ИМПЛАНТАЦИОННЫЙ МЕТАСТАЗ РАКА ГОРТАНИ ПОСЛЕ НАЛОЖЕНИЯ ЧРЕСКОЖНОЙ ЭНДОСКОПИЧЕСКОЙ ГАСТРОСТОМЫ

Squamous cell head and neck carcinoma is frequently associated with dysphagia. An adequate enteral nutrition is the key to successful treatment and rehabilitation of these patients. Percutaneous endoscopic gastrostomy is the preferred route of feeding and nutritional support in head and neck cancer patients with dysphagia. We report a rare case of implantation metastasis of laryngeal cancer following percutaneous endoscopic gastrostomy. Our experience in treating this complication has been described. Percutaneous endoscopic gastrostomy is a less-invasive procedure than open gastrostomy. Percutaneous endoscopic gastrostomy can be accompanied by severe complications such as implantation metastasis at gastrostomy site. Careful monitoring can provide early detection of this complication and early treatment. Развитие дисфагии у пациентов с плоскоклеточным раком головы и шеи является закономерным развитием опухолевого процесса. Адекватное энтеральное питание залог успешного лечения и реабилитации пациентов. Одним из возможных методов коррекции дисфагии является наложение чрезкожной эндоскопической гастростомы. Представлен наш опыт наблюдения и лечения пациентки с имплантационным метастазом рака гортани, после наложения чрезкожной эндоскопической гастростомы. Данный случай иллюстрирует редкое осложнение при наложении чрезкожной эндоскопической гастростомии, имплантационное метастазирование и опыт лечения данной пациентки. ЧЭГ является менее инвазивной процедурой, чем открытая гастростомия, она имеет ряд осложнений, такие как имплантационное метастазирование в области гастростомы. Знание этого осложнения и тщательный контроль со стороны онкологов, может обеспечить раннее выявление этого осложнения и раннее лечение.

Oral squamous cell carcinoma in "young" patients

Aim of the study — to provide for medical oncologists and surgeon, who specialize in treatment of head and neck oncology patients, the most recent information about incidence and feature of oral squamous cell carcinoma (OSCC) in young patientsЦель исследования — предоставить онкологам и хирургам, специализирующимся на лечении пациентов, страдающих раком головы и шеи, наиболее полную информацию о распространенности и особенностях плоскоклеточного рака полости рта у «молодых» пациентов на основе последних литературных данны

Клинический случай метастаза рака носоглотки в щитовидную железу

Background. Nasopharyngeal cancer is a rare head and neck cancer with a relatively high risk of locoregional recurrence and distant metastases. The most common sites of metastases are bones (70–80 %) followed by liver (30 %), lung (18 %), and lymph node (axillary, mediastinal, pelvic, and inguinal). Thyroid gland is an uncommon site of metastasis with an incidence ranging from 0.5% to 24 %. Thyroid metastasis from nasopharyngeal cancer has been reported in only 9 cases in the world literature and no one in Russia. Case report. We report a case of thyroid metastasis from nasopharyngeal cancer found incidentally in a 53-year-old female patient. Conclusion. Metastases to the thyroid gland are rare, and patients with metastatic thyroid disease rarely present with organ-specifc symptoms, thus raising diagnostic diffculties for both clinicians and the pathologists. This clinical report demonstrates the diffculties of differential diagnosis,as well as the importance of a thorough collection of complaints, anamnesis, and clinical examination.Актуальность. Рак носоглотки относится к редким заболеваниям в структуре опухолей головы и шеи. Данное новообразование имеет относительно высокий риск метастазов в регионарные лимфоузлы и отдаленные органы-мишени. Наиболее часто отдаленное метастазирование происходит в кости (70–80 %), печень (30 %), легкие (18 %), а также лимфоузлы (подмышечные, средостения, малого таза, паховые). Метастазы в щитовидную железу являются редким событием и встречаются в 0,5–24 % случаев. В мировой литературе описано 9 случаев метастазов рака носоглотки в щитовидную железу, подобных сообщений в отечественной литературе не найдено. Описание клинического случая. Представлено клиническое наблюдение 53-летней пациентки, у которой первично выявлен метастаз рака носоглотки в щитовидную железу как случайная находка. Заключение. Щитовидная железа редко является органом-мишенью для метастазов, при этом ее метастатическое поражение обычно не сопровождается функциональными нарушениями. По этой причине его диагностика является затруднительной как для клинициста, так и для патолога. Данный клинический случай демонстрирует трудности дифференциальной диагностики, а также показывает важность тщательного сбора жалоб, анамнеза, клинического осмотра.

