Wednesday, September 12, 2018

Melanoma Malignant of the Oral Cavity

oral melanoma malignant

Oral Malignant Melanoma

Malignant Melanoma is actually rare in the oral cavity, only 1% of all melanoma. But the disease can be fatal. If had develop into advanced, malignancy or malignancy can be life threatening. Therefore, early diagnosis and treatment is helpful to prevent the disease is to travel a more severe level.

What Truly Malignant Melanoma?

Melanoma is a skin cancer, which occurs in the pigment-producing cells of the skin, namely melanocytes. Under normal circumstances, the melanocytes are on the outer layer of the skin and produce the brown pigment melanin that is. There is the most number of melanocytes in the skin of the face. But melanoma can also arise in the oral cavity, called Oral Melanoma.

Melanoma occurs when melanocytes divide uncontrollably and invade other tissues (attack). If not cared for rush, melanoma can grow enters the skin tissue that eventually reach the blood vessels and lymph vessels, and spread throughout the body (metastasis). That's when melanomas can lead to death.

How do the Characteristics of Oral Malignant Melanoma?

Oral Melanoma (melanoma arising in the oral cavity) can be seen as the pigmentation, without pain or symptoms (asymptomatic), the brown pigmentation usually dark or black at area of intraoral (inside the mouth). The lesions normally arise in solitary or unit, but never also reported multiple lesions.

An example of the case as found and handled by Mustafa Goregen from Ataturk University, Turkey. His patient's wearing full upper jaw dentures for 20 years. Behind the teeth produced an enlarged lesions arise quickly, solitary, and painless.

The most common place is palate and Mucosa (soft tissues) in the upper jaw. Melanoma may metastasize to the mandible, tongue, and the inside of the cheek.

Characters that should be suspected when Melanoma arises on the skin are:

Asymmetry

The lesions usually are not symmetrical, where one side is not the same size and shape than the other side. Unlike moles that have not experienced violence, usually round in shape and symmetrical.

The boundary is not clear/irregular

The lesions are usually not obvious with the surrounding skin is unbounded, or uneven edges.

Color

Melanoma usually does not arise in one color, but rather a composite of several colors in some parts. For example one side colored bluish or brownish, blackish-colored on the other.

Diameter

Normal moles are not enlarged; however the size of the melanoma continues to grow. Added the size usually runs quickly.

What Causes the Onset of Oral Melanoma?

Until now, the cause is not yet known for sure. But there are factors that are often associated with melanoma, which can occur in any part of the skin. In between excessive sun exposure or the presence of history often sunburned, especially from now on. The risk of melanoma can also be inherited from parents. White skinned people more at risk exposed to this violence. So are people with lots of moles, totaling 50 more in the body, are more at risk of suffering from melanoma.

But melanoma also occur on parts of the body are not exposed to the Sun such as the oral cavity. Oral melanoma reported related to mechanical trauma (as reported in the above case). Mechanical trauma can be caused due to ill-fitting dentures. It also reported the existence of a relationship between oral malignant melanoma with cigarette smoking, alcohol consumption and irritation because oral appliance to another. Benign moles that can also be transformed into maligna (malignant).

Examination of supporting what it takes to help the diagnosis?

Diagnostic imaging technique such as x-ray, CT-Scan, MRI and positron emission tomography (PET scan) can be done to

It also needs to be biopsied tissue, where suspected cancer tissue was taken for examination under a microscope. After the diagnosis needs to be upheld, determined the extent to which melanoma is already penetrations into the network.

The deeper melanoma may have regarding blood vessels and lymph glands. Therefore also need to do a biopsy on lymph glands adjacent to the lesion.

What Care of Can be done?

Oral Melanoma can be cured with surgery, and in certain cases also can be done with radiotherapy, chemotherapy, and immunotherapy. But of course the success rates are higher when the treatment is carried out at an early stage.

Carefully inspection by dermatologist or doctor tremendously helps teeth to check for the presence of oral melanoma and melanoma early. Beware of changes in the body and check with your doctor immediately.


