Warty basalioma. When is a biopsy and histological examination of a basalioma needed? Nodular form of basalioma

In recent years, cancer has often become the main cause of high mortality among the population. Cancer cells can affect absolutely any tissue in the human body, causing various pathological processes. Let us consider in detail what is basal cell skin cancer, what are its causes and whether it is possible to recover from this disease.

What is this type of cancer?

This type of cancer is also called basalioma. It most often develops on the face, neck, or nose. It prefers to infect the male population over 40 years of age. It has been noted that representatives of the Mongoloid race and the Negroid race are not susceptible to this type of cancer.

The name "basalioma" comes from the fact that oncological cells begin their development from the basal layer of the skin, which is located deepest.

Causes of Skin Cancer

At present, the question of histogenesis (a set of processes leading to the formation) of this disease has not yet been fully resolved. Many are of the opinion that basal cell skin cancer develops from pluripotent epithelial cells. Differentiation can occur in different directions. We list some of the reasons that, according to most experts, can provoke the development of this pathology:

• genetic predisposition.
• Violations at work immune system.
• External influences of unfavorable factors.
• Development against the background of radiodermatitis, tuberculous lupus, psoriasis.

Basal cell skin cancer (the photo shows this) occurs most often in the epidermis and hair follicles. It grows slowly and rarely metastasizes. Some doctors consider basalioma not as a cancer or a benign formation, but as a tumor with locally destructive growth.

Quite often, under the influence of strong carcinogens, such as x-rays, basal cell skin cancer turns into carcinoma.

Provocateurs of basalioma

There are many risk factors for this disease:

1. The most serious provocateur is ultraviolet radiation.
2. Belonging to the male sex. It is noted that its representatives are much more likely to be exposed to such a disease.
3. Having light skin. It has been established that people with dark skin practically do not suffer from this pathology.
4. The tendency of the skin to get sunburn.
5. Work under the open sun for a long time. As you get closer to the equator, the frequency of this disease increases. Most often develops basal cell or neck.
6. High concentration of arsenic in drinking water. Those who are forced to work with this substance are at risk.
7. Polycyclic aromatic resins can also cause the development of this disease. They can be contained in coal tar, shale, soot.
8. Long-term use of immunosuppressants.
9. Some hereditary disorders, such as albinism or
10. Chronic ulcers.
11. Thermal burns.
12. Ionizing radiation.

It has also been found that excessive insolation (irradiation sunlight) in childhood can subsequently lead to the development of cellular cancer.

Basalioma classification

From a histological point of view, this pathology classified as undifferentiated and differentiated cancer. The first category includes:

• solid basalioma;
• pigment;
• morphea-like;
• superficial.

Differentiated is divided into:

• keratotic basalioma;
• cystic;
• adenoid.

According to the international classification, the following variants of skin cancer are distinguished:

1. Solid basal cell carcinoma. This form is the most common and represents strands and cells that are arranged compactly. At the same time, basaloid cells do not have clear boundaries, in the center they can be with dystrophic changes and cystic cavities.
2. Pigmented basal cell skin cancer (you can see a photo of it in the article) is characterized by diffuse pigmentation due to melanin content.
3. The superficial type of cancer often forms multiple foci. Relapse can occur after therapy along the borders of the scar.
4. Scleroderma-like is characterized by a strong development of connective tissue, into which, as it were, strands of basal epithelial cells are embedded. They can penetrate deep inside, up to the subcutaneous tissue.
5. A malignant tumor with glandular differentiation is also called adenoid. It differs not only in the presence of large areas, but also in narrow epithelial strands, which consist of several rows of cells that form an alveolar or tubular structure.
6. Basal cell carcinoma of the skin of the right cheek with ciloid differentiation. It is distinguished by the presence of foci with keratinized areas, which are surrounded by cells similar to prickly.
7. Cancer with sebaceous differentiation is quite rare.
8. Fibroepithelial type is a very rare type of basalioma. It usually spreads to the lumbar and sacral regions. Clinically, it may resemble fibropapilloma.

Types of basalioma by type of manifestation

There is a classification of this pathology and the type of manifestation. There are the following types:

1. Nodular-ulcerative basalioma. Consider this basal cell skin cancer. The initial stage (the photo confirms this) is characterized by the appearance of a nodule on the eyelids, in the corners of the mouth. The skin around the pink or reddish color with a matte or shiny surface. After some time, the nodule turns into an ulcer with a greasy coating. After some time, it appears on the surface vascular network, the ulcer is covered with a crust, and seals form along the edges. Gradually, the ulcer begins to bleed and grow into the deeper layers of the skin, but metastases do not form.
2. If the ulcer heals in the center, and growth continues along the edges, then we are talking about cicatricial-atrophic basalioma.
3. Perforating basalioma develops most often in those places that are often injured. Very similar to the nodular-ulcerative form, but develops at a much higher rate.
4. The warty form of cancer in its appearance resembles a head of cauliflower.
5. The nodular appearance is a single nodule that develops upward and protrudes above the surface of the skin.

Only after the form and type of the disease is determined, the doctor determines how to treat the basalioma. About any self-treatment, of course, there can be no question.

Symptoms of the disease

Quite often, if there is basal cell skin cancer, the initial stage (photo confirmation of this) proceeds completely without symptoms. In rare cases, slight bleeding is possible.

Patients may complain that a small ulcer has appeared on the skin, which slowly increases in size, but it is absolutely painless, sometimes itching appears.

Clinical manifestations of basalioma depend on the form of the tumor and its localization. The most common is nodular basalioma. It is a hemispherical knot with a smooth pink surface, in the center of which there is a small depression. The knot grows slowly and resembles a pearl.

With a superficial form of cancer, a plaque appears with clear boundaries, raised and having waxy-shiny edges. Its diameter can be from 1 to 30 mm. Grows very slowly.

If the basal cell carcinoma of the skin is of a cicatricial form, then it looks like a flat scar of a grayish-pink color, slightly pressed into the skin. The edges are raised and have a pearly tint. At the border of the formation, erosion occurs, covered with a pink-brown crust. During this form of cancer, there are periods when scars predominate, and erosion is very slight or absent.

The ulcerative form of basalioma is characterized by the destruction of soft tissues and bones that are located next to the tumor. Ulcers are irregular in shape, their bottom is covered with a gray-black crust, it is usually bumpy, and the edges are raised.

By the way, there is also basal cell skin cancer in cats (multiple primary). At the same time, many basaliomas can be seen on the body of the animal, in addition, mental disorders are observed, which are manifested by inadequate behavior, in addition, skeletal pathology develops. This type of malignant tumor is characterized by slow growth, the depth of the lesion and the risk of recurrence will depend on its size, location, cellular characteristics, and the state of immunity.

A person has great danger represents basal cell skin cancer. Treatment in this case is quite difficult. Pathology, as a rule, is localized on the face, skin around the eyes and nose.

The sclera-like form of basalioma also poses a great danger to humans. But pigmented basal cell skin cancer has a favorable prognosis. This form of treatment responds well.

How can the disease be diagnosed?

In order to make an accurate diagnosis, sometimes it is enough experienced specialist look at the patient. The clinical manifestations of this type of cancer are quite characteristic, and there are no diagnostic difficulties. On the surface, most often the doctor finds single or multiple foci of microerosion, which are covered with easily detachable crusts from above.

Patients most often turn to a dermatologist when problems are detected, but in this case, an oncologist should deal with therapy. If we analyze a smear-scarificat from erosive areas, then in almost 100% of cases this allows us to confirm the diagnosis.

If cytological and histological studies raise any doubts, then the patient is given a biopsy of the lymph nodes.

It is important to distinguish basalioma from lupus, melanoma, keratosis, or psoriasis when making a diagnosis. After all examinations, if the diagnosis is confirmed, the doctor selects the method of therapy strictly individually. This disease does not have the same approach to the treatment of all patients.

Pathology therapy

Once a diagnosis of basal cell skin cancer is confirmed, treatment should begin immediately. Most often, the following methods of dealing with this pathology are used:

• electrocoagulation and curettage;
• cryodestruction;
• radiation therapy;
• the Mohs method, which consists in excising the tumor with intraoperative microscopy of frozen horizontal sections, so that the extent of the upcoming operation can be determined.

The choice of the method of therapy depends entirely on the localization of the tumor, its size, the characteristics of the course and the state of the patient's body. Dermatologists usually prefer to use electrocoagulation at the very beginning of therapy. But it must be remembered that this method of treatment is effective if there are small tumors and they are located in safe places.

If histological examination is required, then the excision method is used. It is most often used in the presence of tumors with malignant course and located in dangerous places, such as on the face or head. With its help, it is possible to obtain a good cosmetic result.

Radiation therapy in the presence of basalioma is rarely used, but if surgery is not possible, then it is simply irreplaceable. Doctors admit that it is quite effective. Irradiation is indispensable even with a high degree of malignancy of the tumor. At the same time, one should be careful about radiation therapy in young patients, since there is a high risk of developing radiation dermatitis and induced malignant formations.

If we consider the Mohs method, then it allows you to preserve healthy tissues as much as possible. This method is effective for recurrent tumors, large sizes and dangerous localization. If there is an excision on the eyelid, then they also resort to that method of therapy.

If a cancerous tumor on the skin has formed quite recently, then it is preferable to use close-focus X-ray therapy. And in advanced cases combined with surgery.

The method of cryodestruction of a tumor is widespread, that is, its removal with the help of liquid nitrogen. This procedure takes little time and is absolutely painless for the patient. There is, however, one drawback: a positive result can only be obtained if the neoplasm is located superficially and does not affect the deeper layers of the skin.

When located, they often resort to its removal with a laser. It is safe and painless, after the intervention, as a rule, a short rehabilitation period and an excellent cosmetic effect.

If there is a basal cell carcinoma of the superficial type, then topical treatment with Fluorouracil cream is prescribed. AT recent times studies are underway on the effectiveness of injections of this drug into lesions. If skin cancer appears for the first time and has a small localization, then interferon injections are used.

Surgical treatment of basalioma

Surgical removal of basalioma is effective in the first stage of treatment. And also if a relapse occurs, or a tumor develops at the site of the scar. During the operation, the tumor is removed, but this method of therapy is undesirable if there are lesions on the face.

