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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


01/19/15

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


01/19/15

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


01/19/15

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


01/19/15

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


01/19/15

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


01/19/15

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


01/19/15

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


01/19/15

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


01/19/15

16

Henry Naland Oncologist Surgeon FK


Ukrida

Friday April 25,2014

17

Henry Naland Oncologist Surgeon FK


Ukrida

Friday April 25,2014

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Henry Naland Oncologist Surgeon FK


Ukrida

Friday April 25,2014

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Henry Naland Oncologist Surgeon FK


Ukrida

Friday April 25,2014

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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


01/19/15

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


01/19/15

23

Henry Naland Oncologist Surgeon FK


Ukrida

Friday April 25,2014

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Henry Naland Oncologist Surgeon FK


Ukrida

Friday April 25,2014

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Henry Naland Oncologist Surgeon FK


Ukrida

Friday April 25,2014

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Henry Naland Oncologist Surgeon FK


Ukrida

Friday April 25,2014

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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


01/19/15

28

Henry Naland Oncologist Surgeon FK


UKRIDA Oncology Lecture
Ukrida

Friday April 25,2014


01/19/15

29

Henry Naland Oncologist Surgeon FK


UKRIDA Oncology Lecture
Ukrida

Friday April 25,2014


01/19/15

30

Henry Naland Oncologist Surgeon FK


UKRIDA Oncology Lecture
Ukrida

Friday April 25,2014


01/19/15

31

Henry Naland Oncologist Surgeon FK


UKRIDA Oncology Lecture
Ukrida

Friday April 25,2014


01/19/15

32

Henry Naland Oncologist Surgeon FK


UKRIDA Oncology Lecture
Ukrida

Friday April 25,2014


01/19/15

33

Henry Naland Oncologist Surgeon FK


UKRIDA Oncology Lecture
Ukrida

Friday April 25,2014


01/19/15

34

Henry Naland Oncologist Surgeon FK


UKRIDA Oncology Lecture
Ukrida

Friday April 25,2014


01/19/15

35

Henry Naland Oncologist Surgeon FK


UKRIDA Oncology Lecture
Ukrida

Friday April 25,2014


01/19/15

36

Henry Naland Oncologist Surgeon FK


UKRIDA Oncology Lecture
Ukrida

Friday April 25,2014


01/19/15

37

Henry Naland Oncologist Surgeon FK


UKRIDA Oncology Lecture
Ukrida

Friday April 25,2014


01/19/15

38

Henry Naland Oncologist Surgeon FK


UKRIDA Oncology Lecture
Ukrida

Friday April 25,2014


01/19/15

39

Henry Naland Oncologist Surgeon FK


UKRIDA Oncology Lecture
Ukrida

Friday April 25,2014


01/19/15

40

Henry Naland Oncologist Surgeon FK


UKRIDA Oncology Lecture
Ukrida

Friday April 25,2014


01/19/15

41

Henry Naland Oncologist Surgeon FK


UKRIDA Oncology Lecture
Ukrida

Friday April 25,2014


01/19/15

42

Henry Naland Oncologist Surgeon FK


UKRIDA Oncology Lecture
Ukrida

Friday April 25,2014


01/19/15

43

Henry Naland Oncologist Surgeon FK


UKRIDA Oncology Lecture
Ukrida

Friday April 25,2014


01/19/15

44

Henry Naland Oncologist Surgeon FK


UKRIDA Oncology Lecture
Ukrida

Friday April 25,2014


01/19/15

45

Henry Naland Oncologist Surgeon FK


Ukrida

Friday April 25,2014

46

Henry Naland Oncologist Surgeon FK


Ukrida

Friday April 25,2014

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Henry Naland Oncologist Surgeon FK


Ukrida

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Henry Naland Oncologist Surgeon FK


Ukrida

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Henry Naland Oncologist Surgeon FK


Ukrida

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Henry Naland Oncologist Surgeon FK


Ukrida

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Henry Naland Oncologist Surgeon FK


Ukrida

Friday April 25,2014

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Henry Naland Oncologist Surgeon FK


Ukrida

Friday April 25,2014

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Dr.Henry Naland Sp.B(K) Onk

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