Melanoma in situ of the lips, eyelids, head, neck, trunk, shoulders, limbs, hips. Diagnosis of melanoma of the mucous membranes. How is melanoma treated?

Melanoma is one of the most malignant tumors that develops in most cases from congenital or acquired pigmented or non-pigmented nevi (birthmarks, moles). Melanoma is a rare disease, but in terms of the variety of manifestations and the number of errors made by doctors in its diagnosis, it differs sharply from other malignant neoplasms.

The tumor can appear at any age, but most of it affects people over 40 years of age. Women suffer from melanoma more often than men (approximately 3:2), probably because facial skin nevi are often injured during cosmetic procedures. Therefore, to prevent the development of melanomas, it is of great practical importance to study the morphology of age spots and factors contributing to their malignancy.

Pigmented formations and factors predisposing to the development of melanoma

Nevi are very different: in size - from point formations to extensive spots (10 cm in diameter), in shape - round, oval, flat or protruding above the skin surface in the form of a platform, tubercle, papilla, and in color - from colorless and light brown to purple and black. Most nevi occur without identifiable causes. In some cases, they are preceded by some kind of injury or swelling in a limited area of ​​\u200b\u200bthe skin, where a pigment spot is then found.

Several varieties of pigmented nevi with different propensity to malignancy have been established. In addition, the aggressiveness of malignant growth of melanomas that have already developed depends on which pigment spot the tumor developed from. Melanomas, which arise from complex birthmarks, have the most intensive malignant growth. However, it should not be forgotten that many melanomas appear without any clinically detectable precursors, although up to 15 or more different pigmented formations can be found on the skin of almost every person. This once again confirms the fact that their degree of malignancy is low.

It is impossible to distinguish a regenerating pigment spot from an ordinary nevus in appearance. Moreover, even experienced pathologists, studying sections of such tumors under a microscope, often find it difficult to express a definite opinion about the picture they observe. It is even more difficult to determine by appearance and even under a microscope a type of pigmented nevus. However, it is extremely important to establish an accurate diagnosis, since the method of treatment depends on it.

During a person's life, pigment formations of various types gradually pass one into another - from those prone to malignancy to more favorable along the course. Despite the difficulties described above in the differential diagnosis of various pigmented lesions, oncologists distinguish them into 5 main types: dermo-epidermal, or borderline, nevus, intradermal (knotty) nevus, mixed nevus, blue (blue) nevus, juvenile (juvenile) melanoma. It is assumed that the mixed nevus is most prone to malignancy, less prone to: dermo-epidermal and intradermal, even less prone to blue nevus and juvenile melanoma.

Dermo-epidermal nevi are common birthmarks, which account for approximately 75% of all pigmented skin lesions. As a rule, they are brown, often hair grows on their surface. On the palms and soles, these spots are extremely rare. Almost every person has several of these spots on the skin, with age their number increases significantly. Smooth superficial birthmarks covered with hair, without knotty blotches, almost never become malignant. Meanwhile, rough spots with intralesional hardening are prone to malignancy. Intradermal (knotty) nevus has the appearance of a flat pigment spot slightly protruding above the skin surface from a few millimeters to 1-2 centimeters in diameter, dark brown or black, often covered with hair. This nevus is found on the skin of any part of the body, as well as on the mucous membranes.

Many pigmented formations on the soles and palms include elements of dermo-epidermal and intradermal nevi, that is, they are complex birthmarks. A mixed nevus consists of dermo-epidermal and intradermal birthmarks in various combinations. Therefore, the size, color and other features of these nevi depend on the predominance of the elements of one or another type of spots. In children with such moles, the nodular nevus occupies almost 70% of the spot. However, with age, this component of the tumor gradually decreases, and in adults no more than 20% of the former mixed nevi contain such nodular inclusions.

Blue nevus is more often found on the skin of the buttocks, the back of the arms and legs, as well as on the skin of the face. This relatively rare pigmented formation comes in a variety of colors - from pale blue to black - and, as a rule, without hairline. In most cases, it appears in the first days after birth and also disappears in the first years of life. Isolated cases of the degeneration of a blue nevus into melanoma are described.

