decrease in calcium level. She died of progression 12 months after operation. Among patients with normalization of postoperative PTH, one had local relapse after 4 years. The patient was re-operated and 1 year after the second operation without relapse. The remaining patients are without relapse/progression.Conclusion. At the time of diagnosis, lymph node metastases are in 6.7 %, distant metastases – 13 %. Normalization of PTH and calcium after surgery suggests a good prognosis, but does not exclude the recurrence in the future, which requires long-term follow-up. Repeated surgery for local recurrence or solitary distant metastases can provide stable remission. Sorafenib in metastatic PC has managed to control hypercalcemia in the short term, however, antitumor efficacy requires further study.
{"title":"Parathyroid carcinoma. The experience of treatment of 15 patients and a review","authors":"N. Severskaya, A. Ilyin, I. Chebotareva, N. V. Zhelonkina, V. Polkin, P. Isaev, D. N. Derbugov, S. Podvyaznikov","doi":"10.17650/2222-1468-2020-10-3-19-26","DOIUrl":"https://doi.org/10.17650/2222-1468-2020-10-3-19-26","url":null,"abstract":"Background. Parathyroid cancer (PC) is extremely rare, usually diagnosed after surgery, there are no clinical recommendations for the treatment of metastatic PC.The study objective is to present the results of a clinical examination and treatment of patients with PC.Materials and methods. Retrospective analysis of 15 PC patients treated from 2001 to 2019. The results of laboratory tests, the surgical approach, the results of treatment, the rate of metastasis and relapse within 19 months (3 months – 11.6 years) after surgery are presented.Results. Tumor size is 35 mm (20–45 mm). Lymph node metastases – 1 (6.7 %), distant metastases – 2 (13 %). The median initial parathyroid hormone (PTH) is 735 pg/mL, calcium 3.22 mmol/L. Severe hyperparathyroidism with osteitis fibrosa cystica – in 6 (40 %). The surgical approach was parathyroidectomy in 10 (67 %), en bloc resection in 5 (33 %). Normalization of PTH and calcium after surgery – 13 (87 %). In two patients with distant metastases, the PTH and calcium remained high. A patient with Th6 vertebral metastasis was successfully operated on, with normalization of PTH and calcium, and 1.5 years was without relapse. A patient with lung and liver metastases received sorafenib after surgery, with decrease in calcium level. She died of progression 12 months after operation. Among patients with normalization of postoperative PTH, one had local relapse after 4 years. The patient was re-operated and 1 year after the second operation without relapse. The remaining patients are without relapse/progression.Conclusion. At the time of diagnosis, lymph node metastases are in 6.7 %, distant metastases – 13 %. Normalization of PTH and calcium after surgery suggests a good prognosis, but does not exclude the recurrence in the future, which requires long-term follow-up. Repeated surgery for local recurrence or solitary distant metastases can provide stable remission. Sorafenib in metastatic PC has managed to control hypercalcemia in the short term, however, antitumor efficacy requires further study.","PeriodicalId":36598,"journal":{"name":"Opuholi Golovy i Sei","volume":"10 1","pages":"19-26"},"PeriodicalIF":0.0,"publicationDate":"2020-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67784297","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 : 2020-11-16DOI: 10.17650/2222-1468-2020-10-3-81-89
D. A. Miroshnichenko, A. Polyakov, A. V. Mordovsky
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.
