Pirogov Russian National Research Medical Research Articles

Erratum in "Point-of-Care Blood Glucose Testing: Post-Market Performance Assessment of the Accu-Chek Inform II Hospital-Use Glucose Meter" (DOI: 10.26442/00403660.2023.12.202522)

In the article "Point-of-care blood glucose testing: post-market performance assessment of the Accu-Chek Inform II hospital-use glucose meter," published in the Terapevticheskii Arkhiv journal, Vol. 95, No.12, 2023 (DOI: 10.26442/00403660.2023.12.202522), errors were made: the term "measurements at the place of treatment" was changed, as well as the section "Conflict of interest." At the request of the authors' team, errors in the conflict of interest and the wording of the term have been corrected, and the section "Information about the authors" has been updated. The publisher replaced the original version of the published article with the corrected one; the information on the website was also corrected. Correct text of the section "Conflict of interest": Conflict of interest. All authors are not employees or consultants of Roche Diagnostics and have not received any compensation from Roche Diagnostics. Correct wording of the term in Russian: "измерения по месту лечения". Changes were made to the title of the article in Russian: "Измерения глюкозы по месту лечения: пострегистрационное испытание госпитального глюкометра Акку-Чек Информ II", the text of the abstract, keywords, citation, in the text of the article, and abbreviations. Information of the place of work has been updated: Center for Laboratory Diagnostics of the Russian Children Clinical Hospital, a Branch of the Pirogov Russian National Research Medical University. The publisher apologizes to readers and authors for the errors and is confident that the correction of errors will ensure the correct perception and interpretation of the results of the study described in the text.

To 110th anniversary of cardiac surgeon and researcher Igor N. Meshalkin

Igor N. Meshalkin (1913–1996) was Soviet cardiac surgeon, Dr. Sci. (Medicine). He was a graduate of the 2nd Moscow State Medical Institute (2nd MSMI, now the N.I. Pirogov Russian National Research Medical University). He was a participant in the Great Patriotic War. Igor N. Meshalkin began his professional career as a medical resident and an assistant of the clinic of faculty surgery in the 2nd MSMI since 1947; then as a medical resident of the Main Military Hospital of the Armed Forces of the USSR since 1951 and an assistant of the general surgery department of the pediatric faculty in the 2nd MSMI since 1954. In 1958–1963, he headed the Department of Acquired Heart Diseases in the Institute of Experimental Biology and Medicine (now the E.N. Meshalkin National Medical Research Center). In 1963–1977, Igor N. Meshalkin was the head of the department in the Central Clinical Hospital of the 4th Main Directorate of the USSR Ministry of Health. His research interests were focused on urgent abdominal surgery, thoracic surgery, mitral stenosis surgery. Igor N. Meshalkin was the author of 55 scientific works including two monographs. Received 8 November 2023. Accepted 14 November 2023. Funding: The study did not have sponsorship. Conflict of interest: The authors declare no conflict of interest. Contribution of the authors: The authors contributed equally to this article. Acknowledgment: The authors would like to thank Marina, daughter of Igor N. Meshalkin, for providing personal documents and photographs.

Vitamin D and Geriatric Assessment: A Cross-Sectional Study on the Cohort of Centenarians in the Central Region of Russian Federation

Background. The trend towards aging of the population is global, which makes the study of etiology, prevention and treatment of age-related disorders relevant. Increasing number of studies highlights the influence of 25-hydroxyvitamin D deficiency on health state in older people, as well as its correlation with geriatric syndromes prevalence. However, at the moment it is not known whether these patterns persist in patients older than 90 due to the limited number of studies on this population.Aim. To assess the prevalence of vitamin D deficiency in a cohort of centenarians in the central region of Russian Federation and to study its relationship with the presence of geriatric syndromes.Materials and methods. The study was carried out by Russian Gerontology Research and Clinical Centre of Pirogov Russian National Research Medical University and Center for Strategic Planning and Management of Medical and Biological Health Risks. It was a cross-sectional study on the cohort of centenarians (90 years and older). Complex geriatric assessment was performed. Complex geriatric assessment included past medical history, geriatric scales and questionnaires (MMSE, SARC-F, MNA scores). Blood samples were taken to assess the 25-OH vitamin D levels using chemiluminescence method. The study is reviewed by the ethics committee (№ 30 24.12.2019). The statistical analysis was performed using Python version 3.9 and R version 4.1.3.Results. The study included 3,235 people aged 90 to 107 years. Median level of 25-hydroxyvitamin D was 9 ng/ml, 86.7% of participants were found to be 25(OH)D deficient, and in 8.3% insufficiency 25(OH)D was detected. Using the intergroup analysis, the association between 25-OH vitamin D levels and some geriatric syndromes, such as malnutrition, sarcopenia and cognitive impairment was observed. However, after adjusting to physical activity and nutrition statistically significant association was demonstrated only for cognitive impairment.Conclusion. The results obtained on the association between low levels of 25-OH vitamin D and cognitive impairment among centenarians confirm the importance of vitamin D deficiency prevention and might be starting point for future studies.

