chirurgie tratamentul chirurgical al tumorilor cutanate. prezentare de ...

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Rev. Med. Chir. Soc. Med. Nat., Iaşi – 2012 – vol. 116, nr. 1. CHIRURGIE. CAZURI CLINICE. TRATAMENTUL CHIRURGICAL AL TUMORILOR CUTANATE .
Rev. Med. Chir. Soc. Med. Nat., Iaşi – 2012 – vol. 116, nr. 1

CAZURI CLINICE

CHIRURGIE

TRATAMENTUL CHIRURGICAL AL TUMORILOR CUTANATE. PREZENTARE DE CAZURI G. Stătescu, Mihaela Curic, Delia Farcaş, Luminiţa Ivan Spitalul Clinic Militar de Urgenţă “Dr. Iacob Czihac” Iaşi SURGICAL TREATMENT OF SKIN TUMORS. CASE REPORT (Abstract): This is the overview of several hospitalized cases of skin tumors this year based on which we analyzed the information in the literature concerning the clinical features, the evolution and therapy of these skin neoplasms. The tumors that develop in the skin fibrous tissue sometimes on a pr ior lesion need to be analyzed from a multidisciplinary perspective, therefore it is essential for the surgeon, the pathologist and the oncologist to consistently cooperate and to solve all issues related to the evolution of the case, which may be at times less favorable. Patients and method: In what follows we will introduce two clinical cases of dermato-fibrosarcoma protuberans (Darier-Ferrand) met in our recent practice this year, accompanied by the data found in the specialized literature concerning the clinical features, evolution and therapy of these quite rare skin lesions. Also we present another two cases of skin neoplasm. Results: All operated patients have survived since the surgery without any indication of relapse. Discussion: The attention of the surgeons is focused quite rarely on such skin tumors, since the patients with such lesions are usually treated by dermatologists. This cases we met in the r ecent years made us analyze the specialized literature in this field and to draw different conclusions. Conclusions: Each skin tumor where there are doubts concerning the diagnosis must be treated with extreme care and caution. We personally prefer a larger ex cision of an apparently benign tumor rather than making an insufficient excision. The operated patients must be consistently monitored throughout their lives. Key words: SKIN TUMORS, DERMATO-FIBROSARCOMA PROTUBERANS , TUMOR RELAPSE, METASTASES.

Aceste tumori care se dezvoltă din ţesutul fibros de la nivelul pielii (tumori fibrohistiocitare), uneori pe o leziune preexistentă, necesită o abordare multidisciplinară fiind necesară colaborarea coerentă dintre chirurg, anatomopatolog şi oncolog şi pentru a nu avea surprize neplăcute datorate evoluţiei ulterioare nefavorabile a cazului. Dermatofibrosarcomul protuberans (DarierFerrand) este o tumoră cu malignitate intermediară care recidivează frecvent şi poate metastaza dar numai după recidive repetate.

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Afectează de predilecţie tinerii şi adulţii de sex masculin. În toate cazurile de leziuni maligne rolul chirurgului devine important deoarece excizia largă a tumorii cu limite de securitate oncologică reprezintă componenta principală a protocolului terapeutic. Prezentăm două cazuri clinice de dermatofibrosarcom întâlnite în practica noastră din ultimii ani, împreună cu datele găsite în literatura de specialitate cu privire la particularităţile clinice, evolutive şi terapeutice ale acestor leziuni cutanate destul de rar întâlnite.