Basalioma of the skin (squamous cell carcinoma). Basal cell skin cancer, photo, treatment and prognosis

Skin cancer is a disease that develops from a multi-layered squamous epithelium, representing malignant tumor. Most often, it appears on open areas of the skin, a very occurrence of a tumor on the face, the nose and forehead, as well as the corners of the eyes and ears, are most susceptible. The body does not like such formations and is formed there quite rarely; on the trunk, arms and legs, tumors occur no more often in 10% of cases. It is worth noting that the disease does not appear instantly, before that it without fail preceded by some skin changes.

It is customary to isolate basal cell carcinoma, squamous cell carcinoma, that is, melanoma or spinalioma, adenocarcinoma, and such forms of the disease that develop from the appendages of the skin. Any person is at risk, but, nevertheless, most often the disease affects older people over 60 who have fair skin and a large number of spend time in the sun. This is a fairly common pathology and, based on statistics, it ranks third among all types of oncology.

Signs and symptoms of skin cancer

When diagnosing skin cancer, it is customary to distinguish the following characteristic criteria that doctors are guided by:

If the formation has a characteristic asymmetrical shape, that is, when the possible is divided in half, both halves have different sizes and structure.

Most often, pathology is suspected by such a sign as fuzzy boundaries. If a common moles have a smooth boundary line, then cancerous tumors are most often intermittent, “serrated”.

The color of the affected area differs from the usual color of the skin, and is also not characteristic of ordinary formations. The color can be either too dark, or, on the contrary, too light, as well as red, with blue, or even black.

The doctor should also be alerted by the too large size of the formation. All the so-called "moles", which are more than 6 mm in diameter, are a reason for additional research.

The following can be distinguished general symptoms that characterize all types of skin cancer:

Significant weight loss that is not associated with gain physical activity or dietary changes.

Chronic fatigue despite regular rest.

Decreased appetite, no concomitant diseases GIT.

The increase in temperature is within insignificant limits - up to 37.2 degrees, which is kept constant.

Significant enlargement of the lymph nodes, which are easily determined by palpation.

All advanced stages are characterized by a pronounced pain syndrome which is permanently present.

Doctors also identify certain signs that are very characteristic of malignant tumors from squamous epithelium:

If a wound or sore long time do not heal or bleed.

If one or more spots with a reddish tint suddenly form on any part of the skin.

If any growth is covered with a crust or scales, its upper layers move away, and growth does not stop.

If nodules are found on the body or face that have a shiny surface and differ in color from skin. In their shade, such nodules resemble scars.

Depending on which of the subtypes of the tumor affected the skin, the corresponding symptoms will also differ, so they must be distinguished.

Basal cell carcinomas are characterized the following symptoms:

The appearance of a single formation, having the shape of a hemisphere.

The tumor slightly rises above the skin, has a color either grayish or pink, giving off mother-of-pearl. But in some cases, although not often, basaliomas are indistinguishable from the natural color of the skin.

The formation itself is smooth, and scales are located in its center. If they are removed, then erosion will open.

The tumor does not manifest itself for a long time, it only gradually increases over the years.

Sometimes the formations are multiple, if they are opened, droplets of blood appear.

Mostly this pathology occurs on the face and causes a violation of those organs next to which it is located.

Melanoma

Skin horn. This formation is typical for elderly people who spent a lot of time under the influence of ultraviolet rays.

Abuse alcoholic drinks and even more long-term smoking.

Senile keratoma.

Bowen's disease. This is also a kind of cancer, but it does not penetrate deep into the tissues.

Squamous cell skin cancer

This type of pathological process on the skin has several synonyms, it can also be called squamous epithelioma or spinalioma. It occurs regardless of the area of the body and can be located anywhere. But the open parts of the body are most susceptible to this lesion, as well as underlip. Sometimes doctors find squamous cell carcinoma localized on the genitals.

This tumor is not selective to people by gender, but with regard to age, pensioners are more likely to suffer. As the reasons provoking its appearance, experts indicate scarring of tissues after burns or mechanical damage that are systematic. It can also cause squamous cell carcinoma actinic keratosis, dermatitis chronic type, lichen, lupus tuberculosis and other diseases.

It should be noted that cancer resulting from skin damage by sunlight metastasizes extremely rarely, but formed as a result of scarring of the skin in 30% of cases.

This type of cancer is nodular formations, which can be either single or multiple. As it develops, it becomes less mobile and more painful, begins to bleed even from a light touch, especially for the warty variety.

When the disease is caused by the presence of the papillomavirus in the body, then it is characterized by active growth and a shape resembling a tomato in its structure. Ulcers appear six months after the formation of the tumor.

