Surgical removal of a basalioma

Basalioma is considered one of the most common types of malignant tumor diseases of the skin. It develops from abnormal cells in the deep layer of the epidermis, which is responsible for skin regeneration. Basal cell carcinoma usually appears on the face or neck. Often such tumors can be seen in open areas of the body, due to a number of factors that contribute to the progression of the tumor process.

Causes of basalioma

Among the key and obvious factors contributing to the occurrence of the tumor process of the skin, one can single out prolonged exposure to sunlight. Artificial ultraviolet is just as harmful. It penetrates deeper into the skin and can provoke mutations at the cellular level, so regular visits to the solarium is a bad idea. Reduced immunity is the second risk factor. With reduced immune protection, the specific “shield” from mutated cells weakens. In conditions of active cell division or in violation of blood circulation in a separate area of ​​the skin, it becomes difficult for the body to get rid of atypical units.

Abnormal changes in genes can only occur with a high total dose of ultraviolet radiation, so age is another risk factor. The likelihood of developing skin cancer increases with each passing year. According to a number of studies ^[1]The median age of onset is 65 years. But it is important to understand that people at a young age are also susceptible to pathology.

The substrate from which basalioma can develop over time can be individual skin pathologies, for example, xeroderma pigmentosum, a hereditary dermatological disease expressed by hypersensitivity to ultraviolet rays, or such harmless and habitual neoplasms as moles and freckles. All of them need special attention. In people with fair skin (1 and 2 phototypes on the Fitzpatrick scale ^[2]) malignant tumors of the epidermis occur more often than in dark-skinned and dark-skinned people. Also at risk are representatives of those professions that involve working in the sun, or are constantly exposed to carcinogens (arsenic, coal or soot).

Symptoms of basalioma

The clinical manifestations of basal cell carcinoma are extremely diverse. In the face or on the neck, it is localized in the form of small translucent neoplasms of a round shape or a white cicatricial formation with blurred borders. It may appear tight and shiny, but it does not cause discomfort.

It is worth worrying when open wounds appear on the body that take a long time to heal. Then it is important to see a specialist, because this is how basal cell carcinoma can manifest itself. The wound can bleed for weeks, then crust over and reopen if it is accidentally touched. Dark or red spots on the skin that were definitely not on your body before are also a signal for alarm. They can appear on any part of the body, have blurry boundaries, become larger in size and, as it were, rise above the skin. Red growths may have a scaly surface and slightly raised edges.

Sometimes basalioma appears as pink growths. Outwardly, they have a rounded shape and a raised surface, inside you can see the blood vessels, which become more and more noticeable as the neoplasm grows. Sometimes itching may occur around such a plaque. This is not a common sign of basalioma, but if you suddenly feel like scratching a suspicious spot on your body, while you have never had an allergy before and no such spots have been noticed, you should contact a specialist.

Diagnosis of basal cell carcinoma

What to do if you find a suspicious spot on your body? First, examine the skin for the presence of other similar neoplasms. If you have one or more of the above symptoms, make an appointment with an oncologist or oncosurgeon. The specialist will conduct a survey, and then examine the neoplasm and the whole body for the presence of similar manifestations.

To find out if it is a symptom of a malignant tumor process on the skin, a specialist performs dermatoscopy. This is an instrumental non-invasive study in which the doctor examines moles and other formations on the skin using a special device that magnifies the image many times over. Such an instrument is called a dermatoscope, and it allows you to examine in detail the different layers of the skin. Digital dermatoscopy is carried out automatically; for this, doctors use the FotoFinder Bodystudio ATBM device. It allows you to take pictures and record on video certain fragments of the skin, enter the resulting images into the database, display the image on the monitor screen for point study. Thanks to this technology, during the next visits, the doctor can track all changes in the patient’s skin in dynamics.

If there is a suspicion of a malignant tumor process of the skin, the specialist directs the patient to standard examinations, including a general and biochemical blood test. Diagnosis includes cytological (cell examination) and histological (tissue examination) laboratory tests. The basis for them is a tissue sample, which is taken by scraping from the surface of a suspicious formation. Such a study is highly accurate and allows you to identify pathology in almost 100% of cases.