The operation is performed under local anesthesia, the tumor is removed to the border with healthy cells, for reliability, even slightly affecting them.

Consequences of basal cell skin cancer

There are several types of skin cancer, and depending on this, the course and prognosis of pathologies can also be different. If we talk about the consequences of basalioma, then it must be borne in mind that this tumor most often has a compact location, quite rarely penetrates inside and affects the lymph nodes.

But if an advanced form of cancer is located on the head and neck, then the process of destruction of the tissues of these parts of the body begins. It can even reach the bones, muscles and tendons.

Of all the types of skin cancer, this one is the most cosmetically unpleasant and the slowest to develop. But he, including thermal stages, can be amenable to surgical treatment. Therefore, if your doctor recommends surgery, do not be afraid, you must agree. Despite all its ugliness, the described skin gives patients a chance to recover even in the most advanced cases.

Preventive actions

Those who have already encountered basal cell skin cancer once should take special care to prevent recurrence. After treatment of basalioma, all doctor's recommendations should be followed:

• During the period solar activity, that is, in the summer, it is necessary to limit your stay on the street from 11 am to 5 pm. At this time, ultraviolet radiation is the most aggressive, so its exposure should be avoided. If there is a need to go outside, then it is worth applying a special protective cream to the skin and using hats and glasses.
• Without proper nutrition it is impossible to maintain your immune system at the proper level. It is necessary to limit the amount of animal proteins, they can be replaced with vegetable proteins, such as nuts, legumes.
• The diet should include more vegetables and fruits.
• If there are old scars on the skin, then measures must be taken to prevent injury.
• All sores and wounds on the skin should be treated in a timely manner. If they tend to heal poorly, then a doctor should be consulted.
• If your work involves contact with petroleum products, then you should be especially careful, always use protective equipment.

Cancer of any shape or type is dangerous disease. It is better not to allow its development, but this is not always in our power. If this has already happened, then you should not give up and prepare for the worst. At present, medicine has stepped far forward, and sometimes miracles happen in the most neglected cases.

Take good care of your health and everything will be fine.

Basalioma(squamous cell carcinoma, basal cell epithelioma) is a type of skin cancer. The tumor develops in the basal layer of epithelial tissues from atypical cells of the epidermis and follicular epithelium, does not metastasize. The neoplasm looks like a nodule and is capable of destroying bone and cartilage tissue.

According to the classification of the World Health Organization, basalioma of the skin refers to oncological diseases with slow progress and rare cases of metastasis to associated organs and tissues. Only the upper and middle layers of the epidermis are affected.

Basalioma is a common malignant epithelial neoplasm of the skin. Basalioma appears more often in people over 50 years of age. Women get basal cell carcinoma more often than men.

Symptoms of basalioma

Symptoms of basalioma of the skin appear immediately after the start of growth of the neoplasm.

Common sites for basal cell carcinomas are the face and neck. Small, light pink or flesh-colored nodules are pimple-like, painless, and slow growing. Over time, a light gray crust forms in the middle of such an inconspicuous sore. Basalioma is surrounded by a dense formation in the form of a roller of a granular structure.

If the disease is not diagnosed at the initial stage, the process is aggravated in the future. The appearance of new nodules and subsequent fusion leads to pathological expansion of blood vessels and the appearance of "spider veins" on the surface of the skin.

Often, scars form at the site of ulcers that form in the central part of the tumor. As the basalioma grows, it grows into nearby tissues, including bone and cartilage tissue, which is manifested by pain.

Basalioma treatment

The choice of the final method of treating basalioma is chosen by the doctor, who takes into account the localization of the formation, the severity of the process and the age of the patient.

Which doctors to contact with basalioma

Immunotherapy

For the treatment of basalioma of the skin of the face, the method of immunotherapy is used, which involves the use of a special ointment - imiquod. The tool stimulates the body's production of a sick interferon, which helps in the fight against atypical cells. As a rule, basalioma of the nose is treated with a cream, since this method of therapy does not leave scars. Imiquod is often used before starting chemotherapy.

Medical treatment

In the initial stages and with superficial forms, with contraindications or inability to apply radiation treatment, drug therapy is resorted to. For this, omain ointment is used in the form of daily applications. Antitumor antibiotics are also prescribed - bleomycins, which are administered intravenously at 15 mg 2-3 times a week. The total dose is 300-400 mg.

Photodynamic treatment

The treatment consists in the introduction of special substances (photosensitizers) under the skin that highlight the clear boundaries of the tumor, which is then irradiated with light waves. With facial basalioma, the photodynamic method is a priority therapy option, since it does not lead to cosmetic defects.

cryogenic destruction

Destruction of the tumor by freezing. This method of treatment in some cases is superior to the results of treatment by other methods. With the help of special equipment (cryoprobes) the tumor is frozen using liquid nitrogen. Advantages of cryotherapy:

• painlessness of the intervention;
• bloodlessness of manipulation;
• the minimum number of complications;
• ease of implementation;
• outpatient treatment without anesthesia.

Wound healing after cryodestruction is characterized by the absence of cosmetic defects, which eliminates the need for additional plastic surgery. This is important when the tumor is located on the face.

Radiation therapy

The method is used if the patient's condition or the location of the basalioma does not allow for surgical removal. Radiation therapy is done by irradiation with short-focus gamma radiation. The results of radiation therapy are aesthetically better than surgical removal of the basalioma. The only drawback of the method is the duration of treatment (on average 20-25 sessions).

Surgical removal of a basalioma

Surgery is performed on an outpatient basis, under local anesthesia.

The tumor is excised widely - for “reinsurance”, doctors capture another five millimeters around the basalioma in order to minimize the risk of relapse after recovery. Since this method of solving a problem on the face is difficult due to a cosmetic defect after the operation, doctors in open areas use other methods, and operations are performed only on the body.

In rare cases, when the tumor poses a threat, and there are no other methods for removing the tumor, then after the operation, the patient works plastic surgeon. To minimize the consequences of the operation, doctors use the Mohs micrographic method.

Can be removed using a microscope cancerous growth in layers. This operation is also performed under local anesthesia, on an outpatient basis. After Mohs surgery, chemotherapy sessions with fluorouracil are used to achieve the best result.

In some cases, in addition to surgical or destructive methods of treatment, cytostatic drugs (prospidin and bleomycin) are prescribed. In order to raise immunity, folk remedies are used.

Folk remedies for the treatment of basalioma

Traditional methods can slow down the growth of skin tumors, but do not cure the neoplasm. Alternative medicine- exclusively in addition to the conservative or surgical method of tumor removal. If the size of the basalioma increases, you should immediately consult a doctor.

Compress from camphor tincture

To prepare a compress, buy 10 g of camphor crystals in a pharmacy and dilute 500 g of alcohol (50%) or vodka. Let stand until the powder dissolves, shaking the container every day. Then make compresses. The course of treatment is 10 days, then take a five-day break and repeat again. As a rule, the basalioma decreases in size.

Celandine

The skin surface is treated with celandine juice. Often this method of treatment is used when a basalioma of the scalp is diagnosed. Apply and infusion of celandine. To prepare 1 tsp. chopped leaves pour 200 g of boiling water and allow the liquid to cool. Then filter and the product is ready for use. Healing properties are lost per day, so they prepare the remedy only at the rate of the daily intake - a third of a glass 3 times a day.

Carrot

For treatment and prevention, grated carrots used for compress are suitable. Along with applications, they drink a glass of freshly squeezed carrot juice per day.

Tobacco tincture

It is known that basalioma has long been treated with tincture of tobacco. To do this, tobacco from a pack of cigarettes is poured into 200 g of vodka and left in the refrigerator for exactly 2 weeks. This solution should be shaken every day, and then filtered. Tobacco tincture is moistened with cotton wool and fixed with a plaster on the tumor. The course of therapy is 10 days. As a result, even the scar disappears.

Causes of basalioma

Physical effect on the skin main reason the development of the disease.

Factors affecting the development of basalioma:

• excessive time spent in the sun;
• exposure to coal tar, benzene, toluene, arsenic;
• frequent diseases of the skin against the background of reduced immunity;
• exposure to ionizing radiation;
• frequent burns;
• bright skin;
• hereditary predisposition.

Diagnosis of basalioma

Visual diagnostic methods

Clinical manifestations of basalioma are characteristic, and typical cases of basalioma do not present great diagnostic difficulties. As a rule, on the surface of the element there are single or multiple foci of microerosion, covered with easily detachable crusts.

Laboratory diagnostic methods

Cytological examination of a smear-scarificate from eroded areas.

Differential Diagnosis

Differentiate basalioma with the following diseases:

• keratoacanthoma;
• spinocellular epithelioma;
• chancriform pyoderma;
• hard chancre;
• senile keratosis;
• tuberculosis lupus.

Basalioma classification

There are such types of basalioma:

Stages of basalioma

Classification of basalioma by stages of development:

• 1 stage: formation of 2 cm or less.
• 2 stage: the size of the tumor exceeds 2 cm.
• 3 stage: the formation is already affecting the soft tissues.
• 4 stage: The tumor has spread to cartilage and bone.

Basalioma prognosis

In the first stage of basalioma, surgical treatment leads to a 100% recovery. In the second stage of the disease, a complete cure is observed in 95-97% of cases. Such a favorable prognosis is due to the slow growth of tumors and the absence of metastases.

Prevention of basalioma

Questions and answers on the topic "Basalioma"

Question:hello! Can a basalioma on the face reappear six months after removal on the face, but in a different place? The operation was surgical. Thank you.

Answer: Yes it is possible.

Question:They cut out a basal cell carcinoma on the wing of the nose, the seam heals, but similar acne appeared on the beard, can this be a continuation of the basalioma

Answer: This may require a diagnostic test.

Question:Hello, my mom has basalioma. Conducted laser treatment course of 10 days. Now she is at home. Recommendation to smear with panthenol ointment and the like after 2 months to appear. He smears with ointment from this place, the liquid still hurts and radiates to the neck. Would like to know why? Thank you.

Answer: 1-2 days after the procedure, a crust should form at the treatment site, which will protect the wound. The crust gradually dries up and disappears on its own after a while. The healing process usually takes 14 to 20 days. If inflammation appears in the form of reddening of the skin around the wound crust, in swelling and soreness of the skin, you should contact your doctor - he will prescribe a special antibiotic therapy.