{"title":"Monitoring the efficacy of conservative treatment of nasopharyngeal carcinoma by examining Epstein–Barr virus DNA titers in blood plasma (review)","authors":"D. A. Miroshnichenko, A. Polyakov, A. V. Mordovsky","doi":"10.17650/2222-1468-2020-10-3-81-89","DOIUrl":"https://doi.org/10.17650/2222-1468-2020-10-3-81-89","url":null,"abstract":"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.","PeriodicalId":36598,"journal":{"name":"Opuholi Golovy i Sei","volume":"10 1","pages":"81-89"},"PeriodicalIF":0.0,"publicationDate":"2020-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67784269","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 : 2020-11-16DOI: 10.17650/2222-1468-2020-10-3-90-96
N. Ognerubov
Background. Currently, the proportion of pregnancies obtained by assisted reproductive technologies (ARTs) reaches 1.7–4.0 %. Short-term and long-term results of ART implementation require public and, most importantly, legal assessment. Some publications suggest higher risks of congenital deformities and head and neck cancers in children conceived by ART.Objective: to review publications analyzing the problem of head and neck cancers in children conceived by ART and legal protection of the embryo.Materials and methods. We performed retrospective analysis of 42 articles published in 1995–2019, including 33 foreign and 9 Russian articles.Results. Earlier studies have demonstrated that children conceived by ART have an increased risk of cancers, including head and neck cancers, such as central nervous system tumors and retinoblastoma. Recent publications have shown no significant differences in the prevalence of malignant tumors between children born after ART and children conceived naturally. Nevertheless, the risk of developing head and neck tumors is higher in children after ART. The analysis of Russian and international legislation has demonstrated that the legal status of an embryo differs depending on whether it develops in vivo or in vitro.Conclusion. Children conceived by ART are at higher risk of malignant head and neck tumors, primarily central nervous system tumors and retinoblastoma. The legal status of an embryo depends on whether it develops in vivo or in vitro.
{"title":"Head and neck tumors and assisted reproductive technologies: social and legal aspects","authors":"N. Ognerubov","doi":"10.17650/2222-1468-2020-10-3-90-96","DOIUrl":"https://doi.org/10.17650/2222-1468-2020-10-3-90-96","url":null,"abstract":"Background. Currently, the proportion of pregnancies obtained by assisted reproductive technologies (ARTs) reaches 1.7–4.0 %. Short-term and long-term results of ART implementation require public and, most importantly, legal assessment. Some publications suggest higher risks of congenital deformities and head and neck cancers in children conceived by ART.Objective: to review publications analyzing the problem of head and neck cancers in children conceived by ART and legal protection of the embryo.Materials and methods. We performed retrospective analysis of 42 articles published in 1995–2019, including 33 foreign and 9 Russian articles.Results. Earlier studies have demonstrated that children conceived by ART have an increased risk of cancers, including head and neck cancers, such as central nervous system tumors and retinoblastoma. Recent publications have shown no significant differences in the prevalence of malignant tumors between children born after ART and children conceived naturally. Nevertheless, the risk of developing head and neck tumors is higher in children after ART. The analysis of Russian and international legislation has demonstrated that the legal status of an embryo differs depending on whether it develops in vivo or in vitro.Conclusion. Children conceived by ART are at higher risk of malignant head and neck tumors, primarily central nervous system tumors and retinoblastoma. The legal status of an embryo depends on whether it develops in vivo or in vitro.","PeriodicalId":36598,"journal":{"name":"Opuholi Golovy i Sei","volume":"10 1","pages":"90-96"},"PeriodicalIF":0.0,"publicationDate":"2020-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67785544","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 : 2020-07-24DOI: 10.17650/2222-1468-2020-10-2-79-84
А. Zaytsev, А. P. Polyakov, М. V. Ratushny, Т. М. Kobyletskaya, S. Kisariev, А. L. Sugaipov, О. N. Kirsanova
The objective of the scientific report is to describe a rare clinical case of a combination of Forestier’s disease (diffuse idiopathic skeletal hyperostosis) and laryngeal cancer that have common symptoms. Case report. A 68-year-old male patient presented with hoarseness lasting for a year. Indirect laryngoscopy revealed a vocal fold tumor. Histological examination confirmed well-differentiated keratinizing squamous cell carcinoma of the larynx. A 6-cm tumor was located in the projection of the right vocal fold and had no signs of invasion into the supraglottis, subglottis, and anterior commissure. No other focal disorders were detected. The patient has undergone endolaryngeal laser resection of the larynx and tracheostomy. After probe removal, the patient had swallowing difficulties with esophageal content passing to the trachea mainly due to organic changes in the cervical spine at the С З –С 4 level, where there was a massive local calcification of the anterior longitudinal ligament. We also noticed severe movement restriction in the cervical spine: the amplitude of movements did not exceed 10°. The formation of the C 3 –C 4 segment was removed via ventrolateral approach. Conclusion. Dysphagia, dysphonia, and dyspnea may indicate both malignant tumor and large osteophyte causing compression of the trachea and esophagus. In this case, no symptom resolution after tumor removal led to the suspicion of a second disease, namely Forestier’s disease.