E-Health Training of Medical Specialists in Russia

Purpose. The article discusses the improvement of e-Health training of medical specialists in Russia, and the challenges that doctors face when working with different health information systems. 
 Methodology. The study used both qualitative and quantitative data of the online survey conducted during the primary case study. Online survey targeted students of the Department of Medical Informatics and Cybernetics of N.I. Pirogov Russian National Research Medical University and doctors who were receiving initial training under the e-Health advanced training program. The survey aimed to determine systemic challenges and demand for training in various medical information systems. 
 Findings. Research data suggest that in order to bridge the digital gap, educational and training programs should include training versions of medical information systems used in Russian practical healthcare (electronic document flow system, EMIAS, Statistica, Sotsstrakh, Retsipient, etc.). It will enable doctors to enhance their theoretical and practical skills, abilities and knowledge, thus improving the quality of educational and work processes. Practicing health specialists who not only possess the theoretical knowledge, but also actively work in these areas (temporary disability examination, evaluation of medical care quality, work with citizens' appeals, compilation of numerous statistical reports, etc.) should be involved as mentors in the educational process. Simultaneous connection under the same login and password from multiple devices should be restricted to protect personal data and increase the security level of electronic document management systems in Russia.

Parallels between clinical and genetic characteristics in children with primary ciliary dyskinesia

Primary ciliary dyskinesia (PCD) is a rare genetic disorder that leads to chronic inflammatory damage to the airways and auditory organs. This article presents current information and a study aimed at investigating parallels between the course of PCD and clinical and genetic variant of the disease, which contributes to a timely diagnosis and enables personalized treatment approach.The aim of the study was to identify phenotypic characteristics and chronological patterns of PCD course depending on the genotype.Methods. The study was conducted at the Veltischev Research Clinical Institute of Pediatrics and Pediatric Surgery of the Pirogov Russian National Research Medical University (Pirogov Medical University), Ministry of Health of Russia. The study included children with PCD who underwent next generation sequencing (NGS) of the exome.Results. Significant differences were found in the course of PCD based on clinical and genetic characteristics. Children with defects in the genes encoding central pair proteins are characterized by an earlier onset of daily productive cough and recurrent respiratory infections. A similar pattern is typical for patients with defects in the genes encoding the cilia assembly proteins. The first episode of respiratory infection occurs later in patients with defects in the genes encoding dynein handle proteins. Patients who do not have defects in PCD-associated genes are characterized by a late onset of persistent difficulty in nasal breathing, productive cough and respiratory diseases.Conclusion. Identification of clinical and genetic variants of PCD allows prediction of chronological features of the course of the disease.

Experience in managing the process of continuing medical education of medical workers in public health and health care

Introduction. The problem of continuous professional development of medical specialists with higher and secondary medical education is especially relevant at the present stage, when medical knowledge, technologies, and drugs are being improved every day. 
 Purpose. Analysis of the forms of conducting cycles of continuous medical education in the field of health care management and public health at the Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation for the development of the most popular and perfect form of its implementation.
 Materials and methods. An analysis of the main directions of the mnagement of the process of continuous medical education of medical workers in general and in public health and health care in the Federal State Autonomous Educational Institution of Higher Education of the Russian National Research Medical University named after N.I. Pirogov of the Ministry of Health of the Russian Federation. 
 Results. Since 1977 a continuous medical education was started in the USSR. A course for advanced training of doctors in social hygiene was opened at the Department of Social Hygiene and Health Organization of the 2nd Medical Institute. Within the framework of the specialty “Organization of Health Care and Public Health”, the department conducted cycles of professional retraining (PP-504 hours), advanced training: 144 hours (PC-144), 72 hours and 36 hours. Continuing medical education is aimed at obtaining the competencies necessary to perform a new type of professional activity. The plans for further improvement of continuing medical education by the department provide for the renewal of work programs, the creation of distance and new relevant cycles.
 Limitations of the study. An analysis of professional retraining cycles of students of various durations for the acquisition of new qualifications, qualitative expansion of the field of knowledge, skills and abilities in the period 2017–2022 was carried out. 
 Conclusion. The presented data indicate the expediency of managing advanced training within the framework of the specialty “Organization of Health Care and Public Health” using short cycles of advanced training of full-time and distant forms of training of students.

