Basal cell carcinomahttps://en.wikipedia.org/wiki/Basal-cell_carcinoma
Basal cell carcinoma ndiyo aina inayojulikana zaidi ya saratani ya ngozi. Mara nyingi huonekana kama sehemu ngumu ya ngozi iliyoinuliwa isiyo na maumivu. Kidonda (lesion) kinaweza kung'aa na kinaweza kuwa na mishipa midogo ya damu inayopita juu yake, au inaweza kuonyeshwa kama eneo lililoinuliwa na vidonda. Saratani ya seli za misingi (Basal cell carcinoma) hukua polepole na inaweza kuharibu tishu zinazoizunguka, lakini haina uwezekano wa kusababisha metastasis au kifo.

Mambo ya hatari ni pamoja na kukabiliwa na mwanga wa ultraviolet (UV), tiba ya mionzi, mfiduo wa muda mrefu wa arseniki, na utendaji duni wa mfumo wa kinga (k.m. upandikizaji wa chombo). Mfiduo wa mwanga wa UV wakati wa utotoni ni hatari sana.

Baada ya uchunguzi wa biopsy, matibabu ni kawaida kwa kuondolewa kwa upasuaji. Hii inaweza kuwa kwa kukatwa rahisi ikiwa saratani ni ndogo; ikiwa saratani si ndogo, upasuaji wa Mohs unapendekezwa kwa ujumla.

Basal cell carcinoma inachukua angalau 32% ya saratani zote ulimwenguni. Kati ya saratani za ngozi isipokuwa melanoma, karibu 80% ni saratani ya seli za msingi (Basal cell carcinoma). Nchini Marekani, karibu 35% ya wanaume weupe na 25% ya wanawake weupe huathiriwa na basal cell carcinoma wakati fulani katika maisha yao.

○ Uchunguzi na Tiba
#Dermoscopy
#Skin biopsy
#Mohs surgery
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  • Vidonda vya vidonda vinavyoathiri ngozi ya pua kwa mtu mzee mara nyingi hutambuliwa kama Basal cell carcinoma. Pua ni mahali pa kawaida pa kutokea kwa aina hii ya saratani ya ngozi.
  • Basal cell carcinoma inaweza kujitokeza ikiwa na mipaka isiyo ya kawaida na vidonda.
  • Basal cell carcinoma kwa kawaida hutambuliwa kimakosa kama nevus katika Waasia. Pigmented basal cell carcinoma mara nyingi hutokea kwenye pua.
  • Basal cell carcinoma inapaswa kushukiwa ikiwa kinundu kigumu kinachochomoza kwenye mpaka kitazingatiwa.
  • Basal cell carcinoma ina umbo la ulinganifu usio wa kawaida. Kesi hizi mara nyingi hutambuliwa vibaya kama intradermal nevus.
  • Inaweza kutambuliwa vibaya kama nevus intradermal (intradermal nevus).
  • Basal cell carcinoma inaweza kudhaniwa kuwa wart.
  • Basal cell carcinoma inaweza pia kuonekana kwa namna ya kidonda. Katika kesi hii, inapaswa kutofautishwa na saratani ya seli ya squamous.
  • Katika nchi za Magharibi, Basal cell carcinoma inaonekana kama kinundu kigumu chenye telangiectasia.
  • Basal cell carcinoma ina sura sawa na alama ya kuzaliwa, lakini ukweli kwamba kidonda ni nodule ngumu ni muhimu kutofautisha kutoka kwa nevus.
  • Ingawa inaweza kufanana na nevus ya ndani ya ngozi (benign), ni muhimu kutambua kwamba kidonda cha karcinoma ya seli ya msingi (Basal cell carcinoma) ni kigumu.
  • Kwa Waasia, kisa cha kawaida cha Basal cell carcinoma huonekana kama kinundu cheusi chenye mpaka unaochomoza
  • Karcinoma ya seli msingi (Basal cell carcinoma) lazima itofautishwe na melanoma kwani karcinoma ya seli msingi (Basal cell carcinoma) ina utabiri bora zaidi kuliko melanoma.
  • Ikiwa mabaka haya yaliyoenea ni thabiti kwa kuguswa, inaashiria kwa hakika utambuzi wa carcinoma ya seli ya msingi ya uso (superficial basal cell carcinoma).
  • Inaweza kutambuliwa vibaya kama intradermal nevus.
References Basal cell carcinoma: pathogenesis, epidemiology, clinical features, diagnosis, histopathology, and management 26029015 
NIH
Basal cell carcinoma (BCC) ndio aina ya saratani ya ngozi inayojulikana zaidi. Mfiduo wa jua ndio sababu kuu. Takriban visa vyote vya BCC vinaonyesha ishara ya Hedgehog iliyokithiri katika uchanganuzi wa molekuli. Matibabu tofauti yanapatikana na kuchaguliwa kulingana na hatari ya kujirudia, umuhimu wa uhifadhi wa tishu, upendeleo wa mgonjwa, na kiwango cha ugonjwa.
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.
 Update in the Management of Basal Cell Carcinoma 32346750 
NIH
Saratania ya seli msingi (Basal cell carcinoma) ni aina ya saratani ya ngozi inayojulikana zaidi kwa watu wazima wenye ngozi nyeupe wenye umri wa miaka 50 na kuendelea. Idadi yake inaongezeka ulimwenguni pote, hasa kutokana na mwanga wa jua (ultraviolet light). Genodermatosis (genodermatosis) zinaweza kuwafanya watu wawe na uwezekano wa kupata saratani hii katika umri mdogo. Saratania ya seli msingi hutofautiana katika ukali, kuanzia vidonda vidogo vinavyopona kwa urahisi hadi vidonda vikubwa vinavyohitaji majadiliano katika timu maalum za matibabu. Utabiri (prognosis) hutegemea uwezekano wa saratani kurudi au uwezo wake wa kuharibu tishu zilizo karibu. Upasuaji (surgical removal) ndio matibabu ya kawaida kwa kesi nyingi, kuhakikisha kuondolewa kwa usahihi na uwezekano mdogo wa kurudia. Mbinu chache za matibabu (treatment modalities) zinaweza kutibiwa kwa ufanisi vidonda vidogo vinavyopona kwa urahisi.
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.
 European consensus-based interdisciplinary guideline for diagnosis and treatment of basal cell carcinoma-update 2023 37604067
Tiba kuu ya BCC ni upasuaji. Kwa hatari kubwa au ya kurudi ya BCC, hasa katika maeneo muhimu, upasuaji unaodhibitiwa kwa micrographically (micrographically controlled surgery) unapendekezwa. Wagonjwa wenye BCC ya hatari ndogo ya uso (superficial) wanaweza kuzingatia matibabu ya topiki au mbinu za uharibifu. Tiba ya Photodynamic (photodynamic therapy) hufanya kazi vizuri kwa BCC za uso na BCC za nodular zenye hatari ndogo. Kwa BCC ya hali ya juu au metastatic, vizuizi vya Hedgehog (vismodegib, sonidegib) vinapendekezwa. Ikiwa kuna maendeleo ya ugonjwa au kutovumilia kwa vizuizi vya Hedgehog, tiba ya kinga na anti-PD1 antibody (cemiplimab) inaweza kuzingatiwa. Tiba ya mionzi (radiotherapy) ni chaguo nzuri kwa wagonjwa ambao hawawezi kufanyiwa upasuaji, hasa wagonjwa wazee. Electrochemotherapy inaweza kuzingatiwa ikiwa upasuaji au radiotherapy sio chaguo.
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.