Removal of the tumor

As a rule, basal cell carcinoma is characterized by slow growth, therefore, with the timely detection and removal of a neoplasm, a person may not be afraid for his life. Pathology metastasizes very rarely. In the advanced stage, when the basalioma reaches an impressive size, it becomes quite aggressive. In such cases, it can destroy tissues, including cartilage and bones. With such a development of the disease for the patient, the risk of mortality is quite high.

The preferred treatment for basal cell carcinoma is surgical removal. Doctors excise both the tumor itself and a fragment of the surrounding skin, within no more than 5 mm from its borders.

One of the standards of surgical care for malignant tumor processes of the skin is the Mohs micrographic operation (MOHS). The technique is based on the removal of tumor tissue layer by layer. The high efficiency of this operation is achieved due to a detailed approach to the excision of malignant tissues and the preservation of the maximum number of its healthy layers. The operation is performed under local anesthesia. Most often, micrographic surgery is performed when foci of the disease appear on the delicate scalp, eyelids, ears or lips.

Also among the alternative methods of getting rid of basal cell carcinoma, cryotherapy, or cryodestruction, can be distinguished. The technology is based on the use of low temperatures to destroy the tumor. It can only be used in the early stages, until the process of metastasis has begun. Also, curettage with electrocoagulation can be used. Operations are performed under local anesthesia. With a wide dermal curette (surgical spoon), the specialist scrapes out the tumor. Electrocoagulation (cauterization) of the tumor bottom is carried out immediately after curettage. Particular attention is paid to the base and edges of the tumor. After healing, a whitish scar remains.

Other treatments for basalioma

It happens that surgical treatment is impossible, due to the fact that the tumor is located in a hard-to-reach place, for example, in the auricle. In such cases, patients are prescribed radiation therapy. It gives a high chance of recovery, since the malignant tumor process of the skin is sensitive to ionizing radiation.

Targeted therapy is prescribed when the tumor process on the skin is running or when the basalioma has acquired a metastatic character. In this case, a drug such as Vismodegib is prescribed. The drugs used in this therapy act on atypical cells at the molecular level. They block the signal for molecules that feed the tumor, thus inhibiting the mechanism for the development of a malignant neoplasm. Therapy of this plan can be used in combination with other treatments or on its own.

Photodynamic therapy (PDT) can also be used – one of the minimally invasive methods for treating malignant neoplasms. During the procedure, special substances are used – photosensitizers, which accumulate in pathological tissues, as a result of which their sensitivity to light increases significantly. Under the action of light waves of a certain length, these substances cause a photochemical reaction and, as a result, lead to the formation of reactive oxygen species that destroy only atypical cells in which the photosensitizing element is present. Also, in the process of this therapy, the blood vessels that “nourish” the tumor are damaged, which contributes to its death. Healthy tissues are not exposed to radiation during PDT.

Prognosis and prevention

If basal cell carcinoma of the skin was diagnosed at an early stage, then the probability of its successful removal and recovery of the patient is almost 100%. Prevention of the disease should be based on risk factors.

In summer, try not to go outside during the hours of maximum solar activity. If you need to walk at this particular time, apply a special UV-blocking cream with a protection factor of at least 30 units to exposed skin areas. Especially carefully protect the face and neck – basalioma most often appears there. Examine your skin regularly, pay attention to the appearance of new spots and moles, and do not injure old scars. If they are in places where they are constantly exposed to friction and other influences, consult your doctor. Do not ignore ulcers and wounds that do not heal well. Remember that even seemingly harmless formations can be a manifestation of the tumor process on the skin.

Patients from high oncological risk groups should carefully monitor the condition of the skin. If you have been diagnosed with a basalioma and removed, then for several years after the operation, you should be examined four times a year. This is necessary to clarify the prognosis and identify a possible recurrence of the disease. Patients in whom basal cell carcinoma is prone to recurrence should be monitored regularly to monitor pathology over time.

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