Juvenile, or pre-pubescent, melanoma is a benign neoplasm, but histologically it is very similar to a malignant tumor (melanoma). Therefore, only a very experienced pathologist can distinguish true melanoma from juvenile melanoma. This type of nevi is most often detected in adolescents and sometimes in young adults. Juvenile melanoma rarely turns into true melanoma. But if this happens, such a melanoma in development is no different from melanomas that have arisen from other nevi.

Age spots can appear on the mucous membranes of the mouth, nose, external female genital organs, rectum, etc. They are also malignant very rarely. However, then the tumor grows extremely malignantly, extensively metastasizing in the early stages of the disease.

A practitioner often needs to decide which of those with pigmented and non-pigmented formations should be recommended for their removal? The answer to this question follows from the characteristics of the distribution of pigment spots, which indicate that every person has at least one pigment spot on the skin, and very, very few suffer from melanoma. Therefore, nevi are radically removed only in cases where they are injured or irritated by clothing, and also when, for no apparent reason, they begin to become intensely pigmented, increase in size, and bleed.

Pigmented spots are excised within normal skin, retreating from the edge of the spot at least 1 cm. It should immediately be noted that the removed preparation should be sent to an experienced histologist for a thorough pathomorphological examination. If there are no conditions for such a study on site, pigmented formations cannot be removed. Patients in such cases should be referred to oncological dispensaries.

Manifestations of melanoma

Many melanomas occur for no apparent reason and outwardly do not differ from a benign pigmented papilloma, a seal covered with papillae, cracks and folds of various shapes and sizes.

Signs of the transition of a benign pigmented formation to melanoma are as follows: this formation increases, thickens or ulcerates; its pigmentation changes in the direction of strengthening or weakening; redness or congestive areola appears around the base of the spot; there are pigmented or non-pigmented radial radiant strands around the spot; the spot grows exophytically. Often, malignancy of the nevus and further growth of the tumor are manifested by the fact that pigmented or non-pigmented daughter nodules - satellites - begin to be determined on the skin near the unchanged primary spot or lymph nodes increase. Of the above signs, at least one pronounced, and even more so, several more reliably indicate the beginning malignant degeneration of the pigmented formation. The appearance of satellites and an increase in regional lymph nodes mean not only malignancy, but also the spread of the pathological process.

In typical cases of the degeneration of a nevus into melanoma, the following occurs: a birthmark after an injury or without identifiable causes changes color and increases. The entire spot or any part of it begins to rise above the skin. The consistency of a growing tumor can be very different. Its surface is initially smooth, even shiny, then bumps appear on it, which ulcerate and bleed.

In the future, the tumor, as it were, is bordered by a reddish-stagnant roller, from which pigmented or non-pigmented strands that are dense to the touch depart radially. Over time, these symptoms increase, in different people with different intensity; regional and distant metastases appear.

Metastases in melanoma can be in all organs and tissues of the human body, and often they are the first of the detected signs of the disease. Sometimes in patients with even easily defined metastatic tumors of melanoma, the primary focus cannot be detected.

Like all malignant neoplasms, melanoma is divided into 4 stages according to the course of the disease. In these stages, tumors of various sizes and distribution are detected.

I stage. A malignant nevus or an already developed tumor up to 2 cm in diameter, flat or warty, growing only in the skin, without detectable metastases, is found.

II stage. A more extensive tumor, often papillomatous, often with an ulcerated surface, infiltrating the subcutaneous tissue with a single mobile metastasis.

III stage. A tumor of various sizes that invades the subcutaneous tissue and muscles, with a single limitedly mobile regional metastasis or multiple mobile metastases in the nearest lymph nodes.

IV stage. On the skin around the primary tumor or along the lymphatic vessels, metastatic disseminations are found or a tumor of any size with distant metastases is detected.

Melanoma metastasizes via lymphogenous or hematogenous pathways. In the first stages of tumor development, regional (lymphogenic) metastases are more often determined. In many cases, they are the reason for the patient to visit a doctor. Very often there are lymphogenous metastases in the skin near the primary tumor or at a considerable distance from it, single or multiple, of various sizes, colors and textures.

There are 3 forms of skin metastases of melanoma: satellite, erysipeloid and a form that develops according to the type of thrombophlebitis. If metastases appear near the primary tumor in the form of small dark spots of various sizes and colors, slightly rising above the skin, this is a satellite form. If the spread of metastases resembles erysipelas around the primary tumor, the skin at this site becomes brownish-red, swollen and painful - this is the erysipeloid form. Metastasis of melanomas by the type of thrombophlebitis resembles the acute period of this disease. Painful strands with hyperemia of the skin around them spread radially around the tumor. These strands gradually elongate and finally ulcerate.

