Basal cell carcinoma is the most common skin tumor. Its evolution is strictly local (does not give metastases). It occurs on healthy skin (without precancerous lesions) on the face and neck. Basal cell carcinoma is an abnormal proliferation of basal cells in the epidermis.

There are different forms of skin tumors: superficial, nodular (mother-of-pearl with vascularization), infiltrating and scleroderma. Possible causes of basal cell carcinoma are intense and repeated exposure to the sun, especially since childhood, a light skin photo type, a personal history of skin cancer (relapse), and a deficiency of the immune system.

A biopsy before removal of the tumor can be done to confirm the diagnosis, if there are clinical doubts, if the proposed treatment is not surgical, as well as for all clinical forms of poor prognosis or if the surgical procedure requires significant reconstruction.

Surgical intervention consists of the complete removal of the lesion and is the standard treatment. Radiotherapy is a treatment that can be offered as a second-line treatment. Radiotherapy allows a non-invasive treatment. This method is proposed for large inoperable lesions, or difficult to implement for aesthetic or functional reasons (for example, if the tumor is close to the eye).

This treatment is also prescribed as an adjunct to surgery to reduce the risk of local recurrence in case of incomplete surgical resection.

Squamous cell carcinoma is much less common than basal cell carcinoma, and usually appears in older people. Squamous cell cancer (or squamous cell carcinoma), is formed from keratinocytes, which are located mainly at the level of the epidermis (surface layer of the skin). Evolution is local, but there is a possibility of metastases (ganglionic or visceral).

Squamous cell skin cancer is often the result of a pre-cancerous lesion, such as actinic keratosis. Risk factors are the same as for basal cell carcinoma: long and regular exposure to the sun and fair skin. The cancerous growth itself is persistent and appears thick, scaly, and firm, with a red tint.
This tumor can spread locally over time with a metastatic risk of developing in the lymph nodes or internal organs.
Various types of treatments can be offered. Surgery to remove the lesion remains the treatment that is usually offered most often. However, radiotherapy also provides good local control and is offered in case of an inoperable tumor or if the tumor is not completely removed during surgery.

Melanoma is a tumor formed from melanocytes.

Risk factors are:
  • family history,
  • the presence of melanoma in the medical history,
  • fair skin,
  • a lot of nevi on the body,
  • intense sun exposure,
  • love of tanning.

A lesion is suspected if:
  • it is asymmetric,
  • the edges are irregular,
  • has several different colors,
  • has a diameter of more than 6 mm and is progressive (expansion in size, shape and relief).
If a lesion is suspected, a dermatologist must be consulted, who will examine a dermatoscope and perform surgical removal of the lesion for histopathological examination. The prognostic factors studied in anatomical pathology are Breslow tumor depth, ulceration, and invasion of the sentinel lymph node.

Mutation BRAF V600E is analyzed for the possibility of targeted treatment in case of locally advanced or advanced metastatic stage, a combination of anti-BRAF and anti-MEK.

If no mutation is found, treatment with immunotherapy with PD-1 inhibitors may be suggested in advanced or adjuvant stages. At an advanced stage, an 18 FDG PET scanner and an MRI scan of the brain are performed as part of the expansion assessment. In case of metastases to the brain, stereotactic radiotherapy of lesions is carried out (less than 5 lesions) in one to three sessions.
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