本科学报告的目的是描述一个罕见的临床病例，弗赖斯节病(弥漫性特发性骨骼肥厚症)和喉癌合并有共同的症状。病例报告。男性，68岁，声嘶力竭一年。间接喉镜检查发现声带肿瘤。组织学检查证实为喉部高分化角化鳞状细胞癌。一个6厘米的肿瘤位于右侧声带的突出处，没有侵犯声门上、声门下和前联合的迹象。未发现其他局灶性疾病。患者接受了喉内激光切除和气管切开术。取出探头后，患者出现吞咽困难，食管内容物进入气管，主要是由于С З -С 4段颈椎器质性改变，前纵韧带局部大量钙化。我们还注意到颈椎严重的活动受限:活动幅度不超过10°。通过腹外侧入路切除c3 - c4节段。结论。吞咽困难、发音困难和呼吸困难可能提示恶性肿瘤和造成气管和食道压迫的大骨赘。在这个病例中，肿瘤切除后症状没有缓解，导致怀疑第二种疾病，即弗赖斯节病。
{"title":"Combination of Forestier’s disease and laryngeal cancer: a rare clinical case","authors":"А. Zaytsev, А. P. Polyakov, М. V. Ratushny, Т. М. Kobyletskaya, S. Kisariev, А. L. Sugaipov, О. N. Kirsanova","doi":"10.17650/2222-1468-2020-10-2-79-84","DOIUrl":"https://doi.org/10.17650/2222-1468-2020-10-2-79-84","url":null,"abstract":"The objective of the scientific report is to describe a rare clinical case of a combination of Forestier’s disease (diffuse idiopathic skeletal hyperostosis) and laryngeal cancer that have common symptoms. Case report. A 68-year-old male patient presented with hoarseness lasting for a year. Indirect laryngoscopy revealed a vocal fold tumor. Histological examination confirmed well-differentiated keratinizing squamous cell carcinoma of the larynx. A 6-cm tumor was located in the projection of the right vocal fold and had no signs of invasion into the supraglottis, subglottis, and anterior commissure. No other focal disorders were detected. The patient has undergone endolaryngeal laser resection of the larynx and tracheostomy. After probe removal, the patient had swallowing difficulties with esophageal content passing to the trachea mainly due to organic changes in the cervical spine at the С З –С 4 level, where there was a massive local calcification of the anterior longitudinal ligament. We also noticed severe movement restriction in the cervical spine: the amplitude of movements did not exceed 10°. The formation of the C 3 –C 4 segment was removed via ventrolateral approach. Conclusion. Dysphagia, dysphonia, and dyspnea may indicate both malignant tumor and large osteophyte causing compression of the trachea and esophagus. In this case, no symptom resolution after tumor removal led to the suspicion of a second disease, namely Forestier’s disease.","PeriodicalId":36598,"journal":{"name":"Opuholi Golovy i Sei","volume":"10 1","pages":"79-84"},"PeriodicalIF":0.0,"publicationDate":"2020-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67784485","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 : 2020-07-24DOI: 10.17650/2222-1468-2020-10-2-69-78
A. V. Ignatova, A. Mudunov, S. Podvyaznikov, Y. Alymov
Mammary analogue secretory carcinoma (MASC) of the salivary gland is a rare salivary cancer, histologically resembling to secretory carcinoma of the breast. In 2017 World Health Organization reported MASC is a new salivary cancer subtype. The aim of this article is to collect and analyze data about MASC, particularly clinical, histological and molecular profile, to evaluate targeted therapy effects. We discuss a case report of dramatic and durable response with entrectinib and the development of acquired resistance in an NTRK3-fusion positive salivary cancer, detected by next-generation sequencing. Next-generation sequencing as a comprehensive molecular profiling, that helps to investigate molecular profile of rare tumors and gives an opportunity to use an effective therapeutic options. Identifying ETV6-NTRK3 positive MASC provides a better prognosis for metastatic disease by using a novel effective targeted therapy with tyrosine kinase inhibitors (entrectinib, larotrectinib). Despite a durable and dramatic response, we showed an interesting case of the development of acquired resistance to tyrosine kinase inhibitors mediated by the appearance of a novel NTRK3 G623R mutation. Finally, we believe in great perspectives of comprehensive molecular profiling and targeted therapy for rare malignancies with NTRK gene fusions, including second-generation tyrosine kinase inhibitors.