The ulcerative type of squamous cell carcinoma is characterized by similar formations that have an irregular shape with clear boundaries. hallmark is the growth of cancer not deep into the tissue, but an increase in size along the periphery. Its color is red, and a yellowish tinge is found on the surface.

Basal skin cancer

This type of cancer has such synonyms as basalioma or basal epithelioma. It occurs quite often, is prone to relapse, but in most cases does not metastasize.

As the main causes of this type of cancer, scientists identify hereditary factors due to genetic predisposition, as well as malfunctions of the immune system. It is often possible to meet opinions that basalioma develops against the background of exposure to carcinogens or insolation. In this case, skin changes may not be present, but they may take place. For example, this applies to lesions such as psoriasis, nevi, lupus erythematosus and other pathologies. Should not be dropped and ultraviolet radiation as a provoking factor in the growth of basalioma, also thermal burns and arsenic intake. It is also important that formations of this type are often found in those people who spent a lot of time in the sun in childhood.

Basalioma most often grows relatively slowly, occurs in the epidermis or on the scalp, in their follicles. This pathology doctors consider it from the point of view of a kind of tumor, and not as a cancer or a benign formation.

The formations can be both single and multiple, have a round outline from pink to dark red and rise slightly above the level of the skin. There are several forms of basalioma: superficial, pigmented, tumor, ulcerative, cicatricial-atrophic and fibroepithelial.

More often the appearance of basaliomas affects people who have crossed the threshold of 40 years, regardless of gender. In adolescents and children younger age such neoplasms are practically not found, an exception may be its congenital form, which is called the Gorlin-Goltz syndrome.

Cellular skin cancer

Cellular skin cancer is one of the synonyms of basalioma. Therefore, it proceeds according to the same type as the disease described above. It is worth noting that, despite the rather rare metastasis, this variety can still produce "sprouts". In such cases, the prognosis for survival is extremely low, and people suffering from cellular cancer with metastases live no more than a year.

Diagnosis of any skin cancer is practically not difficult. If the patient finds in himself any formation that causes the slightest suspicion, then it is necessary to consult an oncologist.

First, the doctor will visual inspection. Also for this purpose, specialized centers there is a device called an epiluminescent microscope, which reveals internal structure any formation thanks to luminescent lighting.

If the doctor has suspicions, then he prescribes a biopsy, for this a small area of \u200b\u200bthe skin is taken laboratory research for availability cancer cells. The biopsy can be puncture, incisional, excisional, or be cut. For its implementation, a scalpel or a thin blade is used, depending on the type of study chosen.

When research gives positive result and cancer cells are found in the patient, it is necessary to carry out a series of further action aimed at determining the stage of the tumor. For this, blood is taken CT scan, MRI, x-ray chest and sometimes ultrasound. When there is suspicion that pathological process already involved The lymph nodes, the doctor prescribes a study called a fine-needle aspiration biopsy.

Skin Cancer Treatment

The therapeutic effect is prescribed only by a doctor and directly depends on how far the pathological process has gone, and what kind of cancer has affected the person:

The most common method is surgery. In this case, both the tumor itself and the lymph nodes, if they have been affected, are removed.

Radiation therapy is also used to treat skin cancer, that is, it affects the affected areas of the skin with ionizing radiation. One of modern methods elimination of skin cancer is cryogenic therapy or nitrogen treatment. AT this case the tumor is affected by low temperatures. Doctors also use laser and drug therapy in their practice.

One of the effective methods is micrographic surgery according to MOHS, the essence of which is the direct impact on the affected area, due to the fact that the surgical intervention is carried out under a microscope. The prognosis for recovery in this case is very favorable, and after the operation, there is practically no residue left on the skin. visible to the eye defects.

Naturally, if there are indications, the methods can be combined and used in combination. The main thing is to prevent the transition of the disease to one of the last stages.

Prevention of skin cancer

As preventive measures, designed to reduce the number of skin cancer patients, doctors recommend the following:

Maximally protect skin areas from sun exposure, especially prolonged and intense. This rule applies to all people without exception, but it is especially true for pensioners and young children. As well as those who from birth have fair skin.

Use of sunscreen and moisturizers.

Any ulcers and fistulas that do not heal for a long time must be shown to the doctor without fail and treated with radical methods.

Try to protect from mechanical impact and injury and place.

When in contact with potentially hazardous substances use strict personal hygiene measures.

Carry out regular examinations of your body and if you find any suspicious formations, immediately inform your doctor about it.

It should be remembered that the earlier the disease is detected, the more likely it is to forget about it forever in the near future.

