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Melanoma

MelanomaArises from melanocytes. Most often localized in the skin (90%), rarely in the conjunctiva, choroid layer of the eye, mucous membrane of the nose, mouth, vagina, rectum. Melanoma skin appears more frequently in the age of 30-50 years. Among the risk factors large doses of ultraviolet radiation, trauma nevi, family predisposition to melanoma, xeroderma pigmentosum, melanosis. In 50-70% of cases of melanoma of the skin arises from the pigment newusa. The most dangerous border (SpiderMonkey) nevus. More common on the skin of the scrotum, palms, soles, is a flat spot or pigmented nodule size of about 1 cm, not towering over the skin. Rarely, melanoma develops from vnutricerepnogo, blue nevi. Large nevi often turn on the edge of the nevus. In 1/3 of cases of nevus prior melanoma, developed already in adulthood; B1/3 of the cases were congenital. From timely diagnosis depends on the forecast. Any changes nevus increase, discoloration, ulceration, bleeding require immediate surgical intervention. Similar tactics recommended in relation to growing new pigment formation in previously normal skin. Melanoma of the skin often occurs on the scalp, neck, and extremities. After removal of the melanoma can be evaluated factors influencing prognosis. A special role is played by the degree of tumor invasion of the various layers of the skin, which correlates with the development of metastases. Levels of invasion I (in situ), II (involving the papillary layer) and in part III (penetration to the reticular layer) characterize the early diagnosis of the disease. Degree IV (penetration into the reticular layer) and V (subcutaneous adipose tissue) indicate a late diagnosis. During the early stages of invasion 5-year survival rate is 60 to 80%. In addition to the degree of infestation of the skin, the prognosis of the disease affect the localization of the tumor, presence of metastases in regionarnye lymph nodes and other factors. Spreads melanoma in the skin, subcutaneous tissue, lungs, liver, brain and other organs and tissues. The basic method of treatment of localized melanoma is surgical. Regional lymph nodes should be removed when they are enlarged. Adjuvant chemotherapy does not improve the results. For disseminated melanoma shows chemotherapy, with regression of tumor formation observed in 20-40% of patients. The most effective treatment regimens: 1) imidazolecarboxamide 200-250 mg/m2/day, 5 days; 2) lomustin 100 mg/m2 orally on the first day in combination with vincristine 1.2 mg/m2/1st, 8th and 15th days and dactinomycin - 500 Вµg/3 times per week, 6 doses; 3) vinblastine 6 mg/m2/day 1 in combination with cisplatin 120 mg/m2 in/on the first day, and bleomycine-nom-10 megawatts/m 1-5th days. The intervals between courses of chemotherapy 4 weeks. Comments on this article yet. Be the first one! Write a comment.



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