Journal of Volgograd State Medical University

Introduction: One indication for shoulder arthroplasty is gunshot wounds, up to half of which involve peripheral nerve injury, making rehabilitation and rehabilitation for this category of patients complex and time-consuming. Incorporating exercises with a passive upper limb exoskeleton into rehabilitation programs appears to be promising for addressing this issue. The purpose of the study: To analyze the first experience of using eхoskeletal orthoses in the complex rehabilitation of patients after shoulder arthroplasty. Research methodology: The habilitation and rehabilitation experience of four male patients with an average age of (41,4 ± 8,31) years after shoulder arthroplasty using a patented passive upper limb exoskeleton was analyzed. Goniometry and neurological status assessment were performed. Results: Four clinical observations showed that training using the author's design of a passive exoskeleton for the upper limbs for forty days led to compensation for the functions of injured supraspinatus muscles, allowing for the restoration of range of motion in the shoulder-scapular joints after endoprosthetics. In one patient, flexion and abduction in the replaced joint returned to normal. In the remaining patients, restoration of flexion to slightly limited level was achieved in two cases, while in one case, it was significantly limited. Abduction in the damaged shoulder joints was expanded to moderately limited in two cases, but in one case it remained significantly limited. Moreover, in all the injured patients, the rate of increase in the range of motion in the glenohumeral joints after endoprosthetics was 120.0–863.6 %, which, taking into account the current clinical experience, the medical history of the presented patients, short periods of habilitation and rehabilitation, should be considered a good result. Conclusions: The use of the author's design of a passive upper limb exoskeleton in the in habilitation and rehabilitation algorithms for patients after shoulder joint endoprosthetics due to gunshot wounds has shown a significant reduction in the time of functional recovery of damaged limbs.

Relevance: Delayed or failed fracture fusion is observed in 10% of patients. Autosteal plastic, despite its high efficiency, carries the risk of complication at the donor site. As an alternative, biomaterials are increasingly used in combination with the stromal-vascular fraction (SVF), which has osteogenic potential and availability for clinical use. The aim is a comparative analysis of the source of adipose tissue, methods of isolation of the stromal vascular fraction (SVF) and its clinical effectiveness in bone tissue regeneration. The systematic review includes 18 papers from the PubMed database for the period 2014–2024 that meet the criteria: 1) original clinical studies using SVF from human adipose tissue; 2) patients with bone defects of various etiologies; 3) description of the method of obtaining SVF and its qualitative and functional characteristics. The results of the research: It was found that the anatomical site of adipose tissue sampling does not affect the viability of the cellular composition of the SVF. The range of lipoaspirate volumes varies depending on the location and size of the bone defect: for cystic lesions – from 10 to 30 ml of fat, for spinal fusion – 40–60 ml, for sinus lifting – 125–250 ml, for osteochondral lesions of the talus – 140 ml, and for augmentation of shoulder fractures – an average of 270 ml. The choice of cellular dose depends on the volume and location of the damage. The therapeutic efficacy of a single-dose cellular dose is: for local defects – 1.5 × 10⁶ – 2 × 10⁷ cells; for extensive reconstructions – 4 × 10⁷ – 2.2 × 10⁸ cells (40 × 10⁶ cells / cm³ in a scaffold). Conclusion: The combined use of the SVF with biological and synthetic scaffolds (β-TCP, BCP, xenohybrid matrices) is safe and promotes more effective healing of complex bone defects. Randomized controlled trials are needed to standardize protocols and confirm clinical efficacy.

