[Superselective intra-arterial administration of bevacizumab with blood-brain barrier disruption in patients with recurrent malignant gliomas: case report and literature review]. / Superselektivnoe vnutriarterial'noe vvedenie bevatsizumaba s otkrytiem gematoentsefalicheskogo bar'era u patsientov s retsidivnymi zlokachestvennymi gliomami: obzor literatury i klinicheskii sluchai.

Glioblastoma multiforme is characterized by persistent recurrent course despite surgical, radio- and chemotherapeutic treatment. The outcomes of superselective intra-arterial administration of bevacizumab with blood-brain barrier disruption in patients with recurrent glioblastoma have been published. The authors reported significant increase in overall survival (up to 2.5 years). We report treatment of recurrent glioblastoma in a young patient with progressive course of disease despite 4 previous neurosurgical interventions, radiotherapy and first-line chemotherapy. Superselective intra-arterial administration of bevacizumab with blood-brain barrier disruption made it possible to achieve clinical response and improve neurological status.

[Surgical management of cancer patients within the COVID-19 pandemic]. / Strategiya khirurgicheskogo lecheniya onkologicheskikh bol'nykh v usloviyakh pandemii COVID-19.

OBJECTIVE: A systematic review of the world literature data on surgical management and preoperative screening of cancer patients within the COVID-19 pandemic, as well as prevention of SARS-CoV-2 transmission and resumption of elective surgery. MATERIAL AND METHODS: Literature data searching included Pubmed, MedLine, Scopus, Web of Science, and RSCI databases. We enrolled literature data published for the period from March 2020 to June 2020. RESULTS: Retrospective and prospective clinical trials have been analyzed. The review ensures up-to-date data on surgical management of cancer patients under the pandemic, recommendations for resuming the elective surgery, preoperative screening and prevention of COVID-19. CONCLUSION: To date, the COVID-19 pandemic is still not resolved, and infection continues spreading around the world. Thus, there is an urgent need for more thorough research of the strategies for mitigating the effects of pandemic. To date, the recommendations for optimal surgical management of cancer patients within the pandemic are still actively developed considering the benefits of treatment and risks of SARS-CoV-2 infection. Resumption of elective surgery should be progressive and cautious, especially in pandemic areas. For safety reasons, all patients eligible for surgical treatment should be carefully selected according to stratification of risk factors. Thorough preoperative screening, monitoring of symptoms of infection, and use of appropriate adapted personal protective equipment are extremely important.

Epithelioid hemangioendothelioma, an ultra-rare cancer: a consensus paper from the community of experts.

Epithelioid hemangioendothelioma (EHE) is an ultra-rare, translocated, vascular sarcoma. EHE clinical behavior is variable, ranging from that of a low-grade malignancy to that of a high-grade sarcoma and it is marked by a high propensity for systemic involvement. No active systemic agents are currently approved specifically for EHE, which is typically refractory to the antitumor drugs used in sarcomas. The degree of uncertainty in selecting the most appropriate therapy for EHE patients and the lack of guidelines on the clinical management of the disease make the adoption of new treatments inconsistent across the world, resulting in suboptimal outcomes for many EHE patients. To address the shortcoming, a global consensus meeting was organized in December 2020 under the umbrella of the European Society for Medical Oncology (ESMO) involving >80 experts from several disciplines from Europe, North America and Asia, together with a patient representative from the EHE Group, a global, disease-specific patient advocacy group, and Sarcoma Patient EuroNet (SPAEN). The meeting was aimed at defining, by consensus, evidence-based best practices for the optimal approach to primary and metastatic EHE. The consensus achieved during that meeting is the subject of the present publication.

[Malignant giant cell tumor of soft tissue]. / Zlokachestvennaia gigantokletochnaia opukhol' miagkikh tkanei.

Clinical, pathologic, and electron microscopic study of 4 cases of malignant giant cell tumor of soft tissues is presented. Conventional histology and electron microscopy disclosed histiocyte-, fibroblast- and osteoclast-like multinucleated giant cells, cells with 2 and 3 nuclei, and undifferentiated cells. Malignant giant cell tumor of soft tissues is therefore considered to be a special variant of malignant fibrous histiocytoma.

[Clinico-morphologic characterization of lung metastases from osteogenic sarcoma during chemotherapy]. / Kliniko-morfologicheskaia kharakteristika legochnykh metastazov osteogennoi sarkomy pri khimioterapii.

Clinical and morphological characterization of osteogenic sarcoma (OS) and its lung metastases is presented in 16 patients, of whom 7 have not received preoperational chemotherapy. The morphological structures of the primary tumor and its metastases are shown to be of the same type. In most observations, OS metastases have been found to have no signs of therapeutic pathomorphism and their structures are identical to those of anaplastic polymorphocellular sarcoma with osteoid. The average life span of the patients was 35 months after pulmonary metastases removal.

[Clear-cell chondrosarcoma of bone]. / Svetlokletochnaia khondrosarkoma kosti.

