In the article a case of non-resectable differentiated thyroid cancer (DTC) is described. A recurrent thyroid tumor deforms the oropharyngeal lumen and laryngeal vestibule and bears down on the left esophageal wall and trachea. The authors present literature data on Nexavar target therapy and focus on the fact that no cases of combination treatment with target therapy and surgery of non-resectable progressive DTC were described until now. In view of this, this clinical report is unique and dictates a need to determine new Nexavar (Sorafenib) indications for use in a neoadjuvant regimen.

The article presents a literature review considering epidemiological aspects of secondary cancer of the thyroid gland. The authors’ clinical observation of renal cell carcinoma metastasis into the thyroid gland with tumor thrombus of the internal jugular vein is described. The authors emphasize the necessity of complex diagnostics and treatment of renal cell carcinoma.

Establishment of new centers for nuclear medicine in our country made diagnostic and treatment procedures more accessible for patients with differentiated thyroid cancer (DTC). It includes radioiodine therapy, considered as a non-alternative method of treatment, and positron emission tomography combined with computed tomography (PET/CT), which is essential in some clinical cases. For many years suspected tumor relapse with increased level of thyroglobulin and negative radioiodine scan was the only indication for PET/CT use among patients with DTC. But over the last decade the indications for PET/CT use in DTC cases expanded significantly. This review is aimed to analyze currently available data on PET/CT in DTC patients, its indications for use, advantages and limitations, new trends and recommendations.

Basal cell carcinoma (BCC) is the most common type of malignant skin tumors, characterized by selective localization on the head and neck. Currently there is a variety of treatment methods for this disease, but some of them are not feasible due to patients’ age, cancer localization, morphological type, size, or number of tumor lesions. In that respect, local chemotherapy of BCC, especially for the problem face areas, can serve as a good alternative. Clinical and experimental trials have shown a high treatment effect for 30 % Glyciphon ointment in patients with BCC. In this article we present successful examples of treatment of patients with BCC on the problem face areas using Glyciphon.

Objective. Study of local lymphogenic metastasis (inside the conjunctiva) of conjunctival melanoma.

Introduction. Conjunctiva is a transparent mucous membrane with a large number of blood vessels. Normally, it contains melanocytes which explains possibility of development of pigmented tumors in the conjunctiva. Conjunctival melanoma is a rare tumor:
it constitutes about 1–3 % of all malignant tumors of the ocular adnexa, and according to different authors its incidence rate is 0.02–0.08 for 100 thousand people. Melanoma is characterized by frequent recurrences and hematogenic and lymphogenic metastases.

Materials and methods. Fifteen (15) patients with conjunctival melanoma were included in the study. Tumor recurrence and/or tumor seeding were reasons for inclusion in the study. For graphic representation of tumor localization, we developed a diagram of the conjunctival surface which subsequently was improved using a diagram of lymphatic vessels of the bulbar conjunctiva. An interpretive map of the conjunctival surface produced this way was taking into account lymph node structure of the bulbar conjunctiva.

Results and discussion. Recurrence was observed only in 4 of 15 patients. Seedings were usually localized in neighboring or distant areas in respect to the primary lesion localization, which, supposedly, can be explained by the structure of conjunctival lymphatic system.

Conclusion. In one third of the cases (in 5 of 15 patients) primary tumors were localized near large lymphatic vessels. Moreover, in all cases seeding was observed near the same lymphatic collectors, but at a distance from the primary lesion localization. This confirms possibility of local metastasis through conjunctival lymphatic paths.

Objective. Evaluation of ultrasound capabilities for diagnosis of subclinical regional metastases of squamous cell carcinoma of the oral mucosa.

Introduction. Incidence of oral cancer in Russia is 3.86 per 100,000 population, and it’s increasing with the mean annual rate of 1.88 %. Head and neck cancer is characterized by high risk of metastases in regional lymph nodes which varies from 40 to 80 %. Lymph nodes status affects the treatment plan and appears to be the main predictive factor. Therefore, evaluation of the pathways of regional lymphatic outflow in oral mucosa cancer is of prime importance for disease prognosis and treatment selection. Ultrasound investigation (USI) is one of the main instrumental methods of regional lymph node investigation in oral mucosa cancer patients. Nevertheless, effectiveness of B-mode USI, elastometry and elastography for diagnosis of occult metastases of squamous cell carcinoma of the oral mucosa has not been investigated. There is no consensus on the threshold values of S-wave velocity and elastographic parameters in diagnosis of occult metastases.