This literature review is devoted to the analysis of modern approaches to conservative treatment of partial rotator cuff tears (PRCT), which represent a common orthopedic pathology with a tendency to progression in the absence of timely intervention. Despite the development of surgical technologies, conservative treatment remains a priority direction at initial stages and in certain categories of patients, which necessitates the systematization of modern approaches to non-surgical management of this pathology. The aim of the study was to conduct a comprehensive analysis of modern methods of conservative treatment of partial rotator cuff tears with evaluation of their effectiveness and substantiation of rational therapeutic algorithms. A systematic review of scientific publications indexed in PubMed, Scopus, and Web of Science databases was performed, using keywords reflecting conservative treatment methods of rotator cuff injuries. The results of randomized controlled trials, meta-analyses, and systematic reviews devoted to pharmacological therapy, physical rehabilitation, local injection therapy, and innovative approaches were analyzed. Attention is paid to pharmacological approaches, including differentiated use of anti-inflammatory agents considering their mechanisms of action and safety profiles, which allows optimizing symptomatic therapy and minimizing potential risks. Modern principles of physical rehabilitation are considered, based on staged restoration of motor function through a combination of exercises aimed at increasing range of motion, strengthening muscle groups, and stabilizing the scapulohumeral complex. Options for temporary immobilization and functional orthosis, adapted to the degree of structural disorders and individual patient needs, are analyzed, which contributes to creating optimal conditions for reparative processes. Attention is given to the significance of local injection therapy with evaluation of the effectiveness of traditional preparations and orthobiological products. Prospective innovative approaches are analyzed, including the use of exosomes for biological stimulation of repair and exoskeletal systems for functional rehabilitation. The presented data demonstrate the clinical significance of a comprehensive conservative approach, which with rational combination of various therapeutic techniques allows achieving substantial reduction of pain manifestations, restoration of functional capabilities, and improvement of patients' quality of life. The necessity of personalized treatment protocols and interdisciplinary interaction for achieving optimal results in non-surgical management of this common shoulder pathology is particularly emphasized.

Introduction: Nickel oxide nanoparticles (NiO-NPs) are regarded as promising materials; however, the expansion of their applications requires detailed toxicological assessment in relevant experimental systems. In a range of models, nanostructured metal oxides have been shown to induce oxidative and inflammatory responses which, under certain conditions, may be involved in mechanisms of fibrotic remodelling. Macrophages act as early sensors of such exposures; therefore, analysing their functional response enables the characterisation of potential risks associated with NiO-NP exposure and provides a rationale for subsequent stages of safety evaluation. Research methodology: In this study, NiO-NPs were produced by a sol–gel method followed by thermal annealing at different temperatures. For further biological experiments, we selected the sample annealed at 450 °C, which exhibited the most reproducible nanoscale characteristics and was therefore considered optimal. Morphology and size parameters were assessed by electron microscopy, while phase composition and crystallite size were determined by X-ray diffraction, providing a comprehensive physicochemical characterisation of the tested material. Primary murine peritoneal macrophages were used as target cells. Cytotoxicity was evaluated using the MTT assay and morphocytological analysis, and the intensity of the cellular inflammatory response was assessed by measuring nitrite production with the Griess reagent. Results: The optimal NiO-NP sample was characterised by a predominantly nanoscale fraction and structural homogeneity, which supported its use in a cellular model for the assessment of biological effects. Exposure to NiO-NPs caused concentration-dependent impairment of macrophage viability. Marked cellular alterations were observed at high nanoparticle concentrations, whereas lower concentrations induced minimal signs of cellular damage or produced no detectable injury. In parallel, increased nitrite production was recorded, indicating activation of inflammatory mechanisms. Conclusion: Collectively, these data suggest that NiO-NPs may act as inducers of early cellular responses which, under unfavourable exposure conditions, could contribute to the development of a profibrotic tissue phenotype.

Purpose: To compare the effectiveness of different therapeutic options in monitoring patients with early-stage age-related macular degeneration (AMD). Material and methods: The study included 60 patients (120 eyes) aged 40–75 years, mean age (57,4 ± 1,4) years, with early-stage AMD according to the AREDS classification (stage 2) in four groups: the first – 15 patients (30 eyes) – used monofocal glasses for proximity and/or distance, the second – 15 patients (30 eyes) – progressive glasses; the third – 15 patients (30 eyes) – universal progressive glasses and Dietary Supplement Retinorm® 3 capsules 1 time a day with meals for 4 months; the fourth group – 15 patients (30 eyes) – universal progressive glasses and Retinorm® according the same scheme and physiotherapy with a «Visotronic M3» device of 10 procedures during the first two weeks at the beginning of monitoring. The methods of examination included: visual acuity testing, refractometry, tonometry, computerized static perimetry, Goldmann lens ophthalmobiomicroscopy, optical coherence tomography of the central part of the eye fundus with measurement of the thickness of the retina and the choroid in the foveal zone, and fundus autofluorescence examination in the macula area. All parameters were examined three times: before the start of treatment, one and four months after the start of monitoring. Results: No significant changes in the thickness of the retina in the foveal zone were recorded during the monitoring period in all groups. The choroid thickness significantly increased in progressive correction users (p < 0,05). The number of relative scotomas in the central part of the visual field significantly decreased compared to the initial level in progressive correction users who received trophic support with Retinorm® (p < 0,05). Conclusion: The use of progressive spectacle correction combined with the intake of Retinorm® and physiotherapy treatment using the «Vizotronik M3» device shows the most effectiveness by the end of the first month of monitoring for early-stage AMD. The effectiveness of therapy using Retinorm® in combination with progressive correction increases with an increase in the duration of supplementation to four months.

