Sacral tumors are very rare and consists about 1–7% of all spine tumors. Most of sacral tumors are metastatic tumors, the most often primary malignant tumor of the sacrum is chordoma. Treatment of patient with sacral tumors is still a difficult problem. Most of patients receive treatment from nononcological diseases and referred in specialized hospitals with hugе tumor. The sacrum has a complex anatomy due to its close relationship with major vessels, sacroiliac joints, sacral nerve roots and viscera like the bowel and rectum. This makes it hard to achieve wide surgical margins during surgery and increases perioperative morbidity and mortality. The understanding of tumor behavior will help to develop optimal treatment.

Giant cell tumour (GCT) is frequently diagnosed primary bone tumor. GCT histogenesis remains still unknown. This type of primary bone tumor classified in separate group and represents giant cell tumor with typical structure (benign GCT) and with less occurred giant cell tumor with atypical structure (malignancy in GCT). Radiology diagnostic methods are particular valuable in differential diagnosis of this tumor, because even plain radiography reveals GCT with a high accuracy.

A case of the asystolia which had arisen owing to one-stage massive blood loss during distal femur and proximal tibia resection with endoprosthetic reconstruction is described.

Background. The goal of study is to identify factors predicting the need for intra-operative allogeneic blood transfusion in oncological patients undergoing unilateral total knee replacement.
Methods. From 2006 to 2013, 290 patients undergoing primary and 87 revision total knee arthroplasty were enrolled in the retrospective study. Transfused allogeneic red blood cells, allogeneic fresh frozen plasma was calculated. Risk factors were age, weight, height, sex, body mass index, pre-operative hemoglobin level, tumor morphology, pre-operative chemotherapy, pathologic fracture, tranexamic acid using, tourniquet, surgeon, type of anesthesia.
Results. The frequency of allogeneic blood transfusion varied with respect to the type of operative procedure: primary 37% (106/290) versus revision 20% (17/87) total knee arthroplasty (р=0,003; odds ratio, 2,4 [95% confidence interval, 1,33 to 4,24]). Ordered logistic regression analysis showed the most important predictors of the transfusion of allogeneic blood components during primary surgery to be a pre-operative hemoglobin level, weight, lack of use of tranexamic acid, pathologic fracture; during revision surgery: pre-operative hemoglobin level and less skilled surgeon.
Conclusions. For decreasing allogeneic blood transfusion during total knee replacement it is required to increase pre-operative hemoglobin level, to use tranexamic acid and to improve operational skills.

Forty surgical resections with intraoperative use of collagen sponges (Collatamp® EG) impregnated with antibiotic (gentamicin) were performed. The average age of patients was 45 (from 18 to 65). There were no infection complications in the early postoperative period. Collatamp EG can be recommended for orthopaedical patients with high risk of wound infection as additional agent for local antibiotic prophylaxis.

Determination of the advantages (sensitivity, specificity) combining radiology imaging modalities and endoscopy studies in detection of gastrointestinal stromal tumor.

This article is a review of uterine leiomyosarcomas treatment options. Based on the data from different trials we recommend the following treatment strategy. Surgery: total hysterectomy must be done in localized disease, further adjuvant chemotherapy is possible, but the decision should be taken individually. Adjuvant radiation therapy is not recommended due to low influence on overall survival. Advanced uterine leiomyosarcomas should be treated by combined chemotherapy. As a first line we recommend combined regimens including doxorubicin, dacarbazine, ifosfamide and gemcitabine, docetaxel. Trabectedin monotherapy as a 24-hour infusion showed good result in long-term SD and can be used as a second or further lines of treatment. Hormone therapy is possible as supportive treatment if status of steroid hormone receptors in the tumor is positive. The decision on second look surgery in advanced disease should be discussed individually. Also our data of trabectedin use in pts with uterine leiomyosarcomas is fully discussed. We got the same treatment and toxicity results as in STS-201. After the dose reduction till 1,3 mg/m² we got more favorable toxicity profile with the same efficacy but further investigation is needed.

Purpose. To study the effect of doxorubicin immobilized onto carbon nanostructured drug reservoirs on pathological morphology of experimental transplanted tumors.
Materials and methods. Experiments were performed on rats inoculated subcutaneously with sarcoma М-1 in the leg area. For anticancer drug delivery to the parenchyma of neoplasms we applied carbon reservoirs that had been fabricated on the basis of the nanodiamond composite and incubated in 0,01% and 0,1% doxorubicin solution. Immunohistochemical staining of proliferating cell nuclear antigen (PCNA) was performed in histological sections of sarcoma М-1.
Results. Histological examination revealed that around the drug reservoirs impregnated with 0,01% doxorubicin solution, there were narrow zones (0,1–0,35 mm wide) of tumor tissue destruction without the PCNA-positive reaction of cell nuclei. When the doxorubicin concentration increased by 10 times, the zones of the induced damage of М1 sarcoma appeared to be 3–4 times wider. In the tumor tissue adjoining to the areas of total destruction of cellular elements, a stromal edema, dissociation of tumor cells and their death in the mitotic phase were noted.
Conclusion. Doxorubicin-loaded carbon reservoirs implanted into the site of tumor growth produce a local alterative-anddestructive effect on experimental connective tissue tumors. The obtained results suggest that nanodiamond composites are promising for a selective delivery of chemotherapeutic agents to tumors.

Juvenile ossifying fibroma (JOF) is a group of heterogeneous benign fibro-osseous tumors of the craniofacial skeleton in young people. According to the WHO, JOF may present as one of two histologic variants: juvenile psammomatoid ossifying fibroma (JPOF) and juvenile trabecular ossifying fibroma (JTOF). Radiographycally, JOF presents as a well defined, unilocular or multilocular, expansive radiolucency with cortical thinning. The definitive diagnosis of JOF should be based on clinical and radiographic findings, in conjunction with the histopathologic characteristics of the lesion.