Squamous Cell Carcinoma
Squamous cell carcinoma (SCC) or carcinoma.
Squamous cell carcinoma is a type of cancer subtypes and may originate from many organs. A few of such organs, skin, lungs, lips, mouth, bladder, vagina, cervix (cervical), and samples can be increased. Skin cancer, basal cell carcinoma in the this is one of the most common skin cancer. Forming the top layer of the epidermis of the skin comes from squamous cells.
Squamous cell cancer of the mucous membranes throughout the body style of the cover is seen most commonly occurs in sun-exposed parts. Squamous cell carcinoma usually stayed for a while although the epidermis was not treated in time to penetrate the underlying tissue layers. A small percentage of cases metastasize to distant tissues and organs.
Squamous cell carcinomas can be fatal when it happens. The most common mucous membranes, lips and chronic skin infections common in developing squamous cell carcinoma metastasis in places they do. The second most common type of skin cancer is common (10-15%). Chronic (10-20 years) applies for exposure to sunlight. Around the equator as the relative incidence is increasing. Squamous cell cancer more common in men. BCC is the common risk factors in general. Usually erythematous skin, ulcers, crusted lesions are seen in the form. Squamous base often, soft, friable lesions are prone to bleeding with minimal trauma and can be.
Edges of the skin lesion and surrounding tissue makes a high inflammatory response enduration create. Persistent ulceration areas, where previous trauma, burns or old scars (Marjolin’s ulcer) may develop on the tumor. Basal cell or neoplastic changes in a chronic ulcer may result in SCC can be associated with poor prognosis and high mortality. Multifocal superficial actinic skin lesions can arise. Scaly-skinned, and they usually accompanies a patch with minimal trauma Bleed. Diagnosis and evaluation of the lesion may be difficult and may require multiple biopsies. SCC rarely a nodular, as can be seen in eksofitik lesions.
Initially, the components that are growing and ulcerative. And growth of these lesions can occur suddenly. Histopathologic analysis of a few characters are more important in SCC. Irregular masses of epidermal cells, proliferating downwards and will be invading dermis. Will be differentiated depending on the presence of tumor keratinization. 1 to 4 tumors can be classified using Broders classification. SCC behavior of de novo lesions are more aggressive and high metastatic potential. At least 8% has been reported to develop regional and distant metastases.
Squamous Cell Carcinoma (SCC) with Here are the pictures Reasons : Chronic exposure to sunlight as the cause of many cases represents. The disease is so common as the body’s face, neck, bald head skin, hands, shoulders, arms and back like the sun that occures.Ear bucket edge and bottom lip, this type of cancer against the most defenseless body parts constitute. Squamous cell carcinoma of the skin than previously yandigi and scar tissue developed parts, the long-term non-healing wounds,previously X-rays or arsenic, and petroleum-derived chemicals, such as the exposed parts can be developed.
Furthermore, in addition to chronic skin infections and immune system diseases or squamous cell carcinoma of the long period of considered among the reasons. In most cases of squamous cell carcinomas, healthy-looking skin suddenly occures.Some of predisposition to develop this form of cancer, researchers believe may have inherited.
Risk Group: Long periods exposed to the sun in all aspects of this disease are at risk. But fair-skinned, light-haired, blue, green or gray eyes of the people with the highest risk group constituted. Working in professions that require long hours outdoors or enjoy the sun rays for long periods of exposed people are at particular risk. Africans have dark skin, light-skinned individuals than in skin cancer is less.
Squamous cell carcinomas than two-thirds majority or a pre-existing skin inflammation that may have developed the old burn injuries. Treatment: The first preferred form of treatment a complete surgical excision. Radiation in some cases, surgery can not be done.Therapy can be applied instead of excision. Often the lower lip and oral mucosa of smokers seen SCC’si is more aggressive and require more radical treatment. In cases of prolonged sun exposure, and common in patients on immunosuppressive therapy (organ transplants, etc.) has a high recurrence rate and treatment need not be as satisfactory as well.
Regional lymph nodes, ultrasound can be used in aggressive and advanced cases, it is not Indicative of a blood test. Follows: Most recommended form of follow-up control after three months at the end of this year and then double-check the type of SCC, treatment modalities, depending on the needs of patients and controls is done. No benefit was reported that a blood test or X-rays are not available. More details can be found in current national guidelines.
