Primitive neuroectodermal tumor in the zygomaticoorbital region is a rare neoplasm of the head and neck. Due to the necessity for wide radical excision of a primary tumor, there may be serious functional and cosmetic disorders that substantially affect quality of life in patients. Restoration of this region is one of the challenges of reconstructive surgery because of the specific features of the relief of bone structures. The paper describes a clinical case of the site of primitive neuroectodermal tumor in the zygomaticoorbital complex and a method for repairing postresectional defect and completely recovering the function of the organ of vision and aesthetic parameters of the face.

Despite the low incidence of nasopharyngeal tumors, the treatment of patients with this disease remains an important and intricate issue. Its risk factors include smoking and alcoholism. About 60% of nasopharyngeal cancer cases are detected at Stages III–IV due to the fact that the early disease stages are latent. The diagnosis of the disease is difficult because of the specific features of the anatomy of the nasopharynx and physicians’ errors. Chemotherapy can relieve pain in patients and considerably improve their quality of life. Chemoradiation therapy is a main treatment option for locally advanced forms. The now range of choice of chemopreparations is narrow so data on successful chemotherapy are particularly valuable. The effectiveness of therapy depends on a patient’s general health state and comorbid condition. The frequency of complications after chemotherapy is high. Some patients are at risk for febrile neutropenia. The risk factors include over 65 years of age; hyponutrition; previous aggressive chemotherapy; the presence of open wounds; chronic obstructive pulmonary disease; and low hemoglobin levels. It is necessary to thoroughly control clinical blood tests, to alleviate the manifestations of mucositis, to evaluate the effect of performed therapy after each even cycle, and to perform computed tomography of the chest and abdomen and spiral computed tomography of the head and neck. In the absence of contraindications to radiotherapy, this technique should be considered during treatment planning. In patients with nasopharyngeal cancer, the efficiency of performed chemoradiation treatment is higher than that of chemotherapy only.

To treat oropharyngeal squamous cell carcinoma is a complex and multicomponent process. In so doing, most patients starting treatment have already manifestations of malnutrition resulting from underlying disease progression. The degree of malnutrition is determined by the site and sizes of a primary focus and generally remains permanent in patients with oropharyngeal squamous cell carcinoma at all treatment steps. Adequate nutritional support makes it possible to reduce the incidence of complications after surgical treatment and development of radiation responses, to enhance tolerability of treatment, and to improve quality of life in patients.

A surgical approach as dysmasking implies a bitemporal skin incision followed by a single flap from upper facial soft tissues. The advantages of this technique may include a wide surgical approach to the structures of the anterior skull base, a possibility of intraoperative extension of the approach through parapalpebral and/or pre-auricular incisions, the lack of incisions in the central zone of the face, the preservation of the integrity of mimic muscles and the sensitivity of soft tissues in the central zone of the face. This paper gives experience in surgically treating 5 patients with malignant tumors of the paranasal sinuses and skull base. All the cases required a wide approach to the skull base and anterior facial skeleton. This was achieved by the use of the dysmasking approach, if need be, parapalpebral incisions or facial nerve resection followed by single-stage microsurgical neurorrhaphy were made. All operations were performed under endotracheal anesthesia. The wide surgical approach to the tumor, which permitted its removal in the maximum volume without skin incisions in the central zone of the face, as vitally indicated, could be achieved by dysmasking that yielded satisfactory postoperative cosmetic and functional results in all the cases.

The authors developed a novel cryoradiation treatment in patients with locally advanced basal cell and squamous cell carcinoma of the head skin, which included a combination of tumor cryogenic and radiation exposures. of a tumor. Immediately before each radiotherapy session, local tumor cooling is carried out until the freezing temperature is achieved at the tumor-intact tissue border. Irradiation is performed in cycles: at a single daily focal dose of 2.0–2.5 Gy during 5 days at a 2-day interval until the cumulative focal dose of 60–70 Gy is achieved. The results of cryosurgical and cryoradiation treatments were investigated in 112 patients with basal cell (n = 101) and squamous cell (n = 11) carcinoma of the calvarial skin. Among the patients, there were 48 (42.9 %) men and 64 (57.1 %) women; their mean age was 67.1 (39–107) years. The skin tumor was located in the parietal region in 30 (26.8 %) patients, in the temporal region in 55 (49.1 %), in the frontal region in 26 (23.2 %), and in occipital region in 1. The size of the neoplasms in all the patients was more than 1 cm; the tumors belonged to a high recurrence risk group. The method of treatment was chosen according to indicators. The postoperative follow-ups of the patients were 2 to 14 years (median follow-up, 7 years). Recurrences of skin cancer were diagnosed in 5 (4.5 %) of the 18 patients: 1 (1 %) after treatment for its primary forms and 4 (22.2 %) after that of recurrences. Cryosurgical and cryoradiation treatments performed as clinically indicated could yield good functional, aesthetic, and long-term results and ensure effective rehabilitation in patients after the treatment conducted.

