Kronik Yara Görünümlü Karsinomlar
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Tarih
2014
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Namık Kemal Üniversitesi, Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç Kutanöz maligniteler sıklıkla travmatize, degeneratif ve kronik inflame cilt veya skar dokusundan gelişir. Yapılan incelemelerde kutanöz malignitelerin sıklıkla yanık skarları (Marjolin ülser), venöz ülserler, bası yaraları, sistostomi alanları, kronik pilonidal sinüs, hidradenitis süpürativa, lupus skarları, kronik lenfödem, travmatik yaralar, kronik osteomiyelit alanlarında geliştiği gösterilmiştir. Bu çalışmamızda kronik yara görünümü nedeniyle yara bakımı tedavisi almasına rağmen iyileşme göstermeyen, biyopsi sonucunda malignite tespit edilen hastalarda ayırıcı tanı ve uygulanan tedavi yaklaşımlarımız sunulmaktadır. Materyal ve Metot 2008-2012 yılları arasında kliniğimize kronik yara nedeniyle başvurup biyopsi sonucu karsinom çıkan beş hasta çalışmaya alındı. Hastalar daha önce aldıkları tedavi, patolojik tanıları, predispozan faktörler, malign dejenerasyon süresi, rekonstrüksiyon teknikleri, komplikasyon ve nüks açısından retrospektif incelendi. Bulgular: Patolojik inceleme sonucunda 3 hastada verrüköz karsinom, 2 hastada skuamoz hücreli karsinom belirlendi. Malign dejenerasyon süresi ortalama 8 yıl (5- 12) idi. Sonuç Ciltteki kronik irritasyonun veya yumuşak dokunun farklı büyüme faktörlerine maruz kalmasının, aynı zamanda inflamasyona bağlı olarak bu bölgede ortaya çıkan sitotoksik faktörlerin malign transformasyonda önemli rol oynadığı düşünülmektedir Kronik yaralı hastalarda karsinom gelişimini engellemede, iyi yara bakımı, travmadan kaçınmak, iyileşmeyen ülserlerden biyopsi alarak erken tanı konulması önemlidir. En yaygın rastlanan histolojik tümör tipi squamoz hücreli karsinomdur. Uzun süreli iyileşmeyen açık yarası olan ve risk faktörleri bulunan hastalarda kutanöz malignite gelişebileceği akılda tutulmalıdır.
Aim Cutaneous malignancies often develop in traumatized, degenerative, and chronically inflamed skin or scar tissues. The observations indicated that cutaneous malignancies often arise in burn scars (Marjolin's ulcer), venous ulcers, compression wounds, cystostomy sites, chronic pilonidal sinus, hidradenitis suppurativa, lupus scars, chronic lymphedema, traumatic wounds, and sites of chronic osteomyelitis. The current study presents a differential diagnosis and treatment approach in patients who received wound care and treatment due to the presence of chronic wounds and in whom biopsy revealed malignancy. Material and Methods Five patients who presented to the clinic due to chronic wounds between 2008 and 2012 and in whom biopsy revealed carcinomas were included in the study. The patients were retrospectively reviewed in terms of previously administered therapies, pathological diagnosis, predisposing factors, time to malignant degeneration, reconstruction techniques, complications, and recurrence. Results The pathological examination revealed verrucous carcinoma in three patients and squamous cell carcinoma in two patients. The mean of malignant degeneration time was 8 years (5- 12). Conclusion Chronic skin irritation and exposure of the soft tissues to different growth factors, and cytotoxic factors arising due to inflammation are thought to play an important role in malignant transformation. Providing good wound care, avoiding traumas, and obtaining biopsy from non-healing wounds to establish early diagnosis are very important in patients with chronic wounds. Squamous cell carcinoma was the most commonly encountered histological tumor type. Moreover, it must also be remembered that cutaneous malignancies can develop in patients with sustained open wounds and risk factors.
Aim Cutaneous malignancies often develop in traumatized, degenerative, and chronically inflamed skin or scar tissues. The observations indicated that cutaneous malignancies often arise in burn scars (Marjolin's ulcer), venous ulcers, compression wounds, cystostomy sites, chronic pilonidal sinus, hidradenitis suppurativa, lupus scars, chronic lymphedema, traumatic wounds, and sites of chronic osteomyelitis. The current study presents a differential diagnosis and treatment approach in patients who received wound care and treatment due to the presence of chronic wounds and in whom biopsy revealed malignancy. Material and Methods Five patients who presented to the clinic due to chronic wounds between 2008 and 2012 and in whom biopsy revealed carcinomas were included in the study. The patients were retrospectively reviewed in terms of previously administered therapies, pathological diagnosis, predisposing factors, time to malignant degeneration, reconstruction techniques, complications, and recurrence. Results The pathological examination revealed verrucous carcinoma in three patients and squamous cell carcinoma in two patients. The mean of malignant degeneration time was 8 years (5- 12). Conclusion Chronic skin irritation and exposure of the soft tissues to different growth factors, and cytotoxic factors arising due to inflammation are thought to play an important role in malignant transformation. Providing good wound care, avoiding traumas, and obtaining biopsy from non-healing wounds to establish early diagnosis are very important in patients with chronic wounds. Squamous cell carcinoma was the most commonly encountered histological tumor type. Moreover, it must also be remembered that cutaneous malignancies can develop in patients with sustained open wounds and risk factors.
Açıklama
Anahtar Kelimeler
kronik yara, malignite, kutanöz, chronic wound, malignancy, cutaneous
Kaynak
Namık Kemal Tıp Dergisi (International Journal of Basic and Clinical Medicine)
WoS Q Değeri
Scopus Q Değeri
Cilt
2
Sayı
2