Обращение ректора РНИМУ имени Н.И. Пирогова академика С.А. Лукьянова

Message from the Rector of the Pirogov Russian National Research Medical University, Academician S.A. Lukyanov.

Research-to-practice conference as a component of improving knowledge and mastering professional competencies by medical students and young scientists

Aim. To evaluate the importance of certain aspects of research-to-practice conferences, organized by the Department of General Practice of Pirogov Russian National Research Medical University, as well as its contribution to preparing students for future professional activities within the outpatient healthcare and the impact of these events on the interest of participants and speakers for research work.Material and methods. An anonymous online survey included 37 participants in the discussed conferences regarding the respondents’ motivation to attend conferences, assessment of declared subject coverage, the practical applicability of the knowledge gained and other aspects.Results. The most important motivating factors for conference participation were interest in outpatient healthcare (52,4% for the conference "Internal diseases at the prehospital stage" and 87,5% for the conference "A multimorbid patient — continuity between hospital and clinic"), analysis of interesting cases (66,7% and 75%, respectively) and multidisciplinary focus of activities (47,6% and 68,8%). An important aspect was the coverage of current problems of practical healthcare. The most important results were considered by the majority of participants to be expanding their medical horizons (85,7% and 87,5%) and gaining new knowledge on the declared subject (90,5% and 75%). Almost half of the respondents (52,4% and 56,3%) improved their interest in scientific activities as a result of visiting the conferences.Conclusion. Conducting research-to-practice conferences for students, residents and postgraduates serves as a platform for increasing the knowledge and mastering professional competencies. The results of a survey of conference participants and speakers indicate the relevance of involving students in conferences and the numerous benefits they receive, which are discussed in detail in this article.

Georgii S. Bom — the founder of the Department of Traumatology, Orthopedics and Military Surgery of Pirogov Russian National Research Medical University

Georgii S. Bom was the founder of the Department of Traumatology, Orthopedics and Military Surgery of Pirogov Russian National Research Medical University. In 2023 the Department celebrated its 90th anniversary. Prof. S. Bom was also one of the founders of the Moscow orthopedic school and specialized in the treatment of pediatric orthopedic diseases, as well as bone and joint tuberculosis. He developed a number of original surgeries, in particular, an intervention for hallux valgus, which was called «Bom’s surgery». He offered a classification of all types of clubfoot, which is still used in orthopedics. Prof. G.S. Bom is the author of several monographs and a large number of scientific articles.

Клинические проявления и дифференциальная диагностика редкой формы наследственной дисплазии соединительной ткани - синдрома вялой кожи (сutis laxa)

Article is devoted to one of the rare forms of monogenic connective tissue disease, Cutis Laxa with an autosomal recessive type of inheritance (ARCL1C), the Urban-Rifkin-Davis syndrome. The bibliographical data on this disease and the medical records of a 6-year-old male pediatric patient who was observed at the Clinical Genetics Department of the Research and Clinical Institute of Pediatrics named after Academician Yuri Veltischev with the Pirogov Russian National Research Medical University (Moscow, Russia) are presented. In addition to skin lesions, the child had disorders of the cardiovascular, respiratory and urinary systems. The diagnosis was confirmed by the DNA diagnostics results: the two mutations in the compound heterozygous state were found in the LTBP4 gene: the variant rs397515430 p.1342C>T previously described in the scientific sources in exon 11 leading to a stop codon and premature termination of translation - p.Arg475Ter; the second variant, not previously described in the literature, was found in intron 4 - c.452-22A>C. A differential diagnosis with other phenotypically similar diseases was carried out. Further medical supervision of the patient should be carried out with the mandatory involvement of the pulmonologist, the cardiologist and the nephrologist.