The review deals with the results of clinical and experimental studies of the original Russian drug glyciphon used to treat basal cell carcinoma (BCC). Glyciphon is diglycidyl ether of methylphosphonic acid, which has been synthesized at the A. E. Arbuzov Institute of Organic and Physical Chemistry, Kazan Research Center, Russian Academy of Sciences, belongs to a class of organophosphors epoxides. The drug has been experimentally tested by Kazan scientists who revealed the selectivity of its antiblastoma activity, relatively low toxicity, and high safety when it was used long. The antiproliferatve activity of glyciphon in inhibiting DNA synthesis, retarding all mitotic phases, and blocking the entry of cells into S and M phases plays an important role in its mechanism of antiblastoma action. Glyciphon ointment 30 % is effective in the treatment of primary BCC (solitary tumors and polyneoplasms) and its recurrences after radiation and surgery in the absence of a side skin resorption effect. It may be successfully used to treat BCC that are refractory to radiotherapy and surgical dissection and to detect latent foci of multiple BCC. The ointment is registered as an agent for the treatment of Stage I squamous cell carcinoma, as well as basaliomas (including recurrences after surgery and radiotherapy), Bowen,s disease, senile keratosis. Glyciphon is manufactured by OAO “Tatchempharmpreparaty” (Kazan) (as 30 % ointment from the substance made by the affiliate of the A. E. Arbuzov Institute of Organic and Physical Chemistry, Kazan Research Center, Russian Academy of Sciences.

The role of real-time elastography or sonoelastography has been widely discussed recently. However, there are practically no publications which showed the influence of endocrine status in the process for improving of diagnostic value of this method; this issue was the aim of our study. 128 patients (31 – benign adenomas and 97 – thyroid cancer: 13 – follicular and 84 – papillary) were evaluated prospectively. Mean age was 48.3 ± 15.9 years. It was confirmed that the blue colour or 4–5 elastotype of sonoelastography was mainly discovered in thyroid cancer vs adenoma (73.2 % vs 25.8 %, χ2 = 18.96, р = 0.0001). Parameters of the sensitivity, specificity and accuracy were equal 90.7 %, 54.8 % and 82.0 % for sonoelastography, and 95.9 %, 45.2 % and 83.6 % for fine-needle aspiration biopsy, respectively. The combination of sonoelastography with fine-needle aspiration biopsy or with body mass index, presurgical glucose or thyroid-stimulating hormone level increased specificity of sonoelastography by 65.0 %, 70.0 %, 64.7 % and 63.2 %, respectively. Thus, sonoelastography had the same diagnostic accuracy as fine-needle aspiration biopsy in predicting of thyroid cancer. The specificity of sonoelastography could be increased by combination with fine-needle aspiration biopsy as well as thyroid-stimulating hormone or glucose level and body mass index value.

Diagnostics of thyroid cancer (TC) remains a challenging issue due to the high incidence of asymptomatic thyroid nodular pathologies and absence of non-invasive methods of their assessment. Thyroid tumors are classified as benign and malignant with incidence ration approximated as 9:1. Correct and timely differential diagnosis is the basis for correctly choosing a treatment policy and hence determines treatment results. Methods for molecular genetic analysis are being recently developed and introduced into clinical practice, enabling the diagnostic process to be optimized. Analysis of the intracellular and secreted (exosomal) fractions of small regulatory RNAs (microRNAs) is one of the most promising methods for the diagnosis of cancers, including TC. The stability of extracellular microRNA is determined by bonds to proteins, lipoproteins, or its encapsulation into the membrane microvesicles – exosomes. There is reason for suggesting that exosomes with the specific composition of microRNA are a result of the process of active and biologically important secretion while release of other microRNA forms accompanies apoptotic or necrotic cell death. This determines the special diagnostic value of the exosomal fraction of circulating microRNAs, which may reflect the presence and clinically relevant properties of a tumor. This paper discusses the state of the problem and presents methods and preliminary results of the studies conducted by the authors to develop a novel method for diagnosing and monitoring TC. Thus, level of plasma exosomal miR-21 was shown to distinguish patients with benign tumor and follicular CT, while miR-31 can help to distinguish patients with benign tumor and papillary TC. Moreover, reciprocal character of miR-21 and miR-181a concentration in plasma exosomes was detected by comparison of patient with papillary and follicular TC.