Statement of hormonal activity and potential malignancy are the most important issues of diagnosis and selection of appropriate treatment way for patients with adrenal tumors. Adrenal cortical carcinoma (ACC) is rare disease with poor prognosis. Incidience of ACC is about 0.5-2 per million, and no more then 2-4% among adrenal tumors. This draft of guidelines of diagnosis and treatment of ACC is offered to common discussion among wide round of specialists.

Contribution of outstanding Russian surgeons (Pirogov N.I., Inozemcev F.I., Bobrov A.A., Lezhnev N.F., Fyodorov S.P. and their pupils) to thyroid surgery is not fully appreciated yet. Dr. N.I. Pirogov (1831) described the major principles of thyroid anatomy, topography, syntopy and surgery. In 1847, he performed the first strumectomy in Russia with a detailed description of the technique and the outcome. It was also the first surgery on the thyroid in the world performed under general anesthesia. In 1904, Russian surgeon N.F. Lezhnev (Moscow) reported on 106 thyroid surgeries using visual control of recurrent laryngeal nerves in A.A. Bobrov’s clinic since 1893. V.I. Razumovsky was the first to describe medullary and anaplastic carcinoma of the thyroid in 1904. He also recommended laryngoscopy in all patients prior to the surgery. S.P. Fyodorov - Professor of Imperial Military Medical Academy in Saint-Petersburg, was extremely reputable in Europe, he was also interested in ectopic goiter, and lingual goiter. When W. Mayo saw Dr. Fyodorov’s surgical skills he called him “Master of Surgery” and invited Fyodorov to become Surgeon-in-Chief at the Mayo Clinic. Recent political changes opened new opportunities for a more effective cooperation between surgeons throughout the world.

Indirect chromothyrolymphography (ICTLG) utilizes injection of the dye into the Thyroid (T) in order to visu- alize intraorganic lymphatic network, and extra-T lymphatic vessels and regional lymph nodes, as well. In1980- ies we performed a study using either 2-3 ml of 1% Methylene blue in water or alcohol, or 0.4% solu- tion of indigo carmine, or 1% Brilliant green in alcohol to 197 patients. Comparative light microscopic study of 457 stained and unstained cervical lymph nodes was performed. An inexpensive and simple technique, indirect ICTLG gave us an evidence to solve a number of essential questions, such as whether to perform hemithyroidectomy in T1 carcinoma located in the middle of the T gland, or not; to follow the routs of the lymph flow, that are involved in metastasizing of T cancer; and to control parathyroid glands and the recur- rent nerve during resection of the T.

The paper presents the 4 stages of compression elastography standardized technique which is clearly structured on gray-scale images phasing evaluation of qualitative and semi-quantitative elastography. Comparative data on the diagnostic efficiency and reproducibility standard and the proposed methods of elastography in 1034 people with focal formations breast, thyroid, and soft tissues are presented. The advantage of standardized technique is proved.