Question:Can the basalioma of the skin of the face, which is located below the eye, be the cause of the tearing of the eye?

Answer: Hello. No, he can not. But the wrong treatment of basalioma under the eye - maybe.

Question:Is basalioma definitely an oncology or, as the radiologist said, can it resolve itself?

Answer: Hello. According to the classification of the World Health Organization, basalioma of the skin refers to oncological diseases with slow progress. Mild skin damage may disappear over time, but severe basal cell carcinoma requires treatment.

Question:After cystoscopy, a basalioma of 3 mm was found located on the forehead. The doctor offered me the choice of either surgical removal or radiation exposure, said that after the surgery there would be a small crease. But I think that radiation is better, less traumatic, but how dangerous is it to health? Thanks in advance for your reply.

Answer: Hello. After the disappearance of redness, most patients rate the cosmetic result of radiation therapy as good or excellent. Within a year, irradiated skin tends to become pale and thin. Within a few years, telangiectasias (vasodilation), hypopigmentation (blanching) or hyperpigmentation (darkening) of the skin may appear. Radiation scars from basaliomas become worse over time, unlike scars after surgical treatment. The likelihood of long-term effects increases with an increase in the total dose of radiation, the size of the dose per session, and the volume of irradiated tissues. After irradiation of a basalioma for 45 years or more, an increased risk of the formation of new foci of squamous cell and, to a greater extent, basal cell skin cancer remains. This side effect of radiation therapy is most relevant for younger patients. The long-term consequences of basalioma irradiation include scarring of the skin and underlying tissues, leading to limited mobility. Active and passive exercise of the irradiated areas helps maintain mobility and prevent contractures (immobility due to scarring). Due to vascular changes, once irradiated skin recovers worse from surgical interventions. The hair loss that began during irradiation of the basalioma is mostly preserved for life. Additional long-term effects also depend on the location of the irradiated area. For example, irradiation of a basalioma near the eyes can cause ectropion (turning of the eyelid), cataracts (clouding of the lens), but such effects are extremely rare.

Question:Hello! A 4mm light spot was found on the shoulder blade. For 5 months it increased to 6-7 mm and changed: it became pinkish (it turns red from mechanical influences), a light roller formed around. The dermatologist said that it's okay, but it will never go away. The oncologist diagnosed it as a basalioma and offered to excise it immediately. Is it possible to make such a diagnosis without any tests? Is it necessary to delete? What is the best way to excise a basalioma? Laser, freezing, surgery? I work at elevated temperatures, chemical reagents, physical activity.

Answer: Hello. In absentia diagnoses are not made, as well as "by eye", based on personal experience. But in your case, excision with mandatory histology (or IHC) is preferable. I would recommend surgical. All of the above conditions are not suitable for you.

Question:Hello! My dad already 3 years ago had a growth in the form of a mole on the right wing of his nose. After going to the hospital and taking tests, cancer cells were not detected and no treatment was prescribed. But after 2 years it does not go away and we went to the doctors again and after taking tests we were diagnosed with basalioma (the diagnosis was made in oncology). We underwent treatment in the form of 13 irradiations and smeared with methyluracil ointment, but after them there was no result. She shrank and faded and that's it. Doctors no longer provide any help and no medicines are offered. What to do? What treatment can be done or what medicines and ointments can be used?

Answer: Hello. Radiation therapy is one of the treatments for skin basalioma. Sometimes the effect of radiation therapy does not occur immediately. The effectiveness of treatment is determined by repeated cytological examination.

Basalioma (basal cell skin cancer, basal cell epithelioma) is a skin neoplasm that originates in the upper (basal) layers of the skin. The disease occurs in people over 50 years of age, less often recorded in adolescents, newborns. Solitary tumors prevail, located in open areas of the body and scalp. Bsalioma of the auricle, chin, nose, neck, arms and legs are the most common diagnoses among oncological skin pathologies.

Basal cell epithelioma is most common in Australia, USA, Europe. The increase in incidence is 2% annually. Young people are more likely to be exposed to superficial skin cancer, the elderly - to severe forms of pathology, which worsens the prognosis of recovery. Men are more often ill than women.

The ICD disease code is C44, they are often labeled with case histories, making it easier to keep statistics. Able-bodied people and a child, for the duration of treatment or rehabilitation, are assigned a disability. If the neoplasm is treated with liquid nitrogen or a laser, then a sick leave is issued.

Classification of the disease

Classify the disease according to various principles. Most often, the form and stage of neglect are determined as the main indicators. To prescribe adequate treatment, it is very important to determine the type of basalioma. The disease is more often divided into the following forms:

• superficial basalioma;
• nodular basalioma;
• solid basalioma;
• flat basalioma;
• pigment basalioma;
• warty basalioma;
• scleroderma-like basalioma;
• adenoid basalioma;
• ulcerative basalioma.

There is a classification of the disease according to the stages of development (neglect). There are only four of them:

• the first (I) is the initial stage. The size of the neoplasm is up to 2 cm. The dermis around is not changed, it has a completely normal color and turgor.
• second (II). The tumor has grown to the entire depth of the epidermis, but did not have time to affect the subcutaneous fat;
• third (III). The size of epidermal skin cancer is of arbitrary size, but has affected all the soft tissues located under the affected area;
• the fourth (IV) is the advanced stage. Suffer not only the skin, soft tissues, but also bones, cartilage.

The reasons

Until the end, the causes of the occurrence of basalioma have not been clarified. It begins its development from the basal cells of the skin or hair follicle. But this theory has hundreds of opponents, many evidentiary arguments are subject to great doubt. Oncologists say that pathology can provoke various factors. Let's list them:

• skin contact with carcinogenic substances (arsenic, refined products, soot, some types of dyes);
• birth defects;
• resins contained in cigarettes;
• extremely high/low temperatures affecting skin cells;
• intense insolation (stay in the bright midday sun);
• frequent visits to the solarium;
• various pathologies of the skin (senile keratosis, radiodermatitis, tuberculous lupus, psoriatic rashes);
• rough old scars;
• prolonged labor activity outdoors;
• albinism, naturally fair skin;
• excessive pigmentation of epidermal cells;
• dryness of the skin.

Many world luminaries of medicine “blame” reduced immunity, psychosomatics for the development of basaliomas. Cancer begins to develop from skin cells with a decrease in the body's defenses, weakening of internal natural barriers, malfunctions in the endocrine system. Around the mechanism of the development of the disease, endless disputes sharpen. With the development of science, many hypotheses regarding the causes of the development of basaliomas are being clarified or rejected. It will take time for all the answers to be found.

Diagnostic methods

In the early stages, the diagnosis of the disease is difficult, due to the similarity of symptoms with other skin pathologies. After a thorough history of the disease (when and how the disease developed) and anamnesis of life (presence of bad habits, occupational hazards), it is necessary to proceed to the examination of the nearby lymph nodes. At advanced stages of oncology, they are enlarged, dense on palpation.

The main task of the doctor is to distinguish a benign tumor from a malignant neoplasm. Further treatment of these pathologies differs fundamentally, an error in diagnosis is fatal. To verify the diagnosis, a histological analysis of a sample of the affected tissue is required. In parallel, all women are prescribed a cytogram.

The histology of the tumor is determined by a histologist in the cytological laboratory available at each regional oncological dispensary, a large oncological clinic. Histological analysis will also show the type of cancer (skin cancer itself, melanoma). To determine the morphology, it is enough:

• smear;
• scraping;
• biopsy.

The material is taken from the punctate or the most ulcerated surface, trying to capture as much of the discharge as possible. A tissue biopsy is taken for analysis. Histology and cytology is the main method for diagnosing all neoplasms. Less commonly used ultrasound, computed tomography, dermatoscopy.

Symptomatic picture

Symptoms of the flat form of basalioma are always the same: a plaque appears, located at the level with the skin. A ridge-like edge separates the neoplasm from healthy tissues. It is slightly raised above the epidermis. This form of basalioma has the most favorable prognosis for recovery.

What does a nodular basalioma look like? The nodular form of basalioma is always elevated above the skin. It has a pronounced depression, "crowning" the center of the tumor. Even with minimal trauma, the neoplasm bleeds (bleeding occurs), which subsequently quickly leads to anemia and cachexia (exhaustion) of the patient.

Removal of basalioma (skin tumor). Operation video.

removal of basalioma of the skin of the nose with plastic surgery according to Limberg

Biopsy and removal by CO2 laser of a basalioma of the skin of the back of the nose.

Removal of basalioma by laser

MOHS surgery removal of basalioma of the skin in the forehead

The surface shape of the basalioma is easily recognizable by its elastic consistency, which takes on a round or oval shape. The edges are no different from the surface of the neoplasm itself. The tumor spreads throughout the body (lower leg, shoulder, back), therefore, superficial and nodular basalioma of the skin of the back is a common diagnosis among cancer patients.

The pigmented form of basalioma can have a dark, almost black tint, which makes it possible to confuse it with melanoma of the skin. Basalioma looks like a smooth and shiny plaque of a dense consistency. Verification of the diagnosis is carried out only by histological analysis of tissues.

Symptoms of other forms of the disease

Signs of the warty form of basalioma resemble cauliflower in structure. It only grows outwards. The tumor is represented by an association of nodes of various sizes, which mimics a benign wart. Methods and techniques of treatment are already known, giving a 100% prognosis of recovery for this type of disease.

The scleroderma-like (papillary) form of basalioma is limited from healthy tissues by a clear contour. It looks like a plaque, often pale in color. The surface is flat, rough to the touch, dense consistency.

The ulcerative form of basalioma may resemble an old ulcer with its signs. It is large, there is a photo where the tumor exceeds 10 cm in diameter. Ulcerative basalioma quickly grows inside, affecting and disrupting the functioning of muscles and nerve trunks. It is very dangerous, because it grows rapidly and proceeds aggressively. Localized in the head, eyes. These are the main manifestations of the ulcerative form of basalioma.

What is a relapse?

Many types of basalioma are prone to recurrence. After the treatment, the tumor re-forms, worsening the prognosis of the course of the disease. What the relapse looks like can be seen in the photo. If he is suspected, you should immediately visit your oncologist. Usually, recurrent neoplasms require serious combined treatment.