IMPLANTATION METASTASIS OF LARYNGEAL CANCER AFTER PERCUTANEOUS ENDOSCOPIC GASTROSTOMY

Squamous cell head and neck carcinoma is frequently associated with dysphagia. An adequate enteral nutrition is the key to successful treatment and rehabilitation of these patients. Percutaneous endoscopic gastrostomy is the preferred route of feeding and nutritional support in head and neck cancer patients with dysphagia. We report a rare case of implantation metastasis of laryngeal cancer following percutaneous endoscopic gastrostomy. Our experience in treating this complication has been described. Percutaneous endoscopic gastrostomy is a less-invasive procedure than open gastrostomy. Percutaneous endoscopic gastrostomy can be accompanied by severe complications such as implantation metastasis at gastrostomy site. Careful monitoring can provide early detection of this complication and early treatment

PERISTOMAL RECURRENCE OF LARYNGEAL CANCER (LITERATURE REVIEW)

Treatment of recurrent laryngeal cancer remains challenging for clinicians. Peristomal reccurence is one of the severest complications of laryngeal cancer that occurs in 2–15  % of patients after laryngectomy and has a poor prognosis: the two-year survival rate is 45 % in patients with stage I and stage II recurrence (according to G.A. Sisson) and 9 % among patients with stage III and stage IV recurrence. Stomal recurrence usually occurs within 2 years after surgery. The following factors can influence that: location of the tumor in the subglottic region of the larynx, size of the primary tumor, presence of regional metastases, placement of a tracheostoma before laryngectomy, and submucosal spread of the tumor to the trachea. All these factors should be taken into account in patients» management, including prescription of adjuvant therapy and choosing a treatment strategy in patients with primary disease.Since there are multiple factors that can influence peristomal reccurence development, the disease requires comprehensive evaluation in order to provide the most adequate treatment and to prevent stomal recurrence

Die Ermittlung der Spannungen und Verformungen in Teilen eines Diesellokomotivradsatzes bei Wärmebeanspruchungen

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Experience in the use of targeted therapy in patients with radio-resistant forms of thyroid cancer in the Chelyabinsk Regional Clinical Center of Oncology and Nuclear Medicine

Radioiodine therapy of metastatic differentiated thyroid cancer is a highly effective method of treatment which makes it possible to achieve the complete cure of the majority of patients, however in some cases radioiodine refractory type develops, it leads to significant deterioration in overall and relapse-free survival. The article presents own experience of the therapy of radioiodine refractory thyroid cancer by the nexavar (sorafenib)

Antibiotic prophylaxis for head and neck cancer surgery

This review analyzes the research data concerning the problem of antibiotic prophylaxis (ABP) of wound infections after various surgeries for head and neck tumors. In patients with clean wounds, ABP should be used in exceptional cases only (for example, if the patient has any risk factors), otherwise it should be avoided. A short ABP course is recommended for patients with clean-contaminated wounds; however highrisk patients may require a prolonged course. There is some evidence of ABP efficacy in patients with non-contaminated wounds after cervical lymphadenectomy. When choosing a drug for ABP, a doctor should consider the site of surgery and the risk of wound contamination. The optimal drugs after head and neck surgeries include first- and second-generation cephalosporins, ampicillin in combination with sulbactam, metronidazole, and clindamycin. First- and second-generation cephalosporins in combination with metronidazole are preferable, but if the wound is infected with gram-positive bacteria, it is necessary to use clindamycin monotherapy. Reconstructive surgeries with a free flap require a short course of ABP with one of the following combinations: cefazolin + metronidazole, cefuroxime + metronidazole, or ampicillin + sulbactam; if the patient is allergic to beta-lactams, clindamycin can be used. Despite the availability of standard ABP regimens, a surgeon must apply a tailored approach when choosing an ABP regimen for each patient, taking into account risk factors and the volume of surgery

Plate Heat Exchangers for Environmentally Friendly Heat Pumps

Plate heat exchangers are now widely used in different industrial installations due to their unique characteristics important for process engineering. In recent years the use of plate heat exchangers for heat pumps has significantly increased, including the cases with natural refrigerants such as hydrocarbons, ammonia and carbon dioxide. The typical duties of plate heat exchangers in heat pumps with natural refrigerants are defined and acceptable types of plate heat exchangers for each duty discussed. The advantages of plate heat exchangers are very useful in units coupled with evaporators and condensers. In this case the proper selection of the plate materials taking into account the nature of the source of low potential heat for units coupled with evaporators is required. Proper prediction of fouling factor is also important for units coupled with condenser