Hematogenous metastasis through the formation of disseminated tumor elements is more characteristic of melanoma than any other malignant tumor. Metastases occur at any stage of the development of the primary tumor or after its treatment and are found in almost all organs and tissues. More often, they develop in the liver, lungs, bones, brain, and heart.

Hematogenous metastases of melanoma are usually multiple. At the same time, a variety of symptoms are found, depending on the organs and tissues in which the process develops. Metastases are manifested by pain, impaired movement of the limbs, swelling of certain parts of the body, jaundice, compression syndrome, etc. For the purpose of ease of orientation in all this variety of symptoms, most oncologists distinguish three types of hematogenous metastasis: cutaneous, visceral and mixed.

The skin type is characterized by the appearance under the skin in various areas of the scalp, face, trunk and limbs of multiple round or oval nodes, from barely palpable to 2-4 cm in diameter. Small nodes are covered with unchanged skin, and over large ones the skin stretches, becomes thinner, becomes shiny and soon ulcerates. The visceral type of metastasis is spoken of in cases where parenchymal and other distant organs are affected, in which disseminations are detected; solitary metastases are extremely rare.

The mixed type of metastasis is characterized by various manifestations and a different clinical course of the disease, depending on the predominance of the skin or visceral component. Hematogenous melanoma metastases are very often either not recognized or misjudged. Doctors are misled by vague manifestations of the primary focus, the severity of the condition, concomitant intoxication due to the decay of metastatic tumors in distant organs, and they change the direction of research. In most cases, soon after hematogenous metastases have developed, patients die, although the disease can proceed in waves.

Diagnosis of melanoma

Naturally, the local doctor cannot establish the final diagnosis of such a disease, because this requires rather complex studies on special devices. Yes, and this is not required from the local doctor. He should promptly, on the basis of an analysis of complaints and examination data of the patient, suspect melanoma. But even with the slightest suspicion of malignancy of the birthmark, not to mention the clearer symptoms of the disease, no manipulations can be carried out, as a result of which the tumor is injured. A biopsy in these cases is also contraindicated, since after it a generalization of the process is possible.

To clarify the diagnosis of melanoma, various research methods are used: tumor indication with radioactive phosphorus, thermodifferential test, radiation melanuria, cytological studies, and others.

Although the local doctor cannot use them in his daily work, it is useful for him to get an idea of ​​the fundamental principles of their use in order to choose the right tactics in carrying out further research and in a timely manner to refer patients to oncological dispensaries where these diagnostic methods are used. The method of tumor indication with radioactive phosphorus (P32) is based on the ability of phosphorus to accumulate in tissues with increased metabolism. In growing melanomas, in which just the exchange is increased, phosphorus accumulates many times more than in symmetrically located areas of healthy skin. However, this method of diagnosing melanomas, despite its high "sensitivity", is nonspecific. The accumulation of phosphorus depends on the increase in metabolism in tissues (phosphorus is included in nucleic acids), which happens not only with the development of a malignant tumor, but also with other pathological processes. Therefore, in some cases, the indicators of this method are unreliable.

The thermodifferential test is based on determining the temperature difference between the skin area affected by melanoma and the symmetrically located area of ​​healthy skin. The temperature of the skin over melanoma is on average one degree higher than that of healthy skin. However, this method is not always reliable.

Radiation melanuria often appears after tumor irradiation. At the same time, melanogens are released from the tumor cells damaged by the rays, which enter the bloodstream and are excreted in the urine. If you add a solution of ferric chloride to such urine, the latter oxidizes melanogens into melanin, which stains the urine gray or black.

This reaction is recognized by many oncologists as specific for melanomas. However, there are not always enough melanogens in the urine to be detected by this reaction. Sometimes in the stage of dissemination of melanoma (during the decay of tumor cells), melanogens are released from it into the blood, which are detected in the urine by the above method. With intensive decay of the tumor, a large amount of melanogens appears in the urine, they are oxidized in the air, and the urine becomes black. Due to its simplicity, accessibility and safety for the patient, cytological examination is carried out in all necessary cases. To do this, a glass slide is applied to the ulcerated surface of the tumor, and after examining the resulting prints under a microscope, a conclusion is made about the nature of the pathological process. Only the positive results of the study are of practical importance.

