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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">rosped</journal-id><journal-title-group><journal-title xml:lang="ru">Российский педиатрический журнал имени М.Я. Студеникина</journal-title><trans-title-group xml:lang="en"><trans-title>M.Ya. Studenikin Russian Pediatric Journal</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">3033-9006</issn><issn pub-type="epub">3033-9014</issn><publisher><publisher-name>ФГАУ «НМИЦ здоровья детей» Минздрава России</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.46563/2026-1-1-61-70</article-id><article-id custom-type="elpub" pub-id-type="custom">rosped-2033</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>КЛИНИЧЕСКИЕ СЛУЧАИ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>CASE REPORTS</subject></subj-group></article-categories><title-group><article-title>Острая клиническая манифестация саркомы Юинга, распространяющейся из второго шейного позвонка</article-title><trans-title-group xml:lang="en"><trans-title>Acute clinical manifestation of Ewing sarcoma spreading from the second cervical vertebra</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3331-4175</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Рында</surname><given-names>А. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Rynda</surname><given-names>Artemii Yu.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Рында Артемий Юрьевич, канд. мед. наук, нейрохирург отд-я детской онкологии, хирургии головы и шеи и нейрохирургии</p><p>e-mail: artemii.rynda@mail.ru</p></bio><bio xml:lang="en"><p>Artemii Yu. Rynda, MD, PhD, neurosurgeon in the Department of Pediatric Oncology, Head and Neck Surgery, and Neurosurgery</p><p>e-mail: artemii.rynda@mail.ru</p></bio><email xlink:type="simple">artemii.rynda@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7750-5216</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Папуша</surname><given-names>Л. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Papusha</surname><given-names>Lyudmila I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Папуша Людмила Ивановна, доктор мед. наук, проф., зав. отд-м нейроонкологии</p><p>e-mail: ludmila.mur@mail.ru</p></bio><email xlink:type="simple">ludmila.mur@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3932-6257</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ворожцов</surname><given-names>И. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Vorozhtsov</surname><given-names>Igor N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Ворожцов Игорь Николаевич, канд. мед. наук; зав. отд-м детской онкологии, хирургии головы и шеи и нейрохирургии</p><p>e-mail: dr.vorozhtsov@gmail.com</p></bio><email xlink:type="simple">dr.vorozhtsov@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-4451-3233</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Грачев</surname><given-names>Н. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Grachev</surname><given-names>Nikolay S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Грачев Николай Сергеевич, доктор мед. наук, проф., генеральный директор</p><p>e-mail: nick-grachev@yandex.ru</p></bio><email xlink:type="simple">nick-grachev@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7600-6191</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Лопатин</surname><given-names>А. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Lopatin</surname><given-names>Andrey V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Лопатин Андрей Вячеславович, доктор мед. наук, проф., заместитель генерального директора по научно-клинической работе</p><p>e-mail: and-lopatin@yandex.ru</p></bio><email xlink:type="simple">and-lopatin@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-9300-198X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Карачунский</surname><given-names>А. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Karachunsky</surname><given-names>Alexandr I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Карачунский Александр Исаакович, доктор мед. наук, проф., директор Института онкологии, радиологии и ядерной медицины</p><p>e-mail: aikarat@mail.ru</p></bio><email xlink:type="simple">aikarat@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-5893-0508</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Санакоева</surname><given-names>А. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Sanakoeva</surname><given-names>Agunda V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Санакоева Агунда Викторовна, канд. мед. наук, врач-нейрохирург, отд-е детской онкологии, хирургии головы и шеи и нейрохирургии</p><p>e-mail: agu.sanakoeva@gmail.com</p></bio><email xlink:type="simple">agu.sanakoeva@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-9496-3136</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Тараканова</surname><given-names>А. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Tarakanova</surname><given-names>Alexandra V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Тараканова Александра Васильевна, врач-патологоанатом, отд-е патологической анатомии</p><p>e-mail: sequaciou@gmail.com</p></bio><email xlink:type="simple">sequaciou@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7317-7104</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Терещенко</surname><given-names>Г. