Melanoma is the most lethal malignancy of skin, which is characterized with clinical and molecular heterogeneity. The main role in melanoma carcinogenesis belongs to mitogen-activated protein kinase MAPK signaling pathway, which is hyperactivated mostly due to BRAF and NRAS mutations. Aim of the study was the analysis of oncogene mutations in melanomas of different origin. BRAF mutations were found in 60,4%, NRAS in 15,6% and KIT in 1% of tumor samples, most of which were regional metastases. The frequency of BRAF mutations were higher in tumors developed on trunk and extremities (69%), then in melanomas located on face and head with chronic UV exposure (44%). NRAS mutations were more common- in melanomas on face (33%) and low extremities (28%), then in tumors on trunk. BRAF mutations were found in 70% of patients younger 40 years while the median age for the group of patients with NRAS mutations was 62 years. There were no differences in frequency of oncogene mutations observed in pigmented and amelanotic tumors, as well as superficial spreading and nodal melanоmas. Cutaneous melanomas have prevalently epithelioid phenotype and BRAF и NRAS mutation frequencies in epithelioid melanomas were higher than in spindle cell and nevoid ones. Thus BRAF и NRAS mutations are associated with location of primary melanoma, histologic type of tumor and age of patients.

In this article we show the successful experience of surgical treatment of widespread massive recurrent chondrosarcoma of the thoracic wall. reconstruction of the combined defect was performed with latissimus dorsi flap and Synthes Matrix riB titanium plate. Good oncological and functional result show benefits of radical surgical treatment with proper these reconstructive methods.

Background. To analyze results of surgical treatment of pathological fractures in patients with long bones metastasis from breast cancer.
Methods. 22 patients with pathological fractures of the long bones were analyzed retrospectively. methods of bone reconstruction were intramedullary and plate osteosynthesis (53,8%), arthroplasty (46,2%).
Results. The overall survival was 66,2% at 1 year and 36,0% at 3 years (the mean survival time was 16,6 months). Visceral metastases have exerted statistically significant negative impact on survival (p=0,011). The complication rate after surgery was 27,3%. Quality of life and extremity function were significantly improved after surgical treatment (p=0,005).
Conclusions. active surgical treatment of long bone pathological fractures in patients with breast cancer allows to improve quality of life, get good functional results and make conditions for special treatment.

Low-grade central osteosarcoma is a rare subtype of intramedullary osteosarcoma (approximately 1% of all osteosarcomas) that characterized histologically by a spindle cell proliferation associated with trabecular bone formation, and is usually located in the long bones with a predilection for the distal femur and proximal tibia. It has the potential to recur, dedifferentiate, and metastasize subsequent to surgical treatment. Sometimes it is difficult to make a diagnosis and differentiate it with fibrous dysplasia and desmoplastic fibroma. In such cases, careful radiological interpretation is helpful. This tumor usually carries a good prognosis.

We have experience of local treatment of 24 patients with metastases of malignant tumors to the spine by using minimally invasive surgical techniques. Technology of vertebroplasty, thoracoscopic intervention, and transcutaneous spinal fixation allowed to perform decompression and stabilization of the affected metastatic segment minimally invasive.

The article contain information about of effectiveness of the radioisotope scanning and single-photon emission tomography in postoperative control of mandible reconstructive surgery based on our clinical care.

Aim. Аssessment of the effectiveness of patients with melanoma limbs treatment using the isolated perfusion chemotherapy in the conditions of hyperthermia.
Methods. It performed the analysis of 41 patients with lower extremity of disseminated melanoma treatment results. Patients were divided into 2 groups: main group – 24 patients received treatment with an isolated regional perfusion (prI), melphalan (10 mg/ l volume of the lower limbs); comparison group – 17 patients are treated with conventional methods with the implementation of mutilation were used. When the prI used the original methodology for monitoring chemotherapy income levels in the systemic circulation.
Results. It was found that the application of the procedure of isolated regional perfusion for locally disseminated melanoma of the skin contributes to significant increase in survival of patients: the overall two-year survival rate was up to 91,7% compared to 53,8% with standard treatment. local toxicity associated with carrying out the isolated limb perfusion was regional, in most cases did not exceed grade I and II on the extent Wieberdink scale. no cases of systemic toxicity of grade I–II CTC scale were observed, confirming the satisfactory safety of this method in the treatment of cancer.
Conclusion. method of isolated regional limb perfusion is clinically effective and safe in the treatment of locally disseminated melanoma of the skinlimbs, its use can reduce the incidence of recurrence of the disease and avoid performing the amputation surgery.

Implications and dynamics of development of HIV-not associated tumor are described in this article. 35 year old patient with HIV infection had dynamic and aggressive development of cancer of a hair follicle without highly active antiviral drugs.

Primary malignant tumors of the human heart are the extremely rare pathology. Because of the low efficiency of the conservative antitumor treatment, currently, only surgery is the one method of the sufficiently radical treatment. The goal of this publication to demonstrate the radical surgery of the right atrium angiosarcoma after effective neoadjuvant chemotherapy.

Aim. Improve the results of surgical treatment of retroperitoneal tumors involving vena cava inferior.
Materials and methods. 18 patients with retroperitoneal tumors underwent vena cava inferior resection at the p.a. Herzen oncology institution from 2010 to 2016. Nine patients had leiomyosarcoma, 4 – liposarcoma, 2 – intraabdominal desmoid tumor and neuroblastoma, 1 – gastrointestinal stromal tumor. in all cases we observed involving vena cava inferior upper or below of renal vessels in tumor process.
Results. All patients had R0 surgical margin in vena cava wall. 8 patients were performed marginal resection vena cava and 8 – segmental. 3 patients underwent vena cava prosthesis and five patients were without reconstruction, it was determined good venous collateral system. Early complications developed in 4 patients and one of them died. the mean follow-up was 14 months (from 6 to 76). Three patients died from the disease progression and others are alive without signs of disease.
Conclusion. Involving vena cava inferior in tumor process is not a contraindication for surgical treatment. Complication rate is not high. The use of modern methods of reconstructive surgery allows to extend indication for surgical treatment retroperitoneal tumors.

Improvement of the results of treatment of synovial sarcoma in children and adolescents is the target of this study. 38 children and adolescents at the mean age of 10,5±3,7 years (18 males, 20 females) with synovial sarcoma were treated between 1999 and 2014 years in the Research Institution of Pediatric Oncology in the Russian Cancer Center. Treatment included chemotherapy, radiotherapy and surgical operation. The toxicity of intensive chemotherapy was reduced by support of peripheral blood stem cells in the investigation group of patients. 2-year disease-free survival was 66,1±11,3%, overall 5-year survival –75,6±10,6%.