Positron emission tomography combined with computed tomography (PET/CT) enables assessment of not only anatomical and structural but also metabolic changes in tumor mass. F-fluoroethyl tyrosine (F-FET) PET/CT is based on evaluation of transport of F-labeled tyrosine in tissues. We present a clinical case of a patient with a newly diagnosed brain tumor, demonstrating the capabilities ofF-FET PET/CT in assessing the reliable volume and degree of tumor anaplasia, which is important when choosing the treatment approach for a patient.

The study objective is to evaluate the diagnostic capabilities of complex method based on the use of 18 F-fluoroethyltyrozine positron emission tomography (PET) combined with computed tomography (CT) and CT perfusion in the differential diagnosis of glial brain tumors.Materials and methods. One hundred and two patients with glial brain tumors were included in the study. Depending on the degree of malignancy patients were divided into 2 groups: group 1–38 (37.26 %) patients with grade I–II tumors; group 2–64 (62.74 %) patients with grade III–IV tumors. Perfusion CT was performed in 20 (52.6 %) patients from the group with grade I–II tumors and 37 (57.8 %) patients from the group with grade III–IV gliomas. The sensitivity and specificity of such indicators as the maximum standardized uptake value (maxSUV) and the tumor to brain ratio (TBR), in combination with CT perfusion indicators (cerebral blood flow (CBF), cerebral blood volume (CBV), vascular permeability (FED) were studied.Results. The highest diagnostic accuracy was demonstrated by the following parameters: maxSUV 1 (sensitivity and specificity 81 and 82 %, threshold value 2.51, AUC 0.87); TBR 1 (sensitivity and specificity 90.6 and 81.6 %, threshold value 2.07, AUC 0.89). The comprehensive evaluation of CT perfusion and 18 F-fluoroethyltyrozine PET / CT parameters: sensitivity and specificity of TBR 1 + CBF – 97.1 and 94.4 %, respectively; TBR 1 + CBV – 96.6 and 94.4 %, respectively; TBR 1 + FED – 94.6 and 92.3 %, respectively.Conclusion. According to results of obtained analysis, an increase in diagnostic accuracy was revealed for all studied parameters with complex use of two methods – 18 F-fluoroethyltyrozine PET / CT and CT perfusion, in differential diagnosis of glial brain tumors.

Surgical resection is the mainstay in treatment of both benign and malignant craniofacial tumors, and adjuvant radiation therapy is mandatory in malignant lesions; however, it should be avoided in benign lesions.

Relevance. Retinoblastoma (RB) is the most common primary intraocular tumor in children. The incidence of RB ranges from 1:14,000 to 1:20,000 newborns. To date, the survival rates of patients with RB reach almost 100 % with timely and adequate diagnosis. Among childhood oncological diseases, RB accounts for 2.3–4.5 % and 85–90 % among intraocular tumors in children. According to the volume of tumor spread, intra- and extraocular forms of the disease are distinguished. Extraocular RB is the spread of the tumor beyond the eye with invasion of the orbital tissues, as well as the possible involvement of adjacent areas, including intracranial without and with regional and/or remote metastases. The main method of treatment of children with extraocular RB is neoadjuvant chemotherapy (CT) with planning of surgical intervention and adjuvant therapy. High-dose CT (HDCT) with autologous hematopoietic stem cell transplantation (auto-HSCT), it allows to increase relapse-free survival in patients without metastatic lesions of the brain and spinal cord, but with their defeat, the prognosis of survival is extremely unfavorable, the nature of the disease is recurrent with 100 % lethality.Description of the clinical case. We report a case of bilateral RB: OD – with extraocular and intracranial spread of the tumor along the optic nerve with a lesion of the chiasm and a transition to the initial parts of the visual tracts. Secondary glaucoma. OS – with intraocular tumor growth in a 3-year-old child. After neoadjuvant chemotherapy, including intrathecal, a simultaneous two-stage operation was performed in the volume of bone-plastic (temporo-orbito-zygomatic) pterionic craniotomy on the right with prechiasmal resection of the right optic nerve and enucleation of the right eye. In the postoperative period, adjuvant chemotherapy was performed, followed by HDCT with auto-HSCT. Radiation therapy has become the final stage of treatment. Brachytherapy for OS tumor and remote radiotherapy for craniospinal region, right orbit, optic nerve stump with chiasm and pituitary pedicle were successively performed. After 14 months from the beginning of treatment and 5 months after its completion, a leptomeningeal relapse of the disease was detected.Conclusion. Rare observations of RB with damage to the visual tracts do not allow us to sufficiently study the features of the course of the tumor process, as well as to develop a single effective approach to antitumor treatment. Among the causes of mortality in patients with extraocular RB, the main one is metastasis, metastasis in the brain and spinal cord.

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