Iindidi / ithishu ethambileyo-sarcoma / isigulana / umntwana-imithambo-tumors-unyango-pdq

Unyango lwe-Vascular Tumors Treatment (®) -iPatient Version

Ulwazi ngokubanzi malunga neeTumcular Vascular Tumors

IINGONGOMA EZIPHAMBILI

• Izidumba zemithambo ebuntwaneni ezivela kwiiseli ezenza imithambo yegazi okanye izitya ze-lymph.

• Uvavanyo lusetyenziselwa ukufumanisa (ukufumana) kunye nokuchonga amathumba emithambo yabantwana.

• Amathumba e-vascular ebuntwaneni anokuhlelwa ngokwamaqela amane.

• Izidumbu zeBenign

• Amathumba aphakathi (alapha)

• Ephakathi (kunqabile ukunciphisa) amathumba

• Amathumba amabi

Izidumba zemithambo ebuntwaneni ezivela kwiiseli ezenza imithambo yegazi okanye izitya ze-lymph.

Izidumba zeVascular zinokuvela kwisitya segazi esingaqhelekanga okanye iiseli zenqanawa ye-lymph naphi na emzimbeni. Banokuba nobungozi (hayi umhlaza) okanye ubungozi (umhlaza). Zininzi iintlobo zamathumba emithambo. Olona hlobo luqhelekileyo lobunzima be-vascular tumor yi-infantile hemangioma, esisifo esibuhlungu esihlala sihamba sodwa.

Kuba amathumba amabi emithambo enqabileyo anqabile ebantwaneni, akukho lwazi luninzi malunga nokuba loluphi unyango olusebenza kakuhle.

Uvavanyo lusetyenziselwa ukufumanisa (ukufumana) kunye nokuchonga amathumba emithambo yabantwana.

Ezi mvavanyo zilandelayo kunye neenkqubo zinokusetyenziswa:

• Uvavanyo lomzimba kunye nembali: Uvavanyo lomzimba ukukhangela iimpawu zempilo ngokubanzi, kubandakanya nokujonga iimpawu zesifo, ezinje ngamaqhuma, izilonda, okanye enye into ebonakala ingaqhelekanga. Imbali yemikhwa yempilo yesigulana kunye nezifo zangaphambili kunye nonyango ziya kuthathwa.

• Uvavanyo lwe-Ultrasound: Inkqubo apho amaza esandi aphembelela amandla aphezulu (i-ultrasound) akhutshelwa ngaphandle kwizicubu zangaphakathi okanye kwizitho zokwenza i-echoes. Iingqungquthela zenza umfanekiso wezicubu zomzimba ezibizwa ngokuba yi-sonogram. Umfanekiso unokuprintwa ukuze ujongwe kamva.

I-ultrasound yesisu. I-ultrasound transducer edityaniswe kwikhompyuter icinezelwe kulusu lwesisu. I-transducer igxotha amaza esandi kumalungu angaphakathi nakwizicubu ukwenza ii-echoes ezenza i-sonogram (umfanekiso wekhompyuter).

• Ukuskena i-CT (ukuskena i-CAT): Inkqubo eyenza uthotho lwemifanekiso eneenkcukacha zeendawo ezingaphakathi emzimbeni, ezithathwe kwii-engile ezahlukeneyo. Imifanekiso yenziwe yikhompyuter edityaniswe kumatshini we-x-ray. Idayi inokufakwa ngaphakathi emthanjeni okanye iginywe ukunceda amalungu okanye izicwili zibonise ngokucacileyo. Le nkqubo ikwabizwa ngokuba yi-computed tomography, ikhompyuter ye-tomography, okanye ikhompyuter ye-axial tomography.

Ikhompyuter ye-tomography (CT) yesisu. Umntwana ulele phezu kwetafile etyibilika ngesikena se-CT, esithatha imifanekiso ye-x-ray engaphakathi esiswini.

• I-MRI (imaging resonance imaging): Inkqubo esebenzisa umazibuthe, amaza erediyo kunye nekhompyuter ukwenza uthotho lwemifanekiso eneenkcukacha zeendawo ezingaphakathi komzimba. Le nkqubo ikwabizwa ngokuba yimifanekiso yenyukliya yokujonga umfanekiso (i-NMRI).

Imagnetic resonance imaging (MRI) yesisu. Umntwana ulele phezu kwetafile etyibilika kwisikena se-MRI, esithatha imifanekiso engaphakathi komzimba. Iphedi esiswini somntwana inceda ukwenza imifanekiso icace gca.