Lips, tongue, floor of mouth, salivary glands, inside the cheeks, gums and palate affects malignant tumors. Tumors 90% are squamous cell carcinoma and the rest of lymphoma, melanoma, minor salivary gland cancer and sarcoma. Systems affected: digestive sistemil Genetics:
Irrelevant
Tightness appears:
• 12 / 100 000 (30 300 new cases each year). 5000 people die each year from this disease
• Tumors of the oral cavity of all cancers in men, 4% ‘fame, women 2% CPC will bring
• Palm fresh palm leaves, chewing habits, smoking habits as well to keep the end in the mouth, depending is high in Asia.
Age :
• 50 and over. But with the use of smokeless tobacco are increased in the younger age group.
Gender:
• Men = Women
SPECIFICATION AND RESULTS
• Dysphagia
• Socket to come back from the nose.
• Speech problems.
• Lack of tumor-related nasopharyngeal airway and sore throat to swallow many of the weather.
• Reflection due to the pain of unilateral ear pain.
• Often confused with precision and infectious masses or ulcers in the oral cavity. Manual examination of the ulcer often extends beyond their own borders is felt in the hard areas.
• Soft neck mass.
• The lymph glands in the neck by hand.
REASONS
• Tobacco use (smoky or smoke-free).
• The use of snuff.
• Excessive alcohol consumption.
•In the case of lip cancer, exposure to ultraviolet light.
• Vitamin B12 or iron deficiency anemia.
DIAGNOSIS :
IMAGING
• Jumping into the lung to the chest radiograph to rule out.
• Thinking of jumping to the bone if the bone pain and bone scan image.
• Suggestive of brain or liver clinic if there is a jump from computed tomography or MRI.
Biopsy
• Outpatient transoral biopsy, the diagnosis is accurate.
TREATMENT
GOOD SANITARY MAINTENANCE
• The patient paying for surgery.
• Treatment varies depending on location, for example, tongue, cheek wall, pharynx, palate, lips.
• Radiation (We-ray) treatment and / or (drug) in combination with chemotherapy or only the cancerous area is removed completely by surgery is the treatment of choice.
• Lesions that can not be operative radiation therapy and / or are treated with chemotherapy.
• Surgical patients who require nutrition is the most important factor for normal wound healing. If oral feeding is not possible probe inserted into the stomach and / or gastric feeding may be required by drilling holes from the outside.
ACTIVITIES
• Physical condition of the patient can tolerate up.
DIET
• The extent of the disease depends on the ability and chewing or swallowing.
Plugging
PATIENT MONITORING
• Upper airway and digestive systems, or recurrence of a possible focus for the routine examination of the head and neck examination should be performed periodically.
PRECAUTIONS / avoidance
• Prohibiting tobacco smoking or using smokeless tobacco.
• Prohibiting alcohol.
EXPECTED DEVELOPMENT AND PROGNOSIS
Adequate treatment of early lesions, 80% more than the treatment provided.
Over the years, the growing incidence, treatment and skin cancer which is more difficult to control. Risk factors are as previously stated. Patients with skin cancer before the first 18 months of 25% chance of recurrence, 36% increase over five years. HPV (human papillomavirus) infection and increases the risk of squamous cell carcinoma.
Floor consisting of cancers (Marjolin ulcer) is a special place. Was first described in 1828. Burns or trauma, long-lasting bearing on the tension grows. Burns nearly 1015 years after the formation occurs. The most aggressive skin cancer. Metastasis rate is 20%. For treatment of a wide excision and regional lymph node dissection if nodal involvement is required. Radiotherapy may be added. 5-year survival rates are up 34%.Sinus or leg ulcers are a significant risk factor for cancer. Metastases, would be too late to remote areas, regional ganglions can spread early.
Malignant Melanoma (Melanoma, M.M.)
Melanoma, melanin pigments can produce any cell of the body are caused by malignant tumors. Therefore, is seen most often in the skin. In recent years, the recognition of the etiologic factors, clinical and pathological features of diversity is known to elicit the rational treatment was developed.
Malignant melanoma (MM) is a common tumor. In the last 35 years, the incidence rate of up to 4/100.000 twice increased. Therefore, prevention, early diagnosis, early surgical intervention and follow-up is crucial to survival. The incidence increases proportionally with age. Between 35 and 55 years are common. Etiologic factors, a previous nevi, nevi emerging, trauma, solar radiation, chronic irritation-s, racial predisposition is located.