Like all melanoma diagnostic methods described above, the cytological method cannot be absolutely accurate. However, as a result of comparing the data obtained from all studies, it is possible in most cases to establish the correct diagnosis.

Only in cases that are particularly difficult for diagnosis, oncologists remove the tumor within healthy tissues, followed by pathomorphological and histochemical examination. The results of such studies are of decisive importance in the diagnosis of melanomas. But even such an excision of the tumor is performed, as a rule, after the devitalization of its tissues with ionizing rays.

Mucosal melanoma is a relatively rare disease, accounting for less than 1% of all melanomas.

These formations have a much more aggressive growth compared to skin forms, are prone to active metastasis to regional and distant sites, and often recur, which leads to high mortality rates. The prognosis for mucosal melanomas is poor, with a five-year survival rate of 10–15%.

Mucosal melanomas of the head and neck region account for half of all mucosal melanomas. They are mainly localized in the projection of the upper respiratory tract, oral cavity and pharynx. Other forms of mucous melanomas belong to the urogenital area. The distribution of tumors by localization is presented in the table.

According to scientists, unlike other dermatological cancers, mucosal melanoma does not depend on exposure to ultraviolet radiation. In addition, there are no obvious risk factors for this type of tumor, including family history.

Melanoma of the mucous membranes affects the following organs:

• mouth and nose;
• paranasal sinuses;
• trachea and bronchi;
• lips;
• throat
• esophagus;
• stomach;
• intestines;
• gallbladder;
• anorectal area;
• vulva and vagina;
• urethra and bladder;
• conjunctiva of the eye.

For convenience, mucosal melanomas are sometimes divided into three subgroups:

• melanoma of the gastrointestinal mucosa;
• respiratory;
• urogenital melanomas.

Given the tendency to early lymphogenous and hematogenous metastasis, it is sometimes difficult to establish whether the mucosal tumor is primary or metastatic. Depending on the localization, the tumor will have certain features. So, for example, primary melanomas of the oral cavity, nose, pharynx, as well as the anorectal and genital areas first develop in the radial direction, increase in area, taking the form of a spot; only then do they acquire volume, rising above the surface of the mucosa, and begin to infiltrate the underlying base.

Some mucosal melanomas develop from melanocyte cells that are present in the tissue structure of an organ (lips, nose, oral cavity, anorectal region, etc.). The development of primary melanomas on the mucosa of organs, where pigment cells are initially absent (trachea, bronchi), can be explained by violations of tissue embryonic development.

Symptoms of melanoma of the mucous membranes

Symptoms of mucosal melanoma vary significantly. This is primarily due to the localization of the pathological process.

The most common signs of pigmented tumors of the mucous membranes:

• a suspicious spot in the mouth or nasal passages;
• unexplained mucosal defects or ulcerative lesions that do not heal;
• bleeding from the rectum or vagina of unknown etiology;
• hemorrhoids that do not heal for a long time, despite treatment;
• abdominal pain during intestinal motility.

If any of these symptoms appear, a specialist consultation is necessary. Mucosal melanomas can quickly spread to neighboring and distant organs.

Favorite localization for metastases are:

• lungs;
• liver;
• brain;
• The lymph nodes;
• intestines.

Melanoma of the mouth

Oral melanoma is a rare tumor with an incidence of 0.2 per million. Oral melanomas originate from melanocytes normally present in the oral cavity. This form is most common among the elderly. It develops most often in a new place and only in 30% of cases is formed in the place of a pre-existing pigmented formation. Melanoma in the mouth is most often localized on the soft and hard palate, the mucous membrane of the gums of the upper jaw, less often on the tongue, tonsils and uvula. Initially, the tumor is asymptomatic, representing a flat spot. In the process of development, edema, ulceration, bleeding, and toothache occur.

Oral melanoma metastasizes to regional lymph nodes in 25% of patients.