• Biopsy: Ukususwa kweeseli okanye izicwili ukuze zijongwe ngemicroscope ngugqirha wezilwanyana ukujonga imiqondiso yomhlaza. I-biopsy ayisoloko ifuneka ekuchongeni isisu semithambo.

Amathumba e-vascular ebuntwaneni anokuhlelwa ngokwamaqela amane.

Izidumbu zeBenign

Iimvumi zeBenign aziwona umhlaza. Esi sishwankathelo sinolwazi malunga nezi zilonda zamathambo zilandelayo:

• Umntwana hemangioma.

• I-hemangioma yokuzalwa.

• Iimvavanyo zeBenign vascular zesibindi.

• I-spindle cell hemangioma.

• Epithelioid hemangioma.

• I-Pyogenic granuloma (i-lobular capillary hemangioma).

• I-Angiofibroma.

• I-angiofibroma yolutsha.

Amathumba aphakathi (alapha)

Izidumbu eziphakathi ezinengcwangu ekuhlaleni zihlala zisasazeka kwindawo ejikeleze ithumba. Esi sishwankathelo sinolwazi malunga nezi zilonda zamathambo zilandelayo:

• I-Kaposiform hemangioendothelioma kunye ne-angioma.

Ephakathi (kunqabile ukunciphisa) amathumba

Ephakathi (kunqabile ukuhlengahlengisa) amathumba ngamanye amaxesha asasazeka kwamanye amalungu omzimba. Esi sishwankathelo sinolwazi malunga nezi zilonda zamathambo zilandelayo ezingafane zisetyenziswe

• Pseudomyogenic hemangioendotheliomaoma.

• I-hemiformio hemothelioma yesiqhelo.

• Ipapillary intralymphatic angioendothelioma.

• I-hemangioendothelioma edibeneyo.

• IKaposi sarcoma.

Amathumba amabi

Amathumba amabi ngumhlaza. Esi sishwankathelo sinolwazi malunga nezi zilonda zamathambo zilandelayo:

• I-Epithelioid hemangioendotheliomaoma.

• I-Angiosarcoma yezihlunu ezithambileyo.

Unyango ngoKhetho lonyango

IINGONGOMA EZIPHAMBILI

• Kukho iintlobo ezahlukeneyo zonyango kwizicwili zemithambo ebuntwaneni.

• Abantwana abanamathumba e-vascular ebuntwaneni kufuneka ukuba unyango lwabo lucwangciswe liqela lababoneleli ngezempilo abaziingcali kunyango lomhlaza ebantwaneni.

• Unyango lwamathumba e-vascular ebuntwaneni kunokubangela iziphumo ebezingalindelekanga.

• Iindidi ezilishumi elinanye zonyango olusetyenziswayo:

• Unyango lwe-beta-blocker

• Ugqirha

• Ifotokoko

• Ukudibanisa

• Unyango ngamayeza

• Sclerotherapy

• Unyango ngemitha

• Unyango ekujoliswe kulo

• Unyango lwe-Immunotherapy

• Olunye unyango lweziyobisi

• Ukujonga

• Iindidi ezintsha zonyango ziyavavanywa kuvavanyo lweklinikhi.

• Izigulana zinokufuna ukucinga ngokuthatha inxaxheba kuvavanyo lweklinikhi.

• Izigulana zinokungena kuvavanyo lweklinikhi ngaphambi, ngexesha, okanye emva kokuqala unyango lomhlaza.

• Iimvavanyo zokulandelela zisenokufuneka.

Kukho iintlobo ezahlukeneyo zonyango kwizicwili zemithambo ebuntwaneni.

Iindidi ezahlukeneyo zonyango ziyafumaneka kubantwana abanethumba ezinemithambo. Olunye unyango lusemgangathweni (unyango olusetyenziswayo ngoku), kwaye olunye luvavanywa kuvavanyo lweklinikhi. Uvavanyo lweklinikhi yonyango luphononongo olwenzelwe ukunceda ukuphucula unyango lwangoku okanye ukufumana ulwazi kunyango olutsha. Xa uvavanyo lwezonyango lubonisa ukuba unyango olutsha lungcono kunonyango oluqhelekileyo, unyango olutsha kunokuba lunyango olusemgangathweni.

Kuba amathumba e-vascular ebantwaneni anqabile, ukuthatha inxaxheba kuvavanyo lweklinikhi kufuneka kuthathelwe ingqalelo. Olunye uvavanyo lwezonyango luvuleleke kuphela kwizigulana ezingaluqalanga unyango.

Abantwana abanamathumba e-vascular ebuntwaneni kufuneka ukuba unyango lwabo lucwangciswe liqela lababoneleli ngezempilo abaziingcali kunyango lomhlaza ebantwaneni.

