A medical mystery with a happy ending.

      The history of our patient’s case, in its development, resembles a real medical detective story. During a routine medical check-up at her place of residence, doctors suspected a tumor of the right lung. However, already at the stage of the initial computed tomography it became clear that the situation was much more complicated than originally assumed. In addition to the lesion in the lung, specialists identified another neoplasm — in the anterior mediastinum.

      Searching for an exact diagnosis

      To clarify the diagnosis, rule out a metastatic process and determine the optimal treatment strategy, the patient turned to the Republican Clinical Oncology Dispensary of the Ministry of Health of the Republic of Tatarstan named after Prof. M.Z. Sigal. On the recommendation of specialists she was referred to Moscow for PET-CT with dual contrast enhancement. The results of the study showed that, with a high degree of probability, these were two independent malignant processes, which in itself is a rare and clinically complex situation.

      Decision of the multidisciplinary board and choice of tactics

      After additional examinations and discussion of the case at the multidisciplinary board, a decision was made to perform surgical treatment. The patient was admitted to the first thoracic department. Despite the complex combination of pathologies, oncologist Albert Sigal decided to perform a minimally invasive procedure with removal of the mediastinal tumor and the right upper lobe with regional lymph nodes.

      Intraoperative finding

      During the operation the surgeons encountered an unexpected finding. Thanks to the high quality of intraoperative visualization, a suspicion arose of a tumor thrombus originating from the mediastinal neoplasm and extending to the level of the right atrium. Despite the full volume of preoperative studies, this fact was detected only during the surgical intervention.

      Emergency team decision

      The situation required immediate interdisciplinary interaction. Cardiac surgeon Anvar Sadykov (MKDC) joined the discussion remotely, and cardiac surgeon Roman Bugrov from City Clinical Hospital No. 7 promptly arrived in the operating room of the oncology dispensary. Two surgical teams — oncologic and cardiac — worked in the operating room simultaneously.

      Surgery on the beating heart

      The first stage was resection of the right upper lobe. Then the two teams began parallel work. Roman Bugrov together with oncologist of the first thoracic department Konstantin Trofimov removed the tumor thrombus from the right atrium. At the same time Albert Sigal removed the mediastinal tumor and the distal portion of the thrombus. All stages of the operation were performed on the beating heart, without the use of a cardiopulmonary bypass machine. The intervention was carried out with the participation of efferentologist Venera Bikbova, which made it possible to return the patient’s own blood and avoid donor transfusion.

      Operating team

      Oncologists of the first thoracic department:

      PhD (Med.) Albert Sigal

      Konstantin Trofimov

      Cardiac surgeon, City Clinical Hospital No. 7:

      Roman Bugrov

      Anesthesiologist-resuscitator:

      Bulat Zhdanov

      Efferentologist:

      Venera Bikbova

      Operating room nurse:

      Alina Davlieva

      Operating room male nurse:

      Zufar Hamidullin

      Anesthesia nurse:

      Gulnara Krasnobaeva

      Nurses of the extracorporeal treatment unit:

      Liliya Akbirova

      Tatyana Kamaletdinova

      Favorable outcome and prognosis

      The coordinated work of the entire team, including the anesthesiology service, made it possible to perform the operation without complications and with minimal blood loss. The patient was discharged from the hospital on the eighth day after the intervention. A follow-up computed tomography performed three weeks later showed good vessel patency. Histological examination confirmed the presence of two oncological processes at an early stage — adenocarcinoma of the lung and type A thymoma. No metastatic involvement of the lymph nodes was found, which indicates a favorable prognosis for the patient.

      More news about the event:

      In Tatarstan, two tumors were removed from a patient in one operation

      During a routine medical check-up in Tatarstan, two oncological diseases were detected in a local resident at once. 17:38 23.12.2025 GTRK Tatarstan - Kazan

      A medical detective story with a happy ending

      The history of our patient’s case, in its development, resembles a real medical detective story. 17:26 23.12.2025 Ministry of Health of the Republic of Tatarstan - Kazan

      In Tatarstan, two tumors were removed from a patient in one operation

      In Tatarstan a medical check-up led to a serious examination for a local resident. 17:12 23.12.2025 IA Tatar-inform - Kazan

      News from neighboring regions on the topic:

      Doctors in Udmurtia saved a patient with a floating thrombus in the carotid arteries

      Doctors of the First Republican Clinical Hospital of Udmurtia saved a patient with a floating thrombus. 10:07 23.12.2025 IA Udmurtia - Izhevsk

      For the first time at the Tula oncology center, surgeons preserved a patient’s lung with a malignant tumor

      Photo: Ministry of Health of the Tula Region. Tula surgeons preserved a patient’s lung for the first time in the region during cancer surgery. The surgeons of the Tula Regional Oncology Dispensary for the first time in the region performed lung-sparing surgery on a patient with cancer. 16:47 22.12.2025 IA Tula Press.Ru - Tula

      For the first time the Tula oncology dispensary performed bronchoplastic surgery on a patient with a lung tumor

      Photo: Ministry of Health of the Tula Region. At the Tula Regional Clinical Oncology Dispensary, surgeons for the first time in the region successfully performed bronchoplastic surgery — an organ-preserving procedure. 13:17 22.12.2025 IA Tula News Service - Tula

      Doctors of the 1st RKB in Izhevsk extracted a floating thrombus from a patient’s artery

      Such a thrombus can move with the blood flow. Doctors of the 1st RKB in Izhevsk removed a dangerous mobile thrombus from a patient’s carotid artery. 12:44 22.12.2025 Susanin - Izhevsk

      Ryazan doctors destroyed a facial tumor with light therapy

      The patient sought help for a recurrence of a malignant tumor on her face, the regional health ministry press service reported. 10:54 22.12.2025 TKR - Ryazan