Frontal lobes are essential in making complex decisions and ensuring subtle social interactions. Importantly, patients with low-grade glial tumors often have no deficiency detected by standard neurological examination, but they may be completely unable to live a normal life in real world. The key principle in choosing surgical tactics for frontal lobe tumors is analysis of pathway with appropriate functional system adjacent to neoplasm and assessment of its functional safety before surgery. Research data on surgery for glioma near motor centers indicate that transient motor deficiency occurs in 30-90%, persistent deficiency - in 4-47% of cases. Intraoperative monitoring reduces the incidence of persistent deficiency (from 8.2% to 3.4%) and increases extent of resection (from 58% to 75%). To identify corticospinal tract, some studies demonstrate superiority of subcortical stimulation with monopolar probe and multipulse technique over bipolar stimulation. Importantly, complete disappearance of evoked motor potentials during transcranial stimulation is associated with high (up to 85%) risk of persistent motor deficit. New methods for «passive» mapping of speech function (corticocortical evoked potentials) reduce postoperative speech deficit. They are indicated in patients with contraindications for awake craniotomy.

Cavernous malformations of the corpus callosum are rare accounting for less than 1% of all subtentorial cavernous malformations. Clinical manifestations are usually caused by hemorrhage into adjacent parenchyma. Epileptic seizures are the most common. Multiple hemorrhages with progressive neurological impairment require surgical intervention.

Pharyngeal pituitary gland is a glandular structure located along the path of Rathke's pouch (along the midline under mucous membrane of the nasopharynx near the lower wall of sphenoid bone). The purpose of this study was to examine literature data on anatomy and physiology of pharyngeal pituitary gland, its possible relationship with extracranial ectopic pituitary adenomas, as well as to describe appropriate patient. Literary data confirm pharyngeal pituitary gland as a permanent human anatomical structure capable of release of all hormones similar to those of anterior pituitary gland. Functional significance of pharyngeal pituitary gland is unknown. However, it may be a source of ectopic adenomas in nasopharynx and skull base. These data are important for diagnosis in patients with endocrine disorders associated with malformations and ectopic pituitary adenomas.

The authors describe 3 patients with tentorial meningiomas (type T6-T7 according to classification by M.G. Yasargil) extending into transverse and sigmoid sinuses towards jugular vein. The authors also analyze foreign experience in the treatment of similar meningiomas and difficulties accompanying choice of treatment strategy for such patients. To preserve functionally significant brain structures and functional status, the authors performed subtotal resection and decompression of caudal nerves within jugular foramen in each case. Neurological symptoms partially regressed in postoperative period in all patients. In long-term follow-up, continued tumor growth in 2 out of 3 patients required redo surgery. Further research of multimodal treatment approach to such patients, including combination of surgery with stereotactic radiotherapy, seems perspective considering close relationship of such meningiomas with functionally significant brain structures, impossibility of safe simultaneous total resection and high probability of continued tumor growth after subtotal resection.

To create a prognostic scale for overall survival in grade 4 astrocytomas based on molecular biological data.

Posterior petrous meningiomas (PPM) are located anterior and posterior to internal auditory meatus. Their relationships with cerebellopontine angle are variable, and they present with various symptoms.

Thyroid nodules in children are relatively rare; the risk of malignancy is considerably higher compared to adults. The optimal extent of surgery, the indications for radioactive iodine therapy (RAI), and the role of molecular genetic testing in children with thyroid carcinoma remain a matter of debate.

The basis of the vital activity of each cell of the body is energy metabolism, necessary for the implementation of physiological needs in norm and pathology. The most important pathways for the synthesis of adenosine triphosphate are glycolysis, the tricarboxylic acid cycle and oxidative phosphorylation. Glucose, free fatty acids and amino acids can be used as a substrate for obtaining energy. As the disease develops, reprogramming occurs in cells with the ability to switch between energy pathways and the choice of its sources, forming a specific metabolic phenotype that ensures cell survival and the formation of clinical characteristics of the disease. The availability of information on pathophysiological changes at the level of cell metabolism is of scientific and practical interest in relation to the development of methods for accurate diagnosis and the choice of personalized tactics in each specific case. This review describes the characteristics of energy metabolism in normal and tumor cells. It also provides information on modern methods for assessing energy metabolism in the body.

Neurofibromatosis type 1 (NF1) is a multisystem genetic disorder associated with a lifelong increased risk of tumor development. Comprehensive monitoring of patients with NF1, involving a multidisciplinary team of specialists and the implementation of screening programs, is crucial for the early detection of associated pathological conditions that contribute to disability and reduced life expectancy. This article presents a clinical case of an adolescent female patient with tumor manifestations of NF1, in whom both diagnosed neoplasms - plexiform neurofibroma and pheochromocytoma, had a symptomatic course, significantly affecting her physical health and quality of life. A multidisciplinary approach and correct treatment led to favorable outcomes, enabling the patient to resume a normal lifestyle, despite the continuation of targeted therapy.