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Saturday, September 8, 2018

What's a Melanoma Malignant Skin Cancer

melanoma malignant

DEFINITION OF MELANOMA

Melanoma maligna is a type of neoplasia which malignant stems from cells that may form melanin everywhere part of the skin or eyes. Also derived from mucus membranes in the pubic area; oral cavity. This disease usually occurs on the adults in de novo or pigmented lentigo maligna nevus. Other definitions of maligna melanoma IE skin malignant tumor originating from the system melanocytic of the skin (melanocytes) to the image be blackish lesions on the skin. Usually causes extensive metastasis in a short time, not only through the flow of lymph to the regional, but also spread through the bloodstream to the tools in, and can cause death. This is a type of cancer of the skin is the most violent and potentially deadly. In America, obtained data on six of the seven died of this cancer sufferer. And the number of people has stricken with increased from year to year. Melanoma Maligna can develop from moles arising out of existing or emerging.

ETIOLOGY

The cause is not known for sure. Can arise from normal skin (de novo) nevus pigmentosus or derived from (junction nevus), melatonin Hutchinson's freckles are pigmented, giant nevus, blue nevus. The cause of the occurrence of skin cancer there are two, namely the cause from within the body as well as from outside the body. Many factors are thought to play a role in the onset of maligna melanoma including genetic factors (existing at birth), Sunshine (maligna melanoma often is associated with the cause of the skin against the Sun's light. For example, the melanoma tumor usually grown men on the back as well as with women, tumors grow on the back of the leg), and also the cause of carcinogens, factor phenotypes (blond hair, blue eyes, light skin like the kneeing on the person bright skinned at the same time, someone who is bright skinned and less pigmented has a high risk of melanoma tumor gets maligna. Generally, melanoma effect on parents, but on any teenager presents to be found), and the presence of potential precursor against melanoma. Other risk factors include namely the Atypical Mole Syndrome, Large Nevi Congenital Melanocytes. Lentigo maligna melanoma family history and the history of positive malignant

EPIDEMIOLOGY

The disease is spread all over the world. Correlation of the incidence of melanoma is usually the opposite of the latitude, i.e. insidennya higher on the area near the Equator and is lower progressively on a region nearer the poles. The disease is rare before puberty, but can be of all ages. The highest incidence in the age of 35-55 years. It can be about the men and women with equal frequency, but morbiditasnya is higher in men.

CLINICAL MANIFESTATIONS

Early forms of very difficult to distinguish with the other tumors. Because melanoma is a fatal disease malignant when distant metastasis, then the ability to recognize early violence needs to be deepened. Localization in the lower extremities was reported, and then in the head/neck, body, extremities top, nails. The key invention malignant melanoma cure is early, so that a diagnosis of melanoma should be increased when the sufferers reported new pigmented lesions or moles that change, such as:
  1. Change in color
  2. Changes in size (especially rapid growth)
  3. The onset of the symptoms (itching, burning, or pain)
  4. Elevation occurred on previously flat lesions
  5. Changes on the surface of or changes in pigmented lesions consistency
  6. The development of satellite lesions

The American Academy of Dermatology stressed the importance of ABCD when evaluating any pigmented lesion, namely:
A = Asymmetry
B = Border irregularity
C = Color variegation
D = Diameter of more than 6 mm

The primary measure of melanoma malignant can be classified in four major types, namely:

1. Lentigo Melanoma Malign
LMM melanotic Hutchinson's also called precancerous freckles are or Dubreilh. Lentigo maligna lesions arise from who has been there before. LMM occupy approximately 5% of primary skin melanoma, primarily occurs in the elderly. Contrary to other melanoma, LMM substype on areas of the body that are exposed to sunlight, especially the face. Lentigo maligna lesions on the usually small colored patches of degeneration; dark brown; Brown or black. On the surface can be found the presence of pigmentation; spots scattered irregularly. The lesion extends vertically and along. Can develop into an invasive nodule blackish blue and somewhat hyperkeratosis

2. The Spreading Melanoma Malignant Surface
Generally arise from normal skin or nevus (de novo). It is the kind that is often encountered, which is about 70% of the entire melanoma malignant. More often found at a younger age compared to LMM, i.e. in the range 40-50 years. Lesions in the form of archiformis plaque measuring 0.5-3 cm long with its edges and along. On the surface there is a mixture of various colors like Brown, grey, blue, black, and often reddish, extends radials. In General after the lesion reaches the size of 1-2.5 cm, occur vertically growth phase and develop into nodules blackish blue. Predictions on the woman found in the lower limbs and backs, while in men the body and neck.

