Henry Naland Oncologist Surgeon

Ukrida Medicine Faculty ,Jakarta

Angka kejadian Kanker Kulit lebih tinggi yang

dari yang dilaporkan
Tumor ganas kulit ukuran kecil jarang
dilaporkan
Tumor yang dilaporkan hanya kasus berat.

Henry Naland Oncologist Surgeon FK

UKRIDA Oncology Lecture
Ukrida

Friday April 25,2014

11/25/2014

Paparan terhadap cahaya matahari yang

tinggi dinegara tropis
Paparan zat karsinogen pada pekerjaan
tertentu: Pembersih Cerobong asap,Pewarna
rambut
Kurangnya perlindungan diri dari cahaya
matahari
Faktor Infeksi kronis yang tak sembuh2 dan
Hygiene diri kurang

Henry Naland Oncologist Surgeon FK

UKRIDA Oncology Lecture
Ukrida

Friday April 25,2014

11/25/2014

I. Golongan Melanoma malignum

atau Melano Carcinome
II. Golongan Non Melano Carcinome
Ca.sel skwamosa (Epidermoid Ca)
Ca.sel basal (Basalioma)
Ca.lain dari derivat kulit

Henry Naland Oncologist Surgeon FK

UKRIDA Oncology Lecture
Ukrida

Friday April 25,2014

11/25/2014

Henry Naland Oncologist Surgeon FK

Ukrida

Friday April 25,2014

Henry Naland Oncologist Surgeon FK

Ukrida

Friday April 25,2014

Dulu dikenal: Melanoma malignum

Berasal dari Tahi lalat (Naevus pigmentosus)
Bentuknya ada yang:
SSM :Superficial Spreading Melanom
Noduler Melanoma malignum
Atipik dan amelanotic melanom
Lebih banyak pada orang berkulit putih

Henry Naland Oncologist Surgeon FK

UKRIDA Oncology Lecture
Ukrida

Friday April 25,2014

11/25/2014

Henry Naland Oncologist Surgeon FK

Ukrida

Friday April 25,2014

Henry Naland Oncologist Surgeon FK

Ukrida

Friday April 25,2014

Tahi lalat yang harus diperhatikan:

Bila: Cepat besar
Warnanya makin hitam
Ada rasa gatal
pada tempat yang sering
tergeser telapak kaki
conjunctiva,daerah pinggang

Henry Naland Oncologist Surgeon FK

UKRIDA Oncology Lecture
Ukrida

Friday April 25,2014

11/25/2014

10

Tumor kulit terganas cepat menyebar kehati,

otak ,paru2 dll
Sering Tumor primernya kecil atau sudah
hilang ,yang ditemukan hanya metastasisnya
saja
Sering primernya berada ditempat
tersembunyi: dinding dubur,vagina
glans penis, dibawah kuku.

Henry Naland Oncologist Surgeon FK

UKRIDA Oncology Lecture
Ukrida

Friday April 25,2014

11/25/2014

11

Stadium menurut TNM Sistim sukar

diterapkan.karena yang lebih menentukan
ketebalan Invasi kedalam lapisan kulit
Berdasarkan invasi sel kanker melanoma
kedalam kulit:
Dibagi menjadi Clark I-IV
Bila sudah ada dikelenjar Getah bening
regional sudah stadium lanjut

Henry Naland Oncologist Surgeon FK

UKRIDA Oncology Lecture
Ukrida

Friday April 25,2014

11/25/2014

12

Henry Naland Oncologist Surgeon FK

Ukrida

Friday April 25,2014

13

Henry Naland Oncologist Surgeon FK

Ukrida

Friday April 25,2014

14

Untuk Stadium dini: Excici dengan batas

sayatan 2-5 cm dari tepi tumor adalah terapi
kuratif
Kelenjar Getah bening regional harus
dieksplorasi dan diperiksa PA nya
Untuk Stadium lanjut perlu selain Radiasi
lokal juga Khemoterapi dengan
DTIC=Dacarbacine dan
Doxorubicin=Adriamycine
Immunoterapi: Interferron

Henry Naland Oncologist Surgeon FK

UKRIDA Oncology Lecture
Ukrida

Friday April 25,2014

11/25/2014

15

Banyak pada daerah tubuh yang terekspose

cahaya matahari: muka
Berupa naevus yang lebih menonjol
dipermukaan kulit, bisa berpigmen
Tumbuh lambat, bila dibiarkan dapat tumbuh
kedalam subkutis dan tulang dibawahnya.
Metastasis kekelenjar getahbening jarang
terjadi.

Henry Naland Oncologist Surgeon FK

UKRIDA Oncology Lecture
Ukrida

Friday April 25,2014

11/25/2014

16

Henry Naland Oncologist Surgeon FK

Ukrida

Friday April 25,2014

17

Henry Naland Oncologist Surgeon FK

Ukrida

Friday April 25,2014

18

Henry Naland Oncologist Surgeon FK

Ukrida

Friday April 25,2014

19

Henry Naland Oncologist Surgeon FK

Ukrida

Friday April 25,2014

20

Henry Naland Oncologist Surgeon FK

Ukrida

Friday April 25,2014

21

Bedah: untuk yang dini terapi bersifat kuratif.