TRPS1 (Tricho-rhino-phalangeal syndrome type 1) - a transcription factor of the GATA family, has recently emerged as a promising immunohistochemical marker for breast cancer. This review summarizes current data on the diagnostic, prognostic, and potential therapeutic relevance of TRPS1, as well as its molecular functions and expression patterns across different breast cancer subtypes. TRPS1 demonstrates high sensitivity, including in diagnostically challenging cases such as triple-negative and poorly differentiated carcinomas, where traditional markers (GATA3, mammaglobin) may be absent or weakly expressed. The advantages of TRPS1 in the differential diagnosis of metastatic lesions and its possible role in prognostic panels are highlighted. Methodological limitations of the using marker, standardization needs and future perspectives for clinical implementation are also discussed in article.

The genes of mismatch repair system (MMR) are responsible for correcting errors in DNA replication. MMR defects (dMMR) lead to mutations in microsatellites - repetitive nucleotide base sequences - resulting in microsatellite instability (MSI). Determination of dMMR/MSI status in tumors is an important factor for the development of patient management tactics, as the dMMR/MSI phenotype serves as both a marker of favorable prognosis and a predictor of response to immunotherapy in tumors of many localizations. MMR status is assessed via immunohistochemistry (IHC) on histological material. However, in some cases heterogeneity of intratumoral MMR protein expression (MMR heterogeneity) becomes an obstacle to this. MMR heterogeneity (areas of weak/absent staining on the background of normal expression) is poorly studied, especially in gastric cancer, in contrast to colorectal cancer and endometrial cancer. The lack of a methodology for interpreting this phenomenon leads to significant difficulties in stratifying patients who are indicated for dMMR/MSI status determination. The article systematizes current data on MMR heterogeneity in gastric cancer and tumors of other localizations, discusses molecular mechanisms, clinical significance and recommendations to overcome diagnostic limitations.

Breast tumors are one of the most common locations of malignant neoplasms. Every year, new aspects of the pathogenesis of breast cancer are discovered; along with genetic, hormonal and other factors, the issue of implantation and metastatic damage to the organ by tumors of other localizations is being increasingly discussed. With evolving diagnostic methods, more and more reports are emerging indicating that sometimes a breast tumor is not a primary lesion, but a site of metastasis. In this paper, the authors present a clinical case of metastasis of endometrioid adenocarcinoma of the endometrium to the breast. In this paper, the authors present a clinical case of metastasis of endometrioid adenocarcinoma of the endometrium to the mammary gland. The final diagnosis was made through analysis of a combination of morphological and immunohistochemical features. This clinical case is unique from a clinical and pathological perspective.

This study analyzes the modern (2021) WHO classification of lung tumors and reviews publications in Russian and English from databases including PubMed, Google Scholar, ClinicalTrials.gov, eLibrary, and CyberLeninka. The aim of this review is to identify key changes in the 2021 WHO classification compared to the 2015 edition and assess their significance for the diagnosis and personalized treatment of non-small cell lung cancer. Special attention is given to the handling of small biopsy specimens, which requires an integrated approach involving morphological examination, immunohistochemistry, and molecular genetic testing.

To evaluate changes in gene expression activity during preoperative testing for tumor hormone sensitivity to aromatase inhibitors and tamoxifen in postmenopausal women with ESR+/HER2- breast cancer.

Study of morphometric and ultrastructural features of follicular adenomas of the thyroid gland.

One of the key differences between ovarian borderline serous tumors and low-grade serous carcinoma is the pattern of extraovarian tumor spread. Therefore, accurate diagnostics of the peritoneal implant's histotype plays a crucial role in treatment and disease prognosis. Despite established histological criteria for differential diagnosis, the classification of implant type remains subjective, and the interobserver reproducibility among pathologists is still understudied.

To improve the stratification algorithm for aggressive B-cell lymphomas in children based on the analysis of genetic changes in the genes TP53, MYC, BCL2, BCL6 and the long arm of chromosome 11 (11q).

The interest in neoadjuvant chemotherapy (NACT) for resectable ductal pancreatic cancer (PC) has increased significantly in recent years, primarily due to unsatisfactory long-term outcomes in these patients. However, oncological rationale for this approach is currently interpreted controversially. Routine NACT for resectable PC remains controversial due to the lack of uniform standards for regimens and number of drug therapy courses, selection criteria, high incidence of chemotherapy-related complications, toxicity, no evidence of benefit for all patients and risks of tumor transition to inoperable category due to delayed surgery. This review is devoted to effectiveness of NACT for resectable PC. The limitations of NACT and biological factors reducing its effectiveness are identified. NACT should not be considered as a standard for resectable PC without individual approach. The main tasks for future research should be criteria for selecting patients for NACT and standardized optimal regimens and number of chemotherapy courses.

To analyze the results of transanal endoscopic and robotic microsurgery for rectal neoplasms.

Gliomas are among the most aggressive primary brain tumors characterized by extremely poor prognosis. Despite standard therapy including surgery, radiotherapy and chemotherapy, median survival remains extremely low. The main obstacles to effective treatment are tumor heterogeneity, blood-brain barrier and difficult targeted delivery of therapeutic agents. This review examines potential of aptamers as an alternative to traditional approaches. A particular attention is paid to mechanisms of aptamer cross-breeding and cellular internalization, particularly receptor-mediated endocytosis. The last one is essential for efficient penetration of these molecules into tumor cells. Analysis of current data demonstrates that aptamers specific to glioma cell surface markers not only provide highly accurate tumor imaging but also open new opportunities for target delivery of therapeutic agents. It is a promising tool for personalized glioblastoma therapy.