Soft tissue sarcomas of the hand and foot comprise a rare subgroup of mesenchymal tumors with more favorable oncological prognosis. For this type of tumors, several options of surgical treatment exist depending on histological subtype, size and local tumor advancement. Additionally, due to significant functional load on the distal parts of the limbs, surgical techniques for treatment of these patients have specific characteristics. However, publications on progression characteristics and prognosis of soft tissue sarcomas of the hand and foot are lacking.

This review describes soft tissue sarcomas of the hand and foot and analyzes surgical techniques for treatment of patients with this type of tumor.

This review presents an analysis of treatment outcomes for patients with metastases of cutaneous melanoma into the regional lymph nodes. Types of surgical interventions currently used in oncological surgery for this pathology are considered, as well as the trends of their future practical application. The results of sentinel lymph node biopsy and regional lymph node dissection in patients with primary tumors with varying thickness and the effect of surgical interventions on treatment effectiveness are presented.

Introduction. Currently, the pathogenetic role of the human papillomavirus (HPV) in carcinogenesis is well studied, that most cases of oropharyngeal squamous cell carcinoma are associated with the persistence of this infection. In addition to HPV infection, the involvement of programmed death-ligand 1 (PD-L1) and p53 proteins in the initiation and progression of oropharyngeal squamous cell carcinoma provides their formation as additional biomarkers in predicting the disease.

Aim. To study the prognostic role of PD-L1 and p53 expression in oropharyngeal squamous cell carcinoma depending on HPV status.

Materials and methods. The study included 62 patients with oropharyngeal squamous cell carcinoma T1–4N0–3M0 (Tumor, Nodus and Metastasis, (TNM), 7th edition) treated in 2015–2020 at the Republican Specialized Scientific and Practical Medical Center of Oncology and Radiology and in the Tashkent and Samarkand city branches. All patients underwent immunohistochemical analysis for the presence of p16INK4a, PD-L1 and p53 protein expression in formalin-fixed and paraffin-embedded tumor tissue samples.

Results. Based on the results of the assessment, it was found that positive HPV status, low and medium levels of PD-L1 expression and positive regulation of wild-type p53 are associated with favorable outcomes in patients with oropharyngeal squamous cell carcinoma. Negative HPV status, high and very high levels of PD-L1 expression, loss of wild type p53 function with upregulation of p53 mutant type leads to worse disease outcomes.

Conclusion. Thus, the assessment of the expression of the onco-suppressor protein p53 helps to determine the biology of cancer cells in patients with oropharyngeal squamous cell carcinoma and suggest sensitivity to ongoing therapy, and by studying the regulation of the PD-L1 protein, antitumor immune regulation can be suggested in these patients.

Introduction. In the structure of fractures of long tubular bones, pathological fractures account for about 1 %, and 2/3 of all cases are pathological fractures associated with bone metastases. Primary bone tumors are complicated by the development of a pathological fracture in 1– 10 % of cases, bone metastases in 8–30 % of cases. With a pathological fracture, as the primary manifestation of the tumor process, as a rule, patients come to the attention of orthopedic traumatologists providing emergency care. In the practice of oncologists, there are often patients with bone tumors who have performed deliberately non-radical surgical interventions associated with insufficient oncological alertness of traumatologists.

Aim. To study and present the results of combined treatment of patients with bone tumors complicated by a pathological fracture.

Materials and methods. The results of treatment and observation of 159 patients with tumors of long tubular bones complicated by a pathological fracture or the threat of its development, who received combined or surgical treatment and were observed in the polyclinic of the Republican Oncological Dispensary from 2008 to 2020, were analyzed.

Results. A pathological fracture that has taken place, in the absence of somatic contraindications, is not a contraindication to neoadjuvant treatment, which allows performing organ-preserving surgical treatment with optimal local and systemic control. However, with verified bone metastases, when segmental bone resections are not shown, and the diagnosis of myeloma (solitary plasmocytoma) is established, it is permissible to perform surgery in a trauma hospital, after consulting an oncologist.

Conclusion. The combined approach in the treatment of malignant bone tumors complicated by a pathological fracture makes it possible to perform a functional-saving, organ-preserving surgical intervention, significantly reducing the risk of tumor recurrence and systemic progression.

Intriduction. Hibernomas account for less than 2 % of all benign lipomatous tumors and 1 % of all lipomatous tumors. They are usually found in 20–40-year old adults (the average age of patients is 38 years). The clinical manifestations are painless soft tissue mass that are mostly slow growing; rapid growth is only found in a small number of patients. We present a case of successful surgical treatment of a pathologically confirmed rare lipomatous tumor of large size, which was located in the soft tissues of the thigh.

Clinical case. A 46-year-old woman was admitted to the hospital due to a tumor 20 × 10 × 10 cm in size, that had developed 10 years ago in the anteromedial aspect of the proximal thigh. Furthermore, she had a history of hypoesthesia one month prior to her admission. During surgery, the femoral nerve was found to be compressed by the large tumor. The resultant symptoms probably caused the patient to seek medical care. Resection was performed by careful dissection, femoral nerve and vessels were spared. Histopathological examination and cytogenetics showed findings suggestive of a hibernoma. At the 6-month follow-up local tumor recurrence or metastasis was not found.

Conclusions. Asymptomatic small-sized hibernoma does not require surgical resection or other treatment. When the tumor is too large and/or has the potential to compress the surrounding tissues, timely radical surgical intervention is reuired.