Education: completed residency at the Russian Scientific Cancer Center named after N.N. N. N. Blokhin” and received a diploma in the specialty “Oncologist”

This disease has many names. basalioma, basal cell epithelioma, ulcusrodens or epitheliomabasocellulare. It refers to diseases that are often found among patients. Basically, in our country, the term "basiloma" is more common in the specialized literature. Since the tumor on the skin has a clear destabilizing growth, regularly recurring. But metastasis does not occur with this cancer.

What causes skin basalioma?

Many experts believe that the reasons lie in individual development organism. In this case, it begins its origin in pluripotent epithelial cells. And they continue their progress in any direction. Genetic factors play an important role in the production of cancer cells. various kinds disorders in the immune system.

Affect the development of the tumor strong radiation, or contact with harmful chemicals that can cause malignant neoplasms.

Basalioma is also able to form on the skin, which does not have any changes. And the skin, which has different skin diseases(posriasis, senile keratosis, tuberculous lupus, radiodermatitis and many others) will be a good platform for the development of cancer.

In basal cell epithelioma, all processes proceed very slowly, so they do not turn into squamous cell carcinoma complicated by metastases. Often the disease starts in top layer skin, in hair follicles, as their cells are similar to the basal epidermis.

Doctors interpret this disease as a specific tumor formation with local destructive growth. Not as malignant or benign tumor. There are times when a patient has been subjected, for example, strong impact harmful x-ray beams. Then the basalioma is able to develop into basal cell carcinoma.

Regarding histogenesis, when the development of tissues of a living organism is carried out, researchers still cannot say anything.

Some think that squamous cell carcinoma begins its origin in the primary skin germ. Some believe that the formation will come from all parts of the epithelium of the skin structure. Even from the germ of the embryo and malformations.

Disease Risk Factors

If a person often comes into contact with arsenic, gets burned, irradiated x-rays and ultraviolet light, the risk of developing basalioma is very high. This type of cancer is often found in people with the first and second type of skin, as well as in albinos. And all of them for a long time experienced the effects of radiation exposure. Even if in childhood a person was often exposed to insolation, then a tumor may appear decades later.

The origin and development of the disease

The outer layer of the skin in patients is slightly reduced in size, sometimes pronounced. Basophilic cells begin to grow, the tumor becomes a single layer. Anaplasia is almost invisible, ontogeny is slightly pronounced. There are no metastases in squamous cell carcinoma, because the cells of the neoplasms, entering the blood ducts, cannot multiply. Since they do not have growth factors, which the tumor stroma should produce.

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Signs of cutaneous basalioma

Basal cell epithelioma of the skin is a solitary formation. The shape is similar to a half ball, the view is more rounded. The neoplasm may slightly protrude above the skin. The color is more pink or greyish-red, with a shade of mother-of-pearl. In some cases, basilioma is indistinguishable from normal skin at all.

To the touch, the tumor is smooth, in its middle there is a small depression, which is covered with a thin, slightly loose sanious crust. If you remove it, then under it you will find a small erosion. Along the edges of the neoplasm there is a thickening in the form of a roller, which consists of small whitish nodules. They look like pearls, according to which basilioma is determined. A person can have such a tumor for many years, only becoming a little larger.

Such neoplasms on the patient's body can be in large numbers. Back in 1979, scientists K.V. Daniel-Beck and A.A. Kolobyakov found that the primary multiple species can be found in 10% of patients. When there are dozens or more tumor foci. And this is then revealed in the non-basocellular Gorlin-Goltz syndrome.

All signs of such skin cancer, even Gorlin-Goltz syndrome, make it possible to divide it into the following forms:

nodular ulcer (ulcusrodens);
superficial;
scleroderma-like (morphea type);
pigment;
fibroepithelial.

If a sick person has a large number of foci, then the forms can be of several types.

Types of basalioma

Superficial type manifests itself by the appearance on the skin pink spots, a little flaky. Over time, the spot becomes clearer, acquiring an oval or rounded shape. On its edges you can see small nodules slightly shiny. They then merge into a dense ring, similar to a roller. In the middle of the spot is a depression that becomes dark, almost brown. It can be single or multiple. And also over the entire surface of the hearth there is a rash of dense, small particles. Almost always, the nature of the rash is multiple, and basilioma flows constantly. Its growth is very slow. Clinical signs very similar to Bowen's disease.

The pigmented type of basalioma resembles, but only the density is stronger. The affected areas have a blue-violet or dark brown tint. For an accurate diagnosis, dermoscopic examination of the spots is carried out.

The tumor type begins with the appearance of a small nodule. Then it gets bigger and bigger. Its diameter becomes about three centimeters. And it looks like a round speck of stagnant pink paint. On the smooth surface of the tumor, dilated small vessels are clearly visible, some are covered grayish bloom. The central part of the affected area may have a dense crust. The growth does not protrude above the skin, and she has no legs. There are two forms of this type: with small and large nodules. It depends on the size of the tumors.

