Malignant melanoma - Melanoma Malignant
☆ Natiijooyinka Stiftung Warentest ee 2022 ee ka yimid Jarmalka, ku qanacsanaanta macaamilka ee ModelDerm ayaa waxyar uun ka hooseysay la-talinta telemedicine-ka ee lacagta lagu bixiyo.
melanoma qiyaastii 2.5cm (1 inch) by 1.5cm (0.6 inch)
In kasta oo kiiskan lagu sheegay melanoma, aragtida aragga waxa ay la mid tahay hematoma cidiyaha. Cidi hematomas (benign) waxay caadi ahaan ku baaba'aan hal ilaa laba bilood gudahood marka la riixo. Sidaa darteed, haddii nabarku sii jiro muddo dheer, melanoma ayaa laga yaabaa in laga shakiyo oo waa in la gooyaa biopsy.
References
Melanoma waa nooc ka mid ah burooyinka oo sameysma marka melanocytes ay noqdaan kuwo xun. Melanocytes waxay ka soo jeedaan qolofta neerfaha. Tani waxay ka dhigan tahay in melanomas aysan ku kori karin maqaarka oo kaliya laakiin sidoo kale meelaha kale ee unugyada neerfaha ee ku safraan, sida mareenka caloosha iyo mindhicirka iyo maskaxda. Bukaanka qaba marxaladda 0 melanoma waxay leeyihiin heerka badbaadada shanta sano ah 97%, halka kuwa qaba heerka IV ay leeyihiin qiyaas kaliya 10%.
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) waa nooc ka mid ah burooyinka maqaarka oo aad khatar u ah, oo mas'uul ka ah 90% dhimashada kansarka maqaarka. Si taas wax looga qabto, khubarada ka socota the European Dermatology Forum (EDF) , the European Association of Dermato-Oncology (EADO) , and the European Organization for Research and Treatment of Cancer (EORTC) ayaa iska kaashaday.
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.
Melanoma, oo ah nooc ka mid ah kansarka maqaarka, ayaa u taagan xiriirka dhow ee uu la leeyahay habka difaaca jirka. Tani waxay caddaynaysaa in ay korodhay dadka hab-dhiskooda difaaca jidhkoodu daciif yahay, joogitaanka unugyada difaaca ee burooyinka asalka ah iyo ku faafitaankooda qaybaha kale ee jidhka, iyo xaqiiqda ah in habka difaaca jirka uu aqoonsan karo borotiinno gaar ah oo laga helo unugyada melanoma. Muhiimad ahaan, daawaynta kor u qaadaysa habka difaaca jirka ayaa muujiyay ballan la dagaallanka melanoma. Iyadoo isticmaalka daawaynta kor u qaadida difaaca jirka ee lagu daaweynayo melanoma horumarsan ay tahay horumar dhow, cilmi-baaris dhawaan la sameeyay ayaa muujineysa in isku darka daawayntan chemotherapy, radiotherapy, ama daaweynta molecular ee bartilmaameedka ah ay si weyn u wanaajin karto natiijooyinka. Si kastaba ha ahaatee, daaweynta difaaca jirka ee noocan oo kale ah waxay kicin kartaa saameyno badan oo la xiriira difaaca jirka oo saameeya xubnaha kala duwan, taas oo xaddidi karta isticmaalkeeda. Horay u fiirsashada, hababka mustaqbalka ee lagu daaweynayo melanoma horumarsan waxa ku lug leh daawayn lagu beegsanayo isbaarooyinka difaaca ee gaarka ah sida PD1, ama daroogooyinka farageliya dariiqyada molecular ee gaarka ah sida BRAF iyo 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.
Sababta ugu weyn ee melanoma waa soo-gaadhista iftiinka ultraviolet ee kuwa leh heerar hoose ee melanin midabka maqaarka (dad cad). Iftiinka UV waxa laga yaabaa inuu ka yimaad qoraxda ama aaladaha haragga. Kuwa qaba nevus badan, taariikhda melanoma ee xubnaha qoyska, iyo shaqada difaaca oo liidata waxay halis weyn ugu jiraan melanoma.
