Klinicko-epidemioloske karakteristike velikog, invazivnog bazocelularnog karcinoma skalpa

We studied a large, invasive basal cell carcinoma of the scalp in 42 operated patients (53 tumors) of which 26 patients with recurrent and 16 with no recurrence. This is a rare clinical form of this tumor that invades the skin in addition to some or all of the following structure: soft tissue scalp, skull, brain and brain membranes. The literature is known as the Giant basal cell carcinoma according to TNM classification of BCC in pT4 stage. Caused by aggressive subtypes of BCC. Treatment is surgical and involves only large, mutilate surgery and extensive reconstruction. Relapse often occurs. The aim was to analyze clinical and epidemiological characteristics of large, invasive basal cell carcinoma of the scalp, finding the causes of relapse and proposal timely diagnosis. We have concluded that the appearance of tumors in the frontal and pariental region of the scalp is related to the presence of known risk factors, that tumors often penetrate bones and brains resulting in more frequent recurrence in this localization. All tumors were caused by aggressive forms of BCC. Patients in the group with recurrent, previously responded to treatment and had more surgery than patients without recurrence. Treatment-related adverse events occurred in most patients (recurrence and / or death). Proucavali smo veliki, invazivni bazocelularni karcinom skalpa kod 42 operisana pacijenta (53 tumora) od kojih je 26 pacijenata sa recidivom i 16 bez recidiva. To je retka klinicka forma ovog tumora koji zahvata pored koze neku ili sve od sledecih struktura: meka tkiva skalpa, kosti lobanje, ovojnice mozga i mozak. U literaturi je poznat kao Gigantski Bazocelularni karcinom a prema TNM klasifikaciji BCC u pT4 stadijumu. Prouzrokuju ga agresivni podtipovi BCC-a. Lecenje je iskljucivo hirursko i podrazumeva velike, mutilantne operacije i obimne rekonstrukcije. Cesto se javlja recidiv. Cilj rada je bila analiza klinickih i epidemioloskih karakteristika velikih, invazivnih bazocelularnog carcinoma skalpa, pronalazenje uzroka ucestalog recidiva i predlog pravovremene dijagnostike. Zakljucili smo da je pojava tumora u ceonoj i temenoj regiji skalpa povezana sa prisustvom poznatih faktora rizika, da se tu cesce desava prodor tumora na kost i mozak i da je na toj lokalizaciji cesci recidiv. Svi tumori su bili izazvani agresivnim formama BCC-a. Pacijenti koji su se ranije javili na lecenje (u proseku imaju vise operacija) dobili su recidiv. Nepovoljan ishod lecenja desio se kod vecine paci