Introduction. One of the variants of intravital pathological and anatomical diagnostics is intraoperative pathological and anatomical ("urgent") examination, which serves for tumor process verification. Urgent intraoperative pathological and anatomical examination is widely used when there are certain differential diagnostic difficulties and limitations of instrumental methods of examination.

The purpose of the study — to analyze the possibilities, limitations and the accuracy of "urgent" pathologic and anatomical diagnostics in oncogynecological diseases.

Materials and methods. We retrospectively analyzed medical records of 378 inpatients treated in the gynecologic oncology department of CHOKZO and NM for the period from January 2016 to January 2021.

Results and discussion. Urgent histological examination was used to diagnose ovarian tumors (82%, n=310); to evaluate the extent of a tumor process in uterine body cancer, ovarian cancer, cervical cancer (peritoneal carcinomatosis, ingrowth into adjacent tissues and organs) (15%, n=57); less often to evaluate resection margin ablation in cervical cancer, uterine body cancer (3%, n=11). In a comparison of conclusions after urgent morphological examination and conduction of material, discrepancies were registered only in hypodiagnostic ovarian tumors (in 5.8% of all "urgent" ovarian tumor studies, n=18), when the question about the malignancy potential of a process cannot be reliably decided. The reliability of intraoperative morphological verification of the process is 94.2%. The sensitivity is 96%, specificity is 97%, which is consistent with the results of other studies.

Conclusions. Intraoperative morphological diagnosis is a highly specific and highly sensitive method of investigation. There are limitations of this diagnostic method depending on the volume of tissue material, quality of cryostat sections, as well as tumor features (e.g., ovarian masses) consisting of heterologous morphological areas. A compliant, multidisciplinary approach is required to successfully meet the challenges of intraoperative examination.

Introduction. The choice of a rational method of treatment in vulvar cancer is one of the most actual and difficult problems of modern clinical oncology. In the majority of cases vulvar cancer occurs in elderly and senile patients, as well as in some patients with locally advanced form.

The aim of the investigation was to assess the possibility of reconstruction after surgical treatment of vulvar cancer.

Materials and Methods. A study was conducted involving 151 patients with squamous cell vulvar cancer in whom the gynecological oncology department of Chelyabinsk regional clinical center of oncology and nuclear medicine performed surgical treatment by various methods in the following volume: dilated vulvectomy with the resection of adjacent anatomical structures with reconstructive and plastic component.

Results. The original ways of plasty of the postoperative wound after vulvectomy were evaluated, the minimum risk of  complications was revealed. The presented technologies permit to use additional variants of the wound defect reconstruction and have a number of advantages in comparison with two dermalfascial flaps from the medial surfaces of the femur used earlier.

Discussion. Studies have shown that vulvar reconstruction using skin flaps can avoid complications and improve patients' quality of life. Reconstruction with flaps is not currently an accepted standard of treatment for vulvar cancer.

Conclusion. The methods of the wound defect closure are possible after radical vulvectomy in patients with squamous cell vulvar cancer and resection of adjacent anatomical structures without reduction of surgical treatment volume. These methods of wound defect closure contribute to the reduction of postoperative complications and significantly reduce postoperative stay in a medical institution.

Introduction. Of greatest interest in the complex treatment of gastric cancer is the assessment of the effect of perioperative chemotherapy on the immediate and long-term results of treatment. Including, the possibility of studying the effectiveness of chemotherapy, its effect on the resectability of the tumor process, determining the possibility of an indirect correlation for intra — and postoperative complications.

The aim of the study is to study the effectiveness of perioperative chemotherapy in the treatment of gastric cancer and its direct effect on the results of surgical treatment.

