CLINICAL CASE OF NON-TYPICAL METASTASIS OF NEUROENDOCRINE LUNG CARCINOMA TO THE VASCULAR MEMBRANE OF THE EYE.

BACKGROUND: Metastases in eye structures are rare (1-5% cases at systemic spread of different malignancies, mainly breast and lung cancers). The prognosis is poor. The overall survival usually does not exceed 12 or even 6 months. If metastases are found in the choroid membrane, the probability that the patient has multiple metastatic lesions of other organs increases significantly. Lung neuroendocrine neoplasms are rare (1-2% of all malignancies in adults), but mainly aggressive tumors. They are cha-racterized by "blurred", nonspecific clinical symptoms, the correct diagnosis is delayed seriously, and distant metastases are seen in more than 40% of patients (usually in chest structures, liver, bones, brain, and adrenal glands; metastasis to vascular membrane of the eye ranks the 6th place). CASE REPORT: Own clinical observation of a male patient with rare metastasis of lung neuroendocrine carcinoma to the choroid of the left eye is presented. The disease is manifested by an ocular metastasis, which was initially considered an embryonic tumor. Other metastatic lesions (hilar lymph nodes, liver, soft tissues) were detected on computed tomography a little bit later. The diagnostic algorithm using routine histological examination and immunohistochemistry, including detection of neuroendocrine markers (chromogranin A, synaptophysin), cytokeratin 7 and Ki-67 expression in primary and metastatic tumors is described.

Prevalence of BRCA1 and BRCA2 genes promoter hypermethylation in breast cancer tissue.

BACKGROUND: Recent advances in the treatment of breast cancer (BC) have been related to the personalization of therapy. The methylation status of the promoter regions of tumor suppressor genes such as BRCA1 and BRCA2 is supposed to be useful as a prognostic factor in BC patients. AIM: To investigate the frequency of hypermethylation in the promoter regions of BRCA1 and BRCA2 genes in tumor tissue of BC patients, and the relation of hypermethylation to the clinical course of the disease. MATERIALS AND METHODS: Molecular genetic studies were performed on 50 BC tissue samples in order to determine the methylation status of the promoter regions of the BRCA1 and BRCA2 genes. RESULTS: Hypermethylation of the BRCA1 promoter region was detected in 34% of BC cases, hypermethylation of the BRCA2 promoter region - in 50% of cases, and hypermethylation of the promoter region of both genes - in 20% of cases. A significant increase in the incidence of hypermethylation of the BRCA2 promoter region was found in the group of patients older than 56 years, mainly in patients with triple-negative breast cancer and without family history of BC. CONCLUSIONS: The high frequency of hypermethylation in the promoter regions of BRCA1 and BRCA2 genes, as well as their co-methylation in tumor tissue of BC patients has been detected.

Histological differential diagnostics of renal oncocytoma.

BACKGROUND: The morbidity rate of kidney cancer has been increasing. Management of patients and their prognosis depend on the specific histological type of tumor. Unfortunately, different renal tumors can have similar histological features, making differential diagnostics challenging. Among the most challenging tasks is differential diagnosis of renal oncocytoma (RO) and chromophobe renal cell carcinoma (ChRCC). AIM: To analyze different histological features of renal oncocytomas and specify their pathognomonic characteristics that may be advantageous for the confirmation of the diagnosis. MATERIALS AND METHODS: The medical records and histopathological reports of 197 patients with diagnosis of either RO or ChRCC were analyzed. 37 histological parameters were then evaluated and their prevalence in RO or ChRCC was compared by performing a contingency table analysis. Odds ratio was also calculated. RESULTS: The most common growth patterns of ROs were solid (53%), nested (47%), cystic (29%), and alveolar (28%). A combination of two or more growth patterns was seen in 82% of cases mostly composing of nested, cystic, alveolar or solid structures. Most tumors exhibited granular inclusions (70%) and dense cytoplasm (58%). CONCLUSION: With more than 95% confidence, the nested pattern, myxoid stroma, granular cytoplasm and round nuclei are likely indicative of RO, whereas the varying nuclear size, raisinoid nuclei and reticular cytoplasm indicate higher likelihood of ChRCC. Therefore, these features should be analyzed for RO confirmation.

Metastatic cardiac tumors: literature review and own observation of testicular tumor metastasis in the right ventricle of the heart.

BACKGROUND: Tumors of the heart are uncommon and usually benign (in 93% cases myxomas are observed). More often secondary, metastatic tumors are detected in the heart, as a rule, at pronounced progression of the malignant neoplasm with multiple lesions of other internal organs (lung, pleura, liver, etc.). Literature review on cardiac metastases of different tumors is given. CASE REPORT: Own observation of a young man with rare single metastasis of malignant testicular germ cell tumor with predominance of embryonic carcinoma in the right ventricle of the heart is presented; the primary tumor was detected after metastasis revealing. The diagnostic algorithm using routine histological study supplemented with immunohistochemistry, including detection of cytokeratin pan, cytokeratin 5/6, cytokeratin 7, CD30, OCT4, TTF-1, hCG, and AFP markers expression, is described.