Unyango luya kujongwa yi-oncologist yabantwana, ugqirha ogxile ekunyangeni abantwana abanomhlaza. I-oncologist yabantwana isebenza nabanye ababoneleli ngononophelo lwempilo yabantwana abaziingcali ekunyangeni abantwana abanomhlaza kwaye begxile kwiindawo ezithile zonyango. Oku kunokubandakanya ezi ngcali zilandelayo:

• Ingcali ye-vascular anomaly specialist (ingcali ekunyangeni abantwana abanezicubu zemithambo).

• Ugqirha wabantwana.

• Ugqirha wamathambo.

• Imitha ye-oncologist.

• Ingcali yomongikazi wabantwana.

• Ingcali yokuvuselela.

• Ingcali yeengqondo.

• Unontlalontle.

Unyango lwamathumba e-vascular ebuntwaneni kunokubangela iziphumo ebezingalindelekanga.

Ngolwazi malunga neziphumo ebezingalindelekanga eziqala ngexesha lonyango lomhlaza, jonga iphepha lethu Iziphumo ezingalunganga.

Olunye unyango, olunje nge-chemotherapy kunye nonyango lwe-radiation, lubangela iziphumo ebezingalindelekanga eziqhubekayo okanye ezibonakalayo kwiinyanga okanye kwiminyaka emva kokuba unyango luphelile. Oku kubizwa ngokuba ziziphumo ezifike emva kwexesha. Iziphumo zasemva kwexesha lonyango zinokubandakanya oku kulandelayo:

• Iingxaki zomzimba.

• Utshintsho kwiimvakalelo, iimvakalelo, ukucinga, ukufunda, okanye inkumbulo.

• Umhlaza wesibini (iintlobo ezintsha zomhlaza).

Ezinye iziphumo ezinokufika emva kwexesha zinokunyangwa okanye zilawulwe. Kubalulekile ukuba uthethe noogqirha bomntwana wakho malunga neziphumo ezinokubakho emva kwexesha ezibangelwa lunyango oluthile. (Jonga isishwankathelo se- malunga neZiphumo eziMva zaNyango zoMhlaza woMntwana ngolwazi oluthe kratya).

Iindidi ezilishumi elinanye zonyango olusetyenziswayo:

Unyango lwe-beta-blocker

I-Beta-blockers sisiyobisi esinciphisa uxinzelelo lwegazi kunye nokubetha kwentliziyo. Xa zisetyenziswa kwizigulana ezinamathumba e-vascular, i-beta-blockers inokunceda ukuncipha amathumba. Unyango lwe-beta-blocker lunokunikwa nge-vein (IV), ngomlomo, okanye lubekwe eluswini (umxholo). Indlela olunikwa ngayo unyango lwe-beta-blocker luxhomekeke kuhlobo lwezidumbu ezinemithambo kunye nalapho kuqala khona ithumba.

I-beta-blocker propranolol ihlala inyango lokuqala lwe-hemangiomas. Iintsana eziphathwe nge-IV propranolol zisenokufuna ukuba unyango lwazo luqale esibhedlele. Ipropranolol ikwasetyenziselwa ukunyanga i-benign vascular tumor yesibindi kunye ne-kaposiform hemangioendothelioma.

Ezinye i-beta-blockers ezisetyenziselwa ukunyanga izicubu ze-vascular zibandakanya i-atenolol, nadolol, kunye ne-timolol.

I-hemangioma ye-infantile inokunyangwa ngepropranolol kunye nonyango lwe-steroid okanye ipropranolol kunye nonyango lwe-beta blocker.

Jonga isishwankathelo solwazi lweziyobisi kwiPropranolol Hydrochloride ngolwazi oluthe kratya.

Ugqirha

Ezi ntlobo zilandelayo zotyando zingasetyenziselwa ukususa iintlobo ezininzi zamathumba e-vascular:

• Ukuzikhupha: Utyando lokususa lonke eli thumba kunye nolunye ulusu olusempilweni olujikelezileyo.

• Utyando lwe-Laser: Inkqubo yotyando esebenzisa umqadi we-laser (umqadi omxinwa wokukhanya okukhulu) njengemela yokusika ngaphandle kwegazi kwizicwili okanye ukususa ulusu njengesikhumba. Utyando nge-laser yedayi e-pulsed inokusetyenziselwa ezinye i-hemangiomas. Olu hlobo lwe-laser lusebenzisa ukukhanya kwesibane esijolise kwimithambo yegazi kulusu. Ukukhanya kutshintshwa kube bubushushu kwaye imithambo yegazi yatshatyalaliswa ngaphandle kokonakalisa isikhumba esikufuphi.