Methods. At the base Chelyabinsk Center of Oncology and Nuclear Medicine, studies are being conducted to assess the effectiveness and tolerability of perioperative chemotherapy in the complex treatment of gastric cancer. Based on the inclusion criteria, 80 patients were selected with a diagnosis of gastric cancer T2-3N0-2M0. The first stage of all patients underwent diagnostic laparoscopy with negative peritoneal washings. The male to female ratio was 51% and 49%, respectively. The average age of the patients was 61 years. By morphological structure, gastric adenocarcinoma prevailed — 85%, cricoid cell carcinoma was 9%, adenocarcinoma with a cricoid cell component — 6%. According to the T category, the patients were distributed as follows: cT2 — 5%; sT3 — 59%; cT4 — 36%. In category N, patients of category N1 prevailed — 59%; patients with cN0 and cN1 were represented in approximately equal proportions, 14% and 19%, respectively. Patients with stage II accounted for 33%, with stage III — 67%. The main combination of drugs was FLOT (87%), FolFox (3%), XELOX (5%), PF (5%) were also used.

Results. The data obtained clearly demonstrate the good tolerability of the performed preoperative chemotherapy, the absence of significant adverse reactions. Drug therapy did not affect the planned timing of the surgical stage of treatment. Also, no effect of chemotherapy on postoperative complications was noted. R0 resection was performed in 100% of cases. In 49% of cases, stage reduction was performed. Significant medical grade III — IV pathomorphosis was obtained in 26% of cases. 
Discussion. Interpretation of therapeutic tumor pathomorphosis for evaluating the effectiveness and planning of adjuvant therapy currently requires further study and evaluation.

Conclusion. Perioperative chemotherapy is not accompanied by adverse reactions affecting the timing and outcome of treatment. The obtained positive clinical effect according to examination data, intraoperative visual assessment suggests an improvement in overall survival and a decrease in one-year mortality in the complex treatment of gastric cancer.

Introduction. The aim of the study was to compare the survival rates of patients with prostate cancer (PC) with lymphogenic metastases (N1) after surgical treatment and after conformal distant radiation therapy followed by adjuvant hormone therapy with analogues of luteinizing-releasing hormone (LHRH).

Materials and methods. The patients were divided into two groups. The first group included 36 patients with prostate cancer after posadilonic prostatectomy with extended pelvic lymphadenectomy followed by continuous adjuvant hormone therapy (analogs of LGRH) for up to two to three years. Lymphogenic metastases were detected after histological examination of the operative material. The second group consisted of 42 patients after neoadjuvant hormone therapy for 6 months (LGRH analogues), a course of distant radiation therapy (DLT) in the traditional mode with a single focal dose (ROD) of 2 Gray (Gy), a total focal dose (SOD) of 72 Gy, followed by adjuvant hormone therapy in a continuous mode (analogs of LGRH) for up to two to three years.

Results. The duration of follow-up was 60 months, with a median of 38 months. The one-year survival rate after surgery was 86.1%, in the group after DLT — 81.2%, the three-year survival rate in group 1 — 80.1%, in group 2 — 76.3%, the five-year survival rates — 72.3% and 69.1% respectively. The one-year cancer-specific survival rate in group 1 was 96.7%, the three-year survival rate was 83.4%, and the five-year survival rate was 52.8%. In the second group, the oneyear survival rate was 91.9%, the three-year survival rate was 74.1%, and the five-year survival rate was 51.4%. 
Conclusion. For the treatment of prostate cancer patients with lymphogenic metastases, prostatectomy with extended pelvic lymphadenectomy can be considered as a treatment option not only in clinical trials. The results of cancer-specific and relapse-free survival show the effectiveness of this treatment option

Introduction. Ovarian cancer is the leading cause of death from gynecological malignancies: the one-year relative survival rate with stages 3 and 4 of the disease is 20%. The results of treatment remain unsatisfactory, which dictates the need to find new methods of treatment. The aim of the study was to evaluate the effectiveness of the use of HIIH (hyperthermic intraperitoneal intraoperative chemoperfusion, HIPEC) in patients with the diagnosis of: ovarian cancer IIIA-From the stage of the disease.

