Skin tumor? Questions to PD Dr. Mathias Tremp

The term "tumor" is often mistakenly equated with "cancer". Not all skin tumours are malignant and need to be treated. In addition to malignant skin tumours such as malignant melanoma (black skin cancer), spinalioma (sting cell cancer) or basalioma (white skin cancer), there are precursors such as actinic keratosis or Bowen's disease.

There are also benign skin tumours such as birthmarks, connective tissue tumours, lipomas (benign fat tumours), haemangiomas (haemangiomas) or age warts.

Read also: Dermatological and reconstructive surgery

What are the risk factors for malignant skin tumours?

The most important risk factors are malignant skin tumours (especially black skin cancer) in the family, many atypical moles, frequent sunburns (especially in the case of spinalioma) and a light skin type.

What is the most malignant form of skin cancer?

Black skin cancer is the most malignant of all skin cancers. The melanoma can grow rapidly and can lead to "offshoots" (metastases) at an early stage. Early and rapid treatment is therefore very important.

What does black skin cancer look like?

The malignant melanoma can look very diverse and there is a danger of confusion with a birthmark or "age wart". The black skin cancer can also develop on skin areas that are not primarily visible, such as the scalp or mucous membrane.

If you observe a conspicuous skin change, the skin spot becomes larger and you have new itching, for example, then you must show the skin change to a specialist.

What is the surgical treatment of a black skin cancer?

After the diagnosis is confirmed by a tissue sample, the removal of the black skin cancer must be carried out with a so-called safety distance. The safety distance is determined by the so-called tumour thickness ("Breslow level").

But a certain size of Breslow also requires a sentinel lymph node biopsy.

Can this make spinalioma or basalioma offshoots?

The spinalioma grows much slower than the malignant melanoma and very rarely makes offshoots. The basal cell carcinoma grows slowly, metastases are usually not formed.

What is the surgical treatment of white skin cancer?

The complete removal of the white skin cancer is important. The surgical removal is performed with a safety distance. If the white skin cancer is difficult to delimit or in an aesthetically delicate region, a so-called fast cut controlled removal can be performed.

This means that a pathologist checks during the operation whether the entire tumour has been removed. Another option is the removal of the tumor and covering with artificial skin, and one week later the reconstruction when the tumor is completely removed.

How is the operation performed?

A simple removal can often be performed under local anesthesia on an outpatient basis. If desired and in the case of larger skin changes, the procedure can also be performed in twilight sleep.

In the face and in the case of major changes, reconstruction often requires so-called sliding flaps or a skin transplant. The removal of the sentinel lymph node is usually performed under general anaesthesia.

How is the aftercare?

After the stitches have been removed, a regular scar massage with a fatty or oily ointment is important. You should also use a SPF 50 sunscreen as soon as the wound has healed.

After the surgical treatment, you must undergo regular check-ups by a dermatologist.

Cost absorption by the health insurance company?

The operation is covered by health insurance.

Do you have questions about reconstructive surgery for small and large skin tumours?

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