Carcinoma cutaneum

Description:

The carcinoma cutaneum is one of the most widespread tumors. The standardized indicators of incidence make among men 26, and among women — 21 on 100 000 population. In the territory of the former USSR the tumor meets in the south of Ukraine, in Moldova, the Krasnodar and Stavropol regions, the Astrakhan and Rostov region more often. Cancer cases of skin increase in recent years. Rate of a gain corresponds to the general growth of incidence of malignant tumors.

Three patterns explain the unequal frequency of a carcinoma cutaneum in different territories.

  1. The tumor meets at residents of the southern areas and areas more often. So in Krasnodar Krai cancer cases of skin are 5 times higher, than in the Tyumen region.
  2. Cancer preferential arises with light coloring of skin at Blacks this tumor occurs at people at 6-10 times less than at white. In the southern regions of our country the carcinoma cutaneum occurs at the white-skinned visitor of the population several times more often than at locals.
  3. The probability of emergence of a carcinoma cutaneum is higher at the persons working in the open air. Especially often the tumor develops at the fishermen and people occupied with agricultural outside work.

Symptoms of the Carcinoma cutaneum:

Superficial form — the most frequent option of a carcinoma cutaneum. It begins with one or several merging painless small knots size there is slightly more match head. The small knot slightly towers over the surface of skin, has yellowish or deadwhite color and a dense consistence. As a rule, during this period patients do not see a doctor.
Eventually the tumor increases in sizes and takes a form of the painless plaque of yellow or grayish-white color with a wax-like shade which is slightly towering over skin. Surface its smooth or rough. Edges act in the form of the dense roller with an uneven scalloped contour. Further in the center of a plaque there is a retraction covered with a scale or a crust. Removal of a crust leads to emergence of a droplet of blood. With increase in the sizes of a tumor retraction turns into the erozirovanny surface covered with a crust and surrounded with dense uneven edges in the form of the roller which is abruptly acting, as if cut off. The described pictures are more characteristic of bazalnokletochny cancer.
The Infiltriruyushchy form has an appearance deeply of an ulceration with the uneven, hilly, covered with crusts from necrotic masses bottom and dense, valikoobrazny edges. The tumor quickly sprouts surrounding fabrics and becomes motionless. Such new growth on histologic structure usually is planocellular cancer.
The papillary form of a carcinoma cutaneum meets seldom. It has an appearance of the dense, towering over a surface, easily bleeding node on the wide basis. The surface of a node is hilly, covered with crusts, often reminds a cauliflower. Such growth form is more often observed at planocellular cancer.

Reasons of the Carcinoma cutaneum:

The contributing factors. The most important factor promoting emergence of a carcinoma cutaneum is long radiation by sunshine of an ultra-violet range. The carcinoma cutaneum can develop under the influence of radoactive radiation. Can lead long thermal influence to developing of a tumor. The professional vrednost capable to cause a carcinoma cutaneum, the contact with arsenic, pitches, tar, soot is.
Precancerous diseases. The carcinoma cutaneum, as a rule, develops against the background of the previous changes of skin. The pigmental xeroderma, Pedzhet's disease, Bowen's disease and Keyr's eritroplaziya are considered as an obligate precancer. The obligate precancer of skin meets seldom, develops slowly, but always turns into cancer.
Optional precancer is chronic dermatitis, is long not healing wounds and ulcers, chronic dystrophic and inflammatory processes.

Cancer therapy of skin:

At a carcinoma cutaneum apply beam, surgical, cryogenic, laser and medicinal treatment, and also their combinations. The choice of a method of treatment depends on localization, a growth form, a stage and a histologic structure of a tumor, and also on a condition of surrounding skin.
At cancer arrangement on the head and especially on a face it is necessary to consider cosmetic effects of treatment that however should not reduce requirements to radicalism of treatment.
Radiation therapy gained distribution at tumors of the small sizes. The total dose Gray provides at 50-70 considerable percent of good results. Worse results at an infiltriruyushchy form, and also at the new growths located in corners of eyes on a nose, an auricle and on sites near a cartilage. Shortcomings of a method are beam damages of healthy fabrics (perichondrites, beam ulcers), and also big (more than 1 month) treatment duration.
Surgical is lecheniyeprimenyat in most cases at cancer of trunks and extremities. A tumor excise at distance 1–2 cm from visible edge. Cryogenic influence is carried out by means of liquid nitrogen. The necrosis of fabrics caused by cooling leads to destruction of a new growth with the subsequent healing without rough hems. The method can be applied at superficial infiltration of skin. Treatment by laser beams also rather effectively. For a necrosis of a tumor one session suffices usually. Healing of the site of a necrosis happens to formation of a thin elastic hem.
Medicinal treatment is used only as a component of the combined treatment which, besides, includes operation and before - or postoperative radiation therapy.
Treatment at a recurrence of a carcinoma cutaneum.
Choice method in treatment of a recurrence of a carcinoma cutaneum is surgical excision of a recurrent tumor with the subsequent plastics of the formed defects.
Treatment in the presence of metastasises of a carcinoma cutaneum.
Indispensable condition at treatment of metastasises of a carcinoma cutaneum is the izlechennost of primary tumor. Surgical removal of metastasises — the main method. An operative measure is undertaken at clinically defined metastasises or identification of the increased lymph nodes, suspicious on metastatic. At restrictedly mobile metastasises carry out the combined treatment — preirradiation with their subsequent surgical removal.