НОВООБРАЗОВАНИЯ У ДЕТЕЙ С СИНДРОМОМ КОСТЕЛЛО: ОПЫТ РОССИЙСКОЙ ДЕТСКОЙ КЛИНИЧЕСКОЙ БОЛЬНИЦЫ

Costello Syndrome is an extremely rare genetic disorder caused by a mutation in the HRAS gene that encodes for a highly active protein that in its turn affects the cell growth and division. Patients have a unique phenotype and multiple developmental abnormalities that suggest the anomaly from the first days of life. The important feature of the disease is a predisposition to the development of neoplasms, both benign and malignant. This fact must obligatory be taken into consideration by physicians who are treating children with Costello Syndrome. Authors present the three clinical cases of children with Costello Syndrome coupled with neoplasms who underwent treatment at the Department of Surgical Treatment Methods of Oncology with the Russian Children's Clinical Hospital with the Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia (Moscow, Russia). The Authors’ experience in treating these patients, including a risk-adapted approach to therapy and early removal of detected formations, can be considered successful as yet. The descriptions of these clinical cases are of scientific and practical interest not only for pediatric oncologists but also for pediatricians, neurologists, cardiologists and other specialists due to the rarity of Costello Syndrome as they contribute to the formation of oncological vigilance.

Centennial experience of the work of the Department of Public Health and Healthсare named after Academician Yu.P. Lisitsyn

Public health and healthcare is an educational and scientific discipline that studies the state of health of the population depending on the environment, lifestyle, and organization of medical care and develops medical and social measures for disease prevention and health improvement of citizens. The department, which solves educational, pedagogical, and scientific problems of social hygiene, was organized in 1924 at the second Moscow State University (Department of Public Health and Public Health named after Academician Y.P. Lisitsyn at the N.I. Pirogov Russian National Research Medical University). The social and hygienic research carried out at the department made it possible to develop and describe the basic principles of Soviet healthcare. In 100 years, 200 dissertation studies have been conducted at the department.
 The Department has always been a model in all areas of activity thanks to its leaders — famous scientists, highly erudite teachers, leading organizers of health care and well-known public figures: Z.P. Solovyov, G.A. Batkis, G.B. Getsov, O.V. Grinina, Yu.P. Lisitsyn.

Academician Viktor Sergeyevich Savelyev (1928–2013) (on the 95th anniversary of his birth)

Outstanding surgeon, scientist, teacher and organizer of healthcare, founder of a large surgical school, Hero of Socialist Labor (1988), academician of the USSR Academy of Medical Sciences (1974), RAMS (1991) and RAS (1997), laureate of the USSR State Prize (1975), the State Prize of the Russian Federation (1992), Demidov Prize (2002) and the A. N. Bakulev Prize (2002), Professor Viktor Sergeevich Savelyev was born on February 24, 1928 in the village of Pakhotny Ugol of the Bondarsky district of the Tambov region in the family of Sergei Dmitrievich Savelyev, a wood sawmill worker, and Olga Kuzminichna, a housewife. In 1945, Viktor Sergeevich entered the 2nd Moscow Medical Institute (now the Pirogov Russian National Research Medical University). After graduating in 1951, he studied in residency at the Department of Faculty Surgery, which was headed by the academician A. N. Bakulev, and was stayed at the department as an assistant. After defending his PhD thesis in 1955, he was appointed a teacher. In 1959, V. S. Savelyev successfully defended his doctoral dissertation, in 1961, he passed the academic title of Professor, in 1967, he was elected the head of the Department of Faculty Surgery. Viktor Sergeevich fully became the successor of A. N. Bakuleva and made the very great contribution to the development of domestic cardiac surgery. The works of V. S. Savelyev played a huge role in the formation and rapid development of vascular surgery. The clinic he headed has accumulated the world’s largest experience in the treatment of acute thrombosis and embolism of the main arteries. Viktor Sergeevich is rightfully one of the founders of modern Russian phlebology. He also made a significant contribution to the development of surgery of the stomach, intestines, bile ducts and pancreas. He was one of the first in the country to use organ-preserving operations on the stomach for complicated duodenal ulcer. Many of Viktor Sergeevich’s works were devoted to various aspects of postoperative management of patients, infusion therapy and parenteral nutrition, pathogenesis, diagnosis and treatment of sepsis. V. S. Savelyev and his students made a significant contribution to the development of abdominal endoscopy. V. S. Savelyev was a major organizer of domestic healthcare, for 34 years he held the post of the chief surgeon of the Ministry of Health of Russia. He was the Chairman of the Scientific Society of Surgeons of Russia (ROH), founder and president of the Russian Association of Phlebologists, editor-in-chief of journals «Thoracic and Cardiovascular Surgery» and «Phlebolymphology». Under his leadership and with his participation as the scientific consultant, 70 doctoral and 180 candidate dissertations were defended. He was the author and co-author of more than 500 scientific papers, including 24 monographs and manuals. The academician Viktor Sergeevich Savelyev died on December 25, 2013 and was buried in Moscow at the Troyekurovo Cemetery.