Scalpel removal must be prescribed, local chemotherapy, laser therapy, cryogenic or radiation treatment are prescribed before or after surgery. When a new tumor is detected, dispensary observation is intensified. You should visit the doctor once every 3 months. A general blood test can be prescribed by a doctor once every 6 months (if there is a stable remission, no relapses). Excision of a new tumor is done using a scalpel technique.

Types of therapy and principles of treatment prescription

To get rid of skin cancer of almost any localization, including behind the ear, laser therapy, cryosurgery, radiation, surgical, combined treatment, and chemotherapy are used. it specialized types treatment of the disease, which can only be prescribed by an oncologist. After identifying the pathology, the patient is necessarily sent to the oncology dispensary at the place of residence. The oncology office keeps a record of patients with a verified diagnosis. The therapeutic scheme is selected, taking into account:

• the stage of basalioma (neglect of the disease);
• the presence of concomitant diseases;
• individual characteristics of the body (fatness, the presence of allergies, age, etc.);
• types of basaliomas;
• severity clinical picture(involvement of nearby tissues, bones, cartilage).

Treatment is carried out in the oncology clinic. This is most effective because the patient is consulted by a chemotherapist, a surgeon, a specialist in radiation treatment (radiologist). After consultations and the necessary diagnostic tests and studies, the optimal therapeutic regimen is collectively selected at the medical consultation.

Radiation treatment

The method of treating oncological diseases with close-focus X-rays (X-ray therapy) is the most famous technique that has been clinically used for decades. It is often supplemented with remote gamma therapy. The method of treatment is effective in the initial stages of the disease. We list the biggest "cons" of this type of therapy:

• decrease in the body's defenses;
• deterioration of the general background of health;
• hair loss of varying degrees of intensity;
• the skin suffers, a zone of redness, peeling, dryness appears;
• loss of appetite, up to the complete denial of food;
• disorders of the digestive system and the cardiovascular system;
• changes in the central nervous system: heaviness in the head, memory impairment, problems with remembering new information.

Treatment is carried out in the conditions of the radiological department that exists at every major oncological dispensary. All of these negative effects (complications) of radiation therapy are short-term, mild, and quickly disappear with symptomatic therapy. To cure the disease, the course of treatment can be extended to one month or more.

laser treatment

Treatment of basalioma with a laser is a progressive method of therapy. During treatment, pain and burning may be felt, therefore local anesthesia is used. Usually it is enough to apply anesthetic ointments. For large neoplasms, tissue chipping is used injectables. The "pluses" of the procedure include:

• no recurrence;
• good cosmetic effect (minimal scars), which allows you to apply the technique on open, visible areas of the body;
• minimum rehabilitation period, lasting from several days to 2 weeks;
• the relative absence of pain, especially with the use of modern local anesthetics.

The cost of laser treatment is in a huge range: it can start from 500 and reach up to 38,000 rubles. But as practice shows, the average value is 6000-9000 rubles. A lot of positive reviews confirm the effectiveness of the procedure. Ideal for the treatment of the elderly due to minimal complications.

Treatment with low temperatures (cryolysis, cryogenic therapy)

Cryodestruction, as a method of treating the oncological process, has been used for more than a decade. The mechanism of action is quite simple: under the influence low temperatures Cancer cells die and are destroyed. Relapses after cryodistruction are extremely rare. The technique is suitable for a small tumor, especially with localization in places close to the bones, cartilage tissue. But not suitable for treating the area around the eyes.

The neoplasm is treated with liquid nitrogen. The cost of the procedure is 300-1150 rubles. average price procedures - 750 rubles. Large oncology clinics provide a similar service, therefore, due to fierce competition among medical institutions there is no need to overpay for manipulation. What the manipulation looks like will show the video.

Photodynamic therapy

Photodynamic therapy is a type of laser treatment, in terms of overall effectiveness it reaches from 78 to 92 percent. The results depend on the qualifications of the doctor and the medications used. The essence of the procedure is the introduction into the body of special drugs that enhance the effect laser beam. The technique is quite expensive.

Manipulation is meaningless for large tumors, ulcerative and sclerosing varieties of basalioma, and multiple neoplasms. The method is contraindicated in pregnancy, many systemic diseases (diabetes mellitus, some diseases of the heart and blood vessels, etc.).

Chemotherapy

Chemotherapy is used when it is impossible to use another type of treatment. Treatment of basalioma with medicines has low efficiency in the first stages of the disease. But the technique has no equal in the formation of metastases, especially in distant organs. Ingestion of anticancer drugs is fraught with complications, poor tolerance, and general intoxication.

Local chemotherapy is more effective. She treats almost all forms of basalioma, including nodular. Ointments with cytostatics are applied in the form of applications. The exposure and dosage are selected by the chemotherapist. Treatment is carried out in the chemotherapy department at oncology dispensaries or large oncology clinics. Curaderm cream is suitable for local chemotherapy (you can buy it in Russia for 9,000 rubles), which reduces the risk of relapse.

Surgery

What is surgical treatment? This is the most common type of therapy. Do not use for hard-to-reach location of the basalioma (corner of the eye, eyelid, internal ear canal). Since scars remain after scalpel intervention, in case of a disease that affects the cheeks, forehead area and other visible parts of the body, they try to resort to other types of treatment.

Surgery involves excision of the tumor. Resection is done by stepping behind the affected tissues for at least 0.5 cm. Scalpel intervention is indispensable for persistent recurrence, with the appearance of metastases. Although basalioma is a neoplasm sensitive to radiation therapy, but in some cases radioresistance (insensitivity to radiation therapy) can be traced, then surgical treatment cannot be dispensed with.

Additionally, surgery may be needed to close large postoperative wounds. For this, an auxiliary intervention using skin flaps is provided. With this approach, the postoperative field heals faster, the risk of colloidal scarring and penetration is reduced. pathogenic flora in fabric. Sometimes excision is carried out with electrocoagulation.

Alternative treatment

Previously, they got rid of basaliomas by folk methods. But this is a rather risky step if you decide on it without the consent of the oncologist. Only after receiving a full consultation, as an addition to the main therapeutic regimen, they take drugs according to the prescriptions of healers. Here are a few recipes:

1. Fraction ASD-3. Lotions should be made for several hours, applying a moistened rag to the affected area.
2. Celandine. This plant has long been used to treat many skin diseases. Cauterization of the neoplasm is carried out with freshly squeezed juice, for which it is enough to simply break the rod or grind the celandine flower. With great care, celandine is used in the eye area (especially in the lower corner), the nipple of the mammary gland, and on the lip.
3. Ointment from celandine and burdock. Half a glass of dry chopped herbal raw materials is poured with a glass of hot goose fat. Weakly heat the oven and simmer the mixture for 2 hours, filter, apply for external topical use.

Effects

The tumor can develop for years without causing discomfort to a person. But this is not always the case. Without an adequate full treatment, oncological process begins to grow not only in breadth, but also in depth. Capturing new areas of the epidermis, the area of ​​the tumor increases, skin innervation and sensitivity are disturbed, the vascular bed, especially the capillary network, begins to suffer.

If the tumor begins to grow inwards, the muscle fibers and nerve pathways get hit. This leads to gross violations of the function of the arms, legs, neck and other parts of the body. With advanced basal cell skin cancer (stage 4), the bone becoming brittle and brittle. The bone frame cannot cope with the anatomical load, leading to disability of the patient of the oncological dispensary.

There are cases when epidermal skin cancer of the chest led to self-destruction of the ribs and sternum, complicating the act of breathing, disrupting the functioning of the lungs. Often, people with basalioma of the temporal region die from bone pathology. With each year of the development of the disease, the risk of metastases to other organs and the lymphatic system increases. These are the unpleasant consequences of skin cancer, so the disease is dangerous.

Prevention rehabilitation forecast

Prevention of basaliomas should begin in early childhood and continue throughout human life. You should avoid excessive insolation (stay in the sun), solarium, give up bad habits, lead a measured lifestyle. It is forbidden to actively sunbathe in the midday sun, not only basalioma, but also melanoma, keratoma may appear. It is justified to use sunscreen or protect exposed areas of the body in the summer. This applies not only to the elderly and the child, but also to the adult population.

An important point in the prevention of any form of basalioma is diet. The diet should be maximally filled with vegetable proteins, vegetables, seasonal fruits. Accidental injuries of old scars, especially rough ones consisting of colloidal tissue, should be avoided. Timely sanitation of difficult-to-heal wounds or extensive burn surfaces help to avoid the development of the oncological process.

The duration of rehabilitation depends on the stage of the disease. If the tumor is detected at the beginning of its development, then rehabilitation measures are not so serious: taking vitamin complexes, improving nutrition, systematic skin hygiene, and improving health in general. Basalioma is not contagious, does not require isolation of a sick person for the period of rehabilitation after any type of treatment.

With the timely detection of the focus and receiving adequate treatment, the prognosis is favorable due to the absence of a pronounced tendency to form metastases. With a tumor in diameter of more than 20 mm, it is detected in the later stages, then a fatal outcome is possible. The larger the tumor itself, the more pronounced the cosmetic defect.

The most interesting on the topic

The classification includes the following forms or types of basalioma:

• nodular basalioma (ulcerative);
• pagetoid, superficial basalioma (pagetoid epithelioma);
• nodular large-nodular or solid basalioma of the skin;
• adenoid basalioma;
• perforating;
• warty (papillary, exophytic);
• pigmented;
• sclerodermiform;
• cicatricial-atrophic;
• Spiegler's tumor ("turban" tumor, cylindrom).

Clinical TNM classification

Designations and interpretation:

T - primary tumor:

• Tx - there is not enough data to evaluate the primary tumor;
• T0 - the primary tumor is not possible to determine;
• Tis - preinvasive carcinoma (carcinoma in situ);
• T1 - tumor size - up to 2 cm;
• T2 - tumor size - up to 5 cm;
• T3 - tumor size - more than 5 cm, soft tissues are destroyed;
• T4 - the tumor grows into other tissues and organs.