Breast cancer immunohistochemical features in young women with BRCA 1/2 mutations.

UNLABELLED: Breast cancer among young women is a rare pathology. In most studies published so far, this patients group is not being analyzed separately. Particularities of this pathology require an additional examination of the immunohistochemical and molecular-genetic markers of the disease for development of the effective treatment protocols. The mutations of BRCA1/2 are the important factor impacting to the disease prognosis along the age of the patient. AIM: To compare the expression of prognostically meaningful immunohistochemical markers such as estrogen receptor (ER), progesterone receptor (PR), HER-2, p53, Ki-67, in tumor cells of the female patients with breast cancer aged less than 36 depending on the presence of absence of mutations in CRCA1/2 genes. METHODS: Two hundred forty-eight patients aged less than 36 at the time of diagnosis of breast cancer were examined clinically. Expression of ER, PR HER-2, p53, Ki-67 was determined by indirect immunohistochemical method. mutations of BRCA1 (185delAG, o5382insC) and BRCA2(6174delT) genes were screened using multiplex PCR in 99 patients. RESULTS: Mutations of BRCA1/2 genes were found in 9.1% of patients. More aggressive clinical course of the disease was seen in mutations carriers, who had 3-years survival of only 55.6%. They did not demonstrated of ER, PR, and HER-2 in 88.0% of the cases. Whereas, patients without BRCA1/2 mutations did no express ER, PR, and HER-2 in only 42.0% of cases. There were no differences between patients with and without mutations in terms of tumor size, presence of metastases in lymph nodes, p53 and Ki-67 expression. CONCLUSION: Presence of BRCA1/2 genes mutations in young women is associated with more aggressiveness of the breast cancer (their 3-years survival is 25,5% less) and absence of the ER, PR, HER-2 receptors, which is unfavorable prognostic factor in terms of hormone therapy. These data should be taken into account at chemotherapy planning, especially in patients with early stages of the disease. There were no differences between patients with and without BRCA1/2 mutations in terms of tumor size, lymph nodes involvement, tumor histology, and p53 and Ki-67 proteins expression.

[Several risk factors of breast cancer development and prognosis of its course].

The article presents some risk factors of breast cancer development and prognosis of the disease in Ukrainian patients. The frequency of 5382ins and 185delAG mutations in gene BRCA 1 and mutations of 6174delT in gene BRCA 2 was detected in the group of patients from Ukraine.

[Clinical effectiveness of nadroparin calcium in the surgical treatment of breast cancer]. / Otsenka klinicheskoi éffektivnosti primeneniia nadroparina kal'tsiia pri khirurgicheskom lechenii raka molochnoi zhelezy.

The report deals with an assessment of frequency of fatal thromboembolic complications after surgery for breast cancer, in particular, frequency and severity of the side-effects of calcium nadroparin treatment as a component of surgical preparation. Considering the low incidence of thromboembolic complications in such patients and the side-effects of anti-coagulant therapy, it is suggested that decisions be made on a strictly individual basis under stringent clinical control.

[Surgical treatment of breast neoplasms in early stages]. / Khirurhichne likuvannia raku molochnoï zalozy u rannikh stadiiakh.

Analysis of literary data and own investigation results for the modern surgical methods of treatment of mammary gland cancer in early stages was performed. Indexes of patients survival after surgical removal of mammary gland (MG) and quadranthectomy did not differ. Preservation of MG constitutes great social and psycho-emotional significance for women-patients.

[Complex estimation of proliferative activity of epithelial cells of the large intestine damaged by polyps and cancer]. / Kompleksna otsinka proliferatyvnoï aktyvnosti klityn epiteliiu slyzovoï obolonky tovstoï kyshky vrazhenoï polipamy ta rakom.

Peculiarities of mitotic regime and expression of proliferating cell nuclear antigen were investigated in 18 polyps and 35 cases of colorectal cancer. Direct relationship between spectrum and degree of manifestation of proliferative activity, level of morphological malignant tumors and accumulation of oncopathology in the patient pedigrees was established.

[The characteristics of protein p53 expression in the mucosal epithelium of the large intestine affected by polyps and cancer]. / Osoblyvosti ekspresiï bilka p53 v epiteliï slyzovoï obolonky tovstoï kyshky, vrazhenoï polipamy ta rakom.

The direct dependence between p53 expression in epithelial cells and the level of morphological malignant neoplasm was established as the result of investigation of expression of this biomolecular marker in 12 polyps and 35 colorectal cancer. It was shown that family cancer syndrome 1 type was observed in pedigrees of majority patients with p53 positive cancers.

[The diagnosis of histiocytic lymphomas]. / O diagnostike gistiotsitarnykh limfom.

The histogenesis, classification, terminology of histiocytic lymphomas is analyzed. The possibilities are shown of their diagnosis evaluating lectin histochemistry data which is of major importance for the prognosis of the clinical course of the disease.