Chronicles of A.I. Pospelov Moscow Society of Dermatovenerologists and Cosmetologists (MSDC was founded on October 4, 1891) 
 Bulletin of the MSDC meeting N 1153

On June 20, 2023, the 1153rd meeting of the Moscow Society of Dermatovenerologists and Cosmetologists named after A.I. Pospelov took place.
 The meeting was held in a "face-to-face" format. There were 86 participants in total. Applications for membership in the Moscow Society of Dermatovenerologists and Cosmetologists named after A.I. Pospelov were not submitted. Elections of delegates to the XXIII Congress of Dermatovenerologists and Cosmetologists of Russia (Corresponding member of the Russian Academy of Sciences, Professor O.Y. Olisova, Professor E.S. Snarskaya, Professor O.B. Tamrazova, Associate Professor A.B. Yakovlev, assistant I.S. Maksimov, doctor V.V. Savenkov) and nomination of candidates for the position of the President of the All-Russian Public Organisation "Russian Society of Dermatovenerologists and Cosmetologists" were held (Academician of the Russian Academy of Sciences A.A. Kubanov).
 Two reports are presented in the clinical part of the meeting: (1) paraneoplastic bullous dermatoses (Sechenov University); (2) Otto–Moncorps keratosis (Sechenov University).
 Reports were made in the scientific part of the meeting: (1) mycobacterial infection combined with skin mycoses in patients with HIV infection: diagnostic issues (Sechenov University, Pirogov Russian National Research Medical University); (2) under the "mask" of a scar (Sechenov University).

Current directions of the department of hygiene, faculty of pediatrics, pirogov russian national research medical university (115th anniversary of the department)

The paper provides the analysis of the research and practical work done at the Department of Hygiene, Pirogov Russian National Research Medical University, for the period between 2018 and 2023 aimed to determine the today’s directions of the Department and demonstrate their relevance, scientific and practical significance; prospective directions of further research are defined. Statistical data processing was performed using the Statistica 13 PL software and the tag (word) cloud service. Staff of the Department did extensive educational and methodological, organizational and methodological, expert and consulting, research work (paragraphs 1, 2, 3, 4, 5, 6, 8, 9, 10, 11, 12 of the academic passport for the specialty 3.2.1. “Hygiene”); a total of 10 textbooks and three toolkits, three guidelines, two software products, one patent for invention and 39 database certificates, 11 collective monographs were published; two hygienic standards were approved; the activity outcomes were presented during 95 scientific and practical events, including that with international involvement. A total of 150 articles were published: 46 in the journals indexed in international databases (Scopus, Web of Science), 58 in the journals indexed by HAC under the Ministry of Education and Science of the Russian Federation, one in the Nature journal. Two candidate and two doctoral theses on the specialty 3.2.1. “Hygiene” were prepared and defended. The activity outcomes provided helped to address the hygienic challenges currently faced by professional community to achieve the national goals of the Russian Federation in the fields of demography, public health and digitalization.

The becoming and development of the academic subject and scientific discipline "public health and health care organization" (to the centenary of the academician Yu. P. Lisitsyn Chair of Public Health and Health Care). Report I (beginning of XX century - 1963)

The article presents analysis of becoming of academic subject and scientific discipline "Public Health and Health Care Organization" in Russia from beginning of the 20th century to 1963. The special attention was paid to the role in their becoming and development that played the Chair of Public Health and Health Care Organization of the Pirogov Russian National Research Medical University that is celebrating its centenary in 2023-2024 academic year. The contribution into this process of its prominent scientists and heads is considered.

