Basal cell carcinoma - Causes, Symptoms, Diagnosis and Treatment
Basal cell carcinoma (Basal cell carcinoma) - a malignant skin tumor that develops from cells in the epidermis. It got its name because of the similarity of the tumor cells with the cells of the basal layer of the skin. Basal cell carcinoma has the basic features of malignancy: invades neighboring tissue and destroys them, recurs even after proper treatment performed. But unlike other malignancies bazalioma hardly gives metastases. With regard to possible surgical treatment of basal cell carcinoma, cryosurgery, laser ablation and radiation therapy. Medical tactic is chosen individually, depending on the characteristics of basal cell carcinoma.
Basal cell carcinoma
malignant skin tumor that develops from cells in the epidermis. It got its name because of the similarity of the tumor cells with the cells of the basal layer of the skin. Basal cell carcinoma has the basic features of malignancy: invades neighboring tissue and destroys them, recurs even after proper treatment performed. But unlike other malignancies bazalioma hardly gives metastases.
scars, burns, ionizing radiation are also factors that increase the risk of basal cell carcinoma. Risk factors include reduced immunity during therapy with immunosuppressants or long flowing disease.
The occurrence of basal cell carcinoma in a child or adolescent is unlikely. However, common congenital form of basal cell carcinoma - a syndrome of Gorlin-Goltz (neobazotsellyulyarny syndrome), which combines a flat surface shape of the tumor, cyst of the mandibular bone defects of the ribs, and other anomalies.
epithelioma);
spider veins ". In the center of the tumor may occur ulceration with gradual increase in ulcer size and its partial scarring. Increasing in size, basal cell can invade surrounding tissues, including cartilage and bone, causing severe pain.
nodosa -yazvennaya basal cell carcinoma characterized by the appearance of protruding seal skin, which has a rounded shape, and similar to the bundle. over time, the seal is increased and ulcerate, its outlines become irregular in shape. Around the characteristic nodules formed "pearl" zone. In most cases, nodular basal cell carcinoma, peptic ulcer is located in the century , in the nasolabial folds, or in the inner corner of the eye.
perforating form of basal cell carcinoma occurs mainly in those places where the skin is constantly injured. From the nodular-ulcerative form of tumor it is distinguished by rapid growth and expressed the destruction of the surrounding tissues. Warty (papillary, exophytic) bazalioma their appearance resembles a cauliflower. It is a dense nodes hemispherical shape, sprawling on the skin surface. A feature of warty form of basal cell carcinoma is the lack of destruction and germination in surrounding healthy tissue.
Nodular (krupnouzelkovaya), basal cell carcinoma - a single protruding from the skin site on the surface of which can be seen "spider veins". Node is growing into tissues as nodular basal cell carcinoma, peptic and out. Pigment form of basal cell carcinoma has a distinctive appearance - a bundle with the outside of his "pearl" paint roller. But the dark pigmentation of the center or the edges of the tumor makes it look like a melanoma. Sklerodermiformnaya basal cell carcinoma is characterized in that the characteristic bundle of pale color with increasing converted into a flat and dense plaques that edge have a clear path. The surface of the plaque rough and it can ulcerate over time.
Rubtsovo-atrophic form of basal cell carcinoma and begins with the formation of the nodule. As tumor growth occurs at the center thereof to form degradation ulcers. Ulcer gradually increases and approaches the edge of the tumor, while the ulcer in the center of scarring occurs. The tumor acquires a specific kind of a scar in the center and the edge of the ulcerated, in which tumor growth is continuing.
The flat surface basal cell carcinoma (epithelioma pagetoid) is a multiple growths of up to 4cm, which do not grow into the skin and do not rise above the surface. Education have different colors from pale pink to red and raised "pearl" edge. This basal cell carcinoma develops in the course of several decades and has a benign course.
Tumor Shpiglera ( "turban" tumor tsilindroma) - a multiple tumor consisting of coated telangiectasia pink-violet units ranging in size from 1 to 10 cm in basal cell carcinoma Shpiglera localized on the scalp, has a long-term benign course
skin cancer, it has a relatively benign course, since it gives metastases. Major complications associated with basal cell carcinoma in that it can spread to the surrounding tissues, causing their destruction. Severe complications, including death occur when the process involves the bones, ears, eyes, brain membranes and so on. N.
cytological and histological examination of scrapings or smears taken from the surface of the tumor. The study under the microscope reveal strands or gnezdovidnye cluster round cells, spindle-shaped or oval. On the edge of the cells are surrounded by a thin rim of cytoplasm.
However, histology of basal cell carcinoma is as diverse as its clinical forms. Therefore, an important role is its clinical and cytological differential diagnosis from other skin diseases. The flat surface of the basal differentiate lupus erythematosus, lichen planus, seborrheic keratoses and Bowen's disease. Sklerodermiformnuyu basal differentiate from psoriasis and scleroderma, a pigment form - melanoma. If necessary, conduct additional laboratory tests aimed at excluding similar to basal cell carcinoma.
Surgical removal of basal cell carcinoma is the most common and effective way to treat it. The operation is performed under limited tumors located in relatively safe places for surgery. Resistance to radiation therapy of basal cell carcinoma or its recurrence is also an indication for surgical removal. When sklerodermiformnoy basal cell carcinoma or recurrent tumor excision is performed using a surgical microscope.
Cryosurgery of basal cell carcinoma liquid nitrogen - a quick and painless procedure, but it is effective only in cases of superficial tumor location and does not exclude the occurrence of relapse. Radiation therapy of basal cell carcinoma with a small amount of process stage I-II conducted by blizkofokusnoy X-ray of the affected area. In the latter case, extensive destruction combined with remote gamma therapy. In severe cases (frequent relapses, large tumor size or deeper germination) radiotherapy can be combined with surgical treatment.
Laser removal of basal cell carcinoma is well suited for older people, in whom surgical treatment can cause complications. It also applies in the case of localization of basal cell carcinoma on the face, because it gives a good cosmetic effect. Local chemotherapy basal cell carcinoma is conducted by applying appliqués of cytotoxic drugs (fluorouracil, methotrexate, etc.) On the affected skin.
Forecast basal cell carcinoma
In general, due to the absence of metastases, a favorable prognosis. However, in advanced stages, and in the absence of adequate treatment of basal cell carcinoma prognosis can be very serious.
Great value for recovery is early treatment of basal cell carcinoma. Due to the inclination of basal cell carcinoma to the frequent recurrence of the tumor more than 20 mm is considered running. If the treatment is carried out until the tumor has not reached such dimensions and does not start to germinate the subcutaneous tissue, in 95-98% there is a persistent cure. In the propagation of basal cell carcinoma in the underlying tissues after treatment remain significant cosmetic defects.