The ulcerative type appears as a variation of the primary variant. And also as a result of the manifestation of superficial or tumor basilioma. A typical feature this form of the disease is considered an expression in the form of a funnel. It looks massive, its fabric seems to be glued to the lower layers, their borders are not clearly visible. The size of the accumulations is much larger than the ulcer. In this variant, there is a noticeable tendency to strong expressions, due to which it begins to collapse Bottom part fabrics. There are times when ulcerative appearance is complicated by growths in the form.

The scleroderma-like or cicatricial-atrophic type has a small, clearly defined focus of infection, compacted at the base, but not protruding above the skin. The color shade is closer to yellowish-whitish. In the middle of the spot, atrophied transformations or dyschromia occur. Sometimes erosive foci of various sizes appear. They have a peel that is very easy to remove. it positive moment when conducting cytological studies.

Fibro epithelial tumor Pinkus is a type of squamous cell carcinoma, but it proceeds quite easily. Outwardly, it looks like a nodule or plaque in the color of a person's skin. The consistency of such a spot is dense and elastic, erosion is not observed on it.

Therapy for skin basalioma

Basal cell epithelioma is treated conservative way. Doctors surgically remove lesions along the border healthy skin. Cryodestruction is also practiced. This treatment is used if surgical intervention may be cosmetic defect. It is possible to smear spots with prospidin and colhamic ointments.

Basalioma, or skin cancer is called malignancy, which can arise from skin cells (epithelium). There are three types of skin cancer:

basalioma or basal cell carcinoma(about 75% of cases); squamous cell carcinoma (about 20% of cases); other types of cancer (about 5% of cases).

Basalioma is the most common type of skin cancer. He doesn't give distant metastases. It is also called a borderline skin tumor due to the benign course of the disease. Among physicians, it is believed that one cannot die from basalioma. However, as with squamous cell carcinoma, it all depends on the degree of neglect and the speed of the disease.

A feature of basalioma, which is noted by all oncologists, is high risk relapse. No method of treating skin basalioma, even deep excision, guarantees that oncology will not reappear. On the other hand, skin basalioma may not reappear even with small interventions.

Basalioma of the skin of small sizes is almost always successful treatment. If you missed the time, the basalioma of the skin has probably already turned into a fetid ulcer about 10 cm in size. It begins to grow into blood vessels, tissues and nerves. In most cases, the patient dies from complications that are caused by the disease. 90% of skin basalioma cases are located on the face.

Squamous cell skin cancer

Squamous cell carcinoma skin is also called true cancer. It often recurs, gives metastases to regional lymph nodes, causes the appearance of separated metastases in various organs.

The causes of squamous cell carcinoma and basalioma are:

ionizing radiation radiation; thermal and mechanical injury; scarring; impact of all kinds chemical compounds: tar, arsenic, fuels and lubricants.

Externally, squamous cell carcinoma and basalioma of the skin can be an ulcer or tumor formation (nodule, plaque, "cauliflower").

Diagnosis of skin cancer

The diagnosis is made to the patient after an examination and a series of tests, including a histological or cytological examination. For a histological examination, an operational biopsy of the tumor is necessary, and for a cytological examination, a scraping or smear is sufficient.

If squamous cell carcinoma and enlarged lymph nodes are detected, a biopsy of these same lymph nodes may be required, followed by a cytological examination of the material obtained. Also, in the format of a routine examination for this form of cancer, ultrasound of the regional lymph nodes, liver and lungs is performed.

Principles of treatment

If you have a basalioma of the skin or squamous cell carcinoma, then the treatment may be different - it all depends on the stage of the disease. In most cases, squamous cell skin cancer, no matter what symptoms it causes, involves surgery. So, the method of excising the skin within healthy tissues is often used: the indentation from the border should be about 5 mm. This procedure is performed under local anesthesia. If skin cancer has reached serious stages and metastasized, then treatment involves the excision of regional lymph nodes.

With basalioma of the skin, treatment can be carried out using methods plastic surgery. This is justified in the presence of large tumors.

Another method of treatment is Mohs surgery. This technique involves the excision of the tumor to the borders of the end of the cancerous tissue. Radiation therapy is used when the tumor is very small or, conversely, on late stages. In some cases, the use of laser destruction, cryodestruction and photodynamic therapy is relevant. Metastatic, or advanced forms of cancer, are treated with chemotherapy.

What causes skin basalioma?