{"title":"Mammary analogue secretory carcinoma of the salivary gland with NTRK fusions: new approaches for diagnostics and targeted therapy (review)","authors":"A. V. Ignatova, A. Mudunov, S. Podvyaznikov, Y. Alymov","doi":"10.17650/2222-1468-2020-10-2-69-78","DOIUrl":"https://doi.org/10.17650/2222-1468-2020-10-2-69-78","url":null,"abstract":"Mammary analogue secretory carcinoma (MASC) of the salivary gland is a rare salivary cancer, histologically resembling to secretory carcinoma of the breast. In 2017 World Health Organization reported MASC is a new salivary cancer subtype. The aim of this article is to collect and analyze data about MASC, particularly clinical, histological and molecular profile, to evaluate targeted therapy effects. We discuss a case report of dramatic and durable response with entrectinib and the development of acquired resistance in an NTRK3-fusion positive salivary cancer, detected by next-generation sequencing. Next-generation sequencing as a comprehensive molecular profiling, that helps to investigate molecular profile of rare tumors and gives an opportunity to use an effective therapeutic options. Identifying ETV6-NTRK3 positive MASC provides a better prognosis for metastatic disease by using a novel effective targeted therapy with tyrosine kinase inhibitors (entrectinib, larotrectinib). Despite a durable and dramatic response, we showed an interesting case of the development of acquired resistance to tyrosine kinase inhibitors mediated by the appearance of a novel NTRK3 G623R mutation. Finally, we believe in great perspectives of comprehensive molecular profiling and targeted therapy for rare malignancies with NTRK gene fusions, including second-generation tyrosine kinase inhibitors.","PeriodicalId":36598,"journal":{"name":"Opuholi Golovy i Sei","volume":"10 1","pages":"69-78"},"PeriodicalIF":0.0,"publicationDate":"2020-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67784350","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 : 2020-07-24DOI: 10.17650/2222-1468-2020-10-2-85-89
L. Kozhanov, А. L. Kozhanov, Y. Vyaltseva, А. Egorova, S. Chulkova
The objective is to report a rare case of laryngeal cancer in spouses. Case report. A 59-year-old female patient was admitted to the Department of Head and Neck Tumors in December 2019 with complaints of hoarseness. In 1997, she had radiotherapy for T1N0M0 laryngeal cancer. After comprehensive examination, she was diagnosed with recurrent laryngeal cancer. The patient has undergone frontolateral laryngeal resection. A 67-year-old male patient was admitted to the Department of Head and Neck Tumors in November 2019 with T3N0M0 laryngeal cancer (diagnosed 2 months before). He has undergone extended frontolateral laryngeal resection followed by radiotherapy in the postoperative period. Discussion. Both patients had no risk factors, such as occupational hazards or smoking. However, both spouses had close relatives with cancer, what indicates their genetic predisposition to malignant tumors. The female patient was found to have human papilloma virus (HPV) in the tumor cells, whereas her spouse was HPV-negative, although rapid histology showed indirect signs of HPV, which does not exclude the elimination of HPV. Conclusion. In this rare case of laryngeal cancer diagnosed in two non-consanguineous spouses, the disease is likely to be caused by their hereditary predisposition, HPV infection, and the fact that they lived in the same socioeconomic conditions.
