Purpose. To assess the impact of biopsy followed by a morphological study of the sentinel lymph node (SLN) on patients survival with skin melanoma (SM). Materials and methods. We analyzed the results of the 79 patient’s examination with SM of the trunk and extremities; the average age was 52.9±17.4 years. We assessed the number of lymph nodes (LN) in each lymphatic pool, their location, carried out the identification of SLN and performed their biopsy. Patients was treated according the results of morphological study removed tissue. In a case, there were found out metastatic lesion of LN, patients was underwent lymphadenectomy followed by adjuvant treatment if medically required. We performed the assessment of significant clinical and morphological signs for the detection of metastases in the SLN, as well as incidence of the SLN’s characteristics on the patient’s survival with SM. Results. We established that the presence of metastases in SLN is an important factor in predicting the survival of patients with melanoma. 3-year survival of patients with metastases SM in SLN was 56.9%, in patients without metastatic lesions of SLN, survival was 81.2% (p <0.001). Our study shown that the overall survival of patients depends on the volume of lesions of SLN: 3-year survival with the size of metastases in SLN up to 2 mm was 76.1%, more than 2 mm - 29% (p=0.002). Conclusion. The morphological status of SLN in patients with SM should be consider as an important prognostic factor for the disease progression, as well as indication for the correlation with a high-risk group for further adjuvant treatment.

Tenosynovial giant cell tumor (TGCT) is a very rare disease that could be easily confused with other processes because of its rareness and silent clinical behavior. TGCT arise from the synovial membrane of joints, tendon sheaths, and bursae. TGCT are classified according to anatomical site of involvement (intra-articular and extra-articular) and growth pattern, including localized and diffuse forms of disease. Defining the diagnosis, clinical characteristics and optimal treatment of TGCT of the skull base is challenged by shortage of cases, described in the literature, variable nomenclature and absence of detailed follow-up. Several conditions with overlapping clinical, radiological, and histological features make the differential diagnosis very difficult. The objectives of the current study are to describe the clinical, radiological, and histopathological features of a rare clinical case, evaluated in our and overview the literature regarding the unique histopathological and radiologic features of TGCT of the TMJ and temporal bone.

Background. Canine osteosarcoma is a most common bone tumor in dogs, usually involving long tubular bones lesion. Limb-sparing treatment method allows to save extremity functionality and sufficiently improve quality of life in comparison with amputation. Objective. Analysis of survival rates and local results after limb-sparing treatment of canine osteosarcoma using bio-implantation (de-immunized allogenic bone populated with recipient stromal mesenchymal cell preparation). Materials and methods. Group of 25 dogs underwent a combined treatment including cisplatinum chemotherapy (60-70 mg/m² i/v infusion at 14-21 day intervals, up to 4 cycles) and wide segmental resection of the affected bone with a bio-implant defect replacement. Overall survival, progression-free survival and local recurrence frequency in the group were analyzed. Results. The median overall survival was 321 day, and median progression-free was 222 days. 4 cases (16.6%) of local relapse were recorded, 2 of which were confirmed by radiography and histological examination, and 2 other by radiography only. Conclusion. Efficiency of the canine appendicular osteosarcoma combined limb-sparing treatment is comparable with amputation practice results (according to scientific literature) while foregoing method is preferable due to higher life quality of patients.

Primary spinal tumors are quite rare and, according the some authors, make up less than 5% of all bone tumors. Surgical method in the treatment of most malignant tumors is the only or the main component of the combined and complex therapy. A radical method of surgical treatment of spinal tumors is to removal of a tumor as a single unit within the surrounding healthy tissue. Objective. To evaluate the results of radical surgical treatment of spinal tumors. Materials and methods. From 2004 to 2018 in the department of vertebral surgery of the National Medical Research Center of Oncology named after N.N. Blokhin treated 50 patients with spinal tumors who underwent surgical treatment in a radical volume. The functional results of the treatment were assessed according to the Karnofsky general condition scale, the Frankel neurological status assessment, and the pain syndrome was evaluated using the VAS and Watkins scales. The analysis of complications of surgical treatment, as well as the evaluation of oncological results was performed. Results. As a result of surgical treatment, the patient showed improvement in general condition, surgical treatment contributed to an increase in the rate of complete relief of pain by 4 times. An improvement in the results of neurological status after performing surgical treatment is also noted. Thus, the results of a clinical study showed good functional results.

Back pain is the most common reason for seeking medical help. The authors analyzed the medical documentation of 6,619 patients (mean age 60.5 years) with back pain. In 97.5% of patients the causes of back pain were degenerative-dystrophic processes of the spine. Vertebral hemangioma as the main and only cause of pain (symptomatic hemangioma) wasn’t observed at all. In 189 (2.9%) patients, an asymptomatic vertebral hemangioma was diagnosed by chance: in x-rays - in 45 (23.8%) patients, computed tomography or magnetic resonance imaging of the spine - in 144 (76.2%) patients. In 76.2% of cases the hemangioma occurred in patients with osteochondrosis of the spine, and in 77.1% of cases also with a hernia and/or disc protrusion. The location of the vertebral hemangioma corresponded to the level of the hernia/disc protrusion in 36.5% of patients. Based on clinical, radiological and magnetic resonance studies and taking into account the absolute signs of aggressiveness, nonaggressive vertebral hemangioma was diagnosed in 186 (98.4%) patients, of which 0.8% patients had a multiple form, and aggressive hemangioma - in 3 (1,6%) patients. Analysis showed that the treatment tactics of patients with back pain should include computed tomography and/or magnetic resonance imaging, even in the absence of hemangioma in spinal x-ray. Patients with aggressive vertebral hemangioma are subject of surgical treatment. There are currently no studies on the use of physical methods on patients with back pain in combination with a nonaggressive vertebral hemangioma that limits the access of such patients to a full-fledged treatment and significantly reduces the effectiveness of rehabilitation.

Among all medical and social problems, malignant formations occupy one of the leading positions. Mastering the sections of reconstructive and plastic surgery, as well as increasing opportunities in the field of traumatology, orthopedics and vascular surgery, enable oncologists to perform organ-preserving operations in many cases, including on the lower limb without compromising the radical nature of tumor removal. The article presents more than 25 different techniques for the use of free and displaced tissue flaps for the replacement of hip, shin and foot defects.According to the data of domestic and foreign authors, the incidence of complete and partial necrosis (10.3-13.5% and 3.7%) with free transplants is significantly higher than with non-free ones (2.5% to 7.8%). Indications for free tissue autotransplantation on the lower extremity are extensive (more than 200 cm² for the hip, 100-150 cm² for the shin, more than 30 cm² for the foot), defects as well as defects after removal of complex composite tissues. A wide range of reconstructive plastic surgery techniques and the possibilities of modern oncology make it possible to develop an optimal algorithm for choosing the method of integrated treatment to improve the quality of life of patients.

A successful experience in the surgical treatment of a patient with a giant left hip liposarcoma with circular envelopment of the sciatic nerve was presented. The technique of tumor removal with preservation of the continuity of the nerve was described, the available intra- and postoperative complications and methods for their correction are described. As a result, a good oncological and functional result has been obtained, which confirms the expediency of applying the organ-preserving tactics in treating patients with giant sarcomas of the extremities.