Cryodestruction of basalioma

Basalioma refers to malignant skin neoplasms. In fact, it is a type of skin cancer. Its formation occurs due to the cells of the basal layer of the epidermis, and only from them, respectively, therefore, the basalioma is located exclusively on the skin. At the same time, although it can grow on any part of the body, most often this neoplasm is located on the head – on the nose, cheeks, eyelids, upper lip, ears, scalp.

Among all malignant tumors, basalioma has the most favorable prognosis for the affected person in terms of treatment effectiveness and survival. The main thing that is required from the patient is to contact the doctor in a timely manner, who, after conducting all the necessary examinations and tests, will determine the method of getting rid of the tumor, for example, prescribe cryodestruction of the basalioma.

What is basalioma, why does it develop in humans, what is dangerous

Basal cell skin cancer, carcinoid, or corrosive skin ulcer are synonymous with basalioma. This tumor is formed from atypically altered cells of the basal layer of the skin.

The prevalence of the disease practically does not depend on the type of skin. Basically, the tumor affects people over the age of 50 years. Of all the types of skin cancer, basalioma occurs in approximately 70-80% of diagnosed cases.

Interestingly, the disease affects men more often than women – the risk of getting sick for a man over 50 is about 35%, for women of the same age – 20-25%.

The tumor disease has its own specifics – it develops only on the skin, and most often occurs on the face and scalp – in about 90% of all cases. The remaining 10% imply the location of the formation on the trunk, upper or lower extremities.

A characteristic feature of a tumor is its malignancy. The neoplasm develops without any shell, it does not grow in a capsule, but simply penetrates into the tissues, violating their normal structure. At the same time, the basalioma grows not only in depth, but also tends to expand the area of ​​the lesion, thus affecting significant volumes of nearby tissues. Deepening into the lower layers of the skin, it can reach the subcutaneous fatty tissue. Usually, the depth of the lesion of the skin can be judged by the area of ​​the external lesion, since they are directly proportional to each other.

Due to the fact that the tumor usually progresses at a rate of no more than 5 millimeters per year, it can be effectively treated with cryodestruction.

The main difference between basalioma and other malignant tumors on the skin is that it does not provoke the development of metastases in nearby tissues.

To date, medicine has not established the exact causes of the development of basaliomas. Among the likely catalysts for the process of atypical cell growth:

• frequent exposure to UV radiation;
• light skin color type with a tendency to burns and freckles;
• the impact of arsenic on the body, for example, due to prolonged use of water with its impurity;
• frequent prolonged contact with carcinogens, ionizing radiation;
• disorders in the immune system;
• pigmentary keroderma;
• Gorling-Goltz syndrome;
• burns, ulcers and scars on the skin.

The danger of the disease lies in the fact that, despite its slow growth, basalioma is capable of destroying deeper layers of tissues over time, especially on the head, affecting nearby organs – the eyes, ear apparatus, skull bones and brain membranes, which can lead to death. .

Cryodestruction: what is the essence of the method

The properties of low temperatures to reduce pain and slow down inflammation have been known to doctors since ancient times. For the first time, the technique of tissue cryodestruction in medicine began to be used as early as 1890, and to rid patients of tumors and neoplasms – in the 20s of the last century. Since the 1920s, medicine began to receive a sufficient amount of liquid nitrogen necessary for the procedure, which made it possible to carry out cryodestruction of various tumors everywhere.

Since 1950 and to this day, liquid nitrogen has been the main cooling agent used during the procedure.

Cryodestruction is a method of treating skin formations, in which their cells are actively exposed to very low temperatures, due to which they are destroyed. The contact of a cryogenic substance – liquid nitrogen – with the surface of the basalioma causes instantaneous freezing of its external and internal tissues. In fact, the internal component of the tumor turns into ice. Due to the fact that the extracellular fluid freezes first, high pressure is created in the tumor cells, which leads to their instant death.