Many experts believe that the reasons lie in the individual development of the organism. In this case, squamous cell carcinoma begins its origin in pluripotent epithelial cells. And they continue their progress in any direction. In the production of cancer cells, a genetic factor plays an important role, as well as various disorders in the immune system.

Affect the development of the tumor strong radiation, or contact with harmful chemicals that can cause malignant neoplasms.

Basalioma is also able to form on the skin, which does not have any changes. And the skin that has various skin diseases (posriasis, senile keratosis, tuberculous lupus, radiodermatitis and many others) will be a good platform for the development of cancer.

In basal cell epithelioma, all processes proceed very slowly, so they do not turn into squamous cell carcinoma complicated by metastases. Often, the disease begins to emerge in the upper layer of the skin, in the hair follicles, since their cells are similar to the basal epidermis.

Doctors interpret this disease as a specific tumor formation with local destructive growth. And not as a malignant or benign tumor. There are cases when the patient was exposed, for example, to strong exposure to the harmful rays of the x-ray machine. Then the basalioma is able to develop into basal cell carcinoma.

Regarding histogenesis, when the development of tissues of a living organism is carried out, researchers still cannot say anything.

Disease Risk Factors

If a person often comes into contact with arsenic, gets burns, is irradiated with X-rays and ultraviolet radiation, then the risk of developing basalioma is very high. This type of cancer is often found in people with the first and second type of skin, as well as in albinos. Moreover, all of them experienced the effects of radiation exposure for a long time. If even in childhood a person was often exposed to insolation, then a tumor may appear decades later.

The origin and development of the disease

VIDEO

Signs of cutaneous basalioma

All signs of such skin cancer, even Gorlin-Goltz syndrome, make it possible to divide it into the following forms:

nodular ulcer (ulcusrodens); superficial; scleroderma-like (morphea type); pigment; fibroepithelial.

If a sick person has a large number of foci, then the forms can be of several types.

Types of basalioma

The superficial type manifests itself by the appearance of pink spots on the skin, slightly flaky. Over time, the spot becomes clearer, acquiring an oval or rounded shape. On its edges you can see small nodules slightly shiny. They then merge into a dense ring, similar to a roller. In the middle of the spot is a depression that becomes dark, almost brown. It can be single or multiple. And also over the entire surface of the hearth there is a rash of dense, small particles. Almost always, the nature of the rash is multiple, and basilioma flows constantly. Its growth is very slow. Clinical signs are strongly similar to Bowen's disease.

The pigmented type of basalioma resembles nodular melanoma, but only the density is stronger. The affected areas have a blue-violet or dark brown tint. For an accurate diagnosis, dermoscopic examination of the spots is carried out.

The tumor type begins with the appearance of a small nodule. Then it gets bigger and bigger. Its diameter becomes about three centimeters. And it looks like a round speck of stagnant pink paint. On the smooth surface of the tumor, dilated small vessels are clearly visible, some are covered with a grayish coating. The central part of the affected area may have a dense crust. The growth does not protrude above the skin, and she has no legs. There are two forms of this type: with small and large nodules. It depends on the size of the tumors.

The ulcerative type appears as a variation of the primary variant. And also as a result of the manifestation of superficial or tumor basilioma. A typical sign of this form of the disease is an expression in the form of a funnel. It looks massive, its fabric seems to be glued to the lower layers, their borders are not clearly visible. The size of the accumulations is much larger than the ulcer. In this variant, there is a tendency to strong expressions, due to which the lower part of the tissue begins to collapse. There are cases when the ulcerative appearance is complicated by growths in the form of papillomas and warts.

The scleroderma-like or cicatricial-atrophic type has a small, clearly defined focus of infection, compacted at the base, but not protruding above the skin. The color shade is closer to yellowish-whitish. In the middle of the spot, atrophied transformations or dyschromia occur. Sometimes erosive foci of various sizes appear. They have a peel that is very easy to remove. This is a positive moment when conducting cytological studies.

Pinkus fibroepithelial tumor is a type of squamous cell carcinoma, but it is quite mild. Outwardly, it looks like a nodule or plaque in the color of a person's skin. The consistency of such a spot is dense and elastic, erosion is not observed on it.

Basal cell epithelioma is treated conservatively. Doctors surgically remove lesions along the border of healthy skin. Cryodestruction is also practiced. Such treatment is used if there may be a cosmetic defect after surgery. It is possible to smear spots with prospidin and colhamic ointments.

Basalioma (synonymous with basal cell carcinoma) is the most common malignant epithelial neoplasm of the skin (80%), arising from the epidermis or hair follicle, consisting of basaloid cells and characterized by locally destructive growth; metastasizes extremely rarely.

