Malignant melanoma - Melanoma Malinna
☆ 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 2.5cm (1 pulzier) b'1.5cm (0.6 pulzier)
Għalkemm dan il-każ ġie djanjostikat bħala melanoma, is-sejba viżwali hija aktar simili għal ematoma tad-dwiefer. Ematomi tad-dwiefer (beninni) tipikament jisparixxu fi żmien 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.
References
Melanoma hija tip ta’ tumur li jifforma meta l-melanoċiti jsiru malinni. Melanoċiti joriġinaw mill-crest newrali. Dan ifisser li l-melanomi jistgħu jiżviluppaw mhux biss fuq il-ġilda iżda wkoll f'postijiet oħra fejn iċ-ċelloli tal-crest newrali jivvjaġġaw, 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, responsabbli għal 90% tal-imwiet mill-kanċer tal-ġilda. Biex jindirizzaw dan, esperti minn the European Dermatology Forum (EDF) , the European Association of Dermato-Oncology (EADO) , and the 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’ kanċer 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 apparat għall-ikkunzar. Dawk b'ħafna nevus, storja ta 'melanoma ta' membri tal-familja, u funzjoni immuni batuta 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 tneħħija permezz ta 'kirurġija. F'dawk b'kanċer kemmxejn akbar, lymph nodes fil-qrib jistgħu jiġu ttestjati għat-tixrid (metastasi). Ħafna nies jitfejqu jekk il-metastasi ma tkunx seħħet. Għal dawk li fihom infirxet il-melanoma, l-immunoterapija, it-terapija bijoloġika, it-terapija bir-radjazzjoni, jew il-kimoterapija jistgħu jtejbu s-sopravivenza. Bit-trattament, ir-rati ta 'sopravivenza għal ħames snin fl-Istati 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-Istati 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 il-kulur ta' nevus eżistenti. Fil-każ ta 'melanoma nodulari, hija d-dehra ta' biċċa ġdida fuq il-ġilda. Fi stadji aktar tard ta 'melanoma, in-nevi jista' ħakk, ulċera jew joħroġ id-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-żona inkwistjoni huwa l-aktar metodu komuni biex wieħed jissuspetta melanoma. Nevus li huma irregolari fil-kulur jew fil-forma huma tipikament ittrattati 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 malinni milli l-użu tal-għajn biss. Id-dijanjosi hija permezz ta' bijopsija ta' kwalunkwe leżjoni 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 stadju 4 li ma tistax titneħħa bil-kirurġija.
#Ipilimumab [Yervoy]
#Pembrolizumab [Keytruda]
#Nivolumab [Opdivo]