Materials and methods. 117 cases of stage IIIA-C ovarian cancer treated at the Chelyabinsk Regional Clinical Center of Oncology and Nuclear Medicine from January 2014 to March 2021 were retrospectively studied. All patients underwent 3 cycles of neoadjuvant chemotherapy (NAPHT) according to the paclitaxel+carboplatin (PCb) scheme, followed by surgical treatment to the extent of maximum cytoreductive surgery. Two study groups were formed: 1 — cases with GIIH (N=57), 2-without GIIH (N=60). On the 14-16 day after the operation, all patients underwent 3 cycles of adjuvant chemotherapy according to the PCb scheme.

Results. A significant increase in overall survival was found in the first group of patients with HIPEC. This technique allows to increase the survival rate of patients for 14 months at stage IIIA-B (p<0.05). At stage IIIC, there was no statistically significant difference in the survival rate of patients. There was a tendency to increase the survival rate by 5 months (p>0.05), which is associated with the pronounced prevalence of the tumor process and the technical impossibility of removing the tumor. 
Discussion. The concentration of drugs in the abdominal cavity and in the blood plasma significantly differs due to the functioning of the peritoneal-plasma barrier, which leads to a lower toxicity in comparison with systemic chemotherapy, and therefore allows you to give a large dose of the drug with fewer adverse events, and the fact of hyperthermia (42°C) has a positive effect on the effectiveness of intraperitoneal chemotherapy. To date, this method has not been included in the clinical recommendations on the territory of the Russian Federation, but data from foreign literature, including randomized trials, have shown the high effectiveness of this method.

Conclusion. The results obtained in the course of our study demonstrate the effectiveness of this technique, in the form of an increase in overall and relapse-free survival with acceptable toxicity.

Introduction. Uveal melanoma is a malignant neoplasm of the vascular tract of the eye. Prevention of metastasis of this tumor is one of the main tasks in order to increase the rates of relapse-free survival of patients. Despite the pronounced immunosuppressive activity of uveal melanoma cells, its lymphocytic microenvironment exerts its antitumor effect.

Aim of the study. Compare the lymphocytic microenvironment of primary uveal melanomas and distant metastases (to the liver).

Мaterials and methods. The tissue material of choroid melanoma after enucleation and the material of tumor metastases for the period 2013-2018 were studied. An immunohistochemical study was performed using CD8, CD4, and CD56 markers for the qualitative and quantitative assessment of lymphocytes in the tumor stroma.

Results. Differences were found in the lymphocytic infiltration of the uveal melanoma stroma and its distant metastases. A statistically significantly greater representation of CD4, CD8-lymphocytes and CD56 cells in tumor metastases than in primary melanoma tissue samples, with CD4-lymphocytes predominant. A direct high-strength correlation was registered between the number of CD4-lymphocytes and CD8-lymphocytes.

Discussion. Malignant cells actively modify their cellular and stromal-vascular environment, ensuring their active growth and reproduction. The question of the immune reactivity of the surrounding cells in relation to uveal melanoma remains debatable. According to our data, which is consistent with a number of other studies, uveal melanoma cells do not completely evade the body's immune response. Thus, the determination of possible points of antitumor exposure can be based on a detailed study of the microenvironment of uveal melanoma.

Conclusions. The pronounced lymphocytic infiltrate found in uveal melanoma metastases in comparison with the primary tumor indicates an active immune response of the body to the tumor. These results of our study confirm the importance of further studying the immune-mediated antitumor effect on uveal melanoma and the need to investigate possible approaches to immunotherapy.

Introduction. To reduce the number of cerebral perfusion studies, the interpretation of which is not possible or can be performed with errors, we retrospectively analyzed cerebral perfusion studies for three years, analyzed the identified errors at the stage of data collection and the stage of study interpretation.

Aims and objectives: to analyze and divide into groups the reasons that led to limitations or impossibility to assess perfusion during interpretation of the obtained data, to develop an algorithm of actions to reduce the number of uninterpreted studies.