Usually develops after 40 years due to prolonged insolation, exposure to chemical carcinogens or ionizing radiation. More common in men. In 80% of cases, it is localized on the skin of the head and neck, in 20% it is multiple.

Clinically, the following forms of basalioma are distinguished:

superficial- characterized by a flaky patch Pink colour, round or oval in shape with a filiform edge, consisting of small shiny knots of pearl, murky pink;

O puffy begins with a dome-shaped nodule, reaching a diameter of 1.5–3.0 cm within a few years,

ulcerative develops primarily or by ulceration of other forms; a basalioma with a funnel-shaped ulceration of a relatively small size is called ulcus rodeus (“corrosive”), and extending deep into (up to the fascia and bone) and along the periphery - ulcus terebrans (“penetrating”);

scleroderma-like basalioma has the appearance of a dense whitish plaque with a raised edge and telangiectasias on the surface.

Histologically, the most common (50–70%) type of structure, consisting of various shapes and sizes of strands and cells of compactly located basaloid cells resembling syncytium. They have rounded or oval hyperchromic nuclei and scanty basophilic cytoplasm, along the periphery of the strands there is a "palisade" of prismatic cells with oval or slightly elongated nuclei - feature basalioma. Often there are mitoses, the cellular fibrous connective tissue stroma forms bundle structures, contains a mucoid substance and an infiltrate of lymphocytes and plasma cells.

The course of basaliomas is long. Relapses occur after inadequate treatment, more often with a tumor diameter of more than 5 cm, with poorly differentiated and invasive basaliomas.

The diagnosis is established on the basis of clinical and laboratory (cytological, histological) data.

Treatment of solitary basaliomas is surgical, as well as with the help of a carbon dioxide laser, cryodestruction; with a tumor diameter of less than 2 cm, intralesional administration of intron A is effective (1,500,000 IU every other day No. 9, the course consists of two cycles). With multiple basaliomas, cryodestruction, photodynamic therapy, chemotherapy (prospidin 0.1 g intramuscularly or intravenously daily, per course of 3.0 g) are performed. X-ray therapy (usually close-focus) is used in the treatment of tumors located near natural holes and also in cases where other methods are ineffective.

Squamous cell skin cancer (syn.: spinocellular cancer, squamous epithelioma) is a malignant epithelial tumor of the skin with squamous differentiation.

It mainly affects the elderly. It can develop on any part of the skin, but more often in open areas ( top part face, nose, lower lip, rear of the hand) or on the mucous membranes of the mouth (tongue, penis, etc.). As a rule, it develops against the background of precancer of the skin. It metastasizes lymphogenously with a frequency of 0.5% for malignant solar keratosis to 60–70% for squamous cell carcinoma of the tongue (average 16%). Foci of squamous cell skin cancer are solitary or primary multiple.

Clinically isolated tumor and ulcerative types of skin cancer.

tumor type, initially characterized by a dense papule surrounded by a corolla of hyperemia, which turns over several months into a dense (cartilaginous consistency) inactive node (or plaque) soldered with subcutaneous adipose tissue, of a red-pink color with a diameter of 2 cm or more with scales or warty growths on the surface (warty variety), bleeding easily at the slightest touch, necrotizing and ulcerating; its papillomatous variety differs more rapid growth, separate spongy elements on broad base, which are sometimes shaped like cauliflower or tomato. It ulcerates on the 3-4th month of the existence of the tumor.

Ulcerative type, characterized by a superficial ulcer of irregular shape with clear edges, spreading not in depth, but along the periphery, covered with a brownish crust (superficial variety); the deep variety (spreading along the periphery and into the underlying tissues) is an ulcer with a yellowish-red color (“greasy”) base, steep edges and a bumpy bottom with a yellow-white coating. Metastases to regional lymph nodes occur on the 3rd-4th month of the existence of the tumor.

Histologically, squamous cell skin cancer is characterized by proliferating into the dermis strands of cells of the spinous layer of the epidermis. Tumor masses contain normal and atypical elements (polymorphic and anaplastic). Atypia is manifested by cells of various sizes and shapes, hyperplasia and hyperchromatosis of their nuclei, and the absence of intercellular bridges. There are many pathological mitoses. Distinguish between keratinizing and non-keratinizing squamous cell carcinoma. Highly differentiated tumors demonstrate pronounced keratinization with the appearance of "horny pearls" and individual keratinized cells. Poorly differentiated tumors do not have pronounced signs of keratinization; strands of sharply polymorphic epithelial cells are found in them, the boundaries of which are difficult to determine. Cells have various shape and size, small hyperchromic nuclei, pale shadow nuclei and nuclei in a state of decay are found, pathological mitoses are often detected. Lymphoplasmacytic infiltration of the stroma is a manifestation of the severity of the antitumor immune response.

