Malignant melanoma - Melanoma Malinna
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Fir-riżultati ta' Stiftung Warentest tal-2022 mill-Ġermanja, is-sodisfazzjon tal-konsumatur b'ModelDerm kien biss ftit inqas milli b'konsultazzjonijiet bit-telemediċina mħallsa.
Fir-riżultati ta' Stiftung Warentest tal-2022 mill-Ġermanja, is-sodisfazzjon tal-konsumatur b'ModelDerm kien biss ftit inqas milli b'konsultazzjonijiet bit-telemediċina mħallsa.
Melanoma ta' madwar 2.5 cm (1 pulzier) b' 1.5 cm (0.6 pulzier).
Għalkemm dan il-każ ġie diagnostikat bħala melanoma, l‑sejb viżwali huwa aktar simili għal ematoma tad-dwiefer. Ematomi tad-dwiefer (beninni) tipikament jisparixxu f’żmien ta’ xahar sa xahrejn, hekk kif jiġu mbuttati ‘l barra. Għalhekk, jekk il-leżjoni tippersisti għal żmien twil, melanoma jista jkun suspettat u għandha ssir bijopsija.
relevance score : -100.0%
ReferencesMelanoma hija tip ta’ tumur li jifforma meta l-melanoċiti jsiru malinni. L-melanoċiti joriġinaw mill-crest nerwali. Dan ifisser li l-melanomi jistgħu jiżviluppaw mhux biss fuq il-ġilda, iżda wkoll f’postijiet oħra fejn iċ-ċelloli tal-crest nerwali ivvjaġġaw, bħall-passaġġ gastrointestinali u l-moħħ. Pazjenti b’melanoma ta’ stadju 0 għandhom rata ta’ sopravivenza għal ħames snin ta’ 97 %, filwaqt li dawk b’marda ta’ stadju IV għandhom rata ta’ madwar 10 % biss.
A melanoma is a tumor produced by the malignant transformation of melanocytes. Melanocytes are derived from the neural crest; consequently, melanomas, although they usually occur on the skin, can arise in other locations where neural crest cells migrate, such as the gastrointestinal tract and brain. The five-year relative survival rate for patients with stage 0 melanoma is 97%, compared with about 10% for those with stage IV disease.
A melanoma is a tumor produced by the malignant transformation of melanocytes. Melanocytes are derived from the neural crest; consequently, melanomas, although they usually occur on the skin, can arise in other locations where neural crest cells migrate, such as the gastrointestinal tract and brain. The five-year relative survival rate for patients with stage 0 melanoma is 97%, compared with about 10% for those with stage IV disease.
Cutaneous melanoma (CM) huwa tip perikoluż ħafna ta’ tumur tal-ġilda, li huwa responsabbli għal 90 % tal-imwiet minn kanċer tal-ġilda. Biex jindirizzaw dan, esperti mill‑European Dermatology Forum (EDF), mill‑European Association of Dermato‑Oncology (EADO) u mill‑European Organization for Research and Treatment of Cancer (EORTC) kienu kkollaboraw.
Cutaneous melanoma (CM) is a highly dangerous type of skin tumor, responsible for 90% of skin cancer deaths. To address this, experts from the European Dermatology Forum (EDF), the European Association of Dermato-Oncology (EADO), and the European Organization for Research and Treatment of Cancer (EORTC) had collaborated.
Cutaneous melanoma (CM) is a highly dangerous type of skin tumor, responsible for 90% of skin cancer deaths. To address this, experts from the European Dermatology Forum (EDF), the European Association of Dermato-Oncology (EADO), and the European Organization for Research and Treatment of Cancer (EORTC) had collaborated.
Il-melanoma, tip ta' kançer tal-ġilda, tispikka għar-relazzjoni mill-qrib tagħha mas-sistema immuni. Dan huwa evidenti mill-okkorrenza akbar tiegħu f'nies b'sistemi immuni mdgħajfa, il-preżenza ta' ċelluli immuni kemm fit-tumuri oriġinali kif ukoll it-tixrid tagħhom għal partijiet oħra tal-ġisem, u l-fatt li s-sistema immuni tista' tirrikonoxxi ċerti proteini li jinsabu fiċ-ċelloli tal-melanoma. Importanti, trattamenti li jsaħħu s-sistema immuni wrew wegħda fil-ġlieda kontra l-melanoma. Filwaqt li l-użu ta' terapiji li jsaħħu l-immunità fit-trattament tal-melanoma avvanzata huwa żvilupp relattivament reċenti, riċerka reċenti tindika li l-kombinazzjoni ta' dawn it-terapiji ma' kimoterapija, radjuterapija, jew trattamenti molekulari mmirati tista' ttejjeb b'mod sinifikanti r-riżultati. Madankollu, immunoterapija bħal din tista' tqajjem firxa ta' effetti sekondarji relatati mal-immunità li jaffettwaw diversi organi, li jistgħu jillimitaw l-użu tagħha. B'ħarsa 'l quddiem, approċċi futuri għat-trattament tal-melanoma avvanzata jistgħu jinvolvu terapiji mmirati lejn punti ta' kontroll immuni speċifiċi bħall-PD1, jew mediċini li jinterferixxu ma' mogħdijiet molekulari speċifiċi bħal BRAF u MEK.
Melanoma is one of the most immunologic malignancies based on its higher prevalence in immune-compromised patients, the evidence of brisk lymphocytic infiltrates in both primary tumors and metastases, the documented recognition of melanoma antigens by tumor-infiltrating T lymphocytes and, most important, evidence that melanoma responds to immunotherapy. The use of immunotherapy in the treatment of metastatic melanoma is a relatively late discovery for this malignancy. Recent studies have shown a significantly higher success rate with combination of immunotherapy and chemotherapy, radiotherapy, or targeted molecular therapy. Immunotherapy is associated to a panel of dysimmune toxicities called immune-related adverse events that can affect one or more organs and may limit its use. Future directions in the treatment of metastatic melanoma include immunotherapy with anti-PD1 antibodies or targeted therapy with BRAF and MEK inhibitors.