Ice crystals, formed as they freeze, carry out rotational movements around the crystallization center, destroying cell membranes. Oxygen and nutrients stop flowing into the body of the basalioma, biochemical processes stop in it. This leads to the fact that cells that did not die under the influence of low temperature die due to oxygen starvation.

The degree of success of the procedure is affected, firstly, by its duration, and secondly, by the temperature of the liquid nitrogen used. For one and a half minutes of freezing at a temperature of -180 degrees Celsius, cryodestruction provides the most effective destruction of tumor cells.

It should be noted that after a course of radiation therapy, the treatment of basalioma through cryodestruction becomes much more difficult, since cells that have received a dose of radiation become more prone to further mutations, which greatly increases the likelihood of a relapse of the disease.

Indications and contraindications to the method

Exposure to liquid nitrogen is recommended in such cases:

• in the presence of multiple basaliomas;
• when a large-sized advanced tumor is detected;
• with deep tumors with germination in the bones of the skull;
• patients with a tendency to form keloid scars;
• patients with a pacemaker.

This method is especially indicated for those affected over the age of 65, since chemotherapy in this case can also provoke the appearance of other neoplasms.

In what cases is cryodestruction a patient not prescribed? Doctors call such contraindications of the method:

• the presence of acute inflammatory diseases of internal organs;
• pathology of the development of body tissues;
• diagnosed endometriosis and fibroids;
• infectious diseases in the acute stage;
• cold intolerance;
• some somatic diseases in the stage of decompensation.

Advantages and disadvantages of cryodestruction compared to other methods of treating basalioma

One of the main advantages of this tumor removal technique, doctors call the low likelihood of recurrence – usually no more than 7,5% of cases, that is, less than after radiation therapy or laser removal.

In addition, the procedure gives a good cosmetic result, especially if the patient carefully follows all the requirements for wound care.

The treatment is carried out on an outpatient basis, so the patient does not need to go to the hospital for this period. Only in rare cases does it become necessary to open a sick leave.

Through cryodestruction, it is possible to destroy a tumor of any area and depth, and for this there is no need to put the patient into a state of drug-induced sleep – local anesthesia is enough.

There is no risk of blood loss in the process of destruction with liquid nitrogen. At the same time, the probability of tissue infection during tumor removal is minimal. There are practically no complications after the operation.

Among the shortcomings of the technique, only one is significant – during freezing, the physician cannot fully and 100% accurately control its depth, due to which there is a possibility of hurting healthy tissues. In addition, a scar remains at the site of the destroyed basalioma, although it is insignificant.

In rare cases, a course of procedures consisting of two or three sessions may be required.

How is the removal of basaliomas with liquid nitrogen

Usually, as part of the preparatory measures before destruction, the doctor conducts an external examination of the tumor, and removes a sample of its tissue for histological examination.

An hour before the start of the procedure, the patient is given an anesthetic, such as Lidocaine or Ketonal.

Liquid nitrogen is applied using a special can with a nozzle for jet spraying. The tip of the nozzle is located 1 cm from the center of the tumor. The entire processing area in the process turns into an icy circle. The nitrogen treatment itself usually takes no more than a minute.

When using nitrogen at a temperature of -196 degrees Celsius, the surface temperature of the neoplasm reaches -180 degrees. At a depth of two millimeters, a temperature of -150 degrees Celsius is set in the tumor tissues.

If the neoplasm has a significant area and depth, the doctor can use the tactic of repeated freezing: it consists in the fact that the site of the lesion is subjected to freezing several times in a row, alternating with thawing.

The spray procedure is not performed if the tumor has an irregular shape, or if it is localized in the eye area. In this case, it is recommended to use a cryoprobe.

With its help, it is possible to freeze the deeper layers of tissues, and at the same time prevent the spreading of cryogen.

Usually, for convenience, the doctor marks the affected area with a marker before starting the procedure, capturing 3 millimeters of healthy skin around the tumor. To protect healthy tissues from the cold, a special guide is used in the process, the walls of which freeze to the borders of the treated area.

After the end of cryodestruction, a sterile dressing is applied to the wound site, the doctor explains to the patient the rules for caring for the affected area, after which the patient can go home.