The course is steadily progressive, with germination in the underlying tissues, pain, dysfunction of the corresponding organ.

The diagnosis is established on the basis clinical picture, as well as the results of cytological and histological studies. Differential Diagnosis carried out with basalioma, keratoacanthoma, solar keratosis, Bowen's disease, skin horn and etc.

Treatment is carried out by surgical removal tumors within healthy tissues (sometimes in combination with X-ray or radiotherapy), chemotherapy is also used surgery, cryodestruction, photodynamic therapy and etc. The choice of treatment method depends on the stage, localization, prevalence of the process, the nature of the histological picture, the presence of metastases, the age and general condition of the patient. So, with the localization of the tumor in the nose, eyelids, lips, as well as elderly people who are unable to tolerate surgical treatment, radiotherapy is more often performed. The success of treatment largely depends on early diagnosis. Prevention of squamous cell skin cancer is primarily in the timely and active treatment precancerous dermatoses. The role of sanitary propaganda among the population of knowledge about clinical manifestations squamous cell skin cancer so that patients see a doctor as soon as possible early dates upon its occurrence. There is a need to warn the public about harmful effects excessive insolation, especially for blondes with fair skin. Importance also has compliance with safety regulations in production, where there are carcinogens. Workers employed in such industries should be subjected to systematic professional examinations.

Cytograms of basaliomas are characterized by small hyperchromic cells with mild signs of atypicality, which are located in the form of dense tissue patches, complexes, strands or individual groups(dense cementation of cells). The background of preparations can be represented by an interstitial substance, structureless masses of cellular decay, as well as keratinizing scales and horny masses.

There are three types of microscopic pictures.

The most common type of cytograms is characterized by small hyperchromic cells arranged in dense tissue patches. Due to the dense arrangement of cells, it is not always possible to determine their shape. Along the edge of such clusters, the cells turn out to be polygonal, sometimes with short processes or “disarranged”. The nuclei occupy almost the entire cell, are located centrally in it, are polymorphic, uneven contours, hyperchromic and diffusely stained, the nucleoli are indistinguishable. The chromatin of the nuclei is coarsely clumpy. The cytoplasm of the cells is sparse and inhomogeneous, intensely basophilic stained.

In addition to small hyperchromic cells, lighter cells of medium size may be found. They are round or polygonal in shape with centrally located nuclei, reminiscent of squamous cell carcinoma cells.

In tissue shreds between cells, there may be dense oxyphilic strands and accumulations of interstitial substance. Sometimes cells seem to be walled up in such vast accumulations of interstitial substance.

In the second type of cytograms, the vast majority of cells of medium and small sizes, round shape, with light cytoplasm and rounded centrally or eccentrically located nuclei. The chromatin of the nuclei is clear, granular or stranded. It evenly fills the nucleus and is intensely colored; enlarged nucleoli are visible in some nuclei. Often there are binuclear cells with bean-shaped nuclei. Cells are located separately, in groups and complexes among abundant fine-grained or homogeneous oxyphilic substance and are, as it were, walled up in it.

In addition to light cells, the preparations contain small hyperchromic polygonal elements of the tumor with sharply hyperchromic, finely tuberous nuclei and not abundant, homogeneous, clearly defined cytoplasm. The background of the drug is oxyphilic intermediate substance and histiocytes.

The third type of cytograms is characterized by relatively large quantity pigment-containing cells (nevus-like variant of basalioma). Pigment-containing cells are oval, elongated, polygonal and, rarely, process-shaped, filled with slate-gray and gray melanin granules. These cells are located separately or are found in the form of strands and clusters. Their nuclei are round and oval, with a compacted contour, small-lumpy, with small nucleoli. Similar cells are found, but in a small number in other variants of basalioma cytograms.

The predominance of pigment-containing cells in the preparation makes it necessary to make a differential diagnosis between basalioma and pigmented nevus. Frequently install accurate diagnosis is not possible, and in conclusion it is only necessary to point out that with such a cytogram, both pigmented basalioma and pigmented nevus can occur.

Clinically, the following forms of basalioma are distinguished:

superficial- characterized by a scaly pink spot, round or oval in shape with a filiform edge, consisting of small shiny nodules of pearl, murky pink;

O puffy begins with a dome-shaped nodule, reaching a diameter of 1.5–3.0 cm within a few years,

scleroderma-like basalioma has the appearance of a dense whitish plaque with a raised edge and telangiectasias on the surface.