• I-Curettage: Inkqubo ekususwa kuyo izihlunu ezingaqhelekanga kusetyenziswa isixhobo esincinci esimile okwecephe ekuthiwa yi-curette.

• Iyonke i-hepatectomy kunye nokufakelwa kwesibindi: Inkqubo yotyando lokususa isibindi sonke kulandele ukufakelwa kwesibindi esisempilweni esivela kumxhasi.

Uhlobo lotyando olusetyenzisiweyo luxhomekeke kuhlobo lwesisu semithambo kunye nalapho ithumba lenzeke emzimbeni.

Kwizilonda ezinobungozi, emva kokuba ugqirha ewususile wonke umhlaza onokubonakala ngexesha lotyando, ezinye izigulana zinokunikwa ichemotherapy okanye unyango ngemitha emva kotyando lokubulala naziphi na iiseli zomhlaza ezisele. Unyango olunikezwe emva kotyando, ukunciphisa umngcipheko wokuba umhlaza ubuye kwakhona, lubizwa ngokuba lunyango oluncedisayo.

Ifotokoko

I-Photocoagulation kukusetyenziswa kwesibane sokukhanya, njenge laser, ukutywina imithambo yegazi okanye ukutshabalalisa izicwili. Isetyenziselwa ukunyanga i-pyogenic granuloma.

Ukudibanisa

Ukudibanisa yinkqubo esebenzisa amasuntswana, afana neziponji ezincinci zejelatin okanye amaso, ukuvimba imithambo yegazi esibindini. Ingasetyenziselwa ukunyanga ezinye izicubu ezinobungozi besibindi kunye ne-kaposiform hemangioendothelioma.

Unyango ngamayeza

I-Chemotherapy lunyango olusebenzisa iziyobisi ukunqanda ukukhula kweeseli zethumba, nokuba kungokubulala iiseli okanye ukuziyeka zahlule. Kukho iindlela ezahlukeneyo zokunika ichemotherapy:

• I-chemotherapy yenkqubo: Xa ichemotherapy ithathwa ngomlomo okanye ifakwe ngaphakathi emthanjeni okanye kwimisipha, amachiza angena kwigazi kwaye anokufikelela kwiiseli zethumba kuwo wonke umzimba. Ngamanye amaxesha kunikezelwa iziyobisi ezingaphezu kwesinye. Oku kubizwa ngokuba yindibaniselwano yemichiza.

• I-chemotherapy yamacandelo: Xa i-chemotherapy isetyenziswa eluswini kwikrimu okanye into yokuthambisa, amachiza ikakhulu achaphazela iiseli zethumba kwindawo enyangiweyo.

• I-chemotherapy yommandla: Xa ichemotherapy ibekwa ngqo kwi-cerebrospinal fluid, kwilungu, okanye kumzimba ofana nesisu, amachiza ikakhulu achaphazela iiseli zethumba kwezo ndawo.

Indlela ichemotherapy enikezelwa ngayo ixhomekeke kuhlobo lwethumba elinyangiweyo. Inkqubo ye-chemotherapy kunye ne-topical isetyenziselwa ukunyanga ezinye izicubu zemithambo.

Sclerotherapy

Isclerotherapy lunyango olusetyenziselwa ukutshabalalisa ingqayi yegazi ekhokelela kwithumba kunye nethumba. Ulwelo luchonyelwe kwisitya segazi, lubangele ukuba lubenamanxeba kwaye lonakele. Ixesha elingaphezulu, isitya segazi esitshatyalalisiweyo sitsala kwisicubu esiqhelekileyo. Igazi lihamba ngemithambo esempilweni ekufuphi. I-Sclerotherapy isetyenziselwa unyango lwe-epithelioid hemangioma.

Unyango ngemitha

Unyango ngemitha lunyango olusebenzisa amandla amakhulu e-x-reyi okanye ezinye iintlobo zemitha yokubulala iiseli zesisu okanye ukuzigcina zikhula. Zimbini iintlobo zonyango lwe-radiation:

• Unyango lwangaphandle lwemitha lusebenzisa umatshini ongaphandle komzimba ukuthumela imitha kwi-tumor.

• Unyango lwangaphakathi lwemitha lusebenzisa into enemitha ye-radio etywinwe kwiinaliti, iimbewu, iingcingo, okanye iicatheters ezibekwe ngqo ngaphakathi okanye kufutshane nethumba.