Determining the optimal methods for analyzing absolute and relative indicators of electromyograms (EMG) remains an urgent task in functional clinical dentistry. Objective: To evaluate the index values that determine the symmetry of the bioelectric activity (BEA) of the masseter muscles that lift the lower jaw in children with physiological occlusion of permanent teeth, based on electromyography data. Material and methods: A functional examination of the maxillofacial region was conducted in 78 children with physiological occlusion, in accordance with the requirements of the Local Ethics Committee. The patients were divided into 3 groups based on their chewing type. Group 1 included children with balanced chewing patterns. Groups 2 and 3 included children with masseterial and temporal chewing patterns, respectively. An electromyograph called “Synapsis” was used. The commonly accepted indices of symmetry of the temporal and masseter muscles, the masseter center, and the index of symmetry of the antimer muscles were evaluated during the “general chewing” test. Results and discussion: The sum of the biopotentials of the average amplitudes of the BEA of the temporal muscles on the right and left sides was (926.22 ± 43.86) μV, and the average amplitudes of the BEA of the masseter muscles on the right and left sides were (1014.42 ± 79.64) μV. The total average amplitude of the BEA of all the analyzed masseter muscles (IMPACT) was (1939.92 ± 349.28) μV. Thus, the temporal muscles accounted for (47.74 ± 1.13) % of the IMPACT value, while the actual chewing muscles accounted for (52.25 ± 1.13) %, and no significant differences were found between the two groups (p ˃ 0.05), indicating that the muscles were working evenly and that the chewing pattern was balanced. Conclusion: The results of the study showed that in addition to the absolute values of BEA, the assessment of relative values, in particular the symmetry indices of the antimer muscles and the masseter center, is particularly important when analyzing EMG. The symmetry index of the antimer muscles ranges from 75 % to 100 % and is characteristic of individuals with physiological occlusion. The masseter center value ranges from 75 to 100 % and indicates an balanced chewing pattern, where the BEA values of the temporal and masseter muscles do not differ significantly. A decrease in the indicator below 74 % determines the masseteric or temporal type of chewing, depending on the prevailing indicators of the masseteric or temporal muscles.

Objective: to study and compare the morphometric parameters of the hybrid layer in the region of cervical defects of non-carious and carious origin using 4th, 5th, and 7th generation adhesive systems during restorative dental therapy. Research methodology: A laboratory study was conducted on 54 extracted permanent teeth, divided into groups: intact (control group, n = 6), with carious lesions (n = 24), and with non-carious defects (n = 24). All specimens were standardized and allocated according to adhesive technique protocols (three-step 4th generation, two-step 5th generation, and one-step 7th generation) using a single type of composite resin. Following restoration of the defects, mesio-distal tooth sections with a thickness of (100 ± 10) µm were prepared. Morphometric parameters of the hybrid layer-thickness, homogeneity, and depth of adhesive penetration at the dentin/composite interface-were assessed using polarizing microscopy at ×200 magnification. Statistical analysis was performed using Student's t-test and the Mann – Whitney U-test with a significance level of p < 0.05. The results: Statistically significant differences were found between the groups. When using the 4th-generation adhesive, hybrid layer thickness was (8.76 ± 0.78) µm for carious and (6.23 ± 0.52) µm for non-carious defects, which most closely approximated the control values (15.24 ± 2.41) µm (p < 0.001). The 7th-generation adhesive demonstrated significantly lower values across all groups (2.41 ± 0.71) and (2.67 ± 0.82) µm, respectively) (p = 0.001; p = 0.002) and high variability (CV 29.46–30.71 %), indicating heterogeneity and instability of the hybrid layer. The 5th-generation system occupied an intermediate position in terms of thickness (3.65 ± 0.87) and (4.52 ± 1.15) µm. Сonclusion: The obtained data indicate the necessity of a differentiated selection of the adhesive system for the restorative therapy of cervical tooth defects of varying etiology, with due consideration for substrate morphology and clinical conditions.