Histologically, the most common (50–70%) type of structure, consisting of various shapes and sizes of strands and cells of compactly located basaloid cells resembling syncytium. They have rounded or oval hyperchromic nuclei and scanty basophilic cytoplasm, along the periphery of the strands there is a "palisade" of prismatic cells with oval or slightly elongated nuclei - a characteristic sign of basalioma. Often there are mitoses, the cellular fibrous connective tissue stroma forms bundle structures, contains a mucoid substance and an infiltrate of lymphocytes and plasma cells.

The course of basaliomas is long. Relapses occur after inadequate treatment, more often with a tumor diameter of more than 5 cm, with poorly differentiated and invasive basaliomas.

The diagnosis is established on the basis of clinical and laboratory (cytological, histological) data.

Treatment of solitary basaliomas is surgical, as well as with the help of a carbon dioxide laser, cryodestruction; with a tumor diameter of less than 2 cm, intralesional administration of intron A is effective (1,500,000 IU every other day No. 9, the course consists of two cycles). With multiple basaliomas, cryodestruction, photodynamic therapy, chemotherapy (prospidin 0.1 g intramuscularly or intravenously daily, per course of 3.0 g) are performed. X-ray therapy (more often close-focus) is used in the treatment of tumors located near natural openings, as well as in cases where other methods are ineffective.

squamous cell cancer

Squamous cell skin cancer (syn.: spinocellular cancer, squamous epithelioma) is a malignant epithelial tumor of the skin with squamous differentiation.

It mainly affects the elderly. It can develop on any part of the skin, but more often in open places (upper face, nose, lower lip, back of the hand) or on the mucous membranes of the mouth (tongue, penis, etc.). As a rule, it develops against the background of precancer of the skin. It metastasizes lymphogenously with a frequency of 0.5% for malignant solar keratosis to 60–70% for squamous cell carcinoma of the tongue (average 16%). Foci of squamous cell skin cancer are solitary or primary multiple.

Clinically isolated tumor and ulcerative types of skin cancer.

tumor type, initially characterized by a dense papule surrounded by a corolla of hyperemia, which turns over several months into a dense (cartilaginous consistency) inactive node (or plaque) soldered with subcutaneous adipose tissue, of a red-pink color with a diameter of 2 cm or more with scales or warty growths on the surface (warty variety), bleeding easily at the slightest touch, necrotizing and ulcerating; its papillomatous variety is characterized by more rapid growth, separate spongy elements on a wide base, which sometimes have the shape of a cauliflower or tomato. It ulcerates on the 3-4th month of the existence of the tumor.

Histologically, squamous cell skin cancer is characterized by proliferating into the dermis strands of cells of the spinous layer of the epidermis. Tumor masses contain normal and atypical elements (polymorphic and anaplastic). Atypia is manifested by cells of various sizes and shapes, hyperplasia and hyperchromatosis of their nuclei, and the absence of intercellular bridges. There are many pathological mitoses. Distinguish between keratinizing and non-keratinizing squamous cell carcinoma. Highly differentiated tumors demonstrate pronounced keratinization with the appearance of "horny pearls" and individual keratinized cells. Poorly differentiated tumors do not have pronounced signs of keratinization; strands of sharply polymorphic epithelial cells are found in them, the boundaries of which are difficult to determine. Cells have various shapes and sizes, small hyperchromic nuclei, pale nuclei-shadows and nuclei in a state of decay are found, pathological mitoses are often detected. Lymphoplasmacytic infiltration of the stroma is a manifestation of the severity of the antitumor immune response.

The course is steadily progressive, with germination in the underlying tissues, pain, dysfunction of the corresponding organ.

The diagnosis is established on the basis of the clinical picture, as well as the results of cytological and histological studies. Differential diagnosis is carried out with basalioma, keratoacanthoma, solar keratosis, Bowen's disease, skin horn, etc.

Treatment is carried out by surgical removal of the tumor within healthy tissues (sometimes in combination with X-ray or radiotherapy), chemosurgical treatment, cryodestruction, photodynamic therapy, etc. are also used. The choice of treatment method depends on the stage, localization, prevalence of the process, the nature of the histological picture, the presence of metastases, the age and general condition of the patient. So, with the localization of the tumor in the area of the nose, eyelids, lips, as well as elderly people who are unable to endure surgical treatment, radiotherapy is more often performed. The success of treatment largely depends on early diagnosis. Prevention of squamous cell skin cancer lies primarily in the timely and active treatment of precancerous dermatoses. The role of sanitary propaganda among the population of knowledge about the clinical manifestations of squamous cell skin cancer is important so that patients consult a doctor as early as possible when it occurs. It is necessary to warn the public about the harmful effects of excessive insolation, especially for fair-skinned blonds. It is also important to comply with safety regulations at work where carcinogenic substances are present. Workers employed in such industries should be subjected to systematic professional examinations.