This research was aimed to developing the scoring system for evaluating indications for wide excision of the Spitz/Read nevus in children and adolescents, the use of which would be of help in reducing the risk of underdiagnosis of skin melanoma and determining the management tactics of patients with spitzoid formations. The purpose of the research was to create a scoring system for evaluating indications for wide excision of the Spitz/Reed nevus in children and adolescents. Materials and methods used: a single-center (N.N. Petrov National Medical Research Center for Oncology, Saint Petersburg, Russia) retrospective (2016-2022) cohort study included 65 childhood and adolescent patients with skin neoplasms of melanocytic and vascular origin. Clinical and dermatoscopic examinations of the skin neoplasm were performed at the pre-invasive stage, which was then followed by its removal and morphological verification. The study group consisted of children and adolescents aged 0 to 18 y/o (median age 14 (12.0; 15.0) y/o) with complex (n=22 or 33.8%), dermal (n=30/46.1%), blue (n=2/3.1%) nevi, Spitz/Reed nevus (n=4/6.2%) and capillary-lobular hemangioma (n=7/10.8%) Results: correlation analysis of 77 factors characterizing the demographic, clinical and dermatoscopic patterns had allowed the Authors to identify signs that are statistically significantly correlated with the Spitz/Reed nevus variable. In the block with demographic data parameters, the main position was occupied by the patient’s age of over 11 y/o (p˂0.001); formation area ≥0.38 cm2 (p=0.010) topped in the block with clinical examination parameters; and starburst pattern (p=0.003), irregular borders (p˂0.001), white-blue veil (p˂0.001), multicomponent (p=0.001), reticular network (p˂0.001), globules (p˂0.001) and vascular structures in the form of a comma (p˂0.001) among dermatoscopic ones. The value of the prognostic coefficient determined the score of each factor, which contributed to the selection of large and small patterns. The gradation of the sum of scores of the identified predictors made it possible to create a scoring system for analyzing indications for wide excision of the Spitz/Read nevus in children and adolescents and to develop a practical BASE-SCRAG scale. The sensitivity of the scale was 100%, the specificity was 62% (95% CI 57-64%). Conclusions: the Spitz/Reed scoring system for evaluating indications for wide excision of a nevus and the BASE-SCRAG practical scale contribute to the stratification of pediatric and adolescent patients in the group for possible dynamic observation and the group of mandatory removal and verification of the pathological skin process.

Currently, the use high doses chemotherapy (HDC) supported by autologous peripheral blood stem cells in consolidation is a necessary therapeutic option in patients with high-risk neuroblastoma (NB). Conditioning regimens and schemes of HDC remain the subject of debate. In recent years, the evidence base of the advantages of tandem myeloablative procedures in comparison with single-transplantation has been actively accumulated in clinical practice. This article presents our own experience of tandem-transplantation with stem cell rescue in the N.N. Petrov National Medical Research Centre of Oncology (Saint-Petersburg) in four patients with initially stratified high-risk group NB; two of them were NMYC amplified. Tandem consolidation included TC ([T]hiotepa, [C]yclophosphamide) and CEM ([C]arboplatin, [E]toposide, [M]elphalan) regimens. The acceptable toxicity of the tandem-transplantation is proved.

The modern Wilms tumor treatment protocols used all over the world can cure up to 90 % of children. Such successes make it possible to actively introduce risk-adapted therapy methods aimed at de-escalating the chemotherapy regimen and radiation therapy impact to the tumor. The most conservative was the stage of surgical treatment, implying the organ-depleting nature of the surgery. Nevertheless, over the past decade, a lot of experience has been accumulated with both nephron-sparing and minimally invasive interventions in patients with both bilateral and unilateral Wilms tumor.We presented the experience of laparoscopic kidney resection with intraoperative ultrasound control in a child with unilateral Wilms tumor, receiving treatment at the N.N. Petrov National Medical Research Center of Oncology.

The article presents a clinical case of simultaneous multiple primary tumors (the left adrenal neuroblastoma and the right lower parathyroid adenoma) in the child 11 years old.The literature describes several cases of primarily multiple tumors, one of which was neurogenic, requiring an individual approach to treatment. The relationship between the occurrence of polyneoplasia and genetic mutations is discussed.

Российский журнал ДЕТСКОЙ ГЕМАТОЛОГИИ и ОНКОЛОГИИ R u s s i a n J o u r n a l o f P e d i a t r i c H e m a t o l o g y а n d O n c o l o g y 14 4 О р и г и н а л ь н ы е и с с л е д о в а н и я || O r i g i n a l s t u d i e s