Vol 8, No 3 (2025)

A subtype of breast cancer with co-expression of estrogen (ER), progesterone (PR) receptors and HER2 amplification, called triple-positive, has a special clinical significance. The biological feature of this subtype is cross-interaction of the ER and HER2 signaling pathways which leads to development of resistance to therapy through activation of the Ras / Mek / MAPK and PI3K / AKT cascades and manifests itself in a unique clinical course. Triple-positive breast cancer is characterized by an unfavorable prognosis and aggressive clinical course, but advances in drug therapy in recent decades have changed this paradigm. Therefore, accurate assessment of the status of hormone receptors and HER2 status plays a crucial role in the effectiveness of treatment of triple-positive carcinomas.

This article presents a comprehensive analysis of clinicopathological features, molecular characteristics, and diagnostic challenges of high-grade endometrial stromal sarcoma (HG-ESS). This rare and highly aggressive mesenchymal neoplasm is characterized by nonspecific clinical symptoms. The prognosis remains poor, with 5-year survival rates not exceeding 30–35 % and median progression-free survival ranging from 7 to 11 months. Three molecular subtypes of HG-ESS have been identified, each with distinct histopathological and immunohistochemical features: YWHAE-NUTM2A / B gene fusion, BCOR-rearranged, BCOR internal tandem duplication. The identification of these molecular subtypes carries significant diagnostic implications and opens new avenues for personalized targeted therapies. However, HG-ESS diagnosis remains challenging due to morphological variability, histological overlap with other uterine mesenchymal neoplasms, and technical limitations in biopsy specimen evaluation. Given the tumor’s aggressive behavior and diagnostic complexities, a multidisciplinary approach involving pathologists, clinicians, and experts in molecular diagnostics is crucial for accurate diagnosis and development of optimal treatment strategy.

Despite its rarity, vulvar cancer retains a high potential for reducing the quality of life of patients and poses serious challenges for doctors.

One of the central tasks of modern oncology is to improve efficiency of methods of early detection and monitoring of vulvar cancer. The most important instrument in solving this problem is diagnostic cytology based on the analysis of cellular material obtained directly from the area of the suspected lesion. The cytologic method is the most important diagnostic tool due to its high sensitivity and specificity, allowing to confidently recognize early signs of the transformation of normal epithelium into cancerous tissue.

The article considers modern views on brown tumor based on the data from international literature and an example from our practice. A case of brown tumor is described. The challenges of diagnosing brown tumor are discussed.