The difficulties of timely diagnosis of primary multiple synchronous breast cancer with histological heterogeneity of tumors are demonstrated by a clinical example. Taking into account the fact that breast cancer continues to lead among all oncological pathology and accounts for 11.8% of all malignant neoplasms, diagnostic algorithms of the stage should be personalized. The presented clinical case demonstrates multidisciplinary errors committed at different stages of the patient’s examination.

Portal vein thrombosis is a partial or complete occlusion of blood flow through the portal vein, resulting from the presence of a thrombus in its lumen. The etiology of portal vein thrombosis is often multifactorial, a combination of local and systemic factors being possible. It is necessary to conduct a wide diagnostic search in order to identify the causes of thrombosis, including liver diseases, malignant neoplasms, infectious diseases, etc. The clinical picture of portal vein thrombosis can vary from low-symptomatic manifestations to an acute course. Chronic portal vein thrombosis can also manifest with nonspecific symptoms. It is known that COVID-19 is associated with increased blood clotting and the development of thromboembolic complications. Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is considered as a trigger factor for the reactivation mechanisms of other viral infections in the patient's body, in particular the herpes group. This article presents a clinical case of COVID-19, complicated by portal vein thrombosis in a patient with EBV/CMV infection.

Introduction. Percutaneous nephrolithotomy (PNL) is the method of choice for the treatment of patients with kidney stones larger than 2 cm. Mini-percutaneous nephrolithotomy (mini-PNL) became widespread due to reduction of injury associated with surgical approach. Creation of puncture access to the pelvicalyceal system without ureteral catheterization is also recently described. The main benefits of such technique are reduction of total operative time and the radiation exposure to the patient and medical personnel. The results of using mini-PNL without prior ureteral catheterization remain insufficiently studied, which predetermined the goal of our study. Purpose. Compare the efficacy and duration of mini-PCNL with and without ureteral catheterization. Materials and methods. We analyzed the treatment outcomes of 111 patients with a single kidney stone. Group I included 60 patients who underwent mini-PCNL according to the standard technique. Group II included 51 patients who underwent mini-PCNL without prior catheterization of the ureter. The average stone size was 19.2 0.92 mm and 18.6  0.93 mm in groups I and II, respectively. The puncture of the pyelocaliceal system of the kidney was performed under X-ray control and US guidance using the free-hand technique. Results. In group I, complete elimination of the stone was achieved in 55 (92%) patients and the mean duration of the operation was 108,3 34,85 min (range: 60 to 210). In group II, complete elimination of the stone was achieved in 50 (90%) patients and the mean duration of the operation was 69,7 22 min (range: 25 to 120 min). In all cases, the severity of complications did not exceed grade II according to Clavien classification, and their rate was 6,7% and 5,9% in group I and group II, respectively. Conclusions. According to the results of the study, the compared groups did not differ in their post-operative complication and stone-free rates. Avoidance of routine ureteral catheterization significantly reduces the operation time and hence the anesthetic risk and radiation load.

The article discusses the normative documents in force in our country of the Ministry of Health that regulate the timing, order and age criteria for examining the mammary glands using x-ray mammography. A sufficient number of disagreements were revealed among the Orders, Letters, and Methodological and Clinical Recommendations that have not lost their legal force, which significantly complicate the daily work of clinicians and radiologists of mammography rooms. The lack of a unified approach to the standard of mammographic examination among the medical community inevitably leads to medical errors and increases the number of untimely diagnoses. In order to improve indicators of early diagnosis of breast cancer and minimize the amount of subsequent treatment, it is necessary to develop a single normative document that defines the algorithm for mammographic examination of the population.

The author presents his own clinical case demonstrating the long stage and difficulties in diagnosing a rare tumor of the Ewing’s Family of Sarcomas in a young patient, due to the peculiarity of the course of the disease, manifested by a non-pathognomonic clinical pattern.