N - damage to the lymph nodes:

• N0 - no regional metastases;
• N0 - no regional metastases;
• N1 - one or more metastases in regional lymph nodes;

M - metastases:

• M0 - no distant metastases;
• M1 - metastases in the lymph nodes and distant organs.

Stages of basalioma

Because it looks like a basalioma in the initial stage (T0 stage), as an immature tumor or preinvasive carcinoma (carcinoma in situ - Tis), it is difficult to determine despite the appearance of cancer cells.

1. At stage 1, the basalioma or ulcer reaches a diameter of 2 cm, is limited to the dermis and does not pass to nearby tissues.
2. In the largest dimension, stage 2 basalioma reaches 5 cm, grows through the entire thickness of the skin, but does not extend to the subcutaneous tissue.
3. At stage 3, the basalioma increases in size and reaches a diameter of 5 cm or more. The surface is ulcerated, the subcutaneous tissue is destroyed adipose tissue. Next comes damage to the muscles and tendons - soft tissues.
4. If stage 4 of skin basalioma is diagnosed, the tumor, in addition to manifestations and damage to soft tissues, destroys cartilage and bones.

We explain how to determine the basalioma according to a simpler classification.

It includes basalioma:

1. primary;
2. deployed;
3. terminal stage.

The initial stage includes T0 and T1 accurate classification. Basaliomas appear as small nodules less than 2 cm in diameter. There are no ulcerations.

The extended stage includes T2 and T3. The tumor will be large, up to 5 cm or more with primary ulceration and soft tissue lesions.

The terminal stage includes T4 accurate classification. The tumor grows up to 10 cm or more, grows into the underlying tissues and organs. In this case, multiple complications may develop due to the destruction of organs.

Risk Factors for Basalioma

Adenoid formation (cystic) It is composed of cyst-like structures and glandular tissue, giving it a lace-like appearance. The cells here are surrounded by regular rows of small cysts with basophilic contents.

Superficial symptoms multicentric (pagetoid) basalioma are manifested by a rounded or oval plaque, which has a border of nodules along the periphery and a slightly sunken center, covered with dry scales. Under them, telangiectasias are visible in the thinned skin. At the cellular level, it consists of many small foci with small dark cells in the superficial layers of the dermis.

Warty (papillary, exophytic) tumor can be mistaken for a cauliflower-shaped wart due to dense hemispherical nodes growing on the skin. It is characterized by the absence of destruction and does not grow into healthy tissues.

Pigmented neoplasm or pagetoid epithelioma it comes in a variety of colors: bluish-brown, brownish-black, pale pinkish and red with raised pearl-shaped edges. With a long, torpid and benign course, it reaches 4 cm.

At cicatricial-atrophic (flat) form of the tumor a nodule is formed, in the center of which an ulcer (erosion) is formed, which spontaneously scars. Nodules continue to grow on the periphery with the formation of new erosions (ulcers).

During ulceration, an infection joins and the tumor becomes inflamed. With the growth of primary and recurrent basalioma, the underlying tissues (bones, cartilage) are destroyed. It can move into nearby cavities, for example, from the wings of the nose - into its cavity, from the earlobe - inside the cartilage shell, destroying them.

For sclerodermiform tumor characterized by a transition from a pale nodule with growth into a plaque of a dense and flat shape with a clear contour of the edges. On a rough surface, sores appear over time.

For Spiegler's tumors (cylindromas) the appearance of multiple benign nodes of pink-violet color, covered with telangiectasias, is characteristic. When localized under the hair on the head, it proceeds for a long time.

Diagnosis of basalioma

If, after a visual examination by a doctor, a basalioma is suspected in a patient, the diagnosis is confirmed by a cytological and histological examination of smears-prints or scrapings from the surface of the neoplasm. In the presence of strands or nest-like clusters of spindle-shaped, round or oval cells with thin rims of cytoplasm around them, the diagnosis is confirmed. Tests for skin cancer (imprint smear) are taken from the bottom of the ulcer and determine the cellular composition.

If, for example, diagnostics is used tumor marker, then there are no specific oncological blood markers to determine the malignancy of basalioma. They could accurately confirm the development of cancer in her. In other laboratory tests, leukocytosis, an increased erythrocyte sedimentation rate, a positive thymol test, and an increased C-reactive protein can be detected. These figures are consistent with other inflammatory diseases. There is some confusion in the diagnosis, so they are rarely used to confirm the diagnosis of neoplasms.

However, due to the diverse histological picture of basalioma, as well as its clinical forms, it is carried out to exclude (or confirm) other skin diseases. For example, lupus erythematosus, lichen planus, seborrheic keratosis, Bowen's disease should be differentiated from flat superficial basalioma. - from the pigmented form, scleroderma and psoriasis - from the sclerodermiform tumor.

Methods of treatment and removal of basalioma

When cellular skin cancer is confirmed, treatment methods are selected depending on the type and how much the tumor has grown and grown into neighboring tissues. Many people want to know how dangerous basalioma is, how to treat it so that there are no relapses. The most proven method of treating small neoplasms is the surgical removal of the basalioma using local anesthesia: lidocaine or ultracaine.

When the tumor grows deep inside and into other tissues, surgical treatment of basalioma after irradiation is used, i.e. combined method. At the same time, the cancerous tissue is completely removed to the border (edge), but if necessary, they go to the nearest healthy areas of the skin, retreating from it 1-2 cm. cosmetic seam and remove it after 4-6 days. The sooner the formation is removed, the higher the effect and the lower the risk of recurrence.

Treatment is also carried out with the following effective methods:

1. radiation therapy;
2. laser therapy;
3. combined methods;
4. cryodestruction;
5. photodynamic therapy;
6. drug therapy.

Radiation therapy

Radiation therapy is well tolerated by patients and is used for small neoplasms. The treatment is long, at least 30 days, and has side effects, since the rays affect not only the tumor, but also healthy cells skin. Erythema or dry epidermitis appears on the skin.

Light skin reactions go away on their own, "stubborn" require local therapy. Radiation therapy in 18% of cases is accompanied by a variety of complications in the form of trophic ulcers, cataracts, conjunctivitis, headaches, etc. Therefore, they carry out symptomatic treatment or with the use of hemostimulating agents. Treatment of the sclerosing form of basalioma with radiation therapy is not carried out due to its extremely low efficiency.

laser therapy

When confirming the diagnosis of "basal cell skin cancer or basal cell carcinoma", laser treatment almost completely replaced other methods of tumor removal. During one session, it is possible to get rid of the disease with a carbon dioxide laser. The tumor is affected by CO2 and evaporated in layers from the skin surface. The laser does not touch the skin and affects the temperature only on the affected area, without touching healthy areas.

Patients do not feel pain, because during the procedure, anesthesia occurs while protecting with cold. There is no bleeding at the site of removal, a dry crust appears, which will fall off on its own within 1-2 weeks. You should not tear it off yourself with your nails, so as not to infect the infection.

This method suitable for patients of all ages, especially for the elderly.

If basal cell carcinoma is found, laser treatment will be preferred due to the following benefits given method:

• relative painlessness;
• bloodlessness and security;
• sterility and non-contact;
• high cosmetic effect;
• short rehabilitation;
• exclusion of relapses.

cryodestruction

What is a basalioma and how to treat it if there are many formations on the face or head, there are large, neglected and growing into the bones of the skull? This is a cell from the basal layer of the skin, which, by dividing, has grown into a large tumor. In this case, cryodestruction will help, especially for those patients who form rough (keloid) scars after operations, who have pacemakers and receive anticoagulants, including Warfarin.

Information! According to the results of the study, after cryodestruction, relapses occur in 7.5%, after surgery - in 10.1%, after radiation therapy - in 8.7% of all cases.

The list of benefits of cryodestruction includes:

• excellent cosmetic result when removing large formations in any part of the body;
• performing outpatient treatment without the use of anesthesia, but under local anesthesia;
• lack of bleeding and a long rehabilitation period;
• the ability to apply the method to elderly patients and pregnant women;
• the ability to treat cold with concomitant diseases in patients who are contraindications for the surgical method.

Information! Cryodestruction, unlike radiation therapy, does not destroy the DNA of the cells surrounding the basalioma. It promotes the release of substances that enhance immunity against the tumor, and prevents the formation of new basaliomas at the site of removal and in other areas of the skin.

After a biopsy confirming the diagnosis, to prevent discomfort and pain during cryodestruction, apply local anesthetics(Lidocaine - 2%) or / and give an hour before the procedure to the patient Ketanol (100 mg) for pain relief.

If liquid nitrogen is applied in the form of a spray, then there is a risk of nitrogen spreading. More precisely and deeper, cryodestruction can be carried out using a metal applicator that is cooled with liquid nitrogen.

It's important to know! It is impossible to freeze squamous cell carcinoma or basalioma with tampons with Wartner Cryo or Cryopharm (does not make sense), since freezing occurs only to a depth of 2-3 mm. It is impossible to completely destroy basalioma cells with these means. The tumor is covered with a scar from above, and oncogenic cells remain in depth, which is fraught with relapse.

Photodynamic therapy

Photodynamic therapy for basalioma is aimed at the selective destruction of tumor cells by substances - photosensitizers when exposed to light. At the beginning of the procedure, a drug, such as Photoditazine, is injected into the patient's vein to accumulate in the tumor. This stage is called photosensitization.

When a photosensitizer accumulates in cancer cells, the basalioma is viewed under ultraviolet light to mark its border on the skin, as it will glow pink, fluorescence occurs, which is called video fluorescent marking.

Next, the tumor is illuminated with a red laser with a wavelength corresponding to the maximum absorption of the photosensitizer (for example, 660-670 nm for Photoditazine). The laser density should not heat living tissue above 38С (100 MW/cm). The time is set depending on the size of the tumor. If the tumor has a size of 10 kopecks, then the exposure time is 10-15 minutes. This stage is called photo exposure.

When oxygen enters chemical reactions the tumor dies off without damaging healthy tissue. In this case, cells of the immune system: macrophages and lymphocytes absorb the cells of a dead tumor, which is called photoinduction of immunity. Relapses at the site of the original basalioma do not occur. Photodynamic therapy are increasingly replacing surgical and radiation treatments.

Drug therapy

If confirmed by studies of basalioma, courses are prescribed for 2-3 weeks.

