Malignant tumors of skin
Malignant tumors of skin – a new growth of external localization of an epitelialny, melanotsitarny, lymphocytic and vascular origin. Develop at advanced age more often. Are shown in the form of plaques, small knots and consolidations with ekzofitny and endofitny growth. When progressing izjyazvlyatsya quite often. Can sprout the subject fabrics, spread in lymph nodes and the remote bodies. The diagnosis is established on the basis of complaints, yielded survey and results of additional researches. Treatment – expeditious removal, chemotherapy, radiation therapy.
Malignant tumors of skin
The concept "malignant tumors of skin" unites in itself the integument new growths coming from epidermis (a bazalnokletochny and planocellular carcinoma), melanotsit (melanoma), an endoteliya of vessels (sarcoma) and lymphocytes (lymphoma). According to various data make 13-25% of total of oncological diseases. Take the third place on prevalence after cancer of a lung and cancer of a stomach. The probability of development increases in process of aging, average age of patients in Russia by data for 2004 makes 68 years. Malignant tumors of skin arise on open areas of a body more often. White-skinned blondes suffer more often than brunettes. Degree of aggression can differ and depends on morphological type of a new growth. Diagnostics and treatment of this pathology are performed by experts in the field of oncology and dermatology.
Reasons of development and classification of malignant tumors of skin
The reasons of development of malignant tumors of skin are finally not found out. Among major factors of risk experts traditionally specify residence in the southern areas, age, light skin, mechanical damages, long insolation and adverse meteorological effects (wind, low temperature, the increased humidity of air). At the same time, in the last decades increase in quantity of malignant tumors of skin at the city dwellers of a midland who are not working in the open air is noted.
Researchers connect this fact with deterioration in an ecological situation, increase in radiation level, existence of a large amount of carcinogens in food and household means, fashion for suntan and prevalence of immune violations. Along with the listed factors existence of precancer diseases of skin matters, including – a senile keratoma, a skin horn, a boundary pigmentary nevus, an eritroplaziya and Bowen's disease.
Are among the most widespread malignant tumors of skin:
- Basal and cellular epitelioma (bazalioma).
- Planocellular cancer of skin (planocellular epitelioma).
- Kaposha's sarcoma.
- Skin lymphoma
Basal and cellular epitelioma
Bazalioma – a malignant tumor of skin with the local aggressive growth and very low tendency to the remote metastasis. Is the most common form of cancer of skin. In 80% of cases it is formed in a face and the head. Can arise on not changed skin or to become result of malignant regeneration of precancer process. The slow current and high tendency to a retsidivirovaniye are characteristic. It is more often diagnosed for people of advanced age.
In the beginning on the surface of skin there is a small painless flat or acting small knot of corporal or pinkish color. Sometimes the malignant tumor of skin has an appearance of the pressed reddish erosion reminding scratch. The basal and cellular epitelioma grows within several years, reaching the size of 1-2 centimeters. In process of growth on a new growth surface at first there is a site a moknutiya, and then – the small center of disintegration covered with a crust.
Under a crust easily bleeding sore or the erosion surrounded with the dense narrow roller of pinkish, brownish or corporal color settles down. The roller consists of a set of small small knots. In the subsequent the ulcer increases and goes deep. Sometimes partial scarring comes to light. With an aggressive endofitny growth mobility of a malignant tumor of skin decreases. Deepening of an ulcer is a sign of infiltriruyushchy growth and destruction of the subject fabrics.
Distinguish several types bazaliy. The superficial basal and cellular epitelioma is usually localized in a trunk. Represents the atrophic erizematozny surface covered with a crust and surrounded with the thin dense roller. The flat cicatricial bazalioma, as a rule, settles down in temporal area, is characterized by existence of the site of an atrophy and scarring with unsharply expressed roller. The knotty malignant tumor of skin can be multiple, the century and a forehead is localized on a hairy part of the head, skin. Represents the small small knots covered with crusts. It izjyazvlyatsya quickly and destroys the subject fabrics. The Sklerodermopodobny bazalioma reminds a sklerodermiya. It is inclined to a retsidivirovaniye.
The malignant tumor of skin is diagnosed on the basis of external survey and data of a histologic research. Treatment – surgical or not surgical removal. Excision, cryodestruction, electrothermic coagulation, radiation etc. are possible. At deep defeat of the subject fabrics Mokhs's operation – excision within visually not changed fabrics with the subsequent microscopic research of cuts of a tumor and (if necessary) stage-by-stage expansion of a zone of removal of fabrics is shown. After excision of a malignant tumor of skin by the patient recommend to avoid direct sunshine. Within 10 years the retsidivirovaniye is observed at 40% of patients.
Planocellular cancer of skin
Planocellular cancer of skin – the malignant tumor of skin developing from a shipovaty layer of epidermis. Comes to light 10 times less often than a bazalioma, men suffer twice more often than women. The white-skinned people living in southern latitudes are more subject to a disease. The risk of developing of a malignant tumor of skin increases at long reception of immunosupressor. Average age of patients – 50-60 years. It is usually formed on open sites of skin, on a lower lip and in a crotch. Can develop against the background of a senile keratoz or arise on the place of traumatic damages: hems after injuries, burns, purulent processes, decubituses or trophic ulcers.