Isticmaalka muraayadda qorraxda iyo iska ilaalinta iftiinka UV waxay ka hortagi kartaa melanoma. Daawaynta caadi ahaan waa ka saarista qaliinka. Kuwa qaba kansar waxyar ka weyn, qanjidhada u dhow ayaa laga baari karaa faafitaanka (metastasis). Dadka intooda badan waa la daaweeyaa haddii metastasis-ka aysan dhicin. Kuwa ay melanoma ku faafto, immunotherapy, therapy biologic therapy, radiotherapy, ama chemotherapy ayaa wanaajin kara badbaadada. Daawaynta, heerka badbaadada shanta sano ee Maraykanka ayaa ah 99% ka mid ah kuwa qaba cudurrada gudaha, 65% marka uu cudurku ku faafo qanjidhada qanjidhada, iyo 25% ka mid ah kuwa faafin fog.
Melanoma waa nooca ugu khatarta badan ee kansarka maqaarka. Australia iyo New Zealand ayaa leh heerarka ugu sarreeya ee melanoma adduunka. Heerarka sare ee melanoma ayaa sidoo kale ka dhaca Waqooyiga Yurub iyo Waqooyiga Ameerika. Melanoma waxay aad uga yar tahay Aasiya, Afrika, iyo Laatiin Ameerika. Gudaha Maraykanka, melanoma waxay ku dhacdaa qiyaastii 1.6 jeer in ka badan ragga marka loo eego dumarka.
○ Calaamadaha iyo calaamadaha
Calaamadaha hore ee melanoma waa isbeddelka qaabka ama midabka nevus ee jira. Xaaladda melanoma nodular, waa muuqaalka buro cusub oo maqaarka ah. Marxaladaha dambe ee melanoma, nevi waxa laga yaabaa inuu cuncuyo, boogo, ama dhiig baxo.
[A-Asymmetry] Asymmetry ee qaabka
[B-Borders] Xuduud (aan caadi ahayn oo geeso iyo gees leh)
[C-Color] Midab (kala duwan oo aan joogto ahayn)
[D-Diameter] Dhexroor (ka weyn 6 mm = 0.24 inch = qiyaastii cabbirka qalin masar)
[E-Evolving] Kor u kac waqti ka dib
cf) Seborrheic keratosis waxa laga yaabaa inay la kulanto qaar ama dhammaan shuruudaha ABCD, oo waxay keeni kartaa digniino been ah.
Metastasis ee melanoma hore waa suurtagal, laakiin waa dhif; In ka yar shan meelood meel melanomas ee la ogaaday goor hore ayaa noqda metastatic. Kala-baxyada maskaxda waxay ku badan yihiin bukaannada qaba melanoma-da. Metastatic melanoma waxa kale oo ay ku fidi kartaa beerka, lafaha, caloosha, ama qanjidhada fog.
○ Diagnosis
Marka la eego aagga laga hadlayo waa habka ugu badan ee looga shakiyo melanoma. Nevus kuwaas oo aan caadi ahayn midab ama qaab ayaa sida caadiga ah loola dhaqmaa sidii musharaxiinta melanoma.
Dhakhaatiirtu waxay caadi ahaan baadhaan dhammaan burooyinka, oo ay ku jiraan kuwa dhexroorkoodu ka yar yahay 6 mm. Marka ay isticmaalaan khabiiro tababaran, dermoscopy-ga ayaa aad waxtar u leh si loo garto nabarrada halista ah marka loo eego isticmaalka isha qaawan oo keliya. Cilad-sheegiddu waa biopsi laga qaado nabar kasta oo maqaarka ah oo leh calaamado muujinaya inuu yahay kansar.
○ Daawaynta
#Mohs surgery
Dhakhtarkaagu waxa laga yaabaa inuu kugula taliyo immunotherapy gaar ahaan haddii aad leedahay marxaladda 3 ama heerka 4 melanoma oo aan lagaga saari karin qaliinka.
#Ipilimumab [Yervoy]
#Pembrolizumab [Keytruda]
#Nivolumab [Opdivo]