Ointments for occlusive dressings are used locally:

• fluorouracil - 5% after pre-treatment skin with Dimexide;
• omaic (colhamic) - 0.5-5%;
• fluorofuric - 5-10%;
• podophyllinic - 5%;
• glycifone - 30%;
• prospidinova - 30-50%;
• metwix;
• as applications - colhamic (0.5%) with the same part of Dimexide.

The ointment should be applied, capturing the surrounding skin by 0.5 cm. To protect healthy tissues, they are lubricated with zinc or zinc salicylic paste.

If chemotherapy is performed, then Lidaza, Wobe-mugos E is used. Multiple basaliomas are treated with intravenous or intramuscular infusion of Prospidin until cryodestruction of the foci.

For tumors up to 2 cm, if they are localized in the corners of the eyes and on the eyelids, interferons are used inside the auricle, since laser, chemotherapy or cryodestruction, as well as surgical excision, cannot be used.

Treatment of basaliomas is also carried out with aromatic retinoids that can regulate the activity of the components of the cyclase system. If drug therapy is interrupted or there are tumors larger than 5 cm, undifferentiated and invasive basaliomas, then relapses may occur.

Alternative therapy in the treatment of skin basalioma: recipes for ointments and tinctures

Folk therapy in the fight against basalioma of the skin

Important! Before treating basalioma folk remedies, it is necessary to do an allergy test for all herbs that will be used as adjuvant therapy.

The most popular folk remedy is decoction based on celandine leaves. Fresh leaves (1 tsp) are placed in boiling water (1 tbsp.), Let stand until cool and take 1/3 tbsp. three times a day. You need to prepare fresh broth each time.

If there is a single or small basalioma on the face, it is carried out by lubrication:

• fresh celandine juice;
• fermented celandine juice, i.e. after infusion for 8 days in a glass bottle with periodic opening of the cork to remove gases.

Golden mustache juice use as a compress during the day, applying moistened cotton swabs, fixing them with a bandage or plaster.

Ointment: powder from the leaves of burdock and celandine(¼ tbsp.) Stir well with melted pork fat and simmer for 2 hours in the oven. Lubricate the tumor 3 times / day.

Ointment: burdock root(100 g) boiled, cooled, kneaded and mixed with vegetable oil(100 ml). Continue to boil the composition for 1.5 hours. Can be applied to the nose, where it is inconvenient to use compresses and lotions.

Ointment: prepare the collection, mixing birch buds, spotted hemlock, red clover, large celandine, burdock root - 20 grams each. Finely chopped onion (1 tbsp) is fried in olive oil (150 ml), then it is collected from the pan and pine resin (resin - 10 g) is placed in oil, after a few minutes - the collection of herbs (3 tbsp.) , after 1-2 minutes, remove from heat, pour into a jar and tightly close the lid. Day insist in a warm place. Can be used for compresses and for lubricating tumors.

Remember! Treatment of basalioma with folk remedies serves as an addition to the main method of treatment.

Life expectancy and prognosis for skin basalioma

If a basalioma is found, the prognosis will be favorable, since metastases do not form. Early treatment of the tumor does not affect life expectancy. In advanced stages, the size of the tumor is more than 5 cm and frequent relapses the survival rate for 10 years is 90%.

As a preventive measure for basalioma, you should:

• protect the body, especially the face and neck from prolonged exposure direct rays of the sun, especially in the presence of fair skin that does not lend itself to tanning;
• use protective and nourishing creams that prevent dry skin;
• radically treat non-healing fistulas or ulcers;
• protect scars on the skin from mechanical damage;
• strictly observe personal hygiene after contact with carcinogenic or lubricants;
• timely treat precancerous skin diseases;

Conclusion! For the prevention and treatment of basalioma should be used complex methods. When neoplasms appear on the skin, you should immediately consult a doctor for early treatment. This will save nervous system and prolong life.

Basalioma is a malignant tumor that grows from the deepest basal layer of the epidermis. In most countries of the world, it is the most frequent view skin cancer and approximately three quarters of all skin tumors. Males are predominantly affected. Basalioma can develop at any age, but about a third of reported cases are in patients over 40 years of age. An increase in the frequency of basaliomas is observed in countries with a hot climate and a high average annual rate ultraviolet radiation. It is characterized by slow growth and lack of metastasis. The most common localization of these tumors are exposed parts of the body, however, these tumors are predominantly located on the chest, neck and head. Due to the slow imperceptible growth, this neoplasm can go unnoticed by both the patient and the doctor for a long time and can be detected only in advanced stages.

Despite the fact that this tumor does not metastasize, it can lead to serious consequences. Its localization in the region of the eye sockets, nose, mouth and auricles is especially dangerous, since during germination it significantly deforms the cartilaginous and even bone basis of these organs and leads to pronounced violation their functions. In addition, the natural openings of these organs provide a pathway through which basaliomas can enter the skull and even affect the brain. Thus, this tumor, which has a non-aggressive behavior in comparison with other malignant tumors, under certain circumstances can even lead to death.

Diagnosis and treatment, as a rule, does not cause difficulties. Most forms this cancer successfully amenable to both radiation and surgical treatment. Medical treatment is also applicable, but due to the predominantly local nature of this tumor, it is rarely used. The likelihood of tumor recurrence depends on its size, penetration depth and the chosen method of treatment, however, there are other factors that can affect this process. Given the slow growth, lack of hematogenous metastasis, and high cure rates, the prognosis for this disease is generally considered to be favorable.

Causes of basalioma

Mandatory causes of basaliomas

• pigment xeroderma;
• Bowen's disease;
• Paget's disease;
• erythroplasia of Queyra.

Bowen's disease
A precancerous skin disease that develops in both men and women more often on exposed parts of the body. The reason for its development is long-term traumatization of the skin by ultraviolet radiation, aggressive chemicals, as well as human papillomavirus. Clinically, the disease is manifested by the formation of a spot with uneven outlines, which eventually transforms into a slowly growing plaque. The plaque can be either smooth and velvety, bright red in the initial stages, or dense, rough, copper-colored, covered with scales, sores and cracks in the subsequent stages.

Paget's disease
This disease is synonymous with breast cancer. It often develops after 50 years in both female and male patients. The peak incidence in women is 62 years, and in men - 69 years. Its first manifestations are a slight reddening of the nipple or a certain area of ​​the areola with superficial peeling and increased tactile irritability. In the future, itching, burning and soreness occurs, serous-bloody discharge from the nipple appears. The classic symptoms are retraction of the nipple and the formation on the areola and the skin around it of an area that looks like an orange peel. The last symptom is caused by swelling of the sebaceous and sweat glands over a deep-seated tumor that compresses lymphatic ducts. On palpation of the armpits, an inflammatory reaction of the lymph nodes is often detected, manifested by their enlargement and soreness.

Erythroplasia of Queira
Inflammatory skin disease of the glans penis and foreskin, often leading to the development of squamous or basal cell skin cancer of this localization. It develops more often in men aged 40 to 70 years. Clinically, it is a scarlet shiny spot, plaque or their accumulation on the mucous membrane of the glans penis, often passing to the foreskin. To the touch, the formation is painless and slightly protrudes above the surface of the skin. Similar to clinical manifestations a disease that develops on the mucous membranes of the genital organs in women is described as Bowen's disease of genital localization.

Relative causes of basaliomas

• keratoacanthoma;
• trophic ulcers;
• solar keratosis;
• seborrheic acanthoma;
• radiation ulcers;
• keloid scars;
• dermal horn;
• syphilitic gummas and granulomas;
• cold abscess in tuberculosis, etc.

Trophic ulcers
These pathological formations cannot be called diseases, since they are vascular or neurogenic complications of such metabolic diseases as diabetes mellitus, atherosclerosis obliterans, deep vein thrombosis of the lower extremities. At diabetes ulcers occur more often on the feet. With arterial and venous insufficiency, ulcers develop on the legs near the ankles. Visually, trophic ulcers are round or oval, long-term non-healing skin defects. To the touch, they are often painless, since an element of polyneuropathy is also present in their formation. A transparent sticky substance is constantly or periodically released on their surface, causing the effect of wetting.

solar keratosis
The appearance of these formations is facilitated by a certain genetic predisposition and intense insolation. This type of keratosis is a numerous foci of skin peeling. Over time, these lesions thicken, rise above the surface of the skin and become pink-white due to the large number of small skin scales. Histologically, these foci are areas of altered tissue that develops in place of a healthy one, which in medicine is referred to as dysplasia and metaplasia. Metaplasia, in turn, is a direct harbinger of tumor degeneration.

Seborrheic acanthoma
A synonym for this disease is senile keratosis. According to the name, it develops mainly in the elderly, but it can rarely occur in young people. More often, this tumor-like formation is localized on closed parts of the body near places often irritated by friction ( bra straps, etc.). As a rule, this formation is a uniformly pigmented soft tumor covered with oily crusts. As the tumor grows, the crusts may crack and shed, being replaced by similar, deeper crusts. The growth of this volumetric education is extremely slow, sometimes reaching several decades. According to various sources, degeneration into basal cell carcinoma occurs no more often than in 5-7% of cases.

Radiation ulcers
Skin damage from ionizing radiation occurs in emergency situations in case of accidents at nuclear facilities or in the course of treatment certain types malignant tumors by irradiating them with waves of the radioactive spectrum. Radiation ulcer develops in stages. Initially, redness forms in the zone of the most intense changes. After a few hours, against the background of redness, multiple small blisters appear, with a tendency to unite. After another 1-2 days, in the projection of the irradiated area of ​​the skin, there is a continuous large painful blister with a transparent yellowish liquid. After a certain time, it opens on its own, exposing the bottom of the ulcer. A distinctive feature of these ulcers is their ability to recur. In other words, after their healing, the ulcer periodically reopens. Thus, late radiation ulcers are foci of increased mitotic activity and excessive formation of connective tissue, and, in fact, areas of metaplasia. Metaplasia of any epithelium, in turn, is a precancerous condition.