Materials and methods. Patients with oral mucosa squamous cell carcinoma (stage cT1–3N0M0) were included in the study. All patients had morphologically verified diagnosis. At the first stage (outpatient) before inclusion into the study, all patients were evaluated by palpation and B-mode USI. If during USI metastases were suspected, FNAB was performed. Patients with cytologically confirmed metastases were not eligible for the study. During the clinical trial, 102 (82.3 %) patients underwent B-mode USI, and 22 (17.7 %) patients underwent USI with elastometry and elastography. USI results were compared with results of histological examination of cervical lymph nodes. Statistical evaluation of USI in different modes was performed.

Results. B-mode USI was characterized by 88.2 % specificity, 0 % sensitivity, 80.4 % accuracy, and 44.1 % efficacy. Positive predictive value (PPV) was estimated as 0 %, and negative predictive value (NPV) as 90.1 %. USI with elastography was characterized by 100 % specificity, 83.3 % sensitivity, 95.5 % accuracy, and 91.7 % efficacy. PPV was estimated as 100 %, and NPV as 94.1 %. Threshold value of elastometry for diagnosis of occult metastases was 2.42 m/s with 83.3 sensitivity, and 87.5 % specificity. Method was characterized by 86.4 % accuracy, 85.4 efficacy, 71.4 % PPV and 93.3 % NPV.

Conclusion. B-mode USI is characterized by low capability for diagnosis of subclinical regional metastases of squamous cell carcinoma of the oral mucosa. Elastometry and elastography offer a possibility to increase USI accuracy for diagnosis of subclinical regional metastases from 80 % to 86-95.5 % and efficacy from 44 % to 85–92 %.

Objective: to improve the results of parotidectomy with using the simultaneously reconstruction surgery in the postoperative defects.

Background. The radical surgical treatment for salivary gland tumors is parotidectomy with preservation of the facial nerve. However, this treatment leads to postoperative defects and Frey’s syndrome (25 % of cases). Elimination of the above-mentioned disadvantages requires plastic, reconstructive surgery.

Materials and methods. In the department of head and neck tumors in the National Cancer Center of Uzbekistan during the period 2015 to 2016 were performed parotidectomy with preservation of the facial nerve and simultaneous retromandibular zone reconstruction with displacing muscle flap in 29 patients. In 25 (86 %) patients diagnosed mixed tumor (pleomorphic adenoma) and 4 (14 %) patients had cancer of parotid gland with the verification of histology.

Results. In all of 29 patients were performed parotidectomy with preservation of the facial nerve and the simultaneous reconstruction of retromandibular zone with displacing own bodymuscle flap reduced postoperative complications, which had been revealed before as a defect and hypersensitivity of the retromandibular area.

Conclusions. Reconstructive-restorative surgery in patients with tumors in the parotid gland after parotidectomy with saving of the facial nerve is decreased number of cosmetic defect and hypersensitivity. Using the own bodymuscle flap is preferred to patients than allotransplant.

The article presents a literature review on the use of the displaced skin and fascial supraclavicular flap in the reconstruction of defects of the head and neck. Given that the flap was relatively recently introduced into clinical practice, we have found it necessary to consider the anatomical features, scope, intake flap technique, complications and long-term results.

The article considers supportive therapy in patients with head and neck tumors during radiotherapy and chemoradiotherapy. Special attention is given to nutritional support on every stage of patient care. The main methods of evaluation of nutritional status and risks are presented, as well as principles of clinical nutrition selection.

Introduction. Prognosis of patients with localized primary cutaneous melanoma depends on various clinical and pathomorphological aspects. The latest ones are the Breslow depth, Clark invasion, ulceration and mitoses in primary tumor. All of this prognostic features have been studied and discussed during last 30 years. The analyses of the prognostic value of this factors is being continued till nowadays, and that is the main idea of our current study.

The aim of our study is to determine the influence of pathomorphological factors on long-term treatment results in patients with primary head and neck cutaneous melanoma.