How to care for the wound surface after removal of the basalioma

After the destruction of the tumor, an open wound remains in its place. Around her, after a few hours, a pronounced red rash appears, similar to hives. At the same time, edema will accumulate at the site of damaged tissues during the day. Where there was previously a basalioma, a bubble is formed, similar to a blister from a burn, filled with liquid. It must not be pierced or damaged in any other way.

Approximately within a day after the appearance, the blister will burst on its own, exposing a weeping ulcer, into which the site of the tumor turns.

Ulcerative lesions must be treated with special antiseptic and healing agents that the doctor will prescribe.

In addition, the wound should be washed every day with baby soap. After washing, a drug and a sterile gauze bandage are applied to it.

12-14 days after the procedure, a crust forms on the site of the ulcer – a scab that protects the wound from infection until it heals completely. The bandage must be worn until the crust falls off on its own, it is forbidden to remove it mechanically.

If initially the basalioma had a size of more than 1 centimeter in diameter, the skin after its removal can heal up to a month. If there is a wound after such a large neoplasm, the attending physician may prescribe vitamin preparations to speed up the healing process.

Until the end of the period of tissue repair at the site of the tumor, it is forbidden to use a solarium, sunbathe, visit a sauna, bath, swimming pool, or swim in open water.

Possible complications after the procedure: what is the danger of cryodestruction of basal skin cancer

According to medical research, based on the results of thousands of procedures performed for the cryogenic destruction of malignant tumors, cryodestruction of a basalioma at an early stage of its development is not much inferior to the surgical removal of a neoplasm in terms of the occurrence of relapses.

However, the removal of more serious tumors that capture large volumes of closely located tissues through cryodestruction may not be appropriate. In some cases, basalioma can spread the affected cells at such a distance and to such a depth that it is extremely difficult to “get” them with nitrogen exposure, and, moreover, to do it accurately and accurately.

As for the main consequences of the procedure, the first thing the patient notices is an extensive edema that develops already in the first week after cryodestruction. This factor is especially inconvenient if the removal of the basalioma was carried out on the face.

The usual consequences of the operation are the formation of a scar, especially if the cryogenic effect has reached the deep layers of the skin, as well as loss of sensitivity in the area of ​​uXNUMXbuXNUMXbthe skin where the scar has formed.

There is also a risk of complications due to such interference with the integrity of the skin. Due to non-compliance with the rules of asepsis during cryodestruction, or in the future due to violation of the requirements for wound care, pathogenic microorganisms can enter it. As a result, the affected area can become inflamed, giving a person discomfort – pain, inflammation around the crust or at the very site of destruction, in some cases even fever and fever. If such symptoms appear, you should immediately consult a doctor who will prescribe antibiotic therapy, as well as the use of special antibacterial ointments.

Another consequence of the procedure is permanent baldness of the scarred area. If this manifestation does not cause much trouble on the body, then hair loss on the head, especially for women, can look really depressing.

At the site of the scar, light pigment spots may form over time, which is especially noticeable in people with dark skin color. They may go away with age, but most often remain for life.

In addition to numbness on the area of ​​the skin that has undergone cryodestruction, peeling and itching may occur – this indicates a violation of blood circulation, and requires a doctor’s consultation.

Basalioma is a type of skin cancer with the most optimistic prognosis for the patient. It does not allow metastases to nearby tissues, and it also rarely recurs after removal. The neoplasm more often affects men, and the age is over 50 years. However, women “over 50” are not immune from its appearance. Thanks to the invention and improvement of the method of cryodestruction, today the diagnosis of basalioma in a patient is absolutely not a cause for panic. After the formation found on the skin is studied, and its malignant nature is confirmed, it is subjected to treatment with liquid nitrogen, due to which the atypical cells of the tumor are destroyed, and it disappears. Subject to the rules for caring for the wound after the procedure, and preventing infection from getting into it, only a small neat scar in the form of a hole will remain at the site of the basalioma after the operation.