Melanoma is one of the most immunologic malignancies based on its higher prevalence in immune-compromised patients, the evidence of brisk lymphocytic infiltrates in both primary tumors and metastases, the documented recognition of melanoma antigens by tumor-infiltrating T lymphocytes and, most important, evidence that melanoma responds to immunotherapy. The use of immunotherapy in the treatment of metastatic melanoma is a relatively late discovery for this malignancy. Recent studies have shown a significantly higher success rate with combination of immunotherapy and chemotherapy, radiotherapy, or targeted molecular therapy. Immunotherapy is associated to a panel of dysimmune toxicities called immune-related adverse events that can affect one or more organs and may limit its use. Future directions in the treatment of metastatic melanoma include immunotherapy with anti-PD1 antibodies or targeted therapy with BRAF and MEK inhibitors.
Il‑kawża primarja tal‑melanoma hija espożizzjoni għad‑dawl ultravjola f’dawk b’livelli baxxi tal‑pigment tal-ġilda melanin (popolazzjoni bajda). Id‑dawl UV jista jkun mix‑xemx jew minn apparat għall‑ikkunzar. Persuni b’ħafna nevus, storja ta’ melanoma fil‑famigja, u funzjoni immuni debbuta huma f’riskju akbar ta’ melanoma.
L‑użu ta’ ħarsien mix‑xemx u l‑evitar tad‑dawl UV jista’ jipprevjeni l‑melanoma. It‑trattament huwa tipikament tneħħi permezz ta’ kirurġija. F’każijiet ta’ kanċer iktar avvanzat, lymph nodes fil‑qrib jistgħu jiġu ttestjati għat‑tixrid (metastasi). Ħafna nies jitfejqu jekk il‑metastasi ma seħħetx. Għal dawk li għandhom melanoma infirxet, l‑immunoterapija, it‑terapija bijoloġika, it‑terapija bir‑radjazzjoni, jew il‑kimoterapija jistgħu jtejbu s‑sopravivenza. B’tratament, ir‑rati ta’ sopravivenza għal ħames snin fl‑Stati Uniti huma 99 % fost dawk b’mard lokalizzat, 65 % meta l‑marda nfirxet għal lymph nodes, u 25 % fost dawk b’tixrid mill‑bogħod.
Il‑melanoma hija l‑aktar tip perikoluż ta’ kanċer tal‑ġilda. L‑Awstralja u New Zealand għandhom l‑ogħla rati ta’ melanoma fid‑dinja. Rati għoljin ta’ melanoma jseħħu wkoll fl‑Ewropa ta’ Fuq u fl‑Amerika ta’ Fuq. Melanoma sseħħ ħafna inqas fl‑Asja, l‑Afrika, u l‑Amerika Latina. Fl‑Stati Uniti, il‑melanoma sseħħ madwar 1.6 darbiet aktar spiss fl‑irġiel milli fin‑nisa.
○ Sinjali u sintomi
Sinjali bikrija ta’ melanoma huma bidliet fil‑forma jew fil‑kulur ta’ nevus eżistenti. Fil‑każ ta’ melanoma nodulari, hija dehra ta’ biċċa ġdida fuq il‑ġilda. Fi stadji aktar tard ta’ melanoma, in‑nevi jistgħu jħakku, ulċeru jew joħorġu d‑demm.
[A‑Asymmetry] Asimetrija tal‑forma
[B‑Borders] Bordur (irregolari bit‑truf u l‑kantunieri)
[C‑Color] Kulur (varjat u irregolari)
[D‑Diameter] Dijametru (akbar minn 6 mm = 0.24 pulzier = madwar id‑daqs ta’ gomma tal‑lapes)
[E‑Evolving] Tevolvi maż‑żmien
cf) Keratosis seborrheic tista’ tissodisfa xi wħud mill‑kriterji ABCD jew kollha, u tista’ twassal għal allarmi foloz.
Metastasi ta’ melanoma bikrija hija possibbli, iżda relattivament rari; inqas minn ħamsa tal‑melanomi dijanjostikati kmieni jsiru metastatiċi. Metastasi fil‑moħħ huma komuni f’pazjenti b’melanoma metastatika. Melanoma metastatika tista’ wkoll tinfirex għall‑fwied, għadam, addome, jew lymph nodes imbiegħda.
○ Dijanjosi
Meta wieħed iħares lejn iż‑zona inkwistjoni, huwa l‑aktar metodu komuni biex jissuspetta melanoma. Nevus li huma irregolari fil‑kulur jew fil‑forma huma tipikament immarkati bħala kandidati ta’ melanoma.
It‑tobba tipikament jeżaminaw il‑moli kollha, inklużi dawk b’dijametru ta’ inqas minn 6 mm. Meta tintuża minn speċjalisti mħarrġa, id‑dermoskopija hija aktar utli biex jiġu identifikati leżjonijiet maligni milli l‑użu tal‑għajn biss. Id‑dijanjosi hija permezz ta’ bijopsija ta’ kwalunkwe lezzjoni tal‑ġilda li għandha sinjali li tkun potenzjalment kanċeroġeni.
○ Trattament
#Mohs surgery
It‑tabib tiegħek jista’ jirrakkomanda immunoterapija, speċjalment jekk għandek melanoma ta’ stadju 3 jew 4 li ma tistax titneħħa bil‑kirurġija.
#Ipilimumab [Yervoy]
#Pembrolizumab [Keytruda]
#Nivolumab [Opdivo]