Materials and Methods. The study retrospectively evaluated 275 CT and MRI brain perfusion studies performed between 2017 and 2019 on 1.5 T MR and 32-slice CT scans.

Results. The result of this study was a better understanding of the causes of the most common errors in perfusion studies. Analysis of the causes allowed us to identify factors that affect the performance of the study and the interpretation of the data obtained. 
Discussion. In order to perform a quality perfusion study, given the many factors affecting the interpretation of the data obtained, a number of conditions on the planning and execution of the study, as well as on the evaluation of the data obtained, must be followed.

Conclusions. Understanding the reasons that lead to limitations or inability to evaluate MRI and CT perfusion studies, adhering to guidelines for planning and evaluating studies allows for correct data and avoids obtaining uninformative studies or studies whose interpretation is limited.

Introduction. Breast cancer in the structure of malignancies in women takes the 1st place. There has been an annual increase in morbidity, including due to improvements in diagnostic interventions and screening. Mammography and ultrasound of the breasts is mandatory when diagnosing breast cancer. The difficulties of diagnosis are revealed in small tumors.

Methods. Breast ultrasounds were performed on the ultrasound machines of the expert class TOSHIBA APLIO 500, PHILIPS EPIQ 5 and PHILIPS EPIQ 7. Mammography and tomosynthesis were performed on mammogram MAMMOMAT INSPITATION PRIME. Core-biopsia under ultrasound control was carried out on the Logiq9 ultrasound scanner. Eighty women were selected with suspected cancer after breast core-biopsy with the category BI-RADS 3, 4 and 5. The size of the node according to ultrasound data was 6-10 mm.

Results. According to core-biopsia has been identified cancer, histologically and immunohystochemically confirmed in 50 cases. In 30 women benign tumors were identified. The most informative mammograms of breast cancer were high tumor density, ray of radiibility and local deformity of soft tissues. Among the characteristic ultrasonic signs of the cancer more often noted vertical orientation, reduced echogenicity, uneven contour, other signs were not so character for the cancer.

Conclusion. You can't focus on a separate sign of education! Only a combination of traits, different diagnostic methods contribute to the correct diagnosis.

Introduction. To evaluate the immediate results of the first experience of implantation of an interpleural port system in comparison with traditional methods of pleural fluid evacuation and improve the quality of life of patients with recurrent metastatic pleurisy.

Materials and methods. A prospective study of 14 cases with recurrence of metastatic pleurisy in 6 months was carried out. 2020 year. The patients were divided into group A (traditional methods of pleurisy evacuation) and group B (implantation of an interpleural port system). The manipulations were performed under local anesthesia.

Results. Pneumothorax was diagnosed in 6 patients (43%) after thoracocentesis and implantation of the port system. In group B, 3 people (21%) had a small pneumothorax, the air was evacuated with a Huber needle. In group A, 3 people (21%) required drainage of the pleural cavity, which delayed hospitalization. In 11 people (78%), of which 7 people (50%) from group B, a clinical decrease in respiratory failure up to stage II. 7 patients (50%) from group B noted the absence of pain and discomfort after surgery. 14 (100%) patients were diagnosed with a recurrence of metastatic pleurisy on day 21, which required hospitalization of patients from group A to a hospital for drainage of the pleural cavity. In group B patients, fluid evacuation was performed on an outpatient basis, thereby not lengthening the period of systemic anticancer therapy. 4 patients (28%) managed to continue antitumor therapy on time. Infectious complications in 3 patients (21%) from group A, where air leakage persisted against the background of tumor disintegration.

Conclusion. The intrapleural port system improves the quality of life, eliminating complications from repeated punctures of the pleural cavity. Simple installation under local anesthesia with the possibility of discharge from the hospital on the 2nd day. Evacuation of pleurisy through the port system by nurses on an outpatient basis. Possibility of intrapleural antitumor therapy and pleural obliteration through the port system.