Indlela unyango lwe-radiation olunikezelwa ngayo ixhomekeke kuhlobo lwethumba le-vascular eliphathwayo. Imitha yelanga isetyenziselwa ukunyanga ezinye izicubu zemithambo.

Unyango ekujoliswe kulo

Unyango ekujoliswe kulo luhlobo lonyango olusebenzisa iziyobisi okanye ezinye izinto ukuhlasela iiseli ezithile zethumba. Unyango ekujoliswe kulo lubangela ukwenzakala okuncinci kwiiseli eziqhelekileyo kunonyango lwechemotherapy okanye unyango ngemitha. Iindidi ezahlukeneyo zonyango olujolisiweyo ziyasetyenziswa okanye zifundiswa ukunyanga amathumba emithambo yabantwana:

• I-Angiogenesis inhibitors: I-Angiogenesis inhibitors ngamachiza amisa iiseli ekwahlukaneni nasekukhuseleni ukukhula kwemithambo yegazi emitsha ekufuneka ukuba amathumba akhule. Unyango ekujoliswe kulo kunyango lwe-thalidomide, i-sorafenib, i-pazopanib, kunye ne-sirolimus zii-angiogenesis inhibitors ezisetyenziselwa ukunyanga amathumba emithambo yabantwana.

• Ujoliso lweMammaliya lwe-rapamycin (mTOR) inhibitors: i-mTOR inhibitors ibhloka iprotein ebizwa ngokuba yi-mTOR, enokugcina iiseli zomhlaza zingakhuli kwaye kuthintele ukukhula kwemithambo yegazi emitsha ekufuneka ukuba amathumba akhule.

• I-Kinase inhibitors: I-Kinase inhibitors ibhloko yeempawu ezifunekayo ekukhuleni kwamathumba. I-Trametinib ifundelwa ukunyanga i-epithelioid hemangioendothelioma.

Unyango lwe-Immunotherapy

I-Immunotherapy lunyango olusebenzisa amajoni omzimba omzimba ukulwa izifo. Izinto ezenziwe ngumzimba okanye ezenziwe elebhu zisetyenziselwa ukonyusa, ukuqondisa, okanye ukubuyisela ukhuseleko lwendalo kwizifo.

Ezi ndidi zilandelayo ze-immunotherapy ziyasetyenziswa kunyango lwe-vascular vascular tumors:

• I-Interferon luhlobo lwe-immunotherapy esetyenziselwa ukunyanga amathumba emithambo yabantwana. Iphazamisa ukwahlulwa kweeseli zethumba kwaye inokucothisa ukukhula kwethumba. Isetyenziswa kunyango lwe-angiofibroma yolutsha, i-kaposiform hemangioendothelioma, kunye ne-epithelioid hemangioendothelioma.

• Unyango lwe-immune checkpoint inhibitor: Ezinye iintlobo zeeseli zomzimba, ezinje ngeeseli ze-T, kunye nezinye iiseli zomhlaza zineeproteni ezithile, ezibizwa ngokuba ziiprotein zokujonga, kumphezulu wazo ezigcina iimpendulo zomzimba zijongiwe. Xa iiseli zomhlaza zinezixa ezikhulu zezi proteni, aziyi kuhlaselwa zibulawe ziiseli T. Amajoni okuvavanywa kwamajoni omzimba athintela ezi proteni kwaye amandla eeseli T okubulala iiseli zomhlaza ayonyuswa.

Zimbini iintlobo zonyango lwe-immune checkpoint inhibitor.

• I-CTLA-4 inhibitor: I-CTLA-4 yiprotein kumphezulu weeseli ze-T ezinceda ukugcina iimpendulo zomzimba zomzimba zijongiwe. Xa i-CTLA-4 incamathele kwenye iprotein ebizwa ngokuba yi-B7 kwiseli yomhlaza, iyeka i-T cell ekubulaleni iseli yomhlaza. I-CTLA-4 inhibitors inamathela kwi-CTLA-4 kwaye ivumela iiseli ze-T ukuba zibulale iiseli zomhlaza. I-Ipilimumab luhlobo lwe-CTLA-4 inhibitor efundwayo kunyango lwe-angiosarcoma yethishu ethambileyo.

Isithinteli sokujonga ukungasebenzi komzimba. Iiproteni zokujonga, ezinje nge-B7-1 / B7-2 kwiiseli ezibonisa i-antigen (APC) kunye ne-CTLA-4 kwiiseli ze-T, zinceda ukugcina iimpendulo zomzimba zomzimba zijongiwe. Xa i-T-cell receptor (TCR) ibophelela kwi-antigen kunye ne