Anastasia Zherlitsyna — timeline

Ministry of health of Ukraine
Medical clinic “Innovation” LLC
07352, Ukraine, Kyiv region, Vyshhorods’kyi district, Lyutizh, Vitryanoho Street
Code for the Unified State Register of Enterprises and Organizations of Ukraine 36076865

MEDICAL DOCUMENTATION
Form of primary accounting
documentation No. 028/0
APPROVED
Order of the Ministry of Health
of Ukraine of February 14, 2012
No. 110

Advisory opinion of an oncologist

1. The name of the health care facility that referred the patient for consultation

2. Patient's name:
   Zherlitsyna Anastasia Stanislavivna

3. Date of birth: 25.04.1976 .

4. Specialty, last name, first name of the consulting physician:
   Oncologist Oksana Mykolaivna Latsinnikova

5. Results of laboratory study:

6. Results of functional, X-ray and other special studies:

7. Specialist's conclusion (established diagnosis):

Main: Diagnosis: GIST of the stomach with secondary impression of the liver.

Condition after EUS-FNA of stomach biopsy (April 21, 2023), liver core biopsy (April 25, 2023), histologically - gastrointestinal stromal tumor (GIST) of the stomach, GIST metastasis in the liver (CSD).

Condition after trepan biopsy of the liver (August 28, 2022, NIR). Histopathological conclusion: leiomyosarcoma of the uterus.

Condition after 4 cycles of chemotherapy according to the Gemcitabine+Docetaxel+Avastin protocol with progression in the liver (MRI of the abdominal cavity, pelvic organs 14.10.2022, CT scan 01.12.2022).

Mutations of Kit, MET were detected (whole genome sequencing ONCOMINE, 12.2022).

Treatment with Pazopanib 05-12.01.2023. with the development of the posterior reverse encephalopathy syndrome and positive dynamics according to CT data from 09.02.2023.

Repeat liver biopsy (January 23, 2023). Histopathological conclusion: metastasis of uterine leiomyosarcoma.

The condition after 3 cycles of chemotherapy according to the Trabectedin protocol with minimal negative dynamics according to the PET-CT data (11.04.2023): Known masses in the liver and the mass on the left, which according to the configuration rather originates from the stomach wall have slightly increased, are metabolically active. Masses in the uterus and in/near the right ovary with low metabolic activity, structurally stable. A significant difference in the activity of liver/stomach and uterine masses suggests different neoplastic processes, in particular, primary aggressive from the stomach/GIST.

Primary biopsy from 08.2022. under review in the CSD laboratory.

Associated diagnosis: Iron deficiency anemia. Type 2 diabetes. Hypovitaminosis D.

Closed comminuted fracture of the distal metaepiphysis of the left radius with displacement of the fragments (February 11, 2023)

Treatment with Glivec from 03.05.2023.

Polydipsia.

8. Recommendations:

1. Continue taking Glivec 400 mg daily.

2. MRI of the brain with intravenous contrast

3. Consultation of an endocrinologist.
4. Consultation of a neurologist (Y.O. Matyash, Dobrobut).
5. Reduce liquid consumption to 2-3 l/day using REO water.

6. Eliquis 2.5 mg 2 times a day continued.

7. Complete cessation of smoking.

8. Control of pressure, pulse rate, especially during periods of deterioration of well-being. Keeping a diary.

June 13, 2023

Doctor consultant _______________________________

/Latsinnikova Oksana Mykolayivna/

Head of polyclinic or inpatient department _______________________________