Introduction. Correction of iron deficiency anemia in patients with malignant neoplasms is an important aspect affecting the quality of life and the effectiveness of special treatments. At the same time, the therapy of comorbid conditions significantly increases the cost of treating cancer patients.

The aim of the study was to conduct a comparative pharmacoeconomic analysis of the two most common methods for correcting iron deficiency anemia in cancer patients: transfusion of erythrocyte suspension and intravenous iron preparations using iron carboxymaltose as an example.

Materials and methods. An observational, analytical, cohort study was carried out, which included 120 cancer patients. The patients underwent laboratory examination. The tests were assessed: a general blood test with an assessment of the morphological characteristics of erythrocytes, serum iron, ferritin, CRP, total protein. An analysis of the costs of iron deficiency anemia therapy was carried out, taking into account the procurement cost of drugs.

Results. It is economically more profitable to use intravenous iron preparations in comparison with transfusion of erythrocyte suspension for the treatment of iron deficiency anemia in patients with malignant neoplasms. The cost of correcting iron deficiency anemia per patient was: when treated with carboxymaltosate iron (Ferinject): 7943.96 rubles, with transfusion of erythrocyte suspension: 16856.40 rubles.

Conclusion. In the treatment of anemia in patients with malignant neoplasms with blood preparations (erythrocyte suspension), an improvement in hematological parameters is noted earlier and to a greater extent than with the use of iron preparation carboxymaltozate («Ferinject»). Nevertheless, the duration of the clinical effect when using erythrocyte suspension is lower than that of a parenteral iron preparation.

Introduction. Level of peptidyl аrginine deiminаse type 4 (PАD-4) is found to be increased in breast cancer patients with controversial views on its role and no data on distribution between subtypes of the disease. 
Materials and methods. PAD-4 level wаs determined in 98 serum аnd 66 tissue sаmples of women with primаry breаst cаncer. They were divided in 5 subgroups bаsed on stаndаrd immunohistochemistry dаtа: group 1 — luminаl А cаncer, 2 — luminаl B Her-2 neg аtive, 3 — luminаl B Her-2 positive, 4 — non-luminаl Her-2 positive, 5 — triple negаtive cаncer. Blood sаmples were tаken before initiаtion of treаtment аnd in 41 cаses аgаin 15-24 dаys аfter definitive surgery. Control sаmples were tаken from 20 heаlthy women. PАD-4 level wаs determined by PCR with Humаn PАD-4 ELISА Kit аnd for tissue by IHC with rаbbit polyclonаl аnti PАDI4/PАD-4 аntibodies. 

Results. Mediаn P АD-4 blood level before treаtment w аs 9,0 ng/ml, with the sаme level аfter surgery. Mediаn P АD-4 level for heаlthy women wаs 1,5 ng/ml which is significаntly different from cаncer group. Median P АD-4 levels for breаst cаncer subgroups were: group 1 — 11,05 ng/ml., group 2 — 11,9., group 3 — 10,8., group 4 — 7,99 аnd in group 5 — 9,9 ng/ml. Expression of P АD-4 in tumor wаs detected in 70% of sаmpes. Expression in points from 0 to 3, meаn vаlue by groups: group 1 — 1,03, group 2 — 0,83, group 3 — 1,25, group 4 — 1,8, group 5 — 2.

Conclusion. PАD-4 blood level was higher in groups of more fаvorаble luminаl cаncer. Expression of PАD-4 in tumor tissue wаs higher in more аggressive Her-2 positive breаst cаncer. Further reseаrch in needed for stаtisticаlly vаlidаted conclusions.

Introduction. Palliative care is aimed at maintaining and improving the quality of life of the patient. Without taking into account the psychosocial aspects, psychological rehabilitation is impossible in the conditions of a psychotraumatic situation of the disease.