Introduction: The study is devoted to studying the expression level of the transcription factor NF-kB in the dentate gyrus of rats, which acts as one of the key mediators in the pathogenesis of neuroinflammation and neurodegeneration associated with diabetes mellitus. The aim of the study was to characterize the expression of NF-kB in the dentate gyrus of 19-month-old rats using a model of diabetes and to evaluate the modulating effect of pharmacological agents (mefargine, aminalon, and succicard). Materials and methods: in aging rats aged 12 months, type 1 diabetes mellitus (DM) was modeled for 6 months by a single injection of streptozotocin (Sigma, USA) dissolved in citrate buffer (0.1 M, pH 4.5) at a dose of 60 mg/kg after 48 hours of food deprivation intraperitoneally. After reaching the age of 18 months, the animals were injected with GABA derivatives for 4 weeks: mefargine, aminalon and succicard. NF-kB was detected by immunohistochemical examination using primary antibodies to the NF-kB protein on paraffin frontal sections of the rat brain. Results: An immunohistochemical study revealed an increase in the expression of NF-kB, an immunoreactive material in the cytoplasm of pericaryons of neurons and the neuropile of the granular and subgranular layers in the dentate gyrus in rats with DM compared with intact animals, reflecting a profound violation of cellular homeostasis and activation of neuroinflammation in brain structures. Cells with a moderate expression level appeared in the cytoplasm of the pericaryons of the neurons of the granular layer, as well as in the neuropile of the granular layer and in the nerve cells of the subgranular layer. Whereas in the intact group, only a few cells had a weak expression level. In animals with DM, which were injected with the studied compounds (aminalon, mefargine, succicard), the expression of NF-kB-immunoreactive material decreased compared with the DM group without treatment. The restorative effect of the studied drugs confirms the expediency of their use for the correction of metabolic disorders in the brain in diabetes mellitus and aging.

Introduction: Adhesion formation following abdominal surgery represents a significant clinical problem affecting a substantial proportion of operated patients. The development of postoperative adhesions leads to pain syndrome, intestinal obstruction, and a reduced quality of life. Currently available barrier agents do not fully meet the requirements for an ideal anti-adhesion material, highlighting the need to develop novel topical dosage forms that combine prolonged biodegradation, adhesion to serosal surfaces, and biocompatibility. The aim of this study is to investigate the biodegradation patterns of an original topical dosage form under in vitro and in vivo conditions. Research methodology: A two-component topical dosage form was prepared, consisting of a film base composed of chitosan and gelatin (at a ratio of 1.25:0.75 with glycerol added as a plasticizer) coated with a mucoadhesive gel layer based on sodium carboxymethylcellulose at a concentration of 1.5 %. The in vitro degradation rate was assessed using 1 cm² samples fixed onto porcine intestinal segments and immersed in porcine blood plasma at 37 °C; the experiment was performed on six batches of six samples each. For the in vivo degradation study, serosal damage to the cecum was modeled in Wistar rats, followed by application of the dosage form samples. Results: Under in vitro conditions, complete loss of the topical dosage form integrity occurred at (133 ± 1.29) h with minimal inter-batch variability. In the in vivo experiment, by day 3 the topical dosage form had transitioned into a hydrogel state, and by day 7 it had completely degraded, accompanied by pronounced serosal regeneration. The barrier function duration (168 h) was comparable to that of Seprafilm and exceeded that of Interceed (72 h). Conclusion: The findings indicate that the topical dosage form based on chitosan, gelatin, and sodium carboxymethylcellulose exhibits controlled biodegradation ensuring a barrier effect throughout the critical period of adhesion formation, confirming its potential for further investigation.

