Melanoma or skin cancer is the most aggressive malignant tumor that can occur in any patient. Such formations can not show themselves for a long time.
Externally, melanomas often resemble moles or nevi that have irregular boundaries and unusual shape. But the main danger of melanoma lies in their early metastasis.
Where does metastasis of melanoma occur?
Melanoma can metastasize into internal organs or lymph nodes. If the tumor thickness is less than 0.75 mm, the probability of occurrence of metastases is very low. If the thickness of the tumor is greater, the risk of metastasis is very high.
And if the tumor reaches 4 mm in thickness, then the probability of regional lymph node metastasis reaches 60%.About 30% of cancer patients have regional and distant metastases.
As a result of the research, the doctors determined that the frequency of metastasis in separate organs is distributed as follows:
- Most often, the metastatic spread of the tumor occurs in the lymph nodes, skin and subcutaneous tissue;
- Approximately 25% of cases of metastasis affect pulmonary structures;
- About 17% of metastasis falls on the liver and the same amount on bone tissue;
- Brain metastases of melanoma affect in 16% of cases.
Sometimes melanoma itself acts as a metastasis, being a common cancer cell of a completely different neoplasm.
Types of distribution of
Skin cancer can metastasize by hematogenous or lymphogenic pathway.
With lymphogenous metastasis, tumor cells enter the lymphocytes, and then spread lymphatically through the lymph nodes. This pathway is considered the most preferred and most characteristic melanoma.
Melanomas can also metastasize and hematogenically, i.e., with blood, spreading malignant cells to other organs such as the lungs or the brain, liver or kidneys, etc.
Specialists even isolate a separate melanoma group that have increased malignancy and a predilection for the earlythe spread of metastases by hematogenesis.
In general, the metastasis of skin cancers are of the following types:
- The node type metastasis, in which secondary formations take the form of multiple disparate nodes localized in the subcutaneous layer. Such tumors are located at different distances from the primary cancerous focus.
- Satellites is a rash of many spots that look similar to a primary tumor. These rashes are usually located in relative proximity to the main focus.
- Thrombophlebitis-like type is a painful, radially spreading dense formation that has dilated veins and causes puffiness of the skin around the melanoma.
- Roget like metastases - this kind of metastasis looks like a painful, bluish-red, swollen skin around the primary focus of melanoma.
Causes of
Metastasis of skin cancer usually happens for the following reasons:
- If the oncologist is in old age;
- If the course of the cancer is complicated by chronic pathologies;
- If the cellular structures of the tumor have sprouted into the wall of any internal organ;
- If the primary skin cancer is represented as a large neoplasm, then the probability of metastasis is much higher.
Symptoms of metastasis of melanoma to lymph nodes and liver
Usually melanoma metastasis, depending on the species and localization, begins in stage II-III of the tumor process.
If metastases of melanoma are located in the lymph nodes, then:
- There is a sudden and causeless increase in lymph nodes;
- Rapid weight loss;
- Chronic fatigue and a constant sense of fatigue;
- Spotting disorders.
If the metastases are localized in the hepatic structures, then they form black melanin aggregations, which are actually affected areas. As a result, the liver has functional and physical disorders that affect the entire body.
In this case, the oncological disease is observed such symptoms, as:
- Increased hepatic dimensions;
- The tuberous structure of the organ;
- Painful sensations in the hypochondrium right;
- Appearance of ascites and jaundice;
- Weight Loss;
- Increases the size of the spleen;
- Disturbs the nausea-vomiting syndrome;
- Frequent bleeding from the nose.
Diagnosis
To detect metastatic spread of skin cancer, diagnostic techniques are used:
- Ultrasound;
- CT;
- Scintigraphic diagnostics;
- Magnetic resonance imaging of the entire body;
- Samples with radio preparations;
- Cytological diagnosis.
Treatment of
Skin cancer is prone to frequent relapses and aggressive course, and it often happens that such formations recur in already more advanced, dangerous forms.
Treatment of metastasis of melanoma generally involves the use of several techniques:
- Surgical removal or lymphadenectomy - when metastases of melanoma are found in nearby sentinel lymph node structures, then not only the lymph nodes of this zone are removed, but the entire lymphoid structure including fat tissues and blood vessels.
- Radiotherapy - a similar approach to the treatment of metastasis has also established itself as an effective method that reduces the progression of oncoprocess.
- Chemotherapy. It is carried out with the use of drugs like Temozolomide, Dakarbazin, Carmustine, Cisplatinum, Vinblastine, Docetaxel, etc. According to the statistics, in addition to slowing or stopping metastasis, the tumor decreases by about a quarter.
- Immunotherapy - is aimed at increasing the body's defenses. The use of adjuvant drugs leads to more favorable predictions than the use of antitumor chemotherapeutic drugs. Adjuvant drugs include Interferon, Nivolumab, Interleukin-2, Ipilimumab, Keitruda, etc. When receiving these funds, metastatic processes are reduced by about 30-45%.
Skin cancer, revealed at an early stage, is completely curable. If the tumor does not extend into the body, but grows horizontally, the chances of a complete cure can reach 97-100%.If onkoobrazovanie grows vertically, the forecasts are unfavorable.
As for metastatic melanomas, they are finally cured quite rarely.
Forecast
On average, with regional metastasis after lymphadenectomy, the five-year survival is about 43%.And the survival rate in patients under 50 years of age is much higher.
About 40% live more than 5 years after surgical removal of metastatic formation.
Therefore, an important assessment of the survival of the oncology process and the proper approach to the selection of treatment methods are an important survival factor. It has been repeatedly proven that effective treatment can significantly increase the chances of long-term survival and significantly prolong the life of the oncogene.