Materials and methods. 174 patients with localized primary head and neck cutaneous melanoma were included (were considered for the analysis) (1995–2014). All the patients were considered for Breslow depth (T), Clark invasion, and ulceration using archived pathomorphological tissue samples. The proliferative tumor activity (mitotic rate) was determined in 24 cases with tumor with tumor thickness less than 1.0 mm.

Results. Recurrence-free survival according to ulceration and N0 correlated with long-term treatment results. So, 5-year survival was worse in group with ulceration – 51,8 ± 5,9 % rather than group without ulceration – 69,5 ± 6,4% (р = 0,046). Recurrence-free survival according to Clark invasion and N0 correlated with long-term treatment results and worsened with growth of invasion level. So, 5-year survival in I level group was 100 % versus 27,8 ± 9,4 % in V level group (р = 0,00014). Recurrence-free survival according to mitotic rate did not correlate with long-term treatment results. So, 5-year survival was 79,5 ± 13,0 % and 81,8 ± 11,6 % respectively.

Conclusions. Ulceration of the primary tumor is a factor affecting the rate of regional metastases, which subsequently leads to decrease in relapse-free survival. Also, a direct relation exists between increased rate of regional and distant metastases and increased Clark level of invasion. Mitotic index has a certain effect on the rate of regional metastases, but it doesn’t manifest in analysis of long-term results. Supposedly, this factor is not “strong” enough.

Objective. Determination of mutation rates in KIT, NRAS and BRAF genes in 21 samples of mucosal melanoma of the upper aerodigеstive tract.

Background. Head and neck mucosal melanomas (or upper aerodigestive tract mucosal melanomas) are rare and aggressive tumors of melanocytic origin. Head and neck mucosal melanoma (HNMM) comprises over 50 % of all mucosal melanomas. The aim was to determine the KIT, NRAS and BRAF mutation frequencies in 21 series of primary HNMM.

Methods. Microdissected tumour cells were used from 21 formalin-fixed paraffin-embedded tumours. The tumour cells were screened for KIT, NRAS and BRAF mutations by direct sequencing.

Results. Overall, 19 % (4 out of 21) of HNMMs harboured KIT, NRAS or BRAF mutations. Mutations in these oncogenes occurred in a mutuаlly exclusive manner. Both NRAS and BRAF mutations were identified at a similar frequency of 4,75 % each (1 and 1 out of 21), whereas KIT mutations were detected in 9,5 % (2 out of 21) of the HNMMs. KIT mutations were located in exon 11.

Conclusion. Our findings shоw that NRAS and BRAF mutations, which are aсcessible for present targeted thеrapies, are only rarеly present in HNMMs, whereas KIT mutations seem to be relatively more frequent.

Incidence of non-Hodgkin’s lymphomas (NHLs) is increasing worldwide. It’s higher in developed countries, and in the last 20 years it increased by more than 50 %, surpassing the rate of increase of Hodgkin’s lymphoma. NHLs of the orbit, eye, and its adnexa comprise 4.1– 8 % of all extranodal lymphomas. This pathology is of special interest for oncologists and ophthalmologists. Diagnostics, treatment, and monitoring of patients with primary NHL of the orbit and ocular adnexa (OA) is an interdisciplinary problem requiring constant interactions between ophthalmologists and oncohematologists. In the article, modern aspects of diagnostics and treatment of NHL of the orbit and OA are considered. An algorithm for examination of this pathology is suggested, recommendations on outpatient monitoring of these patients are presented.

Data on 3597 patients with primary malignant tumors of the visual organ were submitted to the Moscow City Cancer Register of the Moscow Healthcare Department in 2006–2015. Rate of eyelid skin cancer is 75.62 %. Calculated incidence is 3.4 per 100,000 population. The peak of the disease is at 70–80 years of age. The disease was diagnosed in people of age 46–85 years, it was 66.65 % more frequent in women than in men. Basal cell carcinoma comprised 91.14 % of all cases. In 65.7 % of cases the tumor was diagnosed at stage Т1 and Т2, and at stage Т1, when patient can be cured, only in 34 % of cases. 

Objective. Study of incidence of malignant eyelid tumors of epithelial genesis, their prognostic characteristics using data from Moscow City Ophthalmic Oncology Center and Ophthalmic Oncology Department of the Branch # 1 “Ophthalmology Clinic” of the S.P. Botkin City Clinical Hospital of the Moscow Healthcare Department.