The aim of the study was to assess the psychoemotional state of polymorbid palliative cancer patients.

Materials and methods. An observational, analytical, single-stage (cross-sectional) study was conducted, which included 74 cancer patients of a palliative profile. The patients underwent laboratory and instrumental examination. The following tests were evaluated: resilience (S. Maddy's method, D. A. Leontiev's adaptation), life-sense orientations, the level of subjective control, C. D. Spielberger, the severity of chronic pain syndrome; the value of the Charlson comorbidity index, the Karnovsky index (ECOG) was calculated.

Results. The level of the comorbidity index was 3 [2; 5] points, the intensity of chronic pain syndrome-2 [2; 3] points, ECOG-2 [2; 3] points. In polymorbid cancer palliative patients, the presence of a belief in the impact of the struggle on the outcome of what is happening was revealed, however, patients are not always ready to act in a difficult situation. In the examined group, signs of dissatisfaction with their life in the present prevailed, the lack of sufficient freedom of choice, the existence of hope for recovery as a result of the actions of others, primarily doctors. The average (and in some cases high) level of situational and personal anxiety was noted. The association of the comorbidity index and the indicators of the life-meaning orientations test; the indicator of the general internality scale and the ECOG value; the glomerular filtration rate and the indicator of resilience, risk acceptance was revealed. A number of correlations between the indicators of the psychoemotional state and laboratory parameters (the level of hemoglobin, albumin, iron, C-reactive protein) were noted.

Conclusion. In cancer patients with a palliative profile, signs of mental maladaptation were revealed. The average (and in some cases high) level of situational and personal anxiety was noted. The revealed number of correlations focuses on the role of chronic non-communicable diseases in aggravating the psychoemotional status of chronic polymorbid cancer palliative patients.

Introduction. The problem of breast cancer associated with pregnancy for a long time attracts close attention. The incidence is relatively increasing, thanks in part to improved detection methods, but also to the growing trend towards late childbearing.

Material and methods. The features of breast cancer treatment during pregnancy were studied, and the effect of pregnancy on the long-term prognosis and clinical course of breast cancer was evaluated.

Results. All patients received treatment according to the clinical recommendations. Chemotherapeutic treatment was performed in 44 (77%) patients, surgical treatment in 54 (96%) cases, radiation therapy in 40(72%) patients, and hormone therapy in 24 (42%) women. Among the newborns, there were no significant malformations, one child (a girl) had an underdevelopment of the left lung tissue, and laterphysical development in accordance with age.

Conclusion. The decision on the special treatment of breast cancer associated with pregnancy is made individually, the treatment has been planned together with obstetricians and gynecologists. Surgical and chemotherapeutic treatment (starting at 13 weeks) can be performed during pregnancy. Radiation therapy, hormone therapy, and targeted therapy should be postponed until delivery. Most patients have common forms of the disease and aggressive biological types of tumors. Currently, the features of the course of the disease, the prognosis, and the features of treatment in this category of patients are being studied.

Introduction. Nutritional status disorders are common among cancer patients. These disorders significantly reduce the quality of life and worsen the prognosis. Objective: to assess the prevalence of trophic insufficiency in palliative care cancer patients.

Materials and methods. An observational, analytical, single-stage (crosssectional) study was conducted, which included 106 cancer patients of a palliative profile. The patients underwent laboratory and instrumental examination, a comprehensive assessment of the trophic status. 

Results. 77 (72.6%) of the examined patients showed signs of nutritional deficiency. Signs of hypotrophy were found in 19 patients. Hypotrophy of the III degree was not detected in any of the cases, of the II degree — in 4 patients, of the I degree — in 15 patients. Normal or elevated body mass index in some cases is associated with a violation of the nutritional status. A detailed study of the trophic status in cancer patients with palliative profile showed a different significance of each criterion studied. The study of the level of total protein (χ²=1.07, p=0.348), albumin (χ² =7.42, p=0.006), the number of peripheral blood lymphocytes (χ²=12.61, p=0.0004) allowed more often to diagnose a violation of the nutritional status in comparison with somatometric indicators (χ² =2.07, p=0.153) and  the value of transferin (χ² =1.07, p=0.348). The study of variants of the combination of reduced indicators of nutritional status in the examined group of patients showed that the use of one criterion in isolation from other clinical and laboratory indicators will lead to underdiagnosis and underestimation of the severity of trophic disorders.

