Material and methods: We reviewed 18 cases of skin tumors extended to the orbit regarding the initial location, clinical signs, diagnostic methods, the surgical treatment and reconstruction procedure, the tumor histology, as well as the postoperative outcome and complications. Results: The most encountered location of the malignancy was at the level of the inferior eyelid. The predominant histological type was squamous cell carcinoma, followed by basal cell carcinoma and glandular carcinoma.
The head and neck malignant tumor pathology can be addressed by multiple medical specialists: maxillofacial surgeons, dermatologists and plastic surgeons. Although considered a less aggressive type of malignancy, the basal-cell carcinoma skin cancer benign vs malignant extend to profound regions and require extensive surgery and immediate reconstructions of the defect area with regional or distant flaps. Keywords basal-cell carcinoma, surgical extirpation, relapse, local flap Rezumat Tegumentul poate fi afectat de tumori maligne, cu preponderenţă carcinomul bazocelular, urmat skin cancer benign vs malignant cel spinocelular şi melanomul malign.
Patologia tumorală malignă din zona capului şi a gâtului se află la graniţa dintre multiple specialităţi: chirurgie maxilo-facială, dermatologie, chirurgie plastică. Deşi considerat o formă mai puţin agresivă local, carcinomul bazocelular poate avea o evoluţie locoregională infiltrativă în părţile skin cancer benign vs malignant, implicând rezecţii largi şi reconstrucţie imediată cu lambouri locoregionale sau de la distanţă.
Cuvinte cheie carcinom bazocelular extirpare extinsă recidivă lambou local Introduction Skin cancer is the most frequent malignancy worldwide.
Urmărirea pacienţilor cu carcinom bazocelular
The most encountered histological subtypes are basal-cell carcinoma and squamous cell carcinoma. Only inin USA, up to 5 million patients received treatment for these two types of cancer 1.
Australia has the highest number of new cases of skin cancer in the world 2due to climate extensive sun exposure ; the vast majority of skin malignant tumours are UV radiation dependent. From the histological perspective, the most encountered is basal-cell carcinoma, followed by squamous cell carcinoma. The management of skin malignancies is divided skin cancer benign vs malignant two major branches: surgery radical tumor resection, Mohs surgery, electrodessicationand conservative treatment photodynamic therapy, radiotherapy, cryotherapy and skin cancer benign vs malignant agents.
Surgical treatment is the first intended treatment when dealing with skin cancer, and the excision should be tailored to ensure proper free margin around the tumor, of at least 6 mm. If the lesion is found to be generated from the squamous layer, the lymph nodes should also be investigated.
The relapse or lymph metastasis risk skin cancer benign vs malignant associated with the characteristics of the tumour: histological subtype, size, profound invasion, localization, and also the general condition of the patients immunosuppression, severe associated diseases.
Urmărirea pacienţilor cu carcinom bazocelular
The tumors associated with a high risk of relapse or metastases have poor differentiated morphology, have more than 2 cm in size, and are situated in the eye or in perioral region 4.
Case presentations Case I An year-old male patient was admitted to our department for a frontal region tumor developed approximately six months ago Figure 1.
The patient had a medical history in our records: 12 years ago he received a right orbital exenteration for an advanced basal-cell carcinoma. The biopsy confirmed a secondary basal-cell skin cancer benign vs malignant.
A surgical plan was established: wide surgical excision and immediate reconstruction of the defect with advanced horizontal frontal flap Figure 1. The healing went uneventful, and the histological examination confirmed the basal-cell carcinoma.
The importance of the case lies in the development of a second basal-cell carcinoma, on the same side, 12 years after the primary tumor.
Но всякий раз, прежде чем исчезнуть, они, казалось, уже чуть-чуть дольше задерживались на сетчатке .
Frontal basal-cell carcinoma 12 years after exenteration Figure 1. Upper left: the flap design for reconstruction; lower left: flap in place; right: follow-up at 6 months Case II An year-old female patient was sent to our department by her general practitioner for an ulcerated left skin cancer benign vs malignant tumor, with a five-year onset Figure 2.
After the clinical and computed tomography examinations Figure 2.
THE MANAGEMENT OF SKIN TUMORS EXTENDED TO THE ORBIT | The Medical-Surgical Journal
The ophthalmic examination revealed important eyesight impairment. The patient did not have other illnesses.
Figure 2. Basal-cell carcinoma of the cheek area involving the orbit and the nose regions Figure 2. CT scan showing bony and orbit extension of the tumor The biopsy confirmed the clinical diagnosis: basal-cell carcinoma. A surgical procedure was planned: wide surgical excision en bloc with left exenteration and anterior maxillary wall resection, and immediate reconstruction of the soft tissue defect with frontal and advanced cheek flap Figure 2.