Unlike a bazalioma, this malignant tumor of skin proceeds as typical cancer of any localization. The planocellular epitelioma quickly progresses, gives metastasises in regionarny lymph nodes and the remote bodies. At initial stages represents a single spherical small knot. In the subsequent with an ekzofitny growth becomes uneven and increases in a size. With an endofitny growth (ulcer to a form) settles down in the thickness of skin, forms a painful ulcer of the crateriform form with dense corroded edges.
All malignant tumors of skin with ekzofitny and endofitny growth quickly sprout the subject fabrics and become motionless. Destruction of muscles, vessels, nerves, cartilages and bones is possible. The probability of early metastasis is especially high at the malignant tumors of skin which arose in the field of postburn hems, auricles, a lower lip, a brush and genitalia. Patients show complaints to intensive local pains and deterioration in the general state. There are a weakness, increased fatigue, appetite loss, weight reduction, a hyperthermia and symptoms of the general intoxication.
Without treatment the lethal outcome comes 2-3 years later after developing of a malignant tumor of skin. Exhaustion, infectious complications or bleeding from the damaged vessels become a cause of death. The diagnosis is exposed on the basis of symptoms and data of a histologic research. Treatment is quick. At metastasises in lymph nodes in addition apply radiation therapy, at the remote metastasises appoint chemotherapy.
Melanoma – the most malignant tumor of skin. Arises from melanotsit. Can develop on not changed skin or in the field of a pigmentary nevus. More often white-skinned suffer. At patients with dark skin the new growth appears seldom, usually – on soles and palms. Average age of development of a malignant tumor of skin – 20-45 years. Among risk factors – excess insolation, a multiple nevus, a congenital pigmentary nevus and a displastichesky nevus. At the patients having relatives with a melanoma, the probability of a disease increases by 8 times, at the patients who earlier underwent an operation on removal of a melanoma – by 9 times.
The malignant tumor of skin represents a flat spot or the acting small knot of black or dark brown color. Coloring of a new growth can be uniform or non-uniform, the sites sometimes pigmented alternate with the centers of corporal color. Very seldom the melanomas deprived of melanin come to light. When progressing the tumor quickly increases in a size or begins to act more and more over a surface, becomes rough. The peeling is possible. The new growth is easily damaged and bleeds. Can proceed without unpleasant local feelings or be followed by an itch and burning.
The malignant tumor of skin quickly spreads in regionarny lymph nodes and the remote bodies. Gives metastasises in skin in the form of the pigmented and not pigmented new growths in the beginning located near primary tumor, and then – scattered on all body. The diagnosis is exposed on the basis of symptoms, radio phosphoric test, a termografiya and data of a cytologic research. Such visual signs as asymmetry, change of color, roughness of contours and increase in diameter of a nevus more than 5 mm can demonstrate existence of a melanoma.
The biopsy at this malignant tumor of skin is categorically contraindicated. At suspicion of a melanoma take dabs prints for a cytologic research, perform careful external inspection, palpate lymph nodes, pay special attention to signs of possible metastasis in internals. Patients with suspicion of a malignant tumor of skin are directed to a thorax X-ray analysis, appoint MPT and KT of internals, a stsintigrafiya of a liver and other researches. Treatment is surgical. In the postoperative period apply chemotherapy and immunochemotherapy. The forecast is adverse.
Kaposha's sarcoma – the malignant tumor of skin developing from cages of an internal vystilka of lymphatic and blood vessels. Usually arises in the presence of immune violations (at old men, sick HIV, the patients accepting immunosupressor). Among possible risk factors specify onkogenny viruses, injuries and hereditary predisposition. The endemic African form usually comes to light at young people, early metastasis is characteristic.
The classical form of a malignant tumor of skin is more often diagnosed for elderly men. It is shown by formation of multiple crimson or bluish-brown knots and plaques on the lower extremities. The local, gradually extending defeat which over time is complicated by hypostasis and elephantiasis of extremities is for many years observed. In the subsequent the dissemination with damage of lymph nodes, internals, face skin and trunk is possible.
The immunodependent form of a malignant tumor of skin develops at the patients receiving immunosupressor after organ transplantation. The epidemic form comes to light at patients AIDS, bystry rapid development and early metastasis are characteristic of it. Tactics of treatment of a malignant tumor of skin depends on prevalence and a form of a disease. At a classical form with local damage of extremities carry out excision of new growths. At generalization appoint radiation therapy and chemotherapy. The forecast depends on a disease form.
Skin lymphoma – group of the malignant tumors of skin developing from T - and V-lymphocytes. The causes are not established. As possible risk factors consider some viruses, contact with chemicals, the increased radiation level and excessive insolation. Hereditary predisposition is not excluded. New growths can be primary (malignant cages initially affect skin) or secondary (the tumor is formed in lymphoid body, and then disseminirut in skin).
Malignant tumors of skin are shown by an itch, rashes, change of a blood count and increase in regionarny lymph nodes. When progressing process damage of internals is possible. The diagnosis is established on the basis of the given surveys, blood tests, ultrasonography and KT of internals, a sternalny puncture, a biopsy of lymph nodes and other researches. The plan of treatment of a malignant tumor of skin is made taking into account a type of a lymphoma and prevalence of process. Carry out expeditious removal, carry out therapy by immunostimulators and glyukokortikosteroidny medicines, appoint radiation therapy and chemotherapy. The forecast depends on a type of a lymphoma.