Introduction: The relevance of mechanical complications in the transition areas of spinal metal fixation has been emphasized by the authors of numerous studies in recent years. Research objective: Construction of simplified models of 5 morphological types of PTC (Roussouly) with subsequent modeling of various options of metal fixation and evaluation of their deformation and strength properties under compression load in order to determine the optimal levels of instrumentation of the spine (UIV, LIV) and biomechanical predictors of mechanical complications. Research methodology: This study included screening a healthy population (169 volunteers) and selecting five individuals with reference pelvivertebral morphology for each Roussouly morphotype. These individuals underwent spinal CT scanning. The findings were used to create polygonal pelvivertebral models for five Roussouly morphotypes, which subsequently enabled building solid-state analogs simplified in form, but as close as possible in geometric parameters. These five pelvivertebral simplified models provided a basis for finite element (FE) simulations of transpedicular fixation (TPF), a total of 150 models, with subsequent study of their stress-strain behavior (SSB). We paid particular attention to the proximal – upper instrumented vertebra (UIV) – and distal– lower instrumented vertebra (LIV) – instrumentation boundaries. The resulting stress values were systematized and used for further analysis. Results: After systemizing the data of FE analysis in 150 TPF simulations we found that the high-risk areas for positioning the UIV, as well as the LIV, are the apex of thoracic kyphosis (Th6–Th8), the lower thoracic vertebrae (Th9–Th12), as well as the posterior supporting structures of lumbar vertebrae (L1–L2). However, the localization of these levels is closely related to the geometric pelvivertebral shape and features significant variability depending on the Roussouly sagittal morphotype. Our findings showed that pelvivertebral levels that concentrate high degrees of equivalent stress (more than 1.5 MPa) when UIV or LIV are positioned on them should be considered as areas of high biomechanical risk, and using these vertebrae as instrumentation boundaries turns them into predictors of proximal junctional kyphosis (PJK) / distal junctional kyphosis (DJK) deformities and proximal junctional failure (PJF) / distal junctional failure (DJF) mechanic damage. Conclusions: The biomechanical features of metal fixation transition areas (UIV, LIV) depend on their location and the geometric pelvivertebral shape (Roussouly). Instrumentation of the vertebrae with the deformation and strength properties that do not fit within the framework of the standard values determined by this study serves as a predictor of mechanical complications in metal fixation.

Diabetic neuropathic foot ulcers located in the region of the metatarsal heads present a significant clinical challenge due to their high recurrence rate with standard conservative treatment. The purpose of the study: To evaluate the clinical efficacy of minimally invasive distal subcapital non-fixated metatarsal osteotomy in the treatment of neuropathic foot ulcers (Texas Wound Classification 1A) in patients with type 2 diabetes mellitus. Research methodology: A prospective study (01.2022–06.2024) included 23 patients with type 2 diabetes and chronic neuropathic ulcers that had not responded to ≥6 weeks of conservative therapy. Under regional anesthesia, a 3 mm incision was made to perform a transverse metaphyseal osteotomy using a Shannon burr (2 mm, 2500 rpm, 0.8 Nm) under intraoperative radiographic control, followed by manual dorsal displacement of the head without fixation. Full weight-bearing in a specialized shoe was permitted postoperatively. The mean follow-up period was (14.2 ± 3.5) months. Efficacy criteria included: time to complete ulcer healing within 12 weeks, dynamics of pain syndrome according to the Visual Analogue Scale (VAS), quality of life index using the DFS-SF questionnaire, the radiometric parameter of dorsal elevation of the metatarsal head, as well as the frequency of complications and ulcer recurrences. The results of the study: Complete healing was achieved in 91.3 % of patients within an average of (4.2 ± 2.1) weeks. Pain on the VAS decreased from (6.8 ± 1.2) to (2.1 ± 0.8) points (p < 0.001), and quality of life improved by 42.5 % (p < 0.05). The mean dorsal elevation of the metatarsal head was (4.3 ± 1.2) mm (p < 0.001). The recurrence rate over 12 months was 8.7 %. Complications were noted in 21.7 % of patients (serious complications in 4.3 %). Conclusion: Minimally invasive distal subcapital non-fixated osteotomy demonstrated high efficacy in the treatment of resistant diabetic foot ulcers, providing rapid healing, significant pain reduction, improved quality of life, and pronounced biomechanical correction with a low recurrence rate. This method represents a promising minimally invasive alternative requiring further study of long-term outcomes.

Introduction: The relevance of studying sinus arrhythmia (SA) in young athletes is extremely high and is due to several key factors: the high frequency of occurrence in the pediatric population, the difficulties of differential diagnosis, the difficulty of establishing the causes and mechanisms of its occurrence in children involved in sports, as well as the extreme sensitivity of the child's body to autonomic regulation associated with the immaturity of the autonomic nervous system. On the one hand, sports activities enhance the normal SA for children, making it a more pronounced marker of good fitness and effective heart function, on the other hand, sports, especially at the professional level, can become a trigger for detecting hidden heart problems. The aim of our study was to evaluate the role of athletic activity in the development of sinus arrhythmia in children. Materials and methods: Clinical, instrumental [electrocardiography, ECHO cardiography, Holter monitoring, ECG with assessment of spectral parameters of heart rate variability] and laboratory [determination of the level of MV creatine phosphokinase (MV-CPK) activity in blood serum] examinations of 36 boys aged 5–6 years engaged in sports swimming, without participation, were conducted. There are also 18 boys of the same age who participate in recreational swimming. Results and discussion: In the course of the study, the peculiarities of the formation of bradyarrhythmia in children engaged in sports swimming were established. Bradyarrhythmia was not detected during recreational swimming. On the contrary, swimmers who did not have obvious signs of autonomic dysfunction syndrome showed moderate bradyarrhythmia due to athletic exertion. Also, in children from this group, the levels of MB creatine phosphokinase remained within the normal range. Thus, the assessment of laboratory and instrumental indicators can serve as an additional criterion for selecting children for sports, allowing us to develop more differentiated approaches to the training process as a whole. Conclusion: It has been established that CA in young swimmers can occur under the influence of vegetative influences and sports loads. At the same time, it often occurs against the background of asymptotic hypertension and low energy availability. To assess the tolerance of sports loads, it is important to additionally use the determination of MV-CK activity levels and spectral parameters of heart variability.

