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Ministry of Health of Ukraine Ukrainian Medical Stomatolgical Academy Ministry of Health of Ukraine Ukrainian Medical Stomatolgical Academy Methodical Instructions for independent work of students during the training for the practical studies Academic discipline Surgical stomatology Моdule № 3 The topic of the stadies Epithelial tumors of the soft tissues. Tumor-like № 1 formations of the soft tissues: atheroma, rhinophyma, keratoacanthoma, keratolytic papilloma (skin horn). Clinical manifestations, differential diagnosis and treatment. Course IV Faculty Foreign Students Training, Stomatological Poltava – 2020 1 1. Relevance of the topic: The Skin Cancer Foundation recommends the monthly head-to-toe self examination of the skin, so that one can find any new or changing lesions that might be cancerous or precancerous. Skin cancers found and removed early are almost always curable. Learn about the warnings signs of skin cancer and what to look for during a self examination. If you spot anything suspicious, see a doctor. Performed regularly, self-examination can alert you to changes in your skin and aid in the early detection of skin cancer. It should be done often enough to become a habit, but not so often as to feel like a bother. For most people, once a month is ideal, but ask your doctor if you should do more frequent checks. You may find it helpful to have a doctor do a full-body exam first, to assure you that any existing spots, freckles, or moles are normal or treat any that may not be. After the first few times, self-examination should take no more than 10 minutes – a small investment in what could be a life-saving procedure. One in 50 men and women will be diagnosed with melanoma of the skin during their life time. An estimated 76,250 new cases of invasive melanoma will be diagnosed in the US in 2012, with an estimated 9,180 to result in death. One person dies of melanoma every hour (every 62 minutes). Melanoma is the most common form of cancer for young adults 25-29 years old and the second most common form of cancer for young people 15-29 years old. The survival rate for patients whose melanoma is detected early, before the tumor has penetrated the skin, is about 99 percent. The survival rate falls to 15 percent for those with advanced disease. The vast majority of mutations found in melanoma are caused by ultraviolet radiation. The incidence of many common cancers is falling, but the incidence of melanoma continues to rise at a rate faster than that of any of the seven most common cancers. Between 1992 and 2004, melanoma incidence increased 45 percent, or 3.1 percent annually. Melanoma accounts for less than five percent of skin cancer cases, but it causes more than 75 percent of skin cancer deaths. Survival with melanoma increased from 49 percent (1950-1954) to 92 percent (1996-2003). Melanoma is the fifth most common cancer for males and sixth most common for females. Women aged 39 and under have a higher probability of developing melanoma than any other cancer except breast cancer. About 65 percent of melanoma cases can be attributed to ultraviolet (UV) radiation from the sun. One or more blistering sunburns in childhood or adolescence more than double a person's chances of developing melanoma later in life. 2 A person's risk for melanoma doubles if he or she has had more than five sunburns at any age. Survivors of melanoma are about nine times as likely as the general population to develop a new melanoma. Tumor-like new formations of the soft tissues, especially such, as atheroma, are often observed at practice of surgeon-stomatologist. Usually they do not make a threat to life and health of patient, but at certain terms some of them, for example keratoacanthoma, can become malignant tumor. Clear knowledge of clinical displays of this group of new formations will help a doctor to set a faithful diagnosis and avoid flagrant errors. 2. Specific objectives: 2.1. To analyze an aetiology and pathogenesis of epithelial tumours of soft tissues of a head and a neck. 2.2. To define, what is a tumoral process. 2.3. To make the plan of examination of the patient with a tumour of soft tissues of a maxillofacial region. 2.4. To classify tumours of soft tissues. 2.5. To explain clinical attributes of epithelial tumours of soft tissues of a maxillofacial region. 2.6. To draw the scheme of examination and treatment of the patient with epithelial tumours of soft tissues of a maxillofacial region. 2.7. To analyze value of additional methods of examinations of patients with epithelial tumours of soft tissues. 2.8. Dispensary supervision of patients with epithelial tumours of soft tissues of a maxillofacial region. 2.9. To analyse the clinical symptoms of atheroma, rhinophyma, keratoacanthoma, keratolytic papilloma (warty (skin) horn). 2.10. To explain the etiologic and pathogenetic factors of development of tumor- like formations of soft tissues. 