Bazalioma (basal and cellular cancer) — the malignant tumor of skin developing from cells of epidermis. She received the name because of similarity of cells of tumor to cages of a basal layer of skin. Bazalioma possesses the main signs of a malignant new growth: sprouts in the next fabrics and destroys them, recurs even after the correct executed treatment. But unlike other malignant tumors of a bazaliom practically does not give metastasises. Concerning a bazalioma perhaps surgical treatment, cryodestruction, laser removal and radiation therapy. Medical tactics is selected in an individual order depending on characteristics of a bazalioma.
Bazalioma (basal and cellular cancer) — the malignant tumor of skin developing from cells of epidermis. She received the name because of similarity of cells of tumor to cages of a basal layer of skin. Bazalioma possesses the main signs of a malignant new growth: sprouts in the next fabrics and destroys them, recurs even after the correct executed treatment. But unlike other malignant tumors of a bazaliom practically does not give metastasises.
Causes of a bazalioma
Bazalioma occurs generally at people 40 years are more senior. Refer frequent and long stay under direct sunshine to the factors promoting its development. Therefore the residents of the southern countries and people working at the sun are more subject to a disease of bazaliomy. The people having light skin are ill more often than black. Contact with toxic substances and carcinogens (oil products, arsenic, etc.), continuous traumatizing a certain site of skin, hems, burns, ionizing radiation are also the factors increasing risk of emergence of a bazalioma. Decrease in immunity against the background of therapy by immunodepressants belongs to risk factors or it is long the proceeding disease.
Emergence of a bazalioma at the child or the teenager is improbable. However the congenital form of a bazalioma — Gorlin-Golts's syndrome (a neobazotsellyulyarny syndrome) combining a flat superficial form of a tumor, cyst of a mandibular bone, malformations of edges and other anomalies meets.
Classification of a bazalioma
Allocate the following clinical forms of a bazalioma:
- nodular and ulcer;
- warty (papillary, ekzofitny);
- nodulyarny (krupnouzelkovy);
- cicatricial atrophic;
- flat superficial bazalioma (pedzhetoidny epitelioma);
- Shpigler's tumor ("tyurbanny" tumor, tsilindroma)
Most often the bazalioma settles down on a face or a neck. Development of a tumor begins with emergence on skin of a small small knot of light pink, reddish or corporal color. At the beginning of a disease the small knot can remind a usual heat-spot. It slowly grows, without causing any painful feelings. In its center the grayish crust appears. After its removal on skin there is a small deepening which soon again becomes covered by a crust. Existence around a tumor of the dense roller well noticeable at extension of skin is characteristic of a bazalioma. Small granular educations of which the roller consists are similar to pearls.
Further growth of a bazalioma in some cases leads to formation of new small knots which begin to merge with each other over time. Expansion of superficial vessels leads to emergence in the field of a tumor of "vascular asterisks". In the center of a tumor there can be an ulceration to gradual increase in the size of an ulcer and its partial scarring. Increasing in sizes, the bazalioma can sprout in surrounding fabrics, including cartilages and bones, causing at the same time the expressed pain syndrome.
The nodular and ulcer bazalioma is characterized by appearance of the speaker over skin of the consolidation having rounded shape and similar to a small knot. Over time consolidation increases and izjyazvlyatsya, its outlines gain irregular shape. Around a small knot the characteristic "pearl" belt is formed. In most cases the nodular and ulcer bazalioma settles down during a century, in the field of a nasolabial fold or in an internal corner of an eye.
The pro-butting form of a bazalioma arises generally in those places where skin is constantly injured. From a nodular and ulcer form of a tumor it is distinguished by rapid growth and the expressed destruction of surrounding fabrics. Warty (papillary, ekzofitny) the bazalioma the appearance reminds a cauliflower. It represents the dense knots of semi-spherical shape expanding on the surface of skin. Feature of a warty form of a bazalioma is lack of destruction and germination in surrounding healthy fabrics.
The Nodulyarny (krupnouzelkovy) bazalioma is a single speaker over skin knot on which surface "vascular asterisks" are visible. The knot grows not in depth of fabrics as a nodular and ulcer bazalioma, and outside. The pigmentary form of a bazalioma has characteristic appearance — a small knot with the "pearl" roller surrounding it. But dark pigmentation of the center or edges of a tumor makes it similar to a melanoma. The Sklerodermiformny bazalioma differs in the fact that the characteristic small knot of pale coloring in process of increase turns into a flat and dense plaque which edges have an accurate contour. A plaque surface rough and over time it can .