Introduction. Uterine fibroids are the most common benign tumor in women of reproductive age. By age 50, this pathology is diagnosed in 70 % of women, but only a quarter of them develop clinically significant symptoms. Giant fibroids (10–18 % of cases) deserve special attention, as they are accompanied by severe symptoms: chronic bleeding, anemia, and compression of adjacent organs, which significantly impairs quality of life and requires complex surgical treatment. The purpose of the study: To present a clinical case of symptomatic giant uterine fibroids, demonstrating diagnostic features and surgical approach. Research methodology: We analyzed the patient's medical history, clinical presentation, laboratory and instrumental examinations (ultrasound, MRI with contrast), and described treatment strategies taking into account the specific size of the tumor. Results: Patient P., 55, with a normal menstrual cycle, was hospitalized with complaints of a large abdominal mass and heavy menstrual flow. Examination revealed a giant uterine myoma measuring up to 25 cm (equivalent to 35–36 weeks of pregnancy), complicated by hemorrhagic syndrome with the development of anemia (hemoglobin 101 g/L) and compression of the ureters with bilateral hydroureteronephrosis. Following a consultation with a specialist from the Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatal Medicine, a decision was made to perform surgical treatment consisting of a midline laparotomy and extirpation of the uterus and appendages. The weight of the removed macrospecimen was 4115 g. Histological examination confirmed an intramural leiomyoma with degenerative changes and also revealed associated pathology: endometrial hyperplasia, chronic endometritis, and adenomyosis. The postoperative period was uneventful, and the patient was discharged on the seventh day in satisfactory condition. Conclusion: This clinical case demonstrates the unfavorable course of myomatous disease in the absence of timely follow-up. The enormous size of the tumor led to the development of multiorgan complications, requiring radical surgical intervention. This observation highlights the need for regular gynecological monitoring in perimenopausal women to ensure the timely detection and treatment of uterine myomas and prevent life-threatening complications.

Oncocytic neoplasms are extremely rare (approximately 1 % of all parotid gland tumors), and only 0.11–0.5 % of them are malignant, which accounts for less than 0.18–1 % of all malignant salivary gland tumors. Clinically, oncocytic carcinoma often presents as a slow-growing painless mass that may mimic a benign tumor. However, rapid growth, facial nerve involvement, or attachment to surrounding tissues should raise suspicion for malignancy. Treatment is primarily surgical, with adjuvant radiation therapy recommended for positive resection margins, perineural invasion, or high-grade malignancy. Objective: To describe a rare case of a patient with oncocytic carcinoma of the left parotid gland, followed and treated at the Voronezh Regional Scientific and Clinical Oncology Center. Results and discussion. Patient T., 66, presented with headache, shooting pain in the left lower jaw, and a dense, painless mass in the left parotid gland. Despite a combination of clinical and radiographic features suggesting a malignant tumor, a preoperative fine-needle aspiration biopsy revealed a benign tumor, making diagnosis difficult. However, a multidisciplinary team concluded that a malignant epithelial neoplasm was the differential diagnosis. Surgery, followed by histological examination, revealed an oncocytic carcinoma with invasion of the node capsule and perineural invasion. The second stage included external beam radiation therapy with a total focal dose of 60 Gy. Currently, one year after diagnosis and treatment, the patient is doing well, with no progression in the form of relapse or metastasis. Conclusion. Oncocytic carcinoma of the parotid gland presents significant diagnostic and therapeutic challenges due to its rarity, clinical and radiographic similarities to benign lesions, and the limited sensitivity of cytological methods. This case demonstrates the importance of a comprehensive approach integrating clinical, imaging, and histological data. Surgery with adjuvant radiation therapy is the most definitive approach. Long-term observation is necessary due to the risk of late recurrence and metastases.