Melanoma of the nose

Primary respiratory melanoma is most common in the nasal cavity, paranasal sinuses, and very rarely in the larynx and mucosa of the tracheobronchial tree. A tumor of the nasal mucosa, unlike melanoma of the skin of the nose, is a rare disease, its frequency is 0.3 per 1 million (for paranasal sinuses - 0.2 per 1 million). The favorite localization of melanoma on the nasal mucosa is the septum and side walls, and among the paranasal sinuses, the sinuses of the upper jaw and the ethmoid bone are most often involved in the process.

The disease is more common in older people. Common symptoms: unilateral nasal congestion, nosebleeds. Most tumors are presented as a polypoid, brown or black pigmented mass, often ulcerated, and non-pigmented forms are not uncommon.

Melanoma of the lips

Melanoma in the lip area often develops from an already existing pigment spot. Tumors that begin their growth with unchanged mucosa are less common. At first, melanoma on the lip is a pigment spot, which gradually increases in volume, becomes dense, and then infiltrates the underlying base.

Urogenital melanoma

Although rare, melanoma can occur in almost any part of the urogenital tract, including the vulva, vagina, uterus, urethra, and bladder. Pigmentary tumors of the mucous membranes of the urogenital area are more common among women. The genitals account for 18% of all melanomas of the mucous membranes, the urinary tract - 3%. Among the female genital tract, vulva tumors are the most susceptible, with a frequency of 0.1 per 1 million.

Melanoma predominantly develops on the labia majora and clitoris. Older women get sick more often. The most common symptoms are: bleeding, pain, itching, irritation, abnormal discharge.

Diagnosis of melanoma of the mucous membranes

In the diagnosis of mucosal melanoma, errors often occur. Due to its hidden position and lack of noticeable early signs, detection of mucosal melanoma is usually delayed.

When making a diagnosis of primary melanoma, especially if it is rare, it is important to exclude the possibility of a metastatic lesion from a primary cutaneous or ocular melanoma.

If mucosal melanoma is suspected, endoscopic examinations are performed:

• tracheobronchial tree;
• upper respiratory tract;
• esophagus and stomach;
• large intestine;
• rectal segment.

During the diagnostic procedure, the doctor takes fragments of the altered mucosa for analysis. Biopsy of a sample of suspicious tissue and subsequent histopathological examination is the main point in the diagnosis of mucoid melanomas.

Amelanotic forms of tumors, which are often found among mucosal lesions, further complicate diagnosis. Immunohistochemical staining of the material to detect tumor protein (S-100, HMB-45, Melan-A, Mart-1) and tyrosinase enzyme helps in the diagnosis of non-pigmented tumors.

If the spread and metastasis of mucous melanomas is suspected, the body is scanned with visualization: CT, PET CT, MRI.

Treatment of mucosal melanoma

Today, surgical treatment is the main treatment option and can be combined with adjuvant radiotherapy. However, the prognosis for melanomas of the mucous membranes remains unsatisfactory. Local relapses occur in half of the cases. Radiation therapy for melanomas of the mucous membrane of the head and neck somewhat stabilizes the condition, but does not improve survival in common forms of the disease.

At the same time, due to the complex topography of some tumors, it is not always possible to perform a sentinel lymph node biopsy.

For urogenital melanomas, the most accessible is the surgical method. The combination of wide excision of the tumor after a course of radiation gives good results only in the initial stages of melanoma.

Immunotherapy and target therapy have good prospects for the treatment of common mucosal melanomas complicated by metastases to distant organs. Tumor genotyping, detection of BRAF mutations in melanoma make it possible to introduce a new generation into clinical practice

Melanoma is usually called malignant neoplasms that appear on the human skin. In this case, melanoma is formed not only on the skin, but also in the oral cavity, on the gums. Such a tumor is characterized by its causes, symptoms and, accordingly, treatment.

Description of the disease

Gingival melanoma is a cancerous tumor that most often occurs in the alveolar region of the mandible. But in case of not timely treatment, the growth is able to spread cancer cells to other parts of the body and internal organs.

Gum cancer is most common in people over 55 who have a history of other oral diseases.

Symptoms

Depending on the stage of development, gum cancer is accompanied by various symptoms. At the same time, the symptoms of the initial stage of such a disease are similar to the usual flux.

Bleeding

One of the earliest signs of cancer. The affected area of ​​​​the oral cavity begins to bleed at the slightest touch.

puffiness

Develops in later stages of cancer. Moreover, not only the area affected by the tumor swells, but also nearby soft tissues.

