Vol 26, No 6 (2021)

In clinical practice, the most common sporadic variant of solitary parathyroid adenoma. Atypical adenomas of the parathyroid glands are a rare form and present the greatest difficulty in determining the potential for malignancy, the extent of surgical treatment, and the patient’s dynamic follow-up regimen. They are not characterized by the classic signs of malignant growth – invasion beyond the formation capsule or the presence of metastases. Specific clinical and prognostic phenotypes of parathyroid adenomas are highly individual.

No more than 3% of parathyroid adenomas are associated with papillary thyroid cancer. Awareness of such a combination of pathology allows us to assess possible risks and determine the scope of surgical intervention as the only method of radical treatment of pathologically altered parathyroid tissue. With early detection of recurrence of thyroid cancer, it is necessary to conduct additional monitoring of hormonal activity and radiation diagnosis of tumor pathology of the parathyroid glands.

The presented clinical case showed that the cytological and histological diagnosis of parathyroid adenoma against the background of recurrence of advanced thyroid cancer can fundamentally differ at different stages of the morphological study. With parathyroid adenoma in the preoperative period, there may be a discrepancy between these methods of radiation and intraoperative diagnostics and the results of an urgent and planned histological examination. The uncharacteristic course of solitary parathyroid adenoma after thyroidectomy in combination with false positive results due to ultrasound location of thyroid nodules (residual tumors and cancer recurrences, as well as paratracheal metastases) and nervous tissue (paraganglioma) contributes to incorrect preoperative diagnosis of thyroid bed tumors. At the preoperative stage of diagnosing tumor pathology of the parathyroid glands, it is advisable to perform scintigraphy of the parathyroid glands with a simultaneous combination of ultrasound, which will increase the sensitivity of the diagnosis.

After surgical treatment of tumor pathology of the parathyroid tissue, in some cases, the result of differential diagnosis is an immunohistochemical study to form a final diagnosis and determine further patient management tactics.

The importance of a multidisciplinary approach in the surgical treatment of patients with severe combined oncological and cardiovascular pathologies is shown. In modern surgery, there is a place for both simultaneous and staged surgical treatment of this category of patients, which should be determined in each specific clinical case and requires an individual multidisciplinary approach with the inclusion in the discussion of such specialists as an oncosurgeon, a chemotherapist, a radiation therapist, a cardiologist/therapist, cardiovascular surgeon, anesthesiologist and resuscitator.

Two clinical cases of a two-stage and one-stage surgical approach in the treatment of patients with competing gastric cancer and coronary heart disease are presented. One 47-year-old patient underwent two-stage surgical treatment: stage 1 – aortocoronary bypass grafting from mini-thoracotomy (MICS CABG); stage 2 – robot-assisted distal subtotal resection of the stomach (Balfour modification) with D2 lymphadenectomy, formation of intracorporeal gastroenteroanastomosis and interintestinal anastomosis according to Brown. Another 74-year-old patient underwent a one-stage surgical intervention: autovenous coronary artery bypass grafting of the anterior interventricular artery, posterior descending coronary artery on a beating heart, without cardiopulmonary bypass + extended-combined gastrectomy with resection of the distal esophagus, resection of the diaphragm, and D2+ lymphadenectomy. The postoperative period proceeded without complications.

The Russian Journal of Oncology is indexed in many databases, including the Russian Science Citation Index (RSCI). The journal is included in the “List of peer-reviewed scientific publications for publishing the main scientific results of Ph.D. theses” recommended by the Higher Attestation Commission (hereinafter referred to as the HAC List), which is characterized by structuring by scientific branches, scientific fields, and scientific specialties. Since 2021, the journal citation in the RSCI database has been equated in its value to indexing in the Web of Science Core Collection and/or Scopus, which is a criterion for the quality of a publication and a guideline in choosing a scientific journal by the authors for publishing the results of thesis research. Thus, when preparing a thesis paper, the list of publications can include those works of the applicant that are published in scientific journals presented in the HAC List in the relevant specialty, or in scientific journals indexed in RSCI, Web of Science and/or Scopus, regardless of the scientific specialty and relevant fields of science these journals are included in the HAC List, and whether they are included at all.

Taking into account the changes that have taken place, the editors and the publisher continue to publish articles on molecular biology (1.5.3), genetics (1.5.7), oncology, radiation therapy (3.1.6), radiation diagnostics (3.1.25), surgery (3.1.9), neurosurgery (3.1.10), pediatric surgery (3.1.11), cardiovascular surgery (3.1.15), plastic surgery (3.1.16), maxillofacial surgery (3.1.2), pathological anatomy (3.3.2), and clinical laboratory diagnostics (3.3.8) in the Russian Journal of Oncology.