Aim. To determine the relative risk of developing other malignant tumors in patients with thyroid cancer and and the risk of developing thyroid cancer in patients with other malignancies. Methods. A retrospective analysis of 116 patients with multiple neoplasia including thyroid gland involvement was conducted for the period from 1973 to 2010. In order to estimate the relative risk of development of multiple neoplasias including thyroid gland lesions used was the following formula: relative risk = [a / (a + b)] / [c / (c + d)], where a is the number of patients with thyroid cancer with a second malignancy; b is the number of patients with thyroid cancer without a second malignancy; c is the number of patients in the population affected by the same malignant disease, as patients in group a; d is the number of people in the population without any cancer-related pathology. Results. In patients with carcinomas of the thyroid gland the relative risk is higher than in the general population for developing metachronous lymphoma (41.8 for men, 31.7 for women), renal cell carcinoma (55.6 for men, 18.5 for women), prostate cancer (35.7), lung and bronchus cancer (18.8 for women), melanoma (17.1 for women), colon cancer (16.7 for women), cervical cancer (15.8), uterine cancer (11.8), breast cancer (11.5 for women), skin cancer (9.5 in women) and the simultaneous development of renal cell carcinoma (33.8 for men and 46.3 for women), prostate cancer (24.4), melanoma (20.6 for women), cancer of the esophagus (19.4 for men, 17.8 for women), colon cancer (19.0 for men), lymphomas (12.8 for men), cervical cancer (11.3), breast cancer (11.0 for women), skin cancer (8.5 for women). The relative risk of developing metachronous cancer of the thyroid gland is higher than that in the population in patients with melanoma (108.0 in men, 50.4 for women), with malignant neoplasms of the lymphoid tissue (40.2 for men, 40.8 for women), uterine cancer (11.8), skin cancer (8.7 in women), breast cancer (8.0 for women). Conclusion. During preventive medical examinations of patients with thyroid cancer the relative risk of developing subsequent cancers must be taken into account for early diagnosis of multiple neoplasias.
Aim. To improve immediate and remote results of reconstructive restorative procedures in patients with complicated colorectal cancer. Methods. The study is based on clinical experience of treatment of 107 patients who had reconstructive restorative procedures performed in specialized oncology institution after previous Hartmann’s procedure performed in urgent surgical department for complicated colorectal cancer. Reconstructive restorative procedures were performed at different time after the primary operation. To assess functional state of anal sphincter all patients were adminestered sphincteromentry during the preoperative period. Morphological analysis of all tissues removed during the surgery was performed. To evaluate morphological changes of distal end of the stump at different time a histological analysis was performed. Results. According to the results of sphincterometry dynamic reduction of tonic contraction and maximum pressure of anal sphincter is observed. The more the period between Hartmann’s operation and reconstructive restorative surgery, the less pronounced muscle tone of anal sphincter. Histological studies of intestinal wall during the first 3 months after Hartmann’s surgery revealed intact quantity and size of intestinal crypts, non-significant inflammatory infiltration of mucous and submucous layers, during the period of 4 to 6 months - initial signs of diversion colitis, during the period of 7 to 12 months - atrophic changes in mucous membrane (reduction of crypts quantity, their shortening, decreased thickness of mucus), after 1 year - signs of atrophy of its submucous layer. Conclusion. Reconstructive surgery in patients with previous Hartmann’s surgery for complicated colorectal cancer should be performed in specialized departments with all modern methods of surgical, radiation and medical treatment of colon cancer available; based on functional and morphological studies the optimal time frame for reconstructive surgery is 1 to 3 months after the initial surgery.
The article considers the estimation of probability of a lesion of the projection skin flap over tumor for the possibility of displacement of the surgical access into aesthetically acceptable zones during the surgical treatment of nodular breast cancer. The results of examinations of 240 patients (T1-3N0-3M0) were analyzed. It was determined that the risk factors affecting a lesion of the projection skin flap were the presence of the symptom "site" in the patient as well as the topographic and anatomical indicators: tumor less than 3 cm in size, located at a depth of less than 0.8 ± 0.2 cm, tumor more than 3 cm in size, located at a depth of less than 1.5 cm. Based on the data obtained an algorithm for the actions of a practicing oncologist was drawn up for a one-stage reconstruction of the breast from an aesthetically acceptable zone.
Klinefelter syndrome is a genetic disease in males (1 per 1000 newborns) due to the presence of a doubled X chromosome in the karyotype (47XXY karyotype), the most common cause of primary hypogonadism. It is characterized by polymorphism of clinical manifestations, the most common of which are primary male infertility, obesity, metabolic syndrome, type 2 diabetes mellitus, osteopenia and osteoporosis. Clinical variability leads to the development of associated conditions against the background of changes in hormonal regulation and observation by different specialists, as a result to late diagnosis of the syndrome. Endogenous hypercorticism in 2030 % is caused by Itsenko Cushing's syndrome, in the structure of which about 7080 % are unilateral adrenal adenomas (corticosteromas). ACTH-independent hypercorticism leads to a number of metabolic and cardiovascular disorders, including abdominal obesity, arterial hypertension, steroid diabetes, and osteoporosis. Long-term suppression of ACTH, according to the feedback principle, leads to suppression of the secretion of hormones of the pituitary endocrine glands (including sex steroids). The clinical observation illustrates the complex pathophysiological disorders that occur when the hypothalamic-pituitary-adrenal / gonadal axis is disturbed in a combination of two syndromes, as well as the importance of a comprehensive examination of endocrinological patients.
Adrenocortical cancer is a rare tumor originating from cortical adrenal cells, endowed with aggressive potential, a rapidly progressing course and an unfavorable prognosis. The complexity of early diagnosis of the disease is due to several factors: the variability of clinical manifestations associated with the initial multiregulatory influence of steroid hormones on the body’s homeostasis, the rare occurrence of the tumor and, as a result, the lack of understanding of the molecular mechanisms of its carcinogenesis.The increased interest in recent years among oncologists and endocrinologists in understanding the fundamental and clinical aspects of adrenocortical cancer and the search for potential targets for new drugs has led to a detailed study of the cellular and molecular genetic mechanisms involved in normal adrenal ontogenesis and their role in tumor transformation. This review presents the currently known molecular genetic processes and their mediating auto-, para-, endocrine factors involved in normal adrenal ontogenesis and carcinogenesis. The paper analyzes results of trials published in international and Russian journals on molecular oncology and endocrinology indexed in the PubMed, CyberLeninka, Web of Science, Science Direct and eLIBRARY databases.
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