Conclusion. In cancer patients with a palliative profile, nutritional disorders are detected with a high frequency. Somatometric indicators of nutritional status do not fully reflect the presence of trophic disorders. A decrease in the level of albumin, total protein, and the number of peripheral blood lymphocytes makes it possible to more often diagnose a violation of the nutritional status in the studied group of patients. However, none of the criteria for nutritional insufficiency can be used in isolation.

Introduction. The article reveals the organizational and legal basis for aesthetic reconstruction of the breast in the oncology clinic. The increase of patients' requirements for aesthetic results of the breast cancer treatment is outlined. Judicial practice data from open sources on «medical» cases are presented. Materials of external studies are described, where aesthetic reconstruction is presented as an integral part of rehabilitation, prevention of negative consequences of treatment, including mental disorders. The article defines the place of aesthetic reconstruction after breast cancer surgery, raises the problem of the possibility of symmetrical operations on the healthy contralateral breast, preventive breast and pelvic surgery in women with genetically predisposed forms of oncological diseases, expanding the volume of screening in women with a hereditary anamnesis.

The purpose of the study was to compare the requirements for the quality and scope of medical care for breast cancer patients at a state oncology clinic with the professional competencies of the end-doctor oncologist, according to current standards, clinical guidelines, and guidelines for medical care.

Materials and methods.The review of current regulations in the field of medical activity in the profile «Oncology» effective in the Russian Federation. Also the data of the judicial practice from open sources for 2012, 2017-2020 are presente. 

Results. The interpretation of current legal documents of the Russian Federation in the field of medical care in the profile «oncology» gave ambiguous results: probably, there is an intersection of qualification requirements for oncologist and plastic surgeon.

Discussion. Possible ways out and suggestions from the current dangerous, 
from the legal point of view, situation are outlined.

Aim of the study — to provide for medical oncologists and surgeon, who specialize in treatment of head and neck oncology patients, the most recent information about incidence and feature of oral squamous cell carcinoma (OSCC) in young patients.

Material and мethods. Pubmed, ScienceDirect are used for literature search. Data of world literature published since 1983 till 2021 and contain information about incidence, epidemiology, clinic, treatment and prognosis in OSCC in young patients. The data of retrospective and prospective clinical trials were studied.

Results. Determined the relevance of this problem and described incidence and epidemiology. Based on the analysis of the most recent publications, the authors provided data on clinical picture and modern approaches to the treatment and prognosis of OSCC in young patients by comparison with old patients.

Conclusion. Over the past 30 years, the incidence of oral squamous cell carcinoma in young patients has been increasing worldwide while the incidence of classical oral cancer has been decreasing and no clear etiology has been identified. In this review we analyzed and synthesized the literature regarding early onset OSCC. Since 1983, the first assumptions about the uniqueness of the etiology and clinical picture of OSCC in young patients have appeared; till this day, this topic remains relevant for head and neck oncologists. Understanding the biology of the OSCC in young patients can be crucial in determining the prevention of disease, treatment and prognosis for patients.

Introduction. The literature review presents new definitions of the concepts of postoperative cognitive dysfunctions, taking into account the new nomenclature according to DSM-5 (Diagnostic and Statistical Manual of mental disorders, fifth edition — Diagnostic and statistical manual of mental disorders, 5th edition) and time of their manifestations, depending on the age of the surgical intervention performed. The main discussed tactical aspects of the anesthesiologist's management of patients at risk of cognitive impairment in the postoperative period are outlined. The main biological markers, predictors of the development of cognitive postoperative disorders, are emphasized.

