Background. Breast reconstruction for breast cancer (BC) is often associated with the development of complications, which can even lead to unsuccessful consequences in the form of loss of an implant or flap. Despite the rapid development of reconstructive surgery for breast cancer, the percentage of complications continues to remain at a high level and can reach 50%. Undoubtedly, complications during reconstruction with implants and flaps are different and have their own specifics. Sometimes we can successfully manage or prevent these complications by choosing the best reconstruction option for that particular patient. Breast reconstruction using a DIEP flap in patients with risk factors minimizes the rate of complications that occur with implant reconstruction, thereby leading to a good aesthetic result.

Purpose of the study: to evaluate the effectiveness and aesthetic acceptability of the DIEP flap in patients with a history of complications after breast reconstruction with implants/expanders and high-risk factors for complications.

Materials and methods. The study performed 20 breast reconstructions using the DIEP flap in patients with risk factors who had previously experienced complications and had failed implant reconstruction.

Results. The total complication rate was 35%. The dominant complication was long-term seroma in the donor area — 3 cases (15%), all of them had obesity of 1.2 degrees. Loss of the flap occurred in 1 (5%) case with a complicated medical history (grade 3 obesity, radiation therapy). Partial necrosis was detected in 1 (5%) of the subjects. Early postoperative hematoma was detected in 1 (5%) case, which required emergency surgical intervention, without loss or partial necrosis of the flap. Postoperative ventral hernia formed in 1 (5%) woman after previous abdominal surgery. It was also noted that patients with a BMI of 30.0 to 35 kg/m2 and 35 kg/m2 or higher were at significantly greater risk of complications compared to patients with a normal BMI (from 18.5 to 25 kg/m2) p-value 0.05. A history of radiation therapy increased the risk of complications. The difference is statistically significant p-value 0.02. There was no effect of chemotherapy on the number of complications encountered. The Breast Q questionnaire showed a good aesthetic result of 72 points.

Conclusions. The use of the DIEP-flap in patients with a history of complications after breast reconstruction with implants/expanders and high-risk factors for complications is an effective and safe method of breast reconstruction with a good cosmetic result.

Visceral obesity and metabolic syndrome are major risk factors for type 2 diabetes, cardiovascular disease and cancer. Data analyzing the relationship between metabolic syndrome and gastroenteropancreatic neuroendocrine neoplasms are extremely limited (Italian scientists made the greatest contribution to the study of this issue).

The study of the relationship between sporadic neuroendocrine tumors of the gastrointestinal tract (GEP NET) and metabolic syndrome deserves special attention.

The purpose of this article is to analyze the main works that are devoted to the assessment of metabolic syndrome and associated factors in neuroendocrine tumors of the gastrointestinal tract.

Solving the problems of clinical assessment of the presence of metabolic syndrome in neuroendocrine tumors of the gastrointestinal tract can potentially be important both for prognostic purposes and for the development of preventive measures.

In addition to reviewing the main studies devoted to the study of metabolic syndrome in neuroendocrine tumors of the gastrointestinal tract, in this article we present the results of our own research.

Checkpoint inhibitors have radically changed the approach to oncology and have become the new standard of treatment for many solid tumors, significantly increasing the life expectancy of patients. With the advent of a new class of drugs, we are faced with a completely recognized toxicity profile. The spectrum affects other manifestations that affect almost every organ and system of the body. Most often the skin, the secretion of the internal gland, the gastrointestinal tract, lungs, and liver are affected. Complications from the urinary, cardiovascular, muscular-articular, nervous and hematopoietic systems occur less frequently. This article will discuss one of the rare complications that occurs during therapy with checkpoint inhibitors — thrombocytopenia with hemorrhagic syndrome. The main purpose of the article is to increase clinical alertness and highlight the relevance of the problem of rare complications during immunotherapy.

The aim of the article is to provide the reader with some information about etiology, pathogenesis, diagnostic methods, clinical manifestations and treatment of pheochromocytoma. The clinical case describes difficulties in differential diagnosis of retroperitoneal neoplasms, possible errors in obtaining morphological verification of pheochromocytoma, and successful surgical treatment of a patient with a giant pheochromocytoma

Neuroendocrine tumors are nowadays diagnosed quite often and it is important to know that they often lead to carcinoid syndrome due to the production of serotonin by the cells. Clinical manifestations of carcinoid syndrome (flushes, erythema of the skin of the face, neck, chest, development of diarrhea, etc.) significantly reduce the quality of life of patients. Personalized medicine implies a constant search for new means and ways to optimize the diagnosis of diseases and treatment of each patient. The subject of this article is a specific clinical case of carcinoid syndrome in pancreatic NET. The aim of the work is to analyze the effectiveness of biotherapy with somatostotin analogues in the treatment of carcinoid syndrome in pancreatic NET on the example from clinical practice. When discussing the problems of treatment of a patient with carcinoid syndrome in pancreatic NEТ the results of laboratory tests, data of various methods of diagnostics and treatment are used. To confirm the effectiveness of biotherapy with somatostotin analogs, visual material (photos of the patient in dynamics) is offered.

Desmoplastic small round cell tumour (DSRCT) is a very rare and aggressive malignant tumour first described in 1989 [1]. The incidence of DSRCT is approximately 0.2 cases per 1,000,000 population [2]. DSRCT usually occurs in adolescents and young males. DSRCT is characterised by high aggressiveness and despite comprehensive treatment, the prognosis in this disease remains extremely poor. Median progression-free survival (PFS) ranges from 4 to 21 months, overall survival (OS) ranges from 17 to 60 months, and only 10–20% of DSRCT patients cross the 5-year survival threshold [3]. Currently, there are no treatment protocols for DSRCT due to the rarity of the nosology. In this article, we present a clinical case of a patient with DSRCT with multiple peritoneal metastases treated with the VAC-IE regimen with a maximum treatment effect of partial regression.

Metastatic breast cancer is considered an incurable disease, the treatment of which is based on systemic approaches such as chemotherapy, hormonal, targeted and immunotherapy, depending on the biological subtype of the tumor. To determine the extent of the tumor process, imaging research methods are always required to identify a group of patients with oligometastatic disease. Some studies indicate a more favorable prognosis in these patients. The use of local treatment methods, such as surgical or radiotherapy, can potentially improve the prognosis and increase the life expectancy of these patients. At the same time, optimization of systemic therapy approaches should be a priority to obtain the maximum antitumor response.

Unfortunately, it is impossible to determine in advance which patient will benefit the most from local treatment, but nevertheless many cases with long periods of absence of disease progression are described. Additional prospective studies are needed to assess which patients can benefit the most from the addition of local treatments.