Dysplastic nevi also carries a potential tumor. Giant hairy nevi and malignant melanoma can develop at a rate of 80-10%. Therefore, these lesions should be excised from forming tumors. Trauma, foot base is very significant, especially in black skin occurs. Ultraviolet rays from the white primary factor initiating be called melanoma. Extremity melanomas in women tend to remain localized. Also become less ulcers.
Clinically as senile keratosis, basal cell carcinoma, vvart’lar, Kaposi’s sarcoma, pyogenic granuloma, dermatofibromlar be confused with malignant melanoma. Common nevi size, color, ulcers, bleeding and itching are the signs of malignant change.
Lentigo malignant melanoma: common in the elderly, sun-exposed areas, consisting of clinical lesions, such as the map is up to the year. Aggressiveness as a minimum M.M. type (Hutchinson’s Freckle). Survival rate is 60%. Superficial spreading melanoma. The most common type. A pigmented lesion is usually in the ground (intradermal nevus). Nodular structure can be earned over time, become ulcerated.
Nodular malignant melanoma: the body could be anywhere. Nodular structures are easily recognizable due. There is rapid clinical course. All M.M. of up to 10% will generate. The prognosis is poor. Survival is usually around 30%.
Acral Lentigo Malignant Melanoma: palmar, plantar, subungual is located. Lentigo M.M. There are clinical features, such as. Minimal effect of sunlight is seen on the ground. Survival time, the depth is up to 100% for less than 0.76 mm. 0.76 to 1.5 mm. Those with a depth of between 91% survival time is up. Depth of 1.5 mm from the five year survival was 37% in the show.
Two major issues in the surgical treatment of primary cutaneous MCC’s are. First, how to treat neoplasms of the origin, second, the regional lymph node clear when and how. The granting of this decision has helped the depth of the tumor.
Histopathological studies of origin away from the epidermis Clark MCC with invasion depth of the relationship between the presence of potential spill shown. Accordingly M.M. It is divided into five levels.
Level 1: In situ atypical epidermis melanocytes.
Level 2: Melanocytes were extending papillaya.
Level 3: Papillerretiküler have come up between the layers.
Level 4: Reticular dermis and melanocytes reached.
Level 5: Subcutaneous fat tissue was atypical melanocytes.
Breslow and neoplasms of the epidermis from the granular zone of the base of the hill until the distance was measured by ocular micrometer. Fi-level 0.76 mm. has been determined as 10-year period and 95% respectively. Level V is 4 mm thick and 5-year survival for lesions less than 50% is expected.
Systematic scan of the chest radiograph and liver function tests starts with. In addition, tomography, scanning (per region), when necessary, chest, abdomen, pelvis should also be assessed.
MM’un primary excision, the treatment is the most important first step. MM’lu in various thicknesses according to data related to patients, less than 1 mm in depth to be excised only in those local been shown to be very low.
VVHO’s M.M. programs of the lesions according to lesion thickness, 2 mm outside the margin of 1-3 cm of intact tissue, lesions <1 mm in the form of lcm’lik sufficient margin. According to the center of some of the series, 1-4 mm lesions in the extremities and trunk with 2-4 cm margin is sufficient interest. Local recurrence in these applications or intransit metastases (lesions created in the region between the border and the regional node metastases) were not significant differences in the rate. 1. Insitu M.M. to 0.5cm. ensure full ablation margin. 2. Less than 1 mm in depth of the lesion is larger lcm’den primary closure can be removed with no record is appropriate. 3. Medium lesions (1.0-4.0 mm), 2-cm margin is appropriate limit. 4. Thick lesions (> 4 mm), slightly wider margin for the 2cm is achieved by removing local control.
The risk of regional lymph mikrometastazla eclipse thin tumors (<1.0mm)> 4.0 mm) lesions is very high. Thick lesions, systemic retention rate is high.VVHO’nun a wide range, only in those large primary tumor excision, wide excision and elective lymph node dissection revealed no significant difference in those. Clinically there (+) node is kept separate ones.
Lymph nodes in clinical pathology were observed, with the thick ones in the MM medium sentinel lymph node dissection before being made in the case of elective (sentinel) lymph nodes to see if and only if it micrometastasis or metastasis biopsy is done to clean that area is one of the new approach. These nodes are used when determining probdan lenfosintigrafiden and gamma. Ganglion is removed and examined with immunohistochemical dye is called micrometastases. If patients are only followed if the biopsy was negative.
If the general approach, as summarized again, the primary lesion or equal to 1 mm deeper than those with only a wide excision and lymph node is examined. Sentinel for head and neck region (sentinel) node may not be appropriate to search.