The article describes clinical observation of locally advanced metastatic anaplastic thyroid cancer. Difficulties in instrumental and laboratory diagnosis of this pathology and the role of molecular diagnosis in search for highly effective treatment are discussed.

Osteosarcomas are rare tumors with aggressive biology. It is important to refer such patients to a high-volume center, where an accurate diagnosis and optimal treatment are more likely to be performed. In contrast to Ewing's sarcoma, conventional osteosarcomas are believed to be generally resistant to radiation therapy, and the main treatment modalities are surgery and chemotherapy. In this clinical case, we demonstrate the efficacy of combined treatment of osteosarcoma of the femur. Preoperative chemotherapy allowed to evaluate tumor sensitivity to systemic treatment in vivo and optimize adjuvant treatment after R0 resection which allowed to achieve complete clinical response to treatment.

Recently due to significant successes in drug therapy of malignant tumors, the question of quality of life of patients has become more important. Cyclical drug treatment implies intravenous infusion of antitumor agents. Complications associated with this type of therapy include phlebitis and extravasation and, in some cases, lead to full obliteration of vessel lumen and vast skin and hypoderm necrosis. Multiple venous punctions can with time lead to significant technical difficulties in accessing the vein and limit the continuation of therapy. This drives the necessity to search for rational approaches to patient safety during both outpatient and inpatient antitumor drug treatment. To solve this problem, fully implanted venous port systems were developed and implemented in clinical practice which provide organization of aseptic continuous venous access, as well as infusion pumps (for independent prolonged intravenous therapy). Use of these devices allows for continuity and cycling of treatment process, significantly improves patients' quality of life by not limiting daily activities.In the article we present our experience of using microinfusion single-use mechanical systems for antitumor drug therapy and relief of intense pain syndrome in patients with malignant disorders of hematopoietic tissue and solid tumors.

Alveolar rhabdomyosarcoma (ARMS) is an aggressive primitive tumor with limited differentiation of rhabdomyoblasts. Primarily, it occurs in children and teens under 15 years of age in the head and neck region (in 40 % of cases). In patients older than 19-20 years, ARMS is significantly less common and is localized primarily on the limbs, while head and neck region is affected in about 24 % of all cases, involvement of the orbit in the tumor process is very rare. ARMS progression in adults is more aggressive than in children, and prognosis is more unfavorable due to development of regional and distant metastases at the time of diagnosis. Hence, selection of antitumor therapy is limited to drug treatment. Use of multimodal approach to therapy allows to improve treatment outcomes and increase quality of life in patients with ARMS.

Neuroendocrine tumors are rare type of tumors of the gastrointestinal tract. Mostly the patient is diagnosed rather late, the tumors don’t have specific symptoms and there are no sensitive and specific methods of early diagnostics of the disease. Also, to date, the choice of antitumor treatment methods is limited. The article presents a clinical case of effective treatment of a neuroendocrine tumor of the colon with high level of microsatellite instability. After palliative partial colectomy, atypical resection of the liver, female patient with metastatic cancer of the descending colon has been receiving therapy with checkpoint inhibitors (PD-1) which led to long-term stabilization of the process.

Currently, use of CDK4/6 inhibitors in combination with hormone therapy is approved for treatment of patients with advanced or metastatic breast cancer positive for estrogen and progesterone receptors and negative for human epidermal growth factor receptor 2 (HER2). In this clinical observation, analysis of the effectiveness of treatment of a patient with metastatic breast cancer of luminal A subtype is performed. The 1st line combination therapy was CDK4/6 inhibitors (ribociclib) and hormone therapy with aromatase inhibitors (letrozole) and analogues of gonadotropin-releasing hormone (goserelin) with concurrent bone-modifying denosumab therapy. Effectiveness of antitumor drug therapy administered for 7 months, and toxicity of the regimen were evaluated. Effectiveness of the selected combination treatment regimen was demonstrated and confirmed by clinical data, as well as results of laboratory and instrumental examinations. Adverse effects were controlled and managed with symptomatic therapy which allows to continue treatment using previously selected tactics.

Per the majority of authors, melanoma is the most common tumor diagnosed during pregnancy (31 % of all malignant neoplasms). In approximately 1/3 of women melanoma developed in child-bearing age is diagnosed during pregnancy or in the postpartum period. However, only some retrospective studies analyzed the effect of pregnancy on melanoma development, and conclusive data on development, progression and treatment of BRAF-mutant melanoma is lacking. In this subpopulation of patients, BRAF status supposedly can negatively affect disease outcome irrespective of treatment methods.The article presents a clinical case of recurrence of melanoma with the BRAF V600E mutation during pregnancy. The patient underwent lymph node dissection during pregnancy prolongation, after labor she received antitumor drug therapy with МЕК and ВRAF inhibitors. Melanoma recurrence during pregnancy did not worsen treatment outcomes for the mother and embryo.