2.11. To offer the plan of examination of patient with a diagnosis atheroma, rhinophyma, keratoacanthoma, keratolytic papilloma (warty (skin) horn). 2.12. To classify tumor-like formations of soft tissues. 2.13. To interpret principles of diagnostics and treatment of tumor-like formations of soft tissues. 2.14. To draw the graphology chart of lesson. 2.15. To analyse the results of laboratory and instrumental examination. 2.16. To diagrammatize treatment of patients with atheroma, rhinophyma, keratoacanthoma, keratolytic papilloma (warty (skin) horn). 3. Basic knowledge and skills necessary to study the topic (interdisciplinary integration). 3 Previous disciplines. Acquired skills. 1. Ethics. To come into psychological contact to the patient. 2. Histology and To know a morphological structure of the pathomorphology. epithelial tumour of a soft tissues. 3. Inner disease. To apply methods of examination of the patient with epithelial tumours of soft tissues. 4. Propaedeutics of surgical To be able to use methods of additional stomatology. examination of patients with epithelial tumours of soft tissues. Previous disciplines. Acquired skills. 1. Topographical To determine topographic-anatomic areas of head and anatomy. neck. 2. Histology. To prepare material for histological investigation. 3. Pathological To describe the histological picture of tumor-like anatomy. formations of soft tissues. 4. Pathological To interpret etiology and pathogenesis of tumors. physiology. 5. Propaedeutics of To conduct curation of patient with a tumor of maxilla- surgical stomatology. facial region. 6. General oncology. To determine the scheme of examination of patient with a tumor of maxilla-facial region. 4. Tasks for independent work in preparation for the lesson 4.1. The list of the basic terms, parameters, characteristics which the student should master at preparation for employment: The term Definition 1. Carcinogenesis. Although there are many different forms of cancer, the basic multistage process by which various tumors develop is similar for all cancers. This process is called carcinogenesis. Carcinogenesis begins when carcinogens (cancer-causing substances) damage the DNA in a cell (e.g., a genetic mutation) and/or cause changes in other cell components or cell activities that can predispose them to cancer. These altered cells look normal, but they grow faster than the surrounding normal cells – a stage called hyperplasia. 2. A tumour. A tumor or tumour is commonly used as a synonym for a neoplasm [a solid or fluid-filled (cystic) lesion that may or may not be formed by an abnormal growth of neoplastic cells] that appears enlarged in size. Tumor is not synonymous with cancer. While cancer is by definition malignant, a tumor can be benign, pre-malignant, or malignant, or can represent a lesion without any cancerous 4 potential whatsoever. 3. Epithelioma. It is a tumour which is formed of cells of epithelium which cover a surface of a body. Earlier this tumour named a carcinoma. Term Definition 1. Biopsy. Surgical removal of tissue specimen from living organism for histological research. 2. Autopsy. A postmortem surgical removal of tissue specimen for histological research. 3. Aspiration or needle A taking of material from lesion for histological biopsy. research by needle with large diameter. 4. Incisional biopsy A taking of material for histological research by excision of piece of tumor on border of healthy tissues. 4.2. Theoretical questions for the lesson: 4.1 What do you know of epithelial tumours of soft tissue? 4.2 To give the clinical characteristic of a papilloma. 4.3 To give the clinical characteristic of keratoacanthoma. 4.4 To give the clinical characteristic of a skin horn. 4.5 To give the clinical characteristic of nevus. 4.6 What are epitheliomas? 4.7 Clinical displays of malignant growth in epithelial tumours of soft tissues. 4.8 To make the differential diagnostics of epithelial tumours of soft tissues in maxillofacial area. 4.9 What methods of diagnostics use for verification of tumours. 4.10 What methods apply to treatment of epithelial tumours of soft tissues. 4.11 To transfer factors which are provoke to neoplasm of soft tissues. 4.12 To describe the clinical picture of atheroma. 4.13 To describe the clinical picture of rhinophyma. 4.14 To describe the clinical picture of keratoacanthoma. 4.15 To describe the clinical picture of skin horn. 4.16 Methods of diagnostics and additional methods of research of patients. 4.17 Differential diagnostics of tumors of soft tissues. 4.18 Prophylaxis of origin of neoplasms of soft tissues. 4.3. Practical work (task) that is performed in class. 1. To survey the patient. 2. To write the history of disease or an out-patient card. 3. To appoint the plan of examination of the patient. 4. To make a biopsy. 5. To take a material for cytologic research. 5.
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