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Tereshchenko</surname><given-names>Galina V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Терещенко Галина Викторовна, канд. мед. наук, зав. рентгенологическим отд-м</p><p>e-mail: Galina.Tereshenko@dgoi.ru</p></bio><email xlink:type="simple">Galina.Tereshenko@dgoi.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГБУ «Национальный медицинский исследовательский центр детской гематологии, онкологии и иммунологии им. Дмитрия Рогачева» Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Dmitry Rogachev National Medical Research Center for Pediatric Hematology, Oncology and Immunology</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2026</year></pub-date><pub-date pub-type="epub"><day>27</day><month>03</month><year>2026</year></pub-date><volume>1</volume><issue>1</issue><fpage>61</fpage><lpage>70</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Рында А.Ю., Папуша Л.И., Ворожцов И.Н., Грачев Н.С., Лопатин А.В., Карачунский А.И., Санакоева А.В., Тараканова А.В., Терещенко Г.В., 2026</copyright-statement><copyright-year>2026</copyright-year><copyright-holder xml:lang="ru">Рында А.Ю., Папуша Л.И., Ворожцов И.Н., Грачев Н.С., Лопатин А.В., Карачунский А.И., Санакоева А.В., Тараканова А.В., Терещенко Г.В.</copyright-holder><copyright-holder xml:lang="en">Rynda A.Y., Papusha L.I., Vorozhtsov I.N., Grachev N.S., Lopatin A.V., Karachunsky A.I., Sanakoeva A.V., Tarakanova A.V., Tereshchenko G.V.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.rosped.ru/jour/article/view/2033">https://www.rosped.ru/jour/article/view/2033</self-uri><abstract><sec><title>Актуальность</title><p>Актуальность. Саркома Юинга — высокометастатическая форма саркомы, вторая по распространённости первичная злокачественная опухоль костей, поражающая преимущественно подростков. Крайняя редкость этого заболевания в шейном отделе позвоночника может привести к задержке диагностики до тех пор, пока опухоль не достигнет запущенной стадии и не начнёт сдавливать спинной мозг. Начальные симптомы могут включать боль в шее и радикулопатию. Эти симптомы могут быстро прогрессировать, сопровождаясь слабостью конечностей и дисфунк­цией мочевого пузыря или кишечника, развиваясь в течение нескольких дней после начала заболевания. Высокая степень клинической настороженности имеет решающее значение для ранней диагностики и лечения.Цель работы: представить клиническое описание случая острой клинической манифестации саркомы Юинга, распространяющейся из позвонка С2.Материалы и методы. Мы описываем случай у 3-летней девочки без наличия хронических заболеваний или травм в анамнезе. Клинические проявления начались за 6 мес до развёрнутой картины болезни с незначительной прогрессирующей периодической боли в шейном отделе позвоночника, которую сначала расценивали как состояние, обус­ ловленное кривошеей. Через 3 мес при постоянно сохраняющейся симптоматике больной было выполнено рент­ геновское обследование шейного отдела позвоночника, на котором на тот момент не описывали патологических изменений. Спустя 6 мес от начала заболевания произошло резкое нарастание симптоматики в течение нескольких дней до выраженного болевого синдрома, тетрапареза и тазовых нарушений. При МРТ было выявлено поражение 2-го шейного позвонка, затрагивающее как тело позвонка, так и заднюю дугу с инфильтрацией переднего эпидурального пространства, отверстий нервных корешков на уровне 2–3-го шейных позвонков в прилегающие паравертебральные мышцы, а также инвазия опухоли в правую позвоночную артерию с охватом её со всех сторон. При мультиспиральной компьютерной томографии грудной полости было выявлено множественное метастатическое поражение лёгких (всего около 25 метастазов).Результаты. Больной было выполнено экстренное оперативное вмешательство в объёме ламинэктомии от С2 до С4 позвонка с частичной резекцией экстрадурального мягкотканного компонента опухоли. В послеоперационном периоде отмечен практически полный регресс неврологического дефицита — до 4,5 в ногах и 4,5 балла в руках и регресс тазовых нарушений. Больная была переведена в отделение детской онкологии ФГБУ «НМИЦ ДГОИ им. Дмитрия Рогачева», где инициировано проведение мультимодальной химиотерапии и лучевой терапии.Заключение. Первичные саркомы Юинга, поражающие С2 позвонок, встречаются крайне редко. Данная локализация представляет диагностические трудности из-за нетипичной клинической картины, рентгенологической и гистопатологической схожести с другими опухолями. Данный случай определяет высокую значимость междисциплинарного подхода для точной диагностики и оптимального лечения. Точное и своевременное распознавание этих редких форм может способствовать ранней диагностике и улучшению прогноза для больных.Участие авторов: Рында А.Ю., Ворожцов И.Н., Грачев Н.С., Санакоева А.В., Тараканова А.В. — концепция и дизайн исследования; Рында А.Ю., Папуша Л.И., Ворожцов И.Н., Санакоева А.