Aging Research Biobank: First Results — Russian Gerontology Research and Clinical Centre, Pirogov Russian National Research Medical University

This article describes the creating and first results of Aging Research Biobank affiliated with the Institute for Research on Aging, Pirogov Russian National Research Medical University. The Biobank was created to preserve, store and use of various biological species — such as blood, serum, plasma, saliva, gut microbiota and others. These samples are used to conduct research on age-related changes and associated diseases. The article represents in detail the sample collection and storage process, carried out in strict compliance with international standards and recommendations. Each stage of the Biobank operation is supervised by a team of professionals, controlling the quality of biological materials to reduce the risk of errors and damage when collecting and storing of samples. The paper also presents the first results from studies using biological material stored in the Biobank. They make important contributions to the scientific understanding of various aspects of the aging process and age-related diseases. These studies can help identify and analyze the mechanisms of age-related changes, thereby developing new methods to prevent and treat age-related diseases. The creation of the Biobank and its operation also contribute to improving the quality of healthcare and scientific developments in the field of age-related disease research.

Kaposiform hemangioendotheliomas and tufted angiomas: Sirolimus for treating children

Introduction. Kaposiform hemangioendothelioma (KHE) and tufted angioma (TA) are extremely rare vascular tumors characterized by pathologically progressive angiogenesis and lymphangiogenesis. They are also associated with the development of the KazabachMerritt Phenomenon (KMP; Kasabach-Merritt Phenomenon).Material and methods. 8 patients (5 boys, 3 girls) with kaposiform hemangioendothelioma (two out of them with Kazabakh-Merritt syndrome) and 4 patients (3 boys, 1 girl) with tufted angioma were treated at the Russian Children's Clinical Hospital of Pirogov Russian National Research Medical University (Moscow, Russia) . All patients were prescribed Sirolimus therapy for antiproliferative purpose.Results. In all children, positive changes were registered: reduction of vascular tumor volume, gradual improvement of clinical picture and control of complications: pain syndrome, KMP, improvement or restoration of functions in affected organs /systems (increase/restoration of movement volume in joints, compensation for length discrepancy in lower legs). Complete resorption of vascular tumors and clinical symptoms were registered in 3 patients.Conclusion. The obtained encouraging results after Sirolimus therapy prescribed for treating KME and TA allow the authors to recommend this therapy to patients with KME with or without KMP and TA. However, further researches with a large sample of participants is required to confirm the obtained results.

To the сentenary of the department of maxillofacial surgery and dentistry of the Pirogov Russian National Research Medical University

The article is devoted to the transformation of the scientific directions of the Department of Maxillofacial Surgery and Dentistry of the Pirogov Russian National Research Medical University over a 100-year period of development, the history of the creation of the first department of this profile in Russia, modern work on clinical bases.

ШЕЙНАЯ ЭКТОПИЯ ТИМУСА У ДЕТЕЙ

Thymus ectopia is a rare solid neck lesion in children. The location of the formation along the path of thymus migration (thymopharyngeal duct), the echo pattern and the intensity of the MR signal, which is identical to the normally developed thymus, help in making a confident diagnosis. Materials and methods of the research: 14 pediatric patients were treated against the cervical thymus ectopia in 2018-2022 in the Russian Children's Clinical Hospital with the Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia and the National Scientific and Practical Center for Pediatric Hematology, Oncology and Immunology named after Dmitry Rogachev (both located in Moscow, Russia). The diagnosis was set only after the histological examination results in all cases. A differential diagnosis was made with other cystic and solid formations, taking into account its location and distribution according to ultrasound, computed tomography, and magnetic resonance imaging in each case. Results: stable, relapse-free treatment result was achieved after more than a year of follow-up in all cases. The correct diagnosis wasn’t set in every case until the biopsy results due to the rarity and diverse clinical and radiological picture of the disease. Conclusion: cervical thymus ectopia is a benign and relatively rare condition in children that is rarely diagnosed preoperatively by the visualization only. The conservative management may be appropriate in some cases when the thymus is in the chest cavity only, but surgical correction is more often needed in cases with the neck deforming formations.