Basal cell tumor
Introduction
Introduction to basal cell tumor Basal cell carcinoma (also known as umbilical cell carcinoma) is the most common type of skin cancer. It has a high incidence rate, accounting for the first place (about 50%) of orbital malignant tumors. Males are slightly more than females. People are more common than young people. The peak age is between 50 and 60 years old. Generally, they only infiltrate locally and rarely metastasize. However, improper treatment or no treatment may seriously damage the eye tissue and even invade. The paranasal sinuses and the intracranial cause death. Although there is no obvious cause of this disease, it is related to several factors, such as scalp, facial and other exposed parts and more common in outdoor work and light skin, which is related to long-term sun exposure. Long-term intake of inorganic arsenic or drinking water with high arsenic, food, etc. can also occur in this tumor. basic knowledge The proportion of illness: 0.0005% Susceptible people: mostly elderly people over 50 years old Mode of infection: non-infectious Complications: Basal cell tumor Pediatric basal cell nevus syndrome
Cause
Basal cell tumor etiology
Organized students (65%):
Basal cell tumors may be derived from primitive epithelial germ cells, consisting mainly of mesenchymal-dependent pluripotent basal-like cells, and low-grade malignant tumors that differentiate into epithelium or appendages. It can often occur on the basis of chronic radiation dermatitis, and basal cell tumors are easily produced in the case of radiation dermatitis in the site of long-term X-ray contact. In burn scars and other scars, as well as certain hamartomas, such as sebaceous adenine, verrucous epidermis, etc. can also be used as basal cell tumors.
Other factors (35%):
Although there is no obvious cause of this disease, it is related to several factors, such as scalp, facial and other exposed parts and more common in outdoor work and light skin, which is related to long-term sun exposure. Long-term intake of inorganic arsenic or drinking water with high arsenic, food, etc. can also occur in this tumor.
Prevention
Basal cell tumor prevention
At present, due to advances in treatment, after timely treatment of basal cell carcinoma, the mortality rate has dropped below 2%, and the prognosis is good. In addition to daily care and dietary attention, patients with basal cell carcinoma should enhance their confidence, strengthen their nutrition, improve their immunity, develop good habits, maintain a good mood, eliminate negative emotions, and actively and optimistically treat life.
Complication
Basal cell tumor complications Basal cell tumor pediatric basal cell nevus syndrome
Some rare forms of basal cell tumors are also seen: scarring basal cell tumors, often occurring on the face, superficial nodular plaques, slow growth, atrophic scars in the central or peripheral part, and fibroepithelial neoplasia , basal cell nevus syndrome and other rare types.
Symptom
Basal cell tumor symptoms Common symptoms Severe pain Black spleen squamous epithelial hemorrhage Eczema Squamous cell carcinoma Spot rash
The typical clinical manifestations are slow development, ulcers with hard bottom curling, often with pigment on the edges. It is not difficult to diagnose typical cases. The difficulty is that early cases of ulcers have not yet formed. Most of the patients are elderly people over 50 years old. There are transparent nodules near the sacral margin, sputum-like, rash-like or papilloma-like small masses appearing, surrounded by enlarged blood vessels, and cracks on the surface of the masses should be vigilant.
The following iliac crest is a good site for the hair. The lesion is often a tiny, slightly elevated translucent nodule, flat erythema or eczema, pigmented black sputum, surface bulge like papilloma, nodules Peripheral blood vessels around the periphery, covered with suede or scales on the surface, slowly increase, suffered damage, prone to ulceration, typical manifestations of a hard bottom shallow ulcer, surrounded by a sneak edge, uneven, such as Silkworm eclipse, it is called the moxibustion ulcer, the edge of the ulcer hardens and bulges, and the inner roll is caused by the squamous epithelium of the skin part of the ulcer. The reactive fibrous tissue proliferates and is the hard tissue of the ulcer. On the basis of learning, the cancer tissue is infiltrated downward slowly, and the infiltrated cancer nest is terminated every time it reaches the same plane, so the ulcer is generally shallow, but if the ulcer gradually develops to the surrounding tissue, causing extensive damage, but generally not Transfer to a distant place, damage or improper treatment, can lead to the spread of cancer, accelerate its development, expand the lesion, and thus lose the appearance of the silkworm ulcer, so that it is mistaken for squamous cells Or melanoma, early cases have no self-conscious symptoms, but in the case of injury and concurrent infection, it can cause repeated bleeding and severe pain, as well as inflammatory swelling of local lymph nodes, severely developed cases, can damage the eyelids, conjunctiva And intraorbital tissue, invading the paranasal sinus or intracranial.
Examine
Basal cell tumor examination
According to clinical features and pathological changes, the diagnosis of this disease is not difficult, the clinical damage is slow to develop, the edge is pearly or dike-like uplift, generally no inflammatory reaction, mostly occurs in the face and neck is characterized by the usually early basal cell tumor Difficult to distinguish from senile sebaceous gland hyperplasia, keratoacanthoma, squamous cell carcinoma, common sputum and infectious soft palate, pigmented basal cell tumor is sometimes misdiagnosed as malignant melanoma, superficial basal cell tumor sometimes resembles eczema, lichen planus , Bowen's disease, etc., the sclerosing basal cell tumor texture-like localized scleroderma, and finally by histopathological examination for diagnosis and differential diagnosis.
Diagnosis
Diagnosis of basal cell tumor
Differential diagnosis needs to be closely combined with the history of the disease to pay attention to the characteristics of the lesions at various stages of development. For difficult cases, biopsy is needed to determine the diagnosis.
1. Identification with squamous cell carcinoma, the following points are available:
(1) The degree of malignancy of squamous cell carcinoma is higher than that of basal cell carcinoma, and the progress is also faster. For the pathologically slow lesions, basal cell carcinoma should be considered first. On the contrary, the disease course is short, the development is fast, and the growth of the vegetable-like pattern is first. Consider squamous cell carcinoma.
(2) In the case of ulceration of both tumors, first of all, the appearance of ulcers of basal cell carcinoma attracts attention: hard bottom, shallow and flat base, uneven edge, involution, and squamous cell carcinoma Ulcers often have different depths, uneven bases, full edges, and even valgus.
(3) The percentage of basal cell carcinoma containing pigment is higher than that of squamous cell carcinoma. For pigmented lesions, basal cell carcinoma should be considered in addition to tymoma. The nodular surface of squamous cell carcinoma contains a large number of horns. Chemical substances, so the color is generally not black.
(4) Basal cell carcinoma does not metastasize substantially, and squamous cell carcinoma can be transferred to the anterior lymph node and submandibular lymph nodes through lymphatic vessels. Therefore, when lymph node metastasis occurs, squamous cell carcinoma should be considered.
2, the identification of the identification of malignant melanoma: malignant melanoma has a shorter course of disease, faster development, diffuse pigment near the lesion, vascular filling, can develop into a huge mass in a short time, the surface has small cracks, the lesion is very small There is blood flowing out.
