Značaj lokalizacije primarnog tumora u kirurškom liječenju melanoma glave i vrata

master's thesis

• Title (english): Significance of primary tumor localization in surgical treatment of head and neck melanoma
• Author: Matea Hrvojić
• Mentor: Andro Košec (mentor)
• Committee member: Alan Pegan (predsjednik povjerenstva)
• Committee member: Mihael Ries (član povjerenstva)
• Committee member: Andro Košec (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Othorhinolaryngology and Head and Neck Surgery); Zagreb
• Defense date and country: 2022-09-02, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Otorhinolaryngology

Abstract

Gotovo 25% svih melanoma na tijelu javlja se u području glave i vrata, iako glava sama čini 9% površine tijela. Ta se primarna lokalizacija melanoma pokazala smrtonosnijom od ostalih. Prema WHO klasifikaciji, postoji devet različitih vrsta melanoma s obzirom na patogenetske, epidemiološke, kliničke i histopatološke čimbenike. Najčešći je način dijagnosticiranja melanoma klinički pregled. Zlatni standard liječenja melanoma je široka ekscizija. Taj se ekscidirani preparat šalje na patohistološku obradu za provjeru zahvaćenosti rubova. Nakon nje ostaje defekt koji je potrebno zatvoriti. Ovisno o primarnoj lokalizaciji tumora, potrebne su različite rekonstruktivne tehnike, s obzirom na to da su glava i vrat estetski vrlo važne regije. Svaka regija ima svoje posebnosti. Načini su rekonstrukcije poslagani na rekonstruktivnoj ljestvici, od jednostavnijih prema kompleksnijima. Najjednostavniji način rekonstrukcije je primarno zatvaranje, zatim sekundarno cijeljenje, kožni presadci, lokalni i regionalni režnjevi te distalni režnjevi. Ovdje govorimo o rekonstrukciji lezija na specifičnim lokalizacijama - nosu, obrazu, usnama i bradi, čelu i tjemenu, uhu te periokularnom području. Ovisno o primarnoj lokalizaciji tumora, postoje i različiti putevi limfne drenaže, pa tako i različiti zahvati kojima se te regije limfnih čvorova uklanjaju. Ostali su načini liječenja imunoterapija, kemoterapija i biokemoterapija, radioterapija i genska terapija.

Abstract (english)

Nearly 25% of melanoma in the human body occurs on head and neck area, despite the fact that head and neck area makes only 9% of body surface. This primary localization appears to have bigger mortality than the rest of the body. According to the WHO classification, there is nine different kinds of melanoma, based on pathogenetic, epidemiologic, clinical and histopathological factors. It is usually diagnosed clinically. The golden standard of melanoma therapy is surgical wide excision. After excision, tissue is sent to pathohistologic analysis in order to detect residual tumor cells in margins. After the procedure, we are faced with a skin defect which should be somehow managed. Depending on the primary tumor location, different kinds of surgical techniques are availible. Every region has its own special characteristics. Reconstruction possibilities are classified on the reconstructive ladder, from the simplest to the most complicated. The simplest one is primary closure, then secondary intention, skin grafts, local and regional flaps and distal flaps. Here we talk about reconstruction of the lesions on special locations – nose, cheek, lips and chin, forehead and scalp and periocular area. Depending on the primary tumor location, there are different ways of limphatic drainage, and different procedures for removal of affected nodes. Other therapeutic modalities are immunotherapy, chemotherapy, biochemotherapy, radiotherapy and gene therapy.

• Keywords: melanom; novotvorine glave i vrata; kirurgija; ekscizija; rekonstrukcija; primarna lokalizacija tumora
• Keywords (english): melanoma; head and neck cancer; surgery; excision; reconstruction; primary tumor location
• Language: croatian
• URN:NBN: urn:nbn:hr:105:456773
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2023-01-09 12:20:43