Aim of the study: to highlight the main discussed tactical points of anesthesiologist's management of patients, to outline more promising aspects of biochemical laboratory diagnosis of postoperative 
neurocognitive disorders.

Materials and methods. The data were analyzed and systematized based on scientific publications in the general PubMed database for the period 2016-2020.

Results and discussion. New research advances in the search for biological targets, markers and predictors of postoperative neurocognitive disorders at the molecular level are presented, allowing a more precise impact on the pathogenetic mechanisms of neuronal inflammation and assessment of the potential damage to the cognitive status of the patient. The paper outlines more promising aspects of biochemical laboratory diagnosis using markers of innate immunity response to surgical trauma and the resulting systemic inflammation.

Conclusion. Problems requiring further study to find pathogenetic therapy for postoperative neurocognitive disorders have been identified.

Introduction. Oncocytoma is an epithelial tumor, characterized by a benign course and has a favorable prognosis. The description of this clinical case is due to the rare occurrence of lacrimal gland oncocytoma in clinical  practice and a small number of publications in the literature.

Methods. A case study of the lacrimal gland oncocytoma is presented in a young patient, followed up for a long time.

Results. The presented clinical case demonstrates the need for morphological diagnosis of lacrimal gland formations, despite the benign nature of the tumor and the favorable course of the disease.

Discussion. Analysis of a clinical example and a review of the literature clearly demonstrates the need for differential diagnosis of tumors of the lacrimal gland.

Conclusion. It is necessary to include the described pathology in the differential diagnostics of any neoplasms of the lacrimal gland and orbit in order to prevent an unwarranted expansion of surgical intervention, with subsequent dynamic monitoring of patients with this pathology.

Introduction. This article, using a clinical case as an example, reflects the problem of the development of tumor lysis syndrome (TLS). The most common cause of SLO development is antitumor treatment: radiation therapy, radiofrequency ablation, vascular embolization, the use of monoclonal antibodies, high-dose chemotherapy with transplantation of stasis from peripheral blood. This disorder leads to the development of metabolic, hemodynamic, respiratory and renal disorders. The TLS distinguished by high mortality rates, from 17% to 70%.

Materials and methods. Presented a clinical case of patient, 30 years old - observation of successful treatment of TLS of the III degree of clinical course according to Cairo-Bishop, in the conditions of the State Budgetary Healthcare Institution «Chelyabinsk Regional Clinical Center of Oncology and Nuclear Medicine», in the conditions of the intensive care unit and intensive care with the use of renal replacement therapy on the Prismaflex device.

Results and discussion. When the patient applied to the State Budgetary Healthcare Institution «Chelyabinsk Regional Clinical Center of Oncology and Nuclear Medicine», the diagnosis made — Non-Hodgkin lymphoma with a diffuse type of growth of a high degree of malignancy. Revealed the defeat of the lymph nodes, parietal pleura, right hemithorax, atelectasis of the middle lobe of the right lung with air bronchography, hydrothorax on both sides, hydropericardium, free fluid in the pelvic cavity, phlebolitis of the parametric tissue, degenerative-dystrophic changes in the spine. On the first day of hospitalization, antibacterial and pain relief therapy started, and nutritional disturbances were corrected. After the pre-phase chemotherapy (cyclophosphamide, vincristine), the patient's condition worsened, she was transferred to the intensive care unit. Where was the treatment carried out: convulsive syndrome, respiratory failure, acute renal failure, bilateral pneumonia, PE. Against the background of this therapy, special treatment continued - 2 cycles of chemotherapy. After the patient transferred to spontaneous breathing and the indices of blood slags and potassium were normalized, she was transferred to the antitumor therapy department to continue special treatment.

Conclusion. Our algorithm for the treatment of SLO led to positive dynamics and the possibility of carrying out special antitumor therapy for this patient.