Sangat radiosensitif: baik untuk daerah yang
bila dioperasi meninggalkan cacat berat
Sering residif lokal.

Henry Naland Oncologist Surgeon FK

UKRIDA Oncology Lecture
Ukrida

Friday April 25,2014

11/25/2014

22

Dapat terjadi disemua kulit bagian tubuh.

Dapat didahului oleh lesi praecancer
seperti Pseudoepitelioma hiperplasia, ulkus
khronis terutama bekas luka bakar yang tak
sembuh2.
Sering disertai pembesaran kelenjar
getahbening regional

Henry Naland Oncologist Surgeon FK

UKRIDA Oncology Lecture
Ukrida

Friday April 25,2014

11/25/2014

23

Henry Naland Oncologist Surgeon FK

Ukrida

Friday April 25,2014

24

Henry Naland Oncologist Surgeon FK

Ukrida

Friday April 25,2014

25

Henry Naland Oncologist Surgeon FK

Ukrida

Friday April 25,2014

26

Henry Naland Oncologist Surgeon FK

Ukrida

Friday April 25,2014

27

Stadium dini : Pembedahan batas sayatan dan

dasar harus bebas tumor
Kelenjar Getah bening regional yang
membesar harus turut diangkat
Bila batas sayatan tak bebas tumor harus
dieksisi ulang atau radioterapi
Stadium lanjut diperlukan Khemo th/

Henry Naland Oncologist Surgeon FK

UKRIDA Oncology Lecture
Ukrida

Friday April 25,2014

11/25/2014

28

Henry Naland Oncologist Surgeon FK

UKRIDA Oncology Lecture
Ukrida

Friday April 25,2014

11/25/2014

29

Henry Naland Oncologist Surgeon FK

UKRIDA Oncology Lecture
Ukrida

Friday April 25,2014

11/25/2014

30

Henry Naland Oncologist Surgeon FK

UKRIDA Oncology Lecture
Ukrida

Friday April 25,2014

11/25/2014

31

Henry Naland Oncologist Surgeon FK

UKRIDA Oncology Lecture
Ukrida

Friday April 25,2014

11/25/2014

32

Henry Naland Oncologist Surgeon FK

UKRIDA Oncology Lecture
Ukrida

Friday April 25,2014

11/25/2014

33

Henry Naland Oncologist Surgeon FK

UKRIDA Oncology Lecture
Ukrida

Friday April 25,2014

11/25/2014

34

Henry Naland Oncologist Surgeon FK

UKRIDA Oncology Lecture
Ukrida

Friday April 25,2014

11/25/2014

35

Henry Naland Oncologist Surgeon FK

UKRIDA Oncology Lecture
Ukrida

Friday April 25,2014

11/25/2014

36

Henry Naland Oncologist Surgeon FK

UKRIDA Oncology Lecture
Ukrida

Friday April 25,2014

11/25/2014

37

Henry Naland Oncologist Surgeon FK

UKRIDA Oncology Lecture
Ukrida

Friday April 25,2014

11/25/2014

38

Henry Naland Oncologist Surgeon FK

UKRIDA Oncology Lecture
Ukrida

Friday April 25,2014

11/25/2014

39

Henry Naland Oncologist Surgeon FK

UKRIDA Oncology Lecture
Ukrida

Friday April 25,2014

11/25/2014

40

Henry Naland Oncologist Surgeon FK

UKRIDA Oncology Lecture
Ukrida

Friday April 25,2014

11/25/2014

41

Henry Naland Oncologist Surgeon FK

UKRIDA Oncology Lecture
Ukrida

Friday April 25,2014

11/25/2014

42

Henry Naland Oncologist Surgeon FK

UKRIDA Oncology Lecture
Ukrida

Friday April 25,2014

11/25/2014

43

Henry Naland Oncologist Surgeon FK

UKRIDA Oncology Lecture
Ukrida

Friday April 25,2014

11/25/2014

44

Henry Naland Oncologist Surgeon FK

UKRIDA Oncology Lecture
Ukrida

Friday April 25,2014

11/25/2014

45

Henry Naland Oncologist Surgeon FK

Ukrida

Friday April 25,2014

46

Henry Naland Oncologist Surgeon FK

Ukrida

Friday April 25,2014

47

Henry Naland Oncologist Surgeon FK

Ukrida

Friday April 25,2014

48

Henry Naland Oncologist Surgeon FK

Ukrida

Friday April 25,2014

49

Henry Naland Oncologist Surgeon FK

Ukrida

Friday April 25,2014

50

Henry Naland Oncologist Surgeon FK

Ukrida

Friday April 25,2014

51

Henry Naland Oncologist Surgeon FK

Ukrida

Friday April 25,2014

52

Henry Naland Oncologist Surgeon FK

Ukrida

Friday April 25,2014

53

Dr.Henry Naland Sp.B(K) Onk