This symptom is accompanied by discomfort inside the mouth (feeling of internal bursting) and increasing pain. In this regard, it becomes problematic for the patient to chew food and smile.

Pain syndrome

At the first stage of a cancerous growth, pain is felt directly at the site of its localization. But with the growth of the tumor, the pain syndrome also covers other adjacent parts of the oral cavity, up to half of the face.

At the same time, the sensations are so strong that moving any muscle of the face becomes difficult for a person. In this regard, the patient begins to limit himself in talking and eating, which is due to a further decline in strength and a violation of the central nervous system.

Color change

In most cases, melanoma is characterized by a change in color. In this case, the damaged area of ​​the gum becomes a rich red color with pronounced vessels. Also, white blotches and point erosion appear at the site of the neoplasm.

Changing the size of the lymph nodes

Gingival melanoma is characterized by an increase in the parotid or submandibular lymph nodes. This symptom is usually accompanied by cough, shortness of breath and pain in the neck. This is due to the fact that the mutated cells have already spread to the lymph nodes and began to affect other closely located organs (larynx, lungs, bronchi).

hyperthermia

If the patient does not have any inflammatory and infectious processes, then elevated body temperature is considered a clear sign of malignancy. In this case, hyperthermia is often accompanied by drowsiness, general weakness, significant weight loss, nausea and vomiting.

In the early stages of cancer, body temperature varies from 37 to 38 degrees. At stages 3-4, hyperthermia exceeds 38.5 degrees.

There are cases when the above symptoms do not appear until metastases begin to affect other nearby soft tissues and internal organs.

Provoking factors

The direct causes that affect the formation of gingival melanoma have not been established. However, there are various factors that have a negative effect on soft tissues, as a result of which a favorable environment is created for the development of tumor cells on the gums.

Diseases

Chronic and inflammatory diseases of the gums (periodontitis, papilloma and others) with untimely treatment can give rise to malignant neoplasms.

Damage

People whose gums are regularly exposed to mechanical damage are more likely to get melanoma. Such damage is often caused by crowns, prostheses and piercings. In addition, unprofessional tooth extraction also damages the gums and can lead to inflammation and further development of a cancerous tumor.

Wrong way of life

Smoking, drug addiction and alcoholism are considered provocateurs of various diseases, including gum melanoma.

Improper nutrition

The soft tissues of the gums are very sensitive. Eating too hot or spicy food makes them more vulnerable over time.

If a person has a combination of the above reasons, then the risk of getting gingival melanoma increases at least twice.

Diagnostics

To distinguish ordinary dental pathology from gum cancer, the examination should be carried out by a qualified specialist. For diagnosis, various research methods are used.

First, the doctor conducts a visual examination of the oral cavity. If cancer is suspected during such an examination, the doctor directs the patient for additional laboratory tests.

These include fluorescent examination, biopsy and puncture from the lymph nodes. It should be borne in mind that these analyzes are effective only at the initial stage.

At later stages, a study is carried out for biomarkers, x-rays of the facial bones and magnetic resonance therapy. All these diagnostic methods make it possible to determine the size of the growth, its stage, and the depth of spread of mutated cells.

Treatment

Depending on the stage and size of the neoplasm, the prescribed therapy depends.

Surgical intervention

It implies excision of the tumor, regardless of the stage of its development. In this case, a certain tumor-like area of ​​\u200b\u200bthe gum, the affected area of ​​\u200b\u200bthe jawbone, lymph nodes and cervical soft tissues are subject to removal.

Chemotherapy

This method of treatment is carried out with inoperable growths. It is characterized by the introduction of special medicines into the human body. However, they can be administered orally (tablets) or intravenously (injections).

Radiation therapy

The affected part of the gum is exposed to radiation, which can destroy cancer cells. It should be borne in mind that this method stops the spread of metastases, but does not heal a person from cancer.

Complications

The main and most dangerous complication is the spread of metastases to other parts of the body and internal organs. In addition, malignant tumors in the last stages may be accompanied by severe bleeding, which is life-threatening for the patient.

Forecast

Timely detection of gingival melanoma and proper treatment favors the speedy recovery of the patient and avoids relapses.

The mortality rate from this disease is very low.

Prevention

Preventive measures include regular medical examinations, maintaining a healthy lifestyle and performing oral hygiene procedures. In addition, proper nutrition and avoiding smoking will reduce the risk of gingival melanoma.

