Planocelularni karcinom poglavine sa intrakranijalnim širenjem – značaj različitih modaliteta snimanja

  • Srdjan Stošić University Clinical Center of Vojvodina, Center for Radiology, Novi Sad, Serbia
  • Mirela Juković University Clinical Center of Vojvodina, Center for Radiology, Novi Sad, Serbia
  • Jagoš Golubović University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
  • Milana Panjković University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
  • Sanja Stojanović University Clinical Center of Vojvodina, Center for Radiology, Novi Sad, Serbia
DOI: https://doi.org/10.2298/VSP210226100S
Ključne reči: dijagnoza, histološke tehnike, imunohistohemija, magnetska rezonanca, snimanje, neoplazme, invazivnost, karcinom, planocelularni, neurohirurške procedure, skalp

Sažetak


Uvod. Oko 2% svih neoplazmi kože javlja se na poglavini, i mogu biti klasifikovane kao primarne i metastatske. Intrakranijalno širenje je retko kod maligniteta kože, ali se generalno može javiti kada se lečenje odlaže. Planocelularni karcinom (PCK) je drugi najčešći tip nemelanomskog karcinoma kože posle bazocelularnog karcinoma. Oko 3–8% PCK lokalizovano je na poglavini, i u retkim slučajevima mogu se širiti intrakranijalno i infiltrisati tvrdu moždanu opnu (duru). Prikaz bolesnika. Bolesnik star 49 godina  javio se na pregled sa velikom, bolnom tumefakcijom na levoj parijetookcipitalnoj regiji glave. Na snimku dobijenom magnetnom rezonancom (MR) uočene su velike, nehomogene, nekrotične lezije, sa infiltracijom podležuće lobanje i dure. Bolesniku je tumor hirurški odstranjen ekscizijom infiltrisane kože, lobanje i dure sa bezbednosnom marginom od 1 cm, posle čega je urađena kranioplastika korišćenjem prethodno specifično konstruisanog 3D grafta od polimetilmetakrilata. Patohistološkom analizom utvrđen je invazivni PCK, a imunohistohemijskom analizom je nađena CK5/6 i CK7 pozitivnost. Zaključak. U nekim slučajevima, kada se lečenje odlaže, PCK poglavine može izazvati invaziju podležuće lobanje i dure. Modaliteti snimanja kao što su kompjuterizovana tomografija i MR igraju važnu ulogu u proceni širenja tumora i potencijalne invazije svoda lobanje (kalvarje) i dure, zauzimajući važno mesto u preoperativnom planiranju i zbrinjavanju. 

Biografija autora

Srdjan Stošić, University Clinical Center of Vojvodina, Center for Radiology, Novi Sad, Serbia

dr med.

Centar za radiologiju

Klinički centar Vojvodine

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Objavljeno
2023/09/29
Broj časopisa
Vol. 80 Br. 09 (2023): Vojnosanitetski pregled
Rubrika
Prikaz bolesnika