The cicatricial and atrophic form of a bazalioma also begins with formation of a small knot. In process of growth of a tumor in its center there is a destruction to formation of an ulcer. Gradually the ulcer increases and approaches edge of a tumor, at the same time in the center of an ulcer there is a scarring. The tumor takes a specific form with a hem in the center and izjyazvlenny edge in the field of which tumoral growth continues.
The flat superficial bazalioma (pedzhetoidny epitelioma) represents multiple new growths up to 4 cm which do not sprout in depth of skin and do not tower over its surface. Educations have various coloring from pale pinkish till red color and the raised "pearl" edges. Such bazalioma develops within several decades and has a good-quality current.
Shpigler's tumor ("tyurbanny" tumor, tsilindroma) is the multiple tumor consisting of the pink-violet knots from 1 to 10 cm of Bazaliom in size of Shpigler covered with teleangioektaziya is localized on a hairy part of the head, has a long good-quality current.
Though the bazalioma is one of types of cancer of skin, it differs in rather good-quality current as does not give metastasises. The main complications of a bazalioma are connected with the fact that it can extend to surrounding fabrics, causing their destruction. Heavy complications up to a lethal outcome arise when process affects bones, ears, eyes, brain covers, etc.
Diagnostics of a bazalioma
Diagnostics is carried out by the cytologic and histologic research of scrape or dab print taken from a tumor surface. During the research under a microscope find tyazh or gnezdovidny congestions of cages of a rounded, spindle-shaped or oval shape. On edge of a cage are surrounded with a thin obodok of cytoplasm.
However the histologic picture of a bazalioma is also various, as well as its clinical forms. Therefore its clinical and cytologic differential diagnostics with other skin diseases has an important role. The flat superficial bazalioma is differentiated from a red volchanka, red flat depriving, a seboreyny keratoz and Bowen's disease. The Sklerodermiformny bazalioma is differentiated from a sklerodermiya and psoriasis, a pigmentary form — from a melanoma. If necessary conduct the additional laboratory researches directed to an exception similar with bazaliomy diseases.
Treatment of a bazalioma
The way of treatment of a bazalioma is selected individually depending on the sizes of a tumor, its arrangement, clinical form and morphological look, extent of germination in the next fabrics. Primary this developing of a tumor or a recurrence matters. Results of the treatment which was carried out earlier, age and associated diseases of the patient are considered.
Surgical removal of a bazalioma is an effective and most widespread way of its treatment. Operation is performed at limited tumors, places, located in rather safe for surgical intervention. Resistance of a bazalioma to radiation therapy or its retsidivirovaniye is also the indication for surgical removal. At a sklerodermiformny bazalioma or a recurrence of a tumor excision is carried out with application of a surgical microscope.
Cryodestruction of a bazalioma liquid nitrogen — the bystry and painless procedure, however it is effective only in cases of a superficial arrangement of a tumor and does not exclude emergence of a recurrence. Radiation therapy of a bazalioma at the small amount of process of the I-II stage is carried out by short-distance X-ray therapy of an affected area. In case of extensive defeat the last is combined with remote gamma therapy. In difficult cases (a frequent recurrence, the big size of a tumor or its deep germination) X-ray therapy can be combined with surgical treatment.
Laser removal of a bazalioma well suits elderly people in whom surgical treatment can cause complications. It is applied also in case of localization of a bazalioma on a face as gives good cosmetic effect. The local chemotherapy of a bazalioma is carried out by drawing applications from tsitostatik (ftoruratsit, a methotrexate, etc.) on affected areas of skin.
Forecast of a bazalioma
In general, thanks to lack of metastasis, the forecast of a disease favorable. But in the started stages and in the absence of adequate treatment the forecast of a bazalioma can be very serious.
Early treatment of a bazalioma is of great importance for recovery. Because of bent of a bazalioma to a frequent retsidivirovaniye, a tumor more than 20 mm are already considered started. If treatment is carried out so far the tumor did not reach such sizes and did not begin to sprout hypodermic cellulose, then in 95-98% permanent treatment is observed. At distribution of a bazalioma on the subject fabrics after treatment there are major cosmetic defects.