Clinico-roentgeno-morphological characteristics of clear-cell chondrosarcoma are presented. Tumour cells had an abundant clear cytoplasm limited by a well discernible membrane; there were few giant multinuclear cells of the osteoclast type, zones of secondary osteogenesis and calcification. The lobulation of the structure was much less pronounced and the lobules were smaller and no so distinct as compared to an ordinary chondrosarcoma. All patients survived without recurrences and metastases after the operation.

[Malignant fibrous histiocytoma of the soft tissues]. / Zlokachestvennaia fibroznaia gistiotsitoma miagkikh tkanei.

Clinico-morphological characterization of the malignant fibrous histiocytoma (MFH) of soft tissues in 142 patients is presented. According to the authors' data MFH is the most frequent tumour among soft tissue malignant neoplasms (15,7%) in adult patients. The age of patients is predominantly from 40 to 70, the most frequent site is a lower limb (thigh). A typical morphological variant of MFH clearly dominates (73%): there is a tendency to the development of an inflammatory variant at the retroperitoneal tumour site. Recurrences in all group of patients (104) who were followed-up were in 68,3%, metastasis in 45,2%, the 5-year survival in 59,6% of cases. A clear-cut dependence of these indices upon the depth of tumour location soft tissues, node size, tumour site is noted. In view of pronounced domination of a MFH typical variant the final conclusion on the feasibility of separation of other variants can be only made on the basis of a much greater number of cases.

[The relationship between the prostaglandin E level in the tumor and the times of the metastasis of primary osteogenic sarcoma]. / Sviaz' mezhdu urovnem prostaglandinov E v opukholi i srokami metastazirovaniia pervichnoi osteogennoi sarkomy.

Radioimmunoassay was used in 46 cases of osteogenic sarcoma to assess prostaglandin E (PgE) levels in tumor tissue. Those levels were found to vary with age. A correlation was established between the effect of preoperative chemoradiation treatment, on the one hand, and degree of treatment-induced pathomorphosis and PgE concentration in tumor, on the other. High PgE level in osteogenic sarcoma tissue proved prognostically unfavorable whatever age and prior chemoradiation treatment and were associated with shorter metastasis-free survival.

[Steroid hormone receptors in osteogenic sarcomas]. / Issledovanie retseptorov steroidnykh gormonov v osteogennykh sarkomakh.

The method of hormone-receptor complex precipitation with protamine sulfate was used in 57 males suffering osteogenic sarcoma to identify and evaluate cytoplasmic androgen (AR) and estrogen receptor (ER) levels versus age and prior treatment as well as to assess their prognostic significance. AR were most often observed in younger patients and those pretreated with chemo- and radiotherapy whereas ER mostly occurred in older ones. Presence of AR (in untreated tumor or following preoperative therapy) adversely influenced prognosis. It took AR-positive tumors less time to disseminate to the lung after the start of treatment. The use of antiandrogen drugs for osteogenic sarcoma treatment is discussed.

[The results of using high-dose methotrexate in treating osteogenic sarcoma]. / Rezul'taty primeneniia vysokikh doz metotreksata pri lechenii otseogennoi sarkomy.

The interim results of the use of high-dose methotrexate with leucovorin rescue for the treatment of 26 patients with osteogenic sarcoma are discussed. Preoperative chemotherapy was followed by marked regression of primary tumor in one out of seven patients with localized disease. In that group, metastasis-free period lasted 2, 3, 10+, 12, 17+ and 24+ months. Response was observed in two out of 19 (10.6%) cases of metastases. Toxic side-effects were moderate and were mainly nausea (38.5% of patients), vomiting (26.9%), elevation of serum transaminase levels (38.5%) and fever (30.7% of cases).

[Polypeptide growth factors and their interrelation with hormones in the blood plasma of patients with primary bone tumors]. / Polipeptidnye faktory rosta i ikh vzaimosviaz' s gormonami v plazme krovi bol'nykh s pervichnymi opukholiami kostei.

A relationship between blood plasma levels of polypeptide growth factors and those of peptide and sex steroid hormones, as assayed radioimmunologically, was studied in 91 patients with bone tumors of various histology and 45 healthy donors. The levels of insulin-like growth factor (IGF-1) and somatotropic hormone were significantly higher in cases of chondrosarcoma and patients suffering osteogenic sarcoma in the late puberal period as compared to controls and cases of fibrous histiocytoma, giant-cell tumor, benign tumors and tumor-like lesions of the bone. The peak levels of IGF-1, somatotropic hormone and insulin were registered in osteogenic sarcoma patients who developed pulmonary metastases either in the course or after the completion of combined treatment. Somatostatin level was significantly lower in patients with osteogenic sarcoma aged 11-20 years as compared to healthy adolescents, the lowest level being observed in adolescents suffering osteogenic sarcoma with metastases to the lungs. No relationship was established between total testosterone level, on the one hand, and those of IGF-1 and epidermal growth factor, on the other. A reverse correlation was established between concentrations of IGF-1 and total estradiol. The role of polypeptide growth factor antagonists in combined treatment of bone sarcomas is discussed.