Based on currently available literature, clinical examination remains the major method when handling cases of suspected malignancy. However, this method does not allow diagnosing cancer, due to which a large group of patients with possible oral mucosa cancer are referred to an oncologist. The search and use of affordable non-invasive methods for early diagnosis of oral mucosa tumors is an urgent issue facing the health system. The study involved analyzing 134 records of outpatients examined at the Samara Regional Oncological Clinic who were referred by dentists within 2014-2019 from the local polyclinic in Samara due to detection of tumors in oral mucosa and who underwent a biopsy. The patients were divided into two groups according to the examination methods. The inclusion criteria were: detection of various superficial oral mucosa neoplasms; referral from the dentist. The exclusion criteria were as follows: patients with submucosal oral cavity neoplasms referred to the oncologist by other medical specialists or self-referred patients. The control group included 63 patients who, after a conventional examination (including interview, examination, palpation), underwent an incisional biopsy followed by morphological examination at the oncologist’s office. In the major group, in 71 patients at their respective initial dental appointments a special examination algorithm was applied. This algorithm entailed an assessment of the identified risk factors. Indications for biopsy were identified using the histological verification index (HVI). Apart from the conventional examination methods (interview, examination, palpation), autofluorescence stomatoscopy was used, this being done for the purpose of differential diagnostics of inflammation, precancerous and malignant issues, depending on the glow type. In the main group, the initial stages of oral mucosa cancer were detected in 17 patients after biopsy; in the control group – in 4 patients (p=0.004). The developed algorithm used for scoring the patient’s clinical examination data combined with autofluorescence stomatoscopy allowed diagnosing accurately (90% of reliability) precancerous and cancerous diseases, as well as to use invasive research methods (biopsy) strictly following the indications. Aim of study: to improve diagnosis of oral mucosa neoplasms through improvement of the examination algorithm.
The immune system plays a key role in the development and progression of head and neck squamous cell carcinoma. Understanding the dysregulation and blockage of the immune system of malignant tumors in this location can improve treatment outcomes. A special group is made up of patients who have a widespread process and relapse after chemotherapy with platinum drugs, because they have a very poor prognosis and limitations in the possibilities of further treatment. To date, the most important data relate to drugs acting on the PD-1 (programmed cell death protein 1)/PD-L1 (programmed death ligand 1) immune checkpoints, which are used by the tumor to block the immune system, which have allowed to increase the effectiveness of treatment. The article presents a clinical case demonstrating the effectiveness of the use of checkpoint inhibitors after the use of platinum preparations.
Salivary gland carcinomas is a rare family of neoplasms with different histological characteristics and biological behavior. Treatment regimens have remained virtually unchanged for decades, leaving the leading role for surgical treatment and radiation therapy. However, a special place in the salivary gland carcinomas group is occupied by adenoid cystic carcinoma, which is quite often characterized by a recurrent and / or metastatic course with the use of chemotherapy as the main option in treatment. It is worth noting the fact that the results of standard chemotherapy regimens show unsatisfactory results, respectively, with recurrent or metastatic adenoid cystic carcinoma, treatment options are minimal. Accordingly, there is a need to study new therapeutic methods for the treatment of this disease. In this situation, high hopes were placed on targeted therapy, in particular, the family of epidermal growth factor receptors, c-Kit are the most frequently studied molecular targets. Due to the rare occurrence of adenoid cystic carcinoma, the number of cases of using targeted therapy for analysis is relatively small, so each clinical observation is of particular value. The following is a clinical case of treatment of recurrent adenoid cystic carcinoma using a personalized treatment approach.Aim. To describe the clinical observation of the use of targeted drugs in recurrent or metastatic adenocystic cancer of the salivary glands.
The chondrosarcoma of the larynx is a poorly understood and rare malignant tumour. It accounts for only 1% of malignant neoplastic pathology of the larynx, but at the same time it is the most common non-epithelial neoplasm of the larynx. More often occurs in the area of the cricoid cartilage, namely the inner plate, less often in the area of the vocal folds and the epiglottis. There are no clinical guidelines for the treatment of chondrosarcoma of the larynx, therefore each clinical case describing clinical observations of this rare tumour is of interest. A clinical case of chondrosarcoma of the larynx is presented in a 55-year-old man who complained of hoarseness for 3 months. The patient underwent a complete clinical and instrumental examination, but computed tomography (CT) is of the greatest value. According to CT data, a calcified mass is visualized in the cricoid cartilage. At the first stage, the patient underwent resection of the cricoid cartilage in order to verify the diagnosis. Histological examination: low-grade chondrosarcoma. At the second stage, a radical surgical treatment was performed - laryngectomy. 8 months after the operation, the patient has no data on the relapse and progression of the disease according to the survey data. Currently, total laryngectomy is preferred for patients with recurrent low-grade chondrosarcoma. However, a literature review and our case show that the inability to restore the cricoid cartilage of the larynx, which is affected in most cases, often leads to laryngectomy
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