3. Nodular Melanoma Malignant
It can occur without radial growth phase preceded. So ABCD rule could not be applied to this subtype. Approximately 10-30% of cases of melanoma is a type of nodular. A place that often affected are the head, neck and body. The lesions are usually in the form of nodules that raises, Pigmented uniform. Its color ranges from dark brown to blackish-blue, or sometimes amelanotic.

4. Lentigo Maligna Melanoma Akral
Generally arising in normal skin (de novo). Is the type of the rarest (1%), but can be very violent due to the delay in diagnosis. Predictions on the soles of the feet and the hands, fingers and feet, the base of the nails, and mucous membrane. Lesions in the form of spots with pigment scattered with varying intensity. On the surface can arise papule, nodule, and can undergo ulceration.

Melanoma Histology

DIAGNOSIS

Cancer of the skin is different from other diseases, cancer of the skin or a skin disease can be seen directly with the eyes of the examiner. The methods of the examination can be done by anamnesis history of disease. And by the way did the mole surgically removed then observed under the microscope. From the mole surgically removed can be known of her type of cancer and stage of the cancer.

And can also be done with a laser diagnosis. Can capture three-dimensional images of the chemical changes and the structure that has been going on under the surface of human skin. See skin disorders are prominent on the size greater than 2.5 cm.

PATHOGENESIS

Normally, skin cells in the epidermis splits with regular and legs. New cells often reject the old cells to the outer surface of the skin where the old cells will die. This process is controlled by DNA. Skin cancer is valid because there is a disruption in this process in which the cell divides and forms a big growth.

COMPLICATIONS

Melanoma Malignant is a type of skin cancer which is the most malignant; it can spread to other bodies such as go to the lymphatic glands, causing hypertension, hypercholesterolemia.

THERAPY OR TREATMENT

The actions that are performed on patients with cancer melanoma maligna complete appointment this is the cancerous tissue with the surgery, has been known to occur when the spread of advanced operations needed to lift network the surroundings. For medicaments treatment with chemotherapy (anti-cancer drugs) that are grouped into several categories: alkylating agents, plant alkaloids, anti metabolite, antitumor antibiotics, enzymes, hormones and biological response modifiers. And treatment in nonmedikomentosa includes radiotherapy, surgery and physical therapy.

Division of therapy based on the stage of melanoma:

Stadium Clinic I Melanoma Maligna
To date method of surgery with wide excision is still a way of melanoma treatment. Handling on the lesion type ALM requires special measures more than other types, namely:
  • For the lesion located at the base of the nail (subungual melanoma) and finger the distal part of the hands or feet, do disarticulation metakarpal or metatarsal.
  • For lesions located in the fingers or toe proximal part, performed an amputation karpometakarpal or tarsometatarsal
  • For lesions on the palms of the hands or feet (palmar or plantar melanoma), extensive excision is done with the boundary edges of the excision are tailored to the anatomy and functions

Determination of optimal excision border and consideration of adoption of regional lymph glands as a prophylactic actions, especially depending on the type and location of melanoma malignant, the degree of invasion of Clark and depth (thickness) Breslow.

Stadium Clinic II Melanoma Maligna
Wide excision accompanied the adoption of regional lymph glands.

Stadium Clinic III Melanoma Maligna
Systemic Chemotherapy
Chemotherapy the best traditional agents namely Dacarbazine Triazeno Imidazole Carboxamide Dimethyl/(DTIC). Can be given individually or combined with other systemic medications Chemotherapy. Response to treatment with DTIC occurs in 20-25% of sufferers. Systemic Chemotherapy recommended is:
DTIC: 200-300 mg/m2 (intravenous) for 5 days, repeated every 3-4 week.
Nitrosourea: 200 mg/m2 single dose (oral), repeated every 6 weeks.
Or a combination of DTIC and nitrosourea.

Immunotherapy
BCG is a non-specific active immunotherapy, primarily used for the melanoma treatment metastasis to hold a malignant skin. Given intraregional and provide sufficient influence is beneficial. The results are uncertain, depending on the immune system.

Lately done immunotherapy adoptive, using leukaferesis to get the lymphocytes of cancer patients, then the cells were incubated with interleukin-2, to form the killer cells that enable limfokin (LAK), and then the cells LAK is infused back with the granting of interleukin-2.

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