Introduction. Radical surgical resections in the treatment of malignant tumors of the spine have proven effective in improving both overall and disease-free survival of patients. Indications for such interventions are primary malignant tumors of the spine, primary benign tumors with aggressive growth, and solitary metastatic lesions in patients with a favorable oncological prognosis. Due to the anatomical features of the vertebral column, it is very difficult to perform radical resections. An even more difficult task is to perform such interventions for multilevel spinal lesions.

The study objective is to evaluate the results of radical surgical treatment for multilevel tumor lesions of the spine.

Materials and methods. From 2004 to 2019, in the department of spine surgery of the N.N. Blokhin National Medical Research Center of Oncology treated 36 patients with spinal tumors, who underwent multilevel radical resections. The analysis of this surgical treatment of patients with multilevel neoplastic lesions of the spine was carried out.

Results. Performing radical surgical interventions on the spine makes it possible to reduce the frequency of local relapses, improve functional results and overall survival of patients. After performing multilevel resections, complications often occur.

Chordomas of the sacrococcygeal region account for more than 50 % of all sacral tumors. These malignant neoplasms grow slowly and are asymptomatic for a long time. As a result, chordomas often reach large sizes and affect the neurovascular structures of the sacrum and pelvic organs. The use of en-bloc resection allows to increase survival rates and reduce the risk of progression. However, this method of chord treatment is difficult for surgeons and in most cases, after surgery, the quality of life of patients decreases. The improvement of imaging methods, the success of oncological orthopedics and radiation therapy allow performing radical organ-preserving operations. In this article, we will consider the modern concept of treatment with a sacrococcygeal chord.

We performed retrospective analysis of publications describing cases of Ewing sarcoma of the skull base with exceedingly rare locations (including the area of the sphenoid bone, its wings, sinus, and adjacent structures). Ewing sarcoma is usually diagnosed in children. The peak incidence is registered in patients aged 10–15 years, whereas adults and children under 5 years of age are very unlikely to develop this disease. In this article, we also report a case of Ewing sarcoma of the skull bones affecting the sphenoid bone and sphenoid sinus. The patient has undergone surgery followed by chemoradiotherapy. High invasion potential (tumor spread in several directions), high malignancy, and compression of the adjacent structures of the brain make the analysis of Ewing sarcoma located in areas that cannot be easily approached particularly interesting for neurosurgeons, since surgery is the main treatment option for such patients.

Background. Retinoblastoma is a malignant intraocular tumor developing from the retinal neuroectoderm and diagnosed primarily in young children. This type of cancer is associated with a high risk of multiple primary tumors emerging after treatment completion. Multiple primary tumors are two or more independent tumors developing in one patient. Treatment of this disease is challenging.

Objective – to evaluate the impact of risk factors on the efficacy of therapy for multiple primary tumors and to analyze treatment outcomes.

Materials and methods. A 2-year-old boy was diagnosed with bilateral retinoblastoma (OD – stage T3bN0M0 and OS – stage T3cN0M0). He received special treatment from September 2005 to November 2006. In 2012, the patient underwent cataract surgery: the lens was removed, then an intraocular lens was installed, and laser dissection of the posterior capsule of the lens was performed. Six years later, in August 2018, the patient was diagnosed with osteosarcoma. The boy received combination organ-sparing therapy according to the EURAMOS-1 treatment protocol for osteosarcoma. During therapy, he developed a secondary tumor, namely osteoblastic osteosarcoma. Both the boy and his father were found to have a mutation in the RB1 gene.

Results. Currently, patient’s condition is satisfactory; he has no complains. The boy is in remission for 2 years.

Conclusion. The development of secondary tumors depends on the genetic factors, type of treatment for primary tumor, and environmental factors. Therefore, it is extremely important to assess risk factors for multiple primary tumors at the moment of primary retinoblastoma detection. The results of such assessment will help to choose an optimal treatment strategy.

In this study we analyzed the quality of life in 62 patients (35.5 % of men and 64.5 % of women; mean age 55 years) who had tumor lesions in different parts of the spine and were treated in the Department of Vertebral Surgery, N.N. Blokhin Russian Cancer Research Center, Ministry of Health of Russia. We assessed the association between the quality of life and psychological characteristics of patients – coping strategies and personal resources. We used a general questionnaire for assessing patients’ quality of life (The Medical Outcomes Study Short Form 36 Items Health Survey) and special questionnaires for cancer patients (Quality of Life Questionnaire – Core 30, QLQ-C30), patients with tumor lesions to the spine (Spine Oncology Study Group Outcomes Questionnaire, SOSG OQ), and psychodiagnostic methods, such as Ways of Coping, Big Five, and Life-meaning Orientations. We have identified an association between the quality of life and all parameters of psychodiagnostic questionnaires, better quality of life correlated with more pronounced psychological characteristics reflecting the maturity of the individual (internality, activity, presence of meaningful goals, ability to seek social support, etc.). Lower personal maturity and poorer constructive coping strategies were associated with worse somatic symptoms and their impact on the quality of life.