Background. Morphologically both mandibular sarcomas and sarcomas of other origin are very similar, but have difference in there clinical manifestation. Surgery is a gold standard. After partial mandibular resection simultaneous reconstruction is used to improve functional and esthetic aspects. Materials and methods. 82 patients with primary mandibular sarcomas were observed in the Russia Cancer Research Center from I960 till 2008. Osteosarcoma was the most common histological subtype. Surgery alone is the standard of care. Combined chemoradiotherapy is rarely used for specific histological subtypes. Simultaneous reconstruction was made in 23 patients. Reconstructive plate was used in 8 patients. In 3 cases musculo-cutaneous transferred flap was used. Vasculorised bone grafts were transplanted inl5 cases. Results. 5 - year survival in surgery group was 48%. None of patients who received chemoradiotherapy reached 4 year survival checkpoint. Local recurrences were higher when 2 or more anatomic areas where involved. Conclusion. Surgery is still a golden standard of care. Histological subtype, tumor location, surgery technique are the main prognostic factors.

The use of ultrasound in the diagnosis of bone pathology is limited because of the reflection of ultrasound waves from bone surface, perhaps there is a possibility to receive the information in case of cortical bone destruction and formation of soft tissue extraosseal component. The aim of study was to reveal the possibilities of ultrasound computed tomography in the diagnosis of malignant bone tumors. For this purpose 86 patients with bone lesions were examined. 77 (90%) patients had malignant tumors. On the base of received data typical ultrasound characteristics of malignant bone tumors were revealed. Clinical usage of the method was detected.

Regional intra-arterial chemotherapy in the treatment of high grade osteosarcomas is used to decrease the tumor volume and increase the amount of limb salvage surgeries. Combined neoadjuvant chemotherapy including systemic and regional infusion also decreases the risk oflocal recurrence and metastasis. Using combined intra-arterial and intra-venal chemotherapy good pathologic response was achieved in 81% of patients with 23% of complete necrosis. 5- year survival of 68% was achieved in children. Local recurrences where observed in 8,7% comparing to 27/5% in the group withjust adjuvant chemo. 5- year RFS and PFS were 66,8 % and 46.5% respectively. Regional chemotherapy maybe recommended for routine use due to high efficacy and low percent of complications.

115 patients with locally advanced STS treated in MRRC RAMS were analyzed. In group 1 were included 32 patients who received preoperative thermo-chemo-radiotherapy (TCRT) and surgery with intraoperative radiation therapy (IORT). The group 2 consisted of 31 patients treated with preoperative chemo-radiotherapy (CRT) followed by surgery with IORT. The group 3 included 22 patients received TCRT, without surgery. The control group consisted of 30 patients treated with surgery only. IORT didn’t increase an incidence of postoperative complications. None of the patients in group 1 had local recurrence during 5 years. The locoregional-recurrence-free-survival (LRFS), metastasis-free survival and overall survival rates (86-100%, 70-49%, 80-64%) at 5 years were higher in groups with IORT compared to the control (32, 18, 25,5%). Rates of recurrence in group 3 (TCRT) didn’t differ significantly from the control during the first 4 years, moreover, the first year LRFS was even higher (p=0,05).

PEComas, occasionally associated with tuberous sclerosis complex, are defined by the presence of perivascular epithelioid cells that coexpress muscle and melanocytic markers. The family of tumors includes angiomyolipoma, clear cell sugar tumor of the lung, limphangioleiomyomatosis and very rare tumors in the other locations, which natural history and prognostic features undefined. The majority of PEComas are benign. Clear criteria for malignancy in PEComas have not be elaborated, owning to their rarity. Histogenesis of PEComas is unknown.

The diagnosis of infantile fibrosarcoma was made retrospectively in 15 patients. Follow up showed 4 recurrences, no metastases and death during 1-3 years. The lesion were 2-8 cm; occured in the upper and lower extremities, trunk and head. Patients had a long history of painless intramuscular mass (median duration 3 month). All tumors are finely sclerotic, containing nests of fibroblasts with clear cytoplasm and bland cytologic features of nuclei. Areas of spindled cells with nuclear enlargement and hyperchromatism were identified. No necrosis and mitotic activity less than 4 mf/10 HPF were present. Ultrastructurally, the tumor composed of neoplastic fibroblasts. No other cell differentiation were identified. We discuss the overlapping clinicopathologic features and differences between infantile fibrosarcoma and adult fibrosarcoma.

Article reviews a treatment experience of 9 patients with axial bone tumors with the use of endoscopic surgery. Endosurgery in ligation of internal iliac vessels showed decrease of bloodless and in some cases was needed to remove paraspinal tumor. The removal technique dumbbell neurogenic tumors with combined approach is described. Indications and stages of this surgery are shown. The analysis of complications is discussed, recommendations for their preventive care are described.

Background. The aim of our study was to improve the diagnosis of cutaneous melanoma by synthesis, systematization and development of new ultrasound criteria for the primary tumor. Materials and methods. The prospective analysis of the ultrasound study results of primary skin melanoma of different localization in 140 patients. The results of preoperative ultrasound examination were compared with data of histology of the resected tumor. Results. Ultrasonic semiotic signs of the primary tumor were developed. A dependence of the ultrasound picture of the thickness of melanoma was revealed. The most common characteristics of primary skin melanoma are homogeneous structure of low echogenicity (85 (65,9%) cases) and fusiform (79 (61,2%) cases). Conclusion. Ultrasound allows to evaluate the local metastasis of primary skin melanoma and measure its thickness (r=0,91; p<0,001) on pre-operative stage with a high degree of confidence. This contributes early selection of appropriate treatment and increase survival of patients with malignant cutaneous melanoma.