Basal cell carcinoma - Karcinom Bazalnih Stanica
☆ U rezultatima Stiftung Warentest iz Njemačke za 2022., zadovoljstvo potrošača s ModelDermom bilo je samo malo niže nego s plaćenim konzultacijama o telemedicini.
Ulcerirane lezije koje zahvaćaju kožu nosa kod starije osobe često se dijagnosticiraju kao Karcinom Bazalnih Stanica (Basal cell carcinoma). Nos je uobičajeno mjesto pojave ove vrste raka kože.
Karcinom Bazalnih Stanica (Basal cell carcinoma) može se pojaviti s nepravilnim rubovima i čirevima.
Karcinom Bazalnih Stanica (Basal cell carcinoma) može se zamijeniti s bradavicom.
References
Basal cell carcinoma (BCC) je najčešći tip raka kože. Izlaganje sunčevoj svjetlosti je glavni uzrok. Gotovo svi slučajevi BCC-a pokazuju preaktivno Hedgehog signaliziranje u molekularnoj analizi. Dostupni su različiti tretmani koji se biraju na temelju rizika od recidiva, važnosti očuvanja tkiva, preferencijama pacijenata i stupnju bolesti.
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 su najčešći tip raka kože u odraslih osoba svijetle puti u dobi od 50 i više godina. Njihov broj raste diljem svijeta, uglavnom zbog izlaganja sunčevoj svjetlosti. Određena genetska stanja mogu učiniti ljude sklonima razvoju ovih vrsta raka u mlađoj dobi. Basal cell carcinomas variraju u težini, u rasponu od lako izlječivih površinskih ili nodularnih lezija do opsežnijih koje zahtijevaju razgovor sa specijaliziranim medicinskim timovima. Prognoza ovisi o vjerojatnosti povratka raka ili njegovoj sposobnosti da ošteti obližnje tkivo. Kirurgija je standardni tretman za većinu slučajeva, osiguravajući precizno uklanjanje i male šanse za recidiv. Manje invazivne metode mogu učinkovito liječiti površinske lezije.
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.
Primarno liječenje BCC-a je operacija. Za visokorizične ili rekurentne BCC, osobito u kritičnim područjima, preporučuje se mikrografski kontrolirana operacija. Bolesnici s niskorizičnim površinskim BCC-om mogu razmotriti lokalno liječenje ili destruktivne metode. Fotodinamička terapija dobro funkcionira za površinske i niskorizične nodularne BCC. Za lokalno uznapredovali ili metastatski BCC, preporučuju se Hedgehog inhibitori (vismodegib or sonidegib) . Ako postoji progresija bolesti ili intolerancija na Hedgehog inhibitore, može se razmotriti imunoterapija s anti-PD1 antibody (cemiplimab) . Radioterapija je dobra opcija za pacijente koji ne mogu imati operaciju, osobito starije pacijente. Elektrokemoterapija se može razmotriti ako operacija ili radioterapija nisu opcija.
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.
Čimbenici rizika uključuju izloženost ultraljubičastom svjetlu, terapiju zračenjem, dugotrajnu izloženost arsenu i lošu funkciju imunološkog sustava (npr. transplantacija organa). Posebno je štetno izlaganje UV svjetlu tijekom djetinjstva.
Nakon postavljanja dijagnoze biopsijom, liječenje se obično provodi kirurškim uklanjanjem. To se može učiniti jednostavnom ekscizijom ako je rak mali; Ako rak nije mali, općenito se preporučuje Mohsova operacija.
Bazocelularni karcinom čini najmanje 32% svih karcinoma u svijetu. Od karcinoma kože, osim melanoma, oko 80% su karcinomi bazalnih stanica. U Sjedinjenim Američkim Državama oko 35% bijelih muškaraca i 25% bijelih žena u nekom trenutku života oboli od karcinoma bazalnih stanica.
○ Dijagnostika i liječenje
#Dermoscopy
#Skin biopsy
#Mohs surgery