В., Тараканова А.В., Терещенко Г.В. — сбор и обработка материала, статистическая обработка; Рында А.Ю., Карачунский А.И., Санакоева А.В., Тараканова А.В., Терещенко Г.В. — написание текста; Рында А.Ю., Папуша Л.И., Грачев Н.С., Лопатин А.В., Карачунский А.И. — научное редактирование. Все соавторы — утверждение окончательного варианта статьи, ответственность за целостность всех частей статьи.Финансирование. Исследование не имело финансовой поддержки.Конфликт интересов. Авторы заявляют об отсутствии конфликта интересов.</p></sec><sec><title>Поступила 19</title><p>Поступила 19.01.2026Принята к печати 10.02.2026Опубликована 27.02.2026</p></sec></abstract><trans-abstract xml:lang="en"><sec><title>Objective</title><p>Objective. Ewing sarcoma is a highly metastatic form of sarcoma, the second most common primary malignant bone tumor, primarily affecting adolescents. Its extreme rarity in the cervical spine may lead to a delay in diagnosis until the tumor reaches an advanced stage and compresses the spinal cord. Initial symptoms may include neck pain and radiculopathy. These symptoms may progress rapidly, accompanied by limb weakness and bladder or bowel dysfunction, developing within days over the disease onset. A high degree of clinical suspicion is crucial for early diagnosis and treatment. The aim: To present a clinical description of a case of acute clinical manifestation of Ewing’s sarcoma extending from the second cervical vertebra.Materials and methods. We describe a case of a 3-year-old girl without history of chronic illness or trauma. Clinical manifestations of symptoms began 6 months before the full-blown clinical picture, with mild, progressive, intermittent pain in the cervical spine, initially attributed to torticollis. Three months later, with persistent symptoms, the patient underwent a cervical spine X-ray, which at that time revealed no significant pathological changes. Approximately 6 months after onset, symptoms sharply worsened over several days, leading to severe pain, tetraparesis, and pelvic dysfunction. MRI revealed a lesion of the second cervical vertebra, affecting both the vertebral body and the posterior arch, with infiltration of the anterior epidural space, nerve root openings at the level of the second and third cervical vertebrae, and adjacent paravertebral muscles. Tumor invasion of the right vertebral artery encompassed it from all sides. A chest CT scan revealed multiple metastatic lesions in the lungs (approximately 25 metastases in total).Results. The patient underwent emergency surgery, including a laminectomy from the 2nd to 4th cervical vertebrae with partial resection of the extradural soft tissue component of the tumor. Postoperatively, almost complete regression of neurological deficits was noted, with a score of 4.5 in the legs and 4.5 in the arms, as well as regression of pelvic abnormalities. The patient was transferred to the Pediatric Oncology Department of the Dmitry Rogachev National Medical Research Center for Pediatric Hematology, Oncology, and Immunology, where multimodal chemotherapy and radiation therapy were initiated.Conclusion. Primary Ewing sarcomas affecting the C2 vertebra are extremely rare. This location presents diagnostic challenges due to its atypical clinical presentation and radiographic and histopathological similarities to other tumors. This case highlights the importance of a multidisciplinary approach for accurate diagnosis and optimal treatment. More accurate recognition of these rare forms can facilitate early diagnosis and improve patient prognosis.Contribution: Rynda A.Yu., Vorozhtsov I.N., Grachev N.S., Sanakoeva A.V., Tarakanova A.V. — study concept and design; Rynda A.Yu., Papusha L.I., Vorozhtsov I.N., Sanakoeva A.V., Tarakanova A.V., Tereshchenko G.V. — data collection and processing, statistical processing; Rynda A.Yu., Karachunsky A.I., Sanakoeva A.V., Tarakanova A.V., Tereshchenko G.V. — writing the text; Rynda A.Yu., Papusha L.I., Grachev N.S., Lopatin A.V., Karachunsky A.I. — scientific editing. All co-authors approved the final version of the article and are responsible for the integrity of all parts of the article.Acknowledgments. The study had no sponsorship.Conflict of interest. The authors declare no conflict of interest.</p></sec><sec><title>Received</title><p>Received: January 19, 2026Accepted: February 10, 2026Published: February 27, 2026</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>дети</kwd><kwd>саркома Юинга</kwd><kwd>второй шейный позвонок</kwd><kwd>компрессия спинного мозга</kwd><kwd>клиническая манифес­тация</kwd><kwd>тактика лечения</kwd></kwd-group><kwd-group xml:lang="en"><kwd>Ewing sarcoma</kwd><kwd>second cervical vertebra</kwd><kwd>spinal cord compression</kwd><kwd>treatment tactics</kwd><kwd>clinical manifestation</kwd><kwd>children</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Zöllner S.K., Amatruda J.F., Bauer S., Collaud S., de Álava E., DuBois S.G., et al. Ewing sarcoma-diagnosis, treatment, clinical challenges and future perspectives. J. Clin. 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