After malignant melanoma, spinalioma is the second most common malignant skin tumor. Also known as squamous cell carcinoma or prickle cell carcinoma, the cancer originates from the so-called squamous epithelium of the skin or mucous membrane. Like basal cell carcinoma, experts classify spinalioma as "white skin cancer". Around 25 out of every 100,000 people are diagnosed with spinalioma every year.
Below you will find further information and selected spinalioma specialists.
The average age for squamous cell carcinoma is 70 years. Men develop the disease more frequently than women. Areas of skin that are often exposed to the sun are particularly affected. In addition to the face and lips, this also includes the hands and scalp. However, the tongue and genital area can also be affected by prickle cell carcinoma.
The tongue and mouth are often damaged by chronic tobacco and alcohol consumption, which favors squamous cell carcinoma @ freshidea /AdobeStock
As with malignant melanoma, UV exposure from sunlight plays a decisive role in the development of spinalioma . Exposure to the sun over several years can change the genetic material (DNA) in the skin cells in such a way that they degenerate. In many cases, the tumor develops from a precancerous stage(precancerous lesion).
Actinic keratosis appears as sharply defined redness with a sandpaper-like surface structure. Although it is not malignant in itself, you should still have it treated due to the risk of degeneration. In rare cases, a spinalioma can also develop from chronic wounds, burn scars or other skin diseases.
Cancer-causing substances such as arsenic and X-rays or gamma rays can also promote the development of a spinalioma. Human papillomaviruses (HPV) are also suspected of increasing the risk of cancer. Squamous cell carcinoma of the lip is a disease that is more common in pipe smokers and glass blowers.
People with a weakened immune system generally have an increased risk of developing spinalioma. Patients with HIV infections or people who take immunocompromising medication are more likely to develop the disease. They usually also have a less favorable course of the disease.
In the early stages, squamous cell carcinoma still resembles actinic keratosis. It appears in the form of reddened patches with slight scaling. As the disease progresses, the tumor grows nodular with the formation of scales and crusts.
Squamous cell carcinoma of the skin (also spinalioma, prickle cell carcinoma) is the second most common malignant skin tumor @ Luis /AdobeStock
The adherent cornifications of the tumor cannot be removed or bleed when an attempt is made to remove them. Spinalioma causes little or no pain. However, as it grows, it can invade the surrounding tissue and destroy the structures there. Spinaliomas tend to grow slowly. At times, the symptoms appear to improve or even disappear completely.
In contrast to malignant melanoma, spinalioma rarely metastasizes. Squamous cell carcinomas of the skin only metastasize in three to five percent of all cases. Tumors of the mucous membranes and transitional mucous membranes, on the other hand, are more aggressive and have a higher metastasis rate. As a rule, the lymph nodes are affected first and only later other organs.
A dermatologist can quickly identify the typical skin changes as spinalioma. To confirm the diagnosis, the doctor takes a tissue sample of the tumor (biopsy) and has it examined in the laboratory.
Experts use immunohistochemical methods to distinguish squamous cell carcinoma from other skin tumors.
To rule out metastasis, the doctor palpates the surrounding lymph nodes and performs an ultrasound examination. The doctor can detect distant metastases in other organs by means of an X-ray examination or computer tomography.
Various therapeutic procedures can be used to treat spinalioma.
These include
Standard therapy is the complete surgical removal of the tumor. If the lymph nodes are also affected, these are also removed. If surgery is not possible, doctors can freeze the tumor or treat it using photodynamic therapy. In this procedure, certain processes generate toxic substances that damage the tumor. Local chemotherapy and immunotherapy are also among the treatment options.
In advanced stages or in the case of metastases in other organs, doctors treat spinalioma with systemic chemotherapy. Patients receive substances that inhibit cell growth and cell division throughout the body.
After successful treatment, patients must undergo a follow-up check every three to six months. This is important in order to detect possible metastases or relapses at an early stage. Those affected must avoid UV light as much as possible, check their skin regularly and consult a dermatologist immediately if they notice any abnormalities.
The prognosis of the malignant tumor depends primarily on the location and size of the tumor. The depth of invasion, the fine structure of the tumor and the presence of a therapy that weakens the immune system also influence the course of the disease.
Squamous cell carcinomas that are smaller than two centimetres in diameter rarely form metastases and therefore have a good prognosis. They can be treated with surgery and chemotherapy. However, as they are often prone to recurrence, a definitive cure is not possible in most cases.
Existing metastases and late treatment significantly worsen the prognosis. Overall, mortality is rather low. The 5-year survival rate is 70 percent. This means that around 70% of all spinalioma patients are still alive five years after diagnosis.
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