Currently, treatment of patients with early primary operable BRCA mutation-associated breast cancer requires integrative approach. A mutation in BRCA1/2 genes is a prognostically unfavorable factor increasing the risk of cancer of the contralateral breast, as well as ovaries, pancreas, fallopian tubes, and primary peritoneal cancer. In this clinical observation, an integrative multidisciplinary approach to treatment of a young patient with luminal B breast cancer is described which allowed to preserve the patient’s fertility and achieve pregnancy using assisted reproductive technologies.

High effectiveness of the chosen treatment tactics in the framework of integrative approach in a specialized medical facility with experience in treatment of oncological diseases and preservation of reproductive function confirmed by clinical data and results of laboratory and instrumental exams is demonstrated.

Endoscopic trachea stenting is a pressing issue in modern endoscopy. This method is applied in various diseases including benign stenoses associated with complications after long-term mechanical ventilation, malignant stenoses (oncological diseases of the trachea itself, compression from outside by esophageal or mediastinal tumors), post-injury stenoses and developmental defects.

Currently, a certain contingent of patients exists for whom trachea prosthesis and its bifurcation remain the only possible option for stepwise or final treatment. If the lower third of the trachea, bifurcation zone or the main bronchi are affected, the optimal technique is stenting with Y-shaped stents which provide maximal patency of the airways.

Chronic pain syndrome developing in patients with oncological diseases significantly decreases their quality of life which makes effective integrative analgetic therapy a pressing issue. Currently, drugs of various pharmaceutical groups are used for pain management and administered subsequentially in accordance with the pain intensity visual analogue scale. For moderate and severe pain syndrome, opioid analgesics are used which have side effects limiting their use in some cases. Trials showed that new highly specific μ1-opioid receptor agonist tafalgin is characterized by high bioavailability, fast absorption, biotransformation, absence of accumulation which makes its safety profile favorable. Pronounced analgesic effect of tafalgin, as well as ease of administration and absence of significant adverse events, allow to significantly improve the quality of life of patients with chronic pain syndrome.

Combination of oncological and cardiological pathologies is a complex clinical problem requiring a multidisciplinary team of doctors for treatment of a patient. This article presents a case of successful treatment of a patient with serious concomitant pathologies.

During long-term autoimmune processes, most commonly in patients with Sjogren’s disease (SD), lymphoproliferative disorders (LPD) can develop. The risk of mucosa-associated lymphoid tissue lymphoma (MALT lymphoma) with involvement of parotid salivary glands is increased 1,000-fold compared to other immunomorphological variants. Some studies show that the main factors predisposing patients with SD to LPD are long-term enlargement of parotid salivary glands, generalized lymphadenopathy, cryoglobulinemic purpura. Application of an integrative approach to LDP diagnosis in patients with SD, identification of high-risk group for this malignant neoplasm promote its early detection.

A clinical observation of a female patients with long-term SD which was diagnosed along with MALT lymphoma using an integrative approach to diagnosis of both diseases is presented.

In the presented observation, a female patient with diagnosis of nodular lymphocyte-predominant Hodgkin lymphoma (advanced stages) received R-ABVD regimen therapy. Return of clinical symptoms observed at the onset of the disease, as well as renewed growth of the lymph nodes after 4th therapy cycle showed refractory disease. Considering the results of earlier studies, generally showing high effectiveness of primary treatment of patients with nodular lymphocyte-predominant Hodgkin lymphoma, reevaluation of immunomorphological type of lymphoproliferative disease was performed. After change of diagnosis to grade 3A follicular lymphoma, therapy was changed to obinutuzumab in combination with bendamustine leading to fast positive antitumor effect.