Keloid scars
This type of scar develops after wounds with a fuzzy comparison of boundaries or with a large tissue defect. In these cases, the resulting cavities are filled with an excess of detritus - the cellular basis, from which the connective tissue is subsequently formed. Such tissue has the character of a benign tumor, since it is well differentiated and capable of fairly progressive growth. Clinically, such a scar differs in color from healthy skin and is more dense. Interestingly, its growth does not always occur outward, where it immediately becomes noticeable. In most cases, the keloid scar grows inside the wound. Given that it does not have invasive growth, like a malignant tumor, its growth is accompanied by compression of the surrounding structures. Therefore, such a scar itself is a source of chronic inflammation and for this reason must be removed.

Skin horn
To this day, there are disputes regarding the cause of the development of this pathological formation. Some dermatologists consider the horn an independent skin disease, others - a manifestation of senile keratoacanthoma, others - a variant of Bowen's disease. However, it has been proven that in about a quarter of cases this volumetric formation is capable of degenerating into a basalioma. In shape, it really resembles a horn with dimensions rarely exceeding 1–2 cm. The surface of the horn is rough, the consistency is often dense, but it can also be moderately elastic. When scraping, thin scales are separated. The base of the outgrowth may be enlarged and similar to normal skin with signs of inflammation. More often, however, the base of the horn does not differ from its structure.

Syphilitic gummas and granulomas
In addition to direct complications of syphilisassociated with its pathogenesis, there are also indirect complications of gums and granulomas. It must be admitted that such cases are rare in medical practice however, they should not be forgotten. In the case of a long chronic course of syphilis skin changes can become so pronounced that they entail the formation of foci of metaplasia, which are a precancerous condition. For the development of such a scenario, it is necessary that the body be weakened just enough so that the maximum intensity of the protective and regenerative processes is approximately equal to the aggressiveness of pale treponemas - the causative agents of syphilis. Under such conditions, the resulting gummas and granulomas do not heal for a long time, leading to a gradual change in the properties of the skin on which they developed. In the entire history of medicine, no more than 20 such cases have been registered ( according to information for 2013), so they are more scientific than clinical.

cold abscess
This type of abscess is otherwise called an abscess, which more clearly reflects its origin. In most cases cold abscess develops with secondary tuberculosis of the bones, skin, joints or lymph nodes, as well as after incorrect BCG vaccination technique. Most often it is formed in the paravertebral space with caseous melting of one of the vertebrae, as well as on the shoulder. In this case, pus is released outside the main focus, encapsulated and forms an abscess. Such an abscess is called a cold abscess, because the skin over it is rarely changed and painful. When it is opened, a light curdled or crumbly pus is found, which stands out from the wound for a long time. Often, after such abscesses, long-term non-healing fistulas and ulcers remain, which are the substrate for the degeneration of local tissues into tumor ones.

In addition, there are a number of other factors that, according to statistics, increase the likelihood of basal cell skin cancer. These factors include mainly factors of the internal and external environment that have an aggressive effect on the skin. When these factors are combined with an existing relative precancerous disease, the incidence of tumor development increases by 2–5 times.

Factors in the development of basal cell skin cancer

• excessive skin tan;
• freckles;
• numerous moles;
• prolonged contact with arsenic and its derivatives;
• prolonged contact with oil products and tar;
• thermal injury skin ( hypothermia and burns);
• immunosuppression.

Excessive skin tan
Excessive ultraviolet radiation adversely affects the skin through at least two mechanisms. First of all, a strong tan leads to inflammation of the skin. Frequent inflammation, in turn, leads to a steady increase in the rate of reparative processes. At a certain point in time, the proliferation of connective tissue and basal epithelium can become uncontrolled, which is the substrate of the tumor process. Second mechanism negative impact ultraviolet radiation on the skin lies in its direct effect on the DNA of the cells of the basal layer of the skin. In this case, a mutation occurs, leading to the loss of tumor cells functional features and increase the rate of their division.

Freckles
The presence of freckles in a person indicates that there are areas in his skin that easily absorb ultraviolet radiation. It is for this reason that freckles stand out from the rest of the skin. Ultraviolet rays lead to the development of basalioma by mechanisms similar to those above.

Numerous moles
Moles are benign tumors of melanocytic cells. According to statistics, their malignant degeneration often occurs in melanomas, which have an extremely aggressive course. However, in a certain proportion of cases, degeneration into basal cell carcinoma also occurs.

Prolonged contact with arsenic and its derivatives
As you know, arsenic is a poison to the human body. Its feature is the ability to accumulate in the skin and its appendages ( nails, hair) and stay there for many years. With prolonged skin contact with this substance, poisoning does not occur because the required dose is not reached, at which it occurs. However, the accumulated arsenic leads to latent inflammation of the deep layers of the epithelium, leading to its dysplasia.

Prolonged contact with oil products and tar
It has been statistically observed that workers in oil wells, auto repair shops, coal mines and gas stations are more likely to get basal cell skin cancer than representatives of other professions. It is assumed that oil distillation products and tar have a toxic effect on skin. More often, skin damage is limited to its dryness or eczema, however, in some cases, malignant tumors develop in the lungs, brain, and skin.

Thermal injury
Both burns and frostbite are characterized by damage to the deep layers of the skin and muscles. The cold itself does not have a negative effect on the skin, since it keeps the tissue structure unchanged. Thaw is more dangerous because it is accompanied by the formation of ice crystals that destroy skin cells and subcutaneous tissue from the inside. Frequent burns also lead to chronic inflammation. As a result of such lesions, the skin often and profusely regenerates. Active regeneration increases the chances of an error, manifested by a cellular mutation. In addition, frequent thermal injuries lead to the formation of a layer of scar tissue under the skin, which, like keloid scars, tends to become malignant.

Immunosuppression
Immunity in the usual sense not only protects the body from viruses and bacteria, but also prevents the formation of tumor cells. This type of immunity is called antitumor immunity. Its intensity depends on the severity of general immunity. When it is excessively increased, the risk of developing autoimmune diseases increases, and when it is weakened, it increases the risk of benign and malignant tumors.

The identification of these factors lasted more than a dozen years. Numerous studies have been carried out in many countries of the world, in which statistical data have been transformed into certain patterns. For example, basalioma most often develops in miners who have contact with aggressive substances suspended in dust. Engineers, by virtue of their profession, are forced to regularly come into contact with various petroleum products. Firefighters expose their skin to frequent burns, which cannot but affect it.

The highest risk of developing basal cell carcinoma is in fair-skinned people with small amounts of the skin pigment melanin. Freckles and red hair also increase the risk of this disease. The combination of the above factors confirms the reality - the residents of Scotland and Northern Ireland, who have red hair and many freckles, have the greatest predisposition to basalioma. We are talking about predisposition, because in reality in these countries not the most high rate basal cell carcinoma.

The frequency of this disease increases with an increase in the average annual amount of ultraviolet radiation. In other words, as we get closer to the equator, the average number of patients with this most common type of malignant skin tumor increases. However, it is necessary to make an amendment that these statistics are confirmed only in countries with a predominantly fair-skinned population. Black people almost never get skin cancer due to the high concentration of melanin in their skin. The Mongoloid race is also less prone to this disease, however, not to the same extent as Negroid. Biggest Risk rightfully belongs to the Caucasian race.

Immunosuppression develops for many reasons, the most common of which are HIV/AIDS, immunosuppressive treatment, and tumor chemotherapy. Presumably, immunosuppression increases the likelihood of basal cell skin cancer, however, as well as other tumors, through a parallel decrease in the intensity of DNA repair processes. As a result, after a certain time, cells with modified DNA appear, which can provoke tumor growth.

Radiation radiation has a direct destructive effect on tissues. Strong radiation leads to burns, weak - to cell mutation. Long-term skin burns lead to an increase in the activity of connective tissue cells, which in some cases can lead to the development of basalioma. It is noteworthy that tumors that have developed as a result of radiation exposure or severe sunburn are multiple in nature and are each at its own stage of development.

Large moles and scars have a certain potential for growth, despite the fact that the former are initially benign tumors, and the latter are connective tissue filling the wound defect. With growth, a gradual change in the composition of these tissues may occur, accompanied by a loss of their functional properties and the acquisition of a pronounced tendency to division.

The main pathogenetic link in the development of any tumor is a mutation in its genome and blocking of the process called cell apoptosis. Apoptosis is a natural defense mechanism, in which any cell of the body, ceasing to perform its direct functions, must independently destroy itself. Cells lacking this mechanism lose their specificity and multiply freely, producing millions of daughter cells with a similar DNA error. As a result, an area of ​​aggressively growing tissue appears, which does not perform any function, but heavily consumes the resources of the body, that is, a malignant tumor.

In the case of basalioma, its growth occurs infiltratively. In other words, the tumor grows into the surrounding tissues, destroying them along the way. It is for this reason that there is always an active zone of inflammation around the tumor, even if it is small.

Types of basalioma

Tumor growth is accompanied not only by an increase in its size, but also by a change in the contour of the boundaries. The more the contour of the tumor is changed, the more malignant it is, that is, the more pronounced cellular atypia. Despite the fact that basalioma is a slow-growing tumor, signs of inflammation caused by compression of surrounding tissues are almost always found along its periphery. On any form of tumors, pigment can appear. As a rule, it is randomly distributed over the surface of the tumor. Its appearance also says nothing, like the color of the tumor itself. The location of the tumor near vital organs, such as the eyes, nose, ears, can lead to severe deformation of the cartilaginous skeleton. In addition, the tumor tends to spread into the skull through natural openings and cavities. This, in turn, threatens to involve the brain with membranes in the tumor process, which threatens with a fatal outcome.

It is believed that the basalioma never metastasizes, but this is not entirely true. In the United States of America, several cases of basalioma growth in the lungs have been reported. At first glance, such an unusual localization of the tumor could be caused by the spread of tumor cells from the primary focus through the blood. However, upon closer examination, no metastases were found outside the lungs, which is not entirely characteristic of hematogenous dissemination. Another important feature of all cases was that they all developed in patients in whom the tumor had spread to the mucous membrane of the mouth or nose. The only explanation for this manifestation of the tumor was the entry of exfoliated cells into the lungs along with a sigh.

There are the following clinical forms of basalioma:

• nodal;
• superficial;
• cicatricial;
• ulcerative.