{"title":"Laryngeal cancer in two non-consanguineous people (spouses): a case report","authors":"L. Kozhanov, А. L. Kozhanov, Y. Vyaltseva, А. Egorova, S. Chulkova","doi":"10.17650/2222-1468-2020-10-2-85-89","DOIUrl":"https://doi.org/10.17650/2222-1468-2020-10-2-85-89","url":null,"abstract":"The objective is to report a rare case of laryngeal cancer in spouses. Case report. A 59-year-old female patient was admitted to the Department of Head and Neck Tumors in December 2019 with complaints of hoarseness. In 1997, she had radiotherapy for T1N0M0 laryngeal cancer. After comprehensive examination, she was diagnosed with recurrent laryngeal cancer. The patient has undergone frontolateral laryngeal resection. A 67-year-old male patient was admitted to the Department of Head and Neck Tumors in November 2019 with T3N0M0 laryngeal cancer (diagnosed 2 months before). He has undergone extended frontolateral laryngeal resection followed by radiotherapy in the postoperative period. Discussion. Both patients had no risk factors, such as occupational hazards or smoking. However, both spouses had close relatives with cancer, what indicates their genetic predisposition to malignant tumors. The female patient was found to have human papilloma virus (HPV) in the tumor cells, whereas her spouse was HPV-negative, although rapid histology showed indirect signs of HPV, which does not exclude the elimination of HPV. Conclusion. In this rare case of laryngeal cancer diagnosed in two non-consanguineous spouses, the disease is likely to be caused by their hereditary predisposition, HPV infection, and the fact that they lived in the same socioeconomic conditions.","PeriodicalId":36598,"journal":{"name":"Opuholi Golovy i Sei","volume":"10 1","pages":"85-89"},"PeriodicalIF":0.0,"publicationDate":"2020-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67784509","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 : 2020-07-24DOI: 10.17650/2222-1468-2020-10-2-97-100
N. V. Sevian, A. Bekyashev, E. Prozorenko, N. A. Kozlov, D. Naskhletashvili, V. Karakhan, T. G. Gasparyan, D. Avtomonov, E. Bogush, V. Y. Kirsanov, V. Vereshchak, O. Malikhova
Esophageal cancer spreads locally via the circulatory and lymphatic systems and can, extremely rarely, form brain metastases. The development of intracranial metastases is a long-term adverse event indicating poor prognosis. In this paper, we present a case of esophageal cancer with a brain metastasis in a patient who received combination therapy and demonstrated long-term progression-free survival.
{"title":"Brain metastases from esophageal cancer: a case-report","authors":"N. V. Sevian, A. Bekyashev, E. Prozorenko, N. A. Kozlov, D. Naskhletashvili, V. Karakhan, T. G. Gasparyan, D. Avtomonov, E. Bogush, V. Y. Kirsanov, V. Vereshchak, O. Malikhova","doi":"10.17650/2222-1468-2020-10-2-97-100","DOIUrl":"https://doi.org/10.17650/2222-1468-2020-10-2-97-100","url":null,"abstract":"Esophageal cancer spreads locally via the circulatory and lymphatic systems and can, extremely rarely, form brain metastases. The development of intracranial metastases is a long-term adverse event indicating poor prognosis. In this paper, we present a case of esophageal cancer with a brain metastasis in a patient who received combination therapy and demonstrated long-term progression-free survival.","PeriodicalId":36598,"journal":{"name":"Opuholi Golovy i Sei","volume":"10 1","pages":"97-100"},"PeriodicalIF":0.0,"publicationDate":"2020-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47164025","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 : 2020-07-24DOI: 10.17650/2222-1468-2020-10-2-90-96
Е.О. Кудасова, Е.В. Кочурова, Владимир Николаевич Николенко, П. А. Деменчук, А. В. Зотов, Т.М. Васильева
Introduction. Timely maxillofacial orthopedic care is aimed at leveling the message of the oral cavity with the nasal cavity and its paranasal sinuses, orbit, helps to improve swallowing, speech, breathing and salivation. The objective of this work is to demonstrate the possibility of application of a polymethyl methacrylate prosthesis with a superhydrophobic modified surface directly on the operating table, as well as to demonstrate the possibility of using in the shortest postoperative period. Materials and methods. Patient Z., 28 years old, clinical diagnosis: chondrosarcoma of the upper jaw on the right, Т2N0M0, stage 2. A resection of the upper jaw was proposed with simultaneous