Basal cell carcinoma - Carcinoma De Células Basais
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As lesións ulceradas que afectan á pel do nariz nun ancián adoitan diagnosticarse como Carcinoma De Células Basais (Basal cell carcinoma). O nariz é un lugar común de aparición deste tipo de cancro de pel.
Carcinoma De Células Basais (Basal cell carcinoma) pode presentar bordes irregulares e úlceras.
Carcinoma De Células Basais (Basal cell carcinoma) pódese confundir cunha verruga.
References
Basal cell carcinoma (BCC) é o tipo máis común de cancro de pel. A exposición á luz solar é a principal causa. Case todos os casos de BCC mostran unha sinalización de Hedgehog hiperactiva na análise molecular. Hai diferentes tratamentos dispoñibles e escollidos en función do risco de recorrencia, a importancia da preservación do tecido, a preferencia do paciente e a extensión da enfermidade.
Basal cell carcinoma (BCC) is the most common malignancy. Exposure to sunlight is the most important risk factor. Most, if not all, cases of BCC demonstrate overactive Hedgehog signaling. A variety of treatment modalities exist and are selected based on recurrence risk, importance of tissue preservation, patient preference, and extent of disease.
Basal cell carcinoma (BCC) is the most common malignancy. Exposure to sunlight is the most important risk factor. Most, if not all, cases of BCC demonstrate overactive Hedgehog signaling. A variety of treatment modalities exist and are selected based on recurrence risk, importance of tissue preservation, patient preference, and extent of disease.
Basal cell carcinomas son o tipo de cancro de pel máis común en adultos de pel clara de 50 anos ou máis. O seu número está aumentando en todo o mundo, principalmente debido á exposición á luz solar. Algunhas condicións xenéticas poden facer que as persoas sexan propensas a desenvolver estes cancros a unha idade máis nova. Basal cell carcinomas varían en gravidade, que van desde lesións superficiais ou nodulares facilmente tratables ata outras máis extensas que requiren discusión en equipos médicos especializados. O prognóstico depende da probabilidade de que o cancro volva ou da súa capacidade para danar o tecido próximo. A cirurxía é o tratamento estándar para a maioría dos casos, garantindo unha eliminación precisa e baixas posibilidades de recorrencia. Os métodos menos invasivos poden tratar eficazmente as lesións superficiais.
Basal cell carcinomas are the most frequent skin cancers in the fair-skinned adult population over 50 years of age. Their incidence is increasing throughout the world. Ultraviolet (UV) exposure is the major carcinogenic factor. Some genodermatosis can predispose to formation of basal cell carcinomas at an earlier age. Basal cell carcinomas are heterogeneous, from superficial or nodular lesions of good prognosis to very extensive difficult-to-treat lesions that must be discussed in multidisciplinary committees. The prognosis is linked to the risk of recurrence of basal cell carcinoma or its local destructive capacity. The standard treatment for most basal cell carcinomas is surgery, as it allows excision margin control and shows a low risk of recurrence. Superficial lesions can be treated by non-surgical methods with significant efficacy.
Basal cell carcinomas are the most frequent skin cancers in the fair-skinned adult population over 50 years of age. Their incidence is increasing throughout the world. Ultraviolet (UV) exposure is the major carcinogenic factor. Some genodermatosis can predispose to formation of basal cell carcinomas at an earlier age. Basal cell carcinomas are heterogeneous, from superficial or nodular lesions of good prognosis to very extensive difficult-to-treat lesions that must be discussed in multidisciplinary committees. The prognosis is linked to the risk of recurrence of basal cell carcinoma or its local destructive capacity. The standard treatment for most basal cell carcinomas is surgery, as it allows excision margin control and shows a low risk of recurrence. Superficial lesions can be treated by non-surgical methods with significant efficacy.
O tratamento principal para o BCC é a cirurxía. Para BCC de alto risco ou recorrente, especialmente en áreas críticas, recoméndase a cirurxía controlada micrográficamente. Os pacientes con CBC superficial de baixo risco poden considerar tratamentos tópicos ou métodos destrutivos. A terapia fotodinámica funciona ben para os BCC nodulares superficiais e de baixo risco. Para BCC localmente avanzado ou metastásico, recoméndanse os inhibidores de Hedgehog (vismodegib, sonidegib) . Se hai progresión da enfermidade ou intolerancia aos inhibidores de Hedgehog, pódese considerar a inmunoterapia con anti-PD1 antibody (cemiplimab) . A radioterapia é unha boa opción para os pacientes que non poden operarse, especialmente os pacientes maiores. Podería considerarse a electroquimioterapia se a cirurxía ou a radioterapia non son unha opción.
The primary treatment for BCC is surgery. For high-risk or recurring BCC, especially in critical areas, micrographically controlled surgery is recommended. Patients with low-risk superficial BCC might consider topical treatments or destructive methods. Photodynamic therapy works well for superficial and low-risk nodular BCCs. For locally advanced or metastatic BCC, Hedgehog inhibitors (vismodegib, sonidegib) are recommended. If there's disease progression or intolerance to Hedgehog inhibitors, immunotherapy with anti-PD1 antibody (cemiplimab) can be considered. Radiotherapy is a good option for patients who can't have surgery, especially older patients. Electrochemotherapy could be considered if surgery or radiotherapy isn't an option.
The primary treatment for BCC is surgery. For high-risk or recurring BCC, especially in critical areas, micrographically controlled surgery is recommended. Patients with low-risk superficial BCC might consider topical treatments or destructive methods. Photodynamic therapy works well for superficial and low-risk nodular BCCs. For locally advanced or metastatic BCC, Hedgehog inhibitors (vismodegib, sonidegib) are recommended. If there's disease progression or intolerance to Hedgehog inhibitors, immunotherapy with anti-PD1 antibody (cemiplimab) can be considered. Radiotherapy is a good option for patients who can't have surgery, especially older patients. Electrochemotherapy could be considered if surgery or radiotherapy isn't an option.
Os factores de risco inclúen a exposición á luz ultravioleta, a radioterapia, a exposición a longo prazo ao arsénico e a deficiente función do sistema inmunitario (por exemplo, transplante de órganos). A exposición á luz UV durante a infancia é particularmente prexudicial.
Despois do diagnóstico por biopsia, o tratamento é normalmente mediante a extirpación cirúrxica. Isto pode ser por simple escisión se o cancro é pequeno; Se o cancro non é pequeno, recoméndase xeralmente a cirurxía de Mohs.
O carcinoma basocelular representa polo menos o 32% de todos os cancros no mundo. Dos cancros de pel distintos do melanoma, preto do 80% son cancros de células basales. Nos Estados Unidos, preto do 35% dos homes brancos e do 25% das mulleres brancas están afectados por carcinoma de células basais nalgún momento da súa vida.
○ Diagnóstico e Tratamento
#Dermoscopy
#Skin biopsy
#Mohs surgery