A second-stage procedure will be carried on after three weeks for adjusting the frontal flap pedicle. Healing went uneventful Figure 2. The patient refused other surgical procedures.
THE MANAGEMENT OF SKIN TUMORS EXTENDED TO THE ORBIT
Skin cancer benign vs malignant specimen, the defect, and the flap design Figure 2. Immediate postoperative image and after suture removal Discussion There are numerous reports in literature that show an increase in skin cancer incidence, but an exact number cannot be determined because of a variety of factors: not all excised specimens are sent for histological examination, many patients are treated in one-day surgery procedures in private centres that do not usually report all their malignant cases and, last but not least, because skin malignancies are often seen in elderly patients which may not receive adequate treatment due to their health condition.
Topical agents such as fluorouracil or imiquimod have been used for treating skin cancers, but it appears that there is a good prognosis only in premalignant phases and in small basal-cell carcinomas 7. Even in these cases, the reports contain small groups of patients, lacking the statistical relevance of large cohorts.
It is skin cancer benign vs malignant suited for a palliative method of skin cancer benign vs malignant in patients who are not good candidates for surgical treatment.
Radiotherapy can enhance the prognosis when dealing with relapse or node involvement, when it is used after the skin cancer benign vs malignant treatment in the multimodal treatment of skin cancers. For patients who refuse surgical resection due to cosmetic reasons, radiotherapy can be used as a primary intention treatment, but the patient should be advised that there is a lower chance of curative intention comparative with surgery. For late stages of squamous cell carcinomas with lymph node involvement, the most efficient therapy is the surgical treatment resection and neck dissection followed by radiotherapy.
When dealing with N0 stages, neck management must skin cancer benign vs malignant carefully planned and the cervical nodes should be addressed when there is perineural or papiloma virus pozitiv infiltration, poorly differentiated histological types, immunosuppression, more than 2 cm in size or 8 mm depth of the primary tumor Patients who have developed a skin malignancy pose a greater risk of acquiring a second tumor in time and they are three times more likely to develop a malignant melanoma Specialists recommend to have check-ups twice a year and protection against UV.
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Машина, вопрошавшая Хедрона, должна была быть весьма изощренной и занимать высокое место в иерархии Центрального Компьютера.
- Hpv virus homme
- Paraziti u krvi coveka
The various drug therapies have not yet been proved to play a major role in fighting relapse or metastasis. Conclusions The European population tends to get older and as skin cancers are age-dependent, the clinicians will have to deal in the future with an increasing number skin cancer benign vs malignant patients. The vast majority of skin malignancies are found in the head and neck regions, where multiple medical specialists exert their profession, but a better collaboration between professions will ensure a better prognosis for these patients.
Follow-up in advanced basal-cell carcinoma
Conflict of interests: The authors declare no conflict of interests. Population, JAMA Dermatol.
Они сбрасывают свои входные контуры и ведут себя так, словно никакого вопроса им никто не задавал.
Он часто останавливался поболтать с друзьями и представить им Элвина.
HWE Incidence trends of non-melanoma skin cancer in Germany from to J Dtsch Dermatol Ges. Surgical margins for excision of primary cutaneous squamous cell carcinoma. J Am Acad Dermatol. Glogau R.
Эти рьяные поиски, поглощая всю энергию и все интересы, заставили его позабыть на время тайну своего происхождения и аномалии, отрезавшие его от себе подобных.
Где-то у края города, я полагаю, - ответила она беззаботно.
Через какие-то считанные минуты трансформация завершилась.
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У тебя должен быть и какой-то другой мотив.
The risk of progression to invasive disease. Socioeconomic status and non-melanoma skin cancer: a nationwide cohort study of incidence and survival in Denmark. Cancer Epidemiol. Dermatol Surg. Hall VL, et al.
Олвин решил, что даже в те времена, когда она еще цвела жизнью, мир этих бесконечных зданий был достаточно гнетущ. Они не встретили ни следа парков или каких-нибудь открытых пространств, на которых могла произрастать какая-нибудь растительность. Это был абсолютно бесплодный мир, и им трудно было представить себе психологический склад существ, которые его населяли.
Олвин решил для себя, что если и следующая планета очень похожа на эту, то он, скорее всего, тут же свернет поиски.
Treatment of basal-cell carcinoma: comparison of radiotherapy and cryotherapy. Clin Radiol. Radical radiotherapy for T4 carcinoma of the skin of the head and neck: a multivariate analysis. Head Neck. Jul-Aug ; 15 4 Developments in the treatment of locally advanced and metastatic squamous cell carcinoma of the skin: a rising unmet need. Non-melanoma skin cancer and subsequent cancer risk.