reconstructive treatment and the application of a dental resection forming denture of the upper jaw. To form a hydrophobic surface, the prosthesis was modified with a high-frequency plasma of sulfur hexafluorides. The study of the quantitative and qualitative composition of microflora on the surface of the resection forming prosthesis was carried out after transportation of the prosthesis from the dental laboratory, after processing of high-frequency plasma of sulfur hexafluoride and before applying the resection forming prosthesis, 3, 7 days after the prosthesis was applied. Results. After modification of sulfur hexafluoride in the medium, the contact angle of contact with distilled water increased, the critical surface tension decreased compared to the initial one, and the hydrophobic properties were increased. Conditionally pathogenic microflora in a diagnostically significant amount was cultivated from the surface of the resection forming prosthesis obtained from the dental laboratory. Bacterial seeding after modification in the plasma of sulfur hexafluoride showed the absence of microflora strains; a slight increase in opportunistic microflora was obtained on days 3 and 7 after application of the prosthesis. In the immediate postoperative period (3 days), the patient complained of pain and discomfort associated with the surgical stage. Conclusions. The presented clinical case indicate that the superhydrophobic surface modified by sulfur hexafluoride contributes to a more stable healing of the postoperative defect.
{"title":"непосредственное модифицированное протезирование при новообразовании верхней челюсти: клиническое наблюдение","authors":"Е.О. Кудасова, Е.В. Кочурова, Владимир Николаевич Николенко, П. А. Деменчук, А. В. Зотов, Т.М. Васильева","doi":"10.17650/2222-1468-2020-10-2-90-96","DOIUrl":"https://doi.org/10.17650/2222-1468-2020-10-2-90-96","url":null,"abstract":"Introduction. Timely maxillofacial orthopedic care is aimed at leveling the message of the oral cavity with the nasal cavity and its paranasal sinuses, orbit, helps to improve swallowing, speech, breathing and salivation. The objective of this work is to demonstrate the possibility of application of a polymethyl methacrylate prosthesis with a superhydrophobic modified surface directly on the operating table, as well as to demonstrate the possibility of using in the shortest postoperative period. Materials and methods. Patient Z., 28 years old, clinical diagnosis: chondrosarcoma of the upper jaw on the right, Т2N0M0, stage 2. A resection of the upper jaw was proposed with simultaneous reconstructive treatment and the application of a dental resection forming denture of the upper jaw. To form a hydrophobic surface, the prosthesis was modified with a high-frequency plasma of sulfur hexafluorides. The study of the quantitative and qualitative composition of microflora on the surface of the resection forming prosthesis was carried out after transportation of the prosthesis from the dental laboratory, after processing of high-frequency plasma of sulfur hexafluoride and before applying the resection forming prosthesis, 3, 7 days after the prosthesis was applied. Results. After modification of sulfur hexafluoride in the medium, the contact angle of contact with distilled water increased, the critical surface tension decreased compared to the initial one, and the hydrophobic properties were increased. Conditionally pathogenic microflora in a diagnostically significant amount was cultivated from the surface of the resection forming prosthesis obtained from the dental laboratory. Bacterial seeding after modification in the plasma of sulfur hexafluoride showed the absence of microflora strains; a slight increase in opportunistic microflora was obtained on days 3 and 7 after application of the prosthesis. In the immediate postoperative period (3 days), the patient complained of pain and discomfort associated with the surgical stage. Conclusions. The presented clinical case indicate that the superhydrophobic surface modified by sulfur hexafluoride contributes to a more stable healing of the postoperative defect.","PeriodicalId":36598,"journal":{"name":"Opuholi Golovy i Sei","volume":"10 1","pages":"90-96"},"PeriodicalIF":0.0,"publicationDate":"2020-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49130548","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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