Nodular form of basalioma

Superficial form of basalioma

Cicatricial form of basalioma

It is important to note that the cicatricial form of basalioma can be both with primary cancer and with relapses ( repeated manifestations) after treatment. The recurrence rate for this type is as high as 40% in some countries due to the deep growth trend of this tumor. When a tumor reaches a vessel or nerve, it often grows along these formations for a long distance. This fact explains the appearance of secondary tumors with an identical pathomorphological picture at a distance from the site of growth of the removed tumor. The growth of these tumors is also slow, so they have a favorable prognosis. Typical localization on the chest, neck and face.

Ulcerative form of basalioma

In addition to the clinical classification there is also a morphological one, which is used mainly by laboratory assistants and doctors and is difficult to understand for people who do not have a special medical education. According to this classification, tumors are divided into many histological variants according to the degree of cellular differentiation and similarity with various tissues of the body.

Diagnosis of basaliomas

Usually, focusing on the above clinical signs of the nodular form, it is enough to simply suspect basal cell carcinoma. However, in the initial stages of growth, when the size of the tumor does not exceed 3–5 mm, it is easy to confuse it with an ordinary mole ( especially if the tumor is pigmented), molluscum contagiosum, or senile seborrheic hyperplasia. Hair can grow from a mole, which does not happen with basalioma. A distinctive feature of molluscum contagiosum and senile seborrheic hyperplasia is a small island of keratin in the central part. When crusted, the tumor can be confused with wart, keratoacanthoma, squamous cell skin cancer, and molluscum contagiosum. In this case, the crusts must be gently exfoliated. With basal cell carcinoma, this is easiest to do. After the bottom of the wound is exposed, for greater certainty and scientific confirmation, it is necessary to make a smear-imprint from the bottom of the ulcer and determine its cellular composition.

Highly pigmented basaliomas are easily confused with malignant melanomas. To prevent this from happening, you need to know that the elevated edges of basal cell carcinoma almost never contain melanin. In addition, the staining of basalioma is often brown, and melanoma has a dark gray tint. The flat form of basal cell carcinoma can be confused with eczema, psoriatic plaques, and Bowen's disease, but when the scales are scraped off the edge of the tumor, the true picture of the disease is revealed.

These clinical signs are intended to guide the doctor towards the correct diagnosis, and its confirmation should be carried out only after a biopsy, cytology or morphological examination of the tumor.

Examination by a doctor

At the appointment with these specialists, the patient may be asked the following questions:

• How long ago did education begin?
• How did it manifest itself, was there pain or itching?
• Are there similar formations anywhere else on the body? If yes, where?
• Is it the first time the patient encounters it or have there been similar formations before?
• What is the type of activity and the conditions in which the patient works?
• How much time, on average, does the patient spend outdoors?
• Does it apply the necessary protective measures in relation to solar radiation?
• Has the patient ever been exposed to excessive radiation exposure? If so, where and approximately what was the total dose?
• Does the patient have relatives with cancer?

In addition, the doctor may refer the patient for additional examinations, such as radiography in two projections, ultrasound procedure, computed tomography and magnetic resonance imaging. These paraclinical studies can provide valuable information about the size and depth of the tumor, its distribution in the cranial cavity, and proximity to vital structures.

Patients with treated basal cell carcinoma should be examined annually by a doctor not only to control tumor recurrence, but also to screen for new tumors. A patient, once treated for oncopathology, automatically falls into the risk category for other tumor diseases.

When is a biopsy and histological examination of a basalioma needed?

The biopsy is performed in a treatment room under aseptic conditions. For this manipulation, weak anesthesia with inhalation drugs is performed or not performed at all. Puncture is carried out in the following way. The tumor is fixed with the fingers of the left hand. An empty syringe with a hollow needle at the end is inserted with the right hand to the middle of the tumor. The advancement of the needle from the edge of the tumor to the center should be accompanied by its rotation. Upon reaching the center of the tumor, the syringe plunger is retracted, after which the needle is removed. Then, with a sharp push, the contents of the needle are thrown onto the glass slide and spread through it with the help of another - a cover glass. With a sufficient amount of biopsy, several samples are made. The thinner the layer of the substance on the glass, the better the prepared samples and the more likely it is to establish the correct diagnosis.

Laboratory tests

Basalioma treatment

The following features reduce the likelihood of successful treatment of basalioma:

• tumor diameter more than 20 mm;
• localization of the tumor near the eyes, nose and lips;
• fuzzy and uneven borders of the tumor;
• low level of immunity of the patient;
• accompanying illnesses;
• infiltrative, micronodular and basosquamous histological type of tumor;
• tumor growth near large blood vessels and nerves.

Is there an effective drug treatment for basalioma?

What are the signs of malignant tumor growth?

BUT– asymmetry ( asymmetry) - any mole that has a benign course in 95% of cases is always symmetrical. The exception is birthmarks, which can have intricate contours and still remain harmless.

B- the border ( border) - the edges of the mole, as a rule, are even and smooth. The appearance of notches, sores or scales on them indicates the beginning of malignancy.

C- color ( color) - a benign papilloma is always the same shade over its entire surface. The appearance of more or less pigmented islands on the surface of the tumor indicates its malignant transformation.

D– diameter ( diameter) - this parameter is the least accurate and most likely misleading, however, it is believed that a tumor up to 6 mm in size is most likely benign, and if this indicator is exceeded, the possibility of its degeneration increases.

E– progression ( evolution) - rapid growth is a characteristic feature of malignant tumors. A benign tumor can normally increase by 1-2 mm per year.

When is surgery to remove a tumor needed?

However, small tumors ( T1 and T2) can be treated, including targeted radiation therapy or local chemotherapy drugs. Such tumors can be cured with only one type of therapy. Tumor sizes corresponding to stages T3 and T4 are an indication for the combined use of radiation and surgical treatment. The goal of surgical treatment is excision and complete removal of the tumor.

The operation to remove the basalioma should be performed in the operating room under aseptic conditions. The type of anesthesia depends on the expected volume of surgery, the location of the tumor and general condition patient. Local infiltrative and conduction anesthesia is performed in patients up to an average of 55-60 years old with a tumor located on the trunk and extremities. The size of the tumor should not exceed 10 mm. For larger tumors with presumed involvement of underlying structures, spinal anesthesia is performed. Localization of the tumor on the neck and back prescribes general anesthesia, regardless of the age of the patient.

Due to its specificity, this tumor does not always have clear boundaries. Often the boundaries are not defined due to ulceration of the edges of the tumor with the transition to healthy tissues. In this case, the oncosurgeon must carefully examine the edges of the tumor before the operation using a special magnifying device or a simple magnifying glass. In the future, focusing on the edges of the tumor, its wedge-shaped resection is performed. Depending on the size of the tumor, a certain distance is retreated from it in order to minimize the likelihood of residual tumor cells in the wound and prevent recurrence. Russian and Western schools disagree on the amount of the required indent. The Russian school is more radical, as it recommends retreating from each edge of the tumor by 2 cm at T1 and T2 and 3 cm at T3. The Western school says that the amount of indentation should not exceed 3 - 5 mm. This is justified by statistical data, indicating that with a margin of 3 mm, the probability of recurrence is in the region of 15%, and with a margin of 4–5 mm, it does not exceed 5%.

Based on the foregoing, it follows that an increase in indentation reduces the likelihood of relapses, but leaves a more pronounced postoperative defect. However, it is important to note that even with the maximum indentation, the probability of tumor recurrence remains within 2–3%. This is due to the specificity of basal cell skin cancer, namely its ability to grow along blood vessels and nerves over considerable distances.

Surgical methods such as laser therapy and cryotherapy deserve special attention. They are mainly used for small tumors. Their advantage is atraumaticity and fast healing rates. However, there is a certain pattern here as well. The success of this method in skilled hands reaches 97% for small tumors, however, with an increase in the size of the tumor, the chance of recurrence also increases.

Today, MOHS surgery is considered the most advanced surgical method for removing basaliomas. This method was proposed in the 30s of the last century and consists in layer-by-layer removal of the tumor and its parallel histological examination. In more detail, the operation is performed as follows. First, the tumor is classically removed, observing the necessary indents. The wound, meanwhile, is tamponed, but not sutured, and the patient is sent to a special ward where he can rest. The tumor itself is sent to the laboratory, where the laboratory assistant, using special equipment, divides it into many thin layers, each of which is examined under a microscope after appropriate staining. The tumor is considered completely removed if in all sections the pathological tissue is surrounded by healthy tissue on all sides. If at any level contact of the tumor tissue with the edge of the cut is detected, then the patient is called again, and an additional piece of tissue is exfoliated in the indicated area, which is also sent to the laboratory. Thus, in stages, the tumor is completely removed along with all the branches. The duration of such an operation takes an average of 8 hours, but there were cases when the operation, with all the interruptions, lasted 2-3 days. The duration of the method is justified by the highest rates of cure and the lowest percentage of recurrence, which in some advanced clinics reaches tenths of a percent.

Treatment of basal cell carcinoma depending on the stage of its development

Basalioma of the second stage
The same methods of treatment are used as in the first stage, but in the form of complex therapy. In most cases, treatment is carried out in 1 - 2 stages. With one-stage treatment, a course of treatment is carried out, as in the first stage, but adjusted for larger size tumors. In two-stage treatment, it is performed first radical removal tumors, and then a control course of radiation therapy. With an increase in tumor size, the effectiveness of cryotherapy and laser removal decreases, so it is important to properly weigh all the pros and cons before choosing a treatment method. Chemotherapy drugs are rarely used from stage 2 basal cell carcinoma onwards.

Basalioma of the third stage
In this case, treatment is carried out in 2 - 3 stages. Two-stage treatment is carried out as in the second stage. Three-stage treatment involves an additional course of chemotherapy or ionizing radiation to reduce the size of the tumor before removing it. Cryotherapy and laser techniques are not used for tumors of this size.

Basalioma of the fourth stage
In the case where removal of the tumor is more beneficial than no treatment, surgery is performed. However, when the tumor spreads to vital structures, it is necessary to refrain from surgery. Radiation therapy of tumors of this size can lead to only a slight decrease in its size and very pronounced side effects. General chemotherapy treatment can also ensure a recurrence of the disease for a certain period of time, but this happens quite rarely. Under certain circumstances, it makes sense to perform a palliative operation in order to reduce compression of the structures surrounding the tumor and improve its sanitary condition.