Most often, women from 30 to 40 years old are affected. Melanoma may cause the spread of metastases. If it is not treated in time, the outcome can be sad.

Symptoms of the disease

Signs of melanoma

• it can be more than 6 mm wide, if the melanoma becomes even larger - this is a clear sign of its growth inside;
• it has an irregular shape;
• color change.

Causes of the disease

• intradermal;
• epidermal-modermal;
• mixed.

The main causes of melanoma on the lip are:

1. Influence of ultraviolet rays;
2. Injury;
3. Hormonal disbalance;
4. Violation in the work of the body.

Lip disease

• smoking cigarettes;
• infection with viruses and infections;
• sun;
• constant chewing of tobacco;
• temperature changes;
• drinking strong coffee;
• strong alcohol;
• and of course the lack of hygiene.

Video: "Lip cancer first symptoms"

Basalioma (basal cell epitolioma) is the most common malignant tumor of the epithelium, which develops from atypical basal cells of the epidermis and follicular epithelium. It is characterized by slow growth, accompanied by inflammatory infiltration and destruction of the surrounding tissue, as well as the absence of a tendency to metastasize. It occurs mainly in elderly and senile people. The most common localization is the face, scalp. Basalioma begins with the appearance of a single dense flat or hemispherical papule with a diameter of 2-5 mm, slightly pinkish or normal skin color. There are no subjective sensations. The papule grows slowly and within a few years reaches 1-2 cm. At the same time, its central part breaks up and becomes covered with a bloody crust, which, when rejected, reveals easily bleeding erosion or a superficial ulcer. Along its periphery, there is a narrow roller, solid or consisting of individual miliary nodules, slightly pinkish in color. Sometimes its color can be pearlescent or dark brown. The resulting ulcer, increasing in size, simultaneously scars in the central part. Depending on the nature of growth, Basalioma can turn: into a large (10 cm or more) flat plaque with a scaly surface; In a mushroom-shaped node significantly protruding above the surface of the skin; into a deep ulcer that destroys underlying tissues, including bones. Squamous cell carcinoma. Squamous cell skin cancer (squamous cell carcinoma) is a malignant tumor that begins in the epidermis and develops into an invasive metastatic tumor. The disease is 10 times less common than basalioma, in men 2 times more often than in women. The development of the neoplastic process is most susceptible to white-skinned patients living in hot sunny countries (Central America, Australia, etc.). Squamous cell carcinoma can begin anywhere on the skin and mucous membranes, most often at the points of their transition into each other (lips, genitals). Initially, a small infiltrate appears, with a slightly elevated hyperkeratotic gray or yellow-brown surface. Subjective sensations in the initial period are absent. The size of the tumor, starting from a few millimeters, gradually increases to 1 cm, after which a dense node is already determined, which then quickly reaches the size of a walnut. Depending on the direction of growth, the tumor can either protrude above the surface of the skin, or grow into the depths of the tissues, undergoing decay with the formation of ulcers. This variant of the growth of spinocellular epithelioma leads to the destruction of not only the skin, but also the underlying tissues (muscles, bones), and also tends to rapidly metastasize, first to the regional lymph nodes, and then to other organs. There is no tendency for the ulcer to heal, local excruciating pains appear, and then general exhaustion and secondary infectious complications develop. Melanoma. Melanoma is the most malignant tumor of the skin, it develops from melanocytes and tends to rapidly metastasize. Melanoma is much less common than basalioma and squamous cell carcinoma, predominantly in Caucasians exposed to excessive insolation, usually after puberty. A tumor can occur on any part of the skin, including the nail bed, either primarily (on unchanged skin) or secondarily (in 30% of cases) as a result of malignancy of the pigment nevus, for example, due to its chronic traumatization. Melanoma is an easily bleeding papule or a flat, slightly raised, dome-shaped or bumpy nodule with a uniform dark brown or black with a bluish tint. Sometimes certain areas of the tumor may be devoid of color, and in rare cases, melanoma may not contain melanin pigment at all. Due to early metastasis, first dense pigmented hemispherical nodules appear near the primary node, and subsequently multiple pigmented and depigmented nodules and nodes scattered throughout the body. Metastases also appear in the internal organs, and, as a rule, earlier than the decay of the primary tumor begins.