The paper presents experience of surgical treatment of 28 patients with reconstruction of the pelvic ring after extensive resection for tumors sacroiliac localization. The mean age of patients was 38 years (18 to 64). according to histological type of the tumors most frequently were: chondrosarcoma – 9 (32,1%), ewing’s sarcoma – 6 (21,4%), chordoma – 2 (7,1%), metastases – 4 (14,3%), others – 3 (9%). Mean operative time was 390 minutes (270 to 750). The volume of intraoperative blood loss averaged 3200 ml (1000 to 9000). postoperative complications were observed in 9 (32,1%) patients. average follow-up was 37,8 months (6–113 months). recurrence were observed in six patients in the period from 4 to 36 months. The mean MSTS score at last available follow-up was 72,5% (43,3–93,3%).

Arthroplasty is a common method of selection of organ-preserving treatment of bone tumors. it allows to improve the quality of life of cancer patients and does not worsen the prognosis of the disease. in 2012–2015, for the first time in Samara regional clinical oncologic dispensary was performed 14 interventions for malignant tumors of the long bones using cancer surgery. The amount of interference resection of the articular end of the femur, tibia or humerus with displacement post-resection defect modular endoprostheses Oncology Salvage System (Biomet). The average time of surgery was 5±0,65 hours. The average amount of intraoperative blood loss – 1085±188 ml. average duration of hospital stay of the patient after surgery was 22±2,85 days. all patients in the postoperative period was prescribed antibiotic and anticoagulant therapy. The average duration of antibiotic therapy after surgery was 6±1,5 days. There were no complications. The anatomic and functional status of all patients was evaluated as good.

The very existence of extra-axial chordoma has been questioned since its initial description, and in fact, similar tumor is described in soft tissue in part of a morphological spectrum that includes mixes tumor and myoepithelioma. in bone, the entity has been described as extra-axial chordoma. in any case, only a small number of tumors bearing histological resemblance to axial chordoma arising from the bone or soft tissue outside the axial skeleton have been reported. these lesions have historically been referred to as parachordoma, chordoma periphericum (CP), or extra-axial chordoma (EAC). with the introduction of the immunohistochemical stain brachyury. the very existence of extra-axial chordoma has been questioned since its initial description, and in fact, similar tumor is described in soft tissue in part of a morphological spectrum that includes mixes tumor and myoepithelioma. in bone, the entity has been described as extra-axial chordoma. in any case, only a small number of tumors bearing histological resemblance to axial chordoma arising from the bone or soft tissue outside the axial skeleton have been reported. these lesions have historically been referred to as parachordoma, chordoma periphericum (CP), or extra-axial chordoma (EAC). with the introduction of the immunohistochemical stain brachyury, a sensitive and specific marker for notochordal origin, chordomas arising in extra-axial locations (i.e., CP, EACh), are now diagnosed with more accuracy and distinguished from parachordoma, which resembles chordoma on histology. the differential diagnosis between EAC and parachordoma is clinically important, EACh positive for brachyury tends to grow and recur with local bone destruction. Prior the specific marker brachyury, the diagnosis of EACh was challenging and therefore the imaging features of EACh have not been comprehensively described. now, there are only a few cases reporting the cytogenetics of the entity: trisomy 15 and loss of chromosome 1, 16 and 17 in one case with chromosomal studies, a loss of chromosomes 9, 10, 20 and 22, a loss of chromosome 17 and a structural rearrangement of chromosome 3 [del (3q)] and chromosomes 2 and 4 [t (2p; 4q)] in a recurrent tumor. Because studies about cytogenetics of parachordoma are rare, the characteristic need to be further explored. we report two cases of recurrent EAC confirmed by the expression of brachyury arising from the distal femur and proximal tibia and describe the imaging findings from radiography and mri at initial diagnosis and at recurrence.

Breast cancer – is the important problem of modern oncology. Its incidence is increasing every year. Breast cancer has particular predisposition to metastasize to the bones. It causes such complications as the pain syndrome, pathologic fractures, compression syndrome, which significantly aggravates the underlying disease. There are no specific scales for evaluating the prognosis of metastatic breast cancer in the spine, which would be considered the biological properties of the tumor, as well as orthopedic and neurological characteristics of the patient. On the basis of 76 patients, the mathematical scale was developed, which can predict the individual prognosis for breast cancer metastases in the spine.

The family of mesenchymal tumors called PEComas (Perivascular Epithelioid Cell Tumors) has been included in the international Classification of Soft Tissue and Bone Tumors since 2002. Literature review confirms difficulties of timely diagnosis and absence of progress in the treatment results. in spite of advances in research of PEComas histological nature of these tumors is still unclear. Further research of prognostic factors is needed to give proper treatment. Patients with PEComas of different primary sites require close follow-up after the treatment irrespective of malignant potential of tumors, as late recurrence and metastases are possible. This paper presents a case report of 11-year-old girl with vaginal PEComa, who is disease-free 10 years after the treatment.

Vascular malformations in children is a serious problem due to the functional, cosmetic, psychological disorders and social disadaptation. Article describes clinical diagnostic features of vascular malformations and their correlation with radiologic methods including US – Doppler and MRI with dynamic contrast enhancement.

Simple or complex defects in the lower leg, and especially in its distal third, continue to be a challenging task for reconstructive surgeons. A variety of flaps were used in the attempt to achieve excellence in form and function. After a long evolution of the reconstructive methods, including random pattern flaps, axial pattern flaps, musculocutaneous flaps and fasciocutaneous flaps, the reappraisal of the works of Manchot and Salmon by Taylor and Palmer opened the era of perforator flaps. This era began in 1989, when Koshima and Soeda, and separately Kroll and Rosenfield described the first applications of such flaps. Perforator flaps, whether free or pedicled, gained a high popularity due to their main advantages: decreasing donor-site morbidity and improving functional and aesthetic outcome. The use as local perforator flaps in lower leg was possible due to a better understanding of the cutaneous circulation, leg vascular anatomy, angiosome and perforasome concepts, as well as innovations in flaps design. Somebody introduced a new expression «like-by-like». This review will describe the evolution, anatomy, flap design, and technique of the main distally pedicled propeller perforator flaps used in the reconstruction of defects in the distal third of the lower leg and foot and our experience.

Lymphedema is a chronic progressive disease, which is caused by lymphatic insufficiency. pathophysiological basic of lymph edema is swelling of tissues, hypertrophy of subcutaneous fat. Accumulation of high protein interstitial fluid stimulates cell proliferation and causes inflammation. chronic inflammation in turn leads to fibrosis of intact lymph collectors and surrounding tissues, these changes are irreversible. complex disturbing factors, namely, the surgical removal of the lymph nodes and postoperative radiotherapy lymphodynamics lead to a breach in the hand.
One of the modern methods of treatment is transplantation of vascularized lymphostasis lymph nodes. The most commonly used fiber groin to move to the armpit on the side lymphostasis.
20 operations inguinal lymph discharge flap on the corpses was carried out to study the anatomical us. objective: to determine the relationship of lymph cells in the inguinal flap, evaluate the possibility of the lateral surface of the fence group inguinal lymph nodes without compromising lymphodynamic lower extremities, which method of double contrast lymph collectors groin was used.
Our anatomical study suggests the heterogeneity of the surface groups of the inguinal lymph nodes, lymph nodes for safe use for transplantation lymph flap should include only the lateral superficial inguinal lymph nodes.