clinicaloncologyКлинический случай в онкологииClinical Case in Oncology3034-14773034-4018ОНКОПРАКТИК10.62546/3034-1477-2023-1-1-63-73clinicaloncology-10Research ArticleКЛИНИЧЕСКИЙ СЛУЧАЙCLINICAL CASEТипичные метастазы, нетипичное течение и морфологияTypical metastases, atypical course of the disease and morphologyhttps://orcid.org/0000-0003-0402-6067БелякН. П.BelyakN. P.

Беляк Наталья Петровна — 3.1.6, кандидат медицинских наук, доцент кафедры онкологии; зав. отделением противоопухолевой лекарственной терапии № 10

Author ID 778562

199034, Санкт-Петербург, Университетская наб., д. 7–9

198255, Санкт-Петербург, пр. Ветеранов, д. 56

Belyak Natalia Petrovna — PhD Med, associate professor at Dept of Oncology; head of Cancer Drug Therapy (Chemotherapeutic) Dept No. 10

Author ID 778562

St. Petersburg 

   

drnpb@mail.ruhttps://orcid.org/0000-0001-7111-1507АндросоваА. В.AndrosovaA. V.

Андросова Александра Валерьевна — 3.1.6, аспирант; врач-онколог отделения противоопухолевой лекарственной терапии № 10 

199034, Санкт-Петербург, Университетская наб., д. 7–9

198255, Санкт-Петербург, пр. Ветеранов, д. 56

Androsova Aleksandra Valeryevna — post-graduate studen; medical oncologist of Cancer Drug Therapy (Chemotherapeutic) Dept No. 10

St. Petersburg 

   

alexa.androsova.1711@mail.ruФГБОУ ВО «Санкт-Петербургский государственный университет»; СПб ГБУЗ «Городской клинический онкологический диспансер»РоссияSt. Petersburg State University; City Clinical Oncology CentreRussian Federation202325032024116373Copyright © Беляк Н.П., Андросова А.В., 20242024Беляк Н.П., Андросова А.В.Belyak N.P., Androsova A.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.oncocase.ru/jour/article/view/10

Дифференцировка опухолей является центральным аспектом гистопатологической классификации солидных злокачественных новообразований и тесно связана с биологическим поведением опухоли (известно, что низкодифференцированная/дедифференцированная опухоль более агрессивна, чем дифференцированная). Механизмы, с помощью которых нарушаются процессы дифференцировки опухолевых клеток, плохо изучены, но патоморфологи и молекулярные биологи ввели концепцию дедифференцировки для объяснения фенотипических изменений, происходящих в солидных опухолях. В настоящей публикации обсуждается случай выявления дедифференцированного рака, где даже с помощью молекулярного тестирования опухолевого образца до конца не получилось однозначно определить первоисточник процесса, что повлекло за собой трудности выбора лечебной тактики. Основной вопрос, который был поставлен в клиническом случае: должно ли лечение основываться на молекулярных маркерах, выявленных в опухоли, или его следует проводить согласно рекомендациям по лечению опухолей невыявленной первичной локализации с помощью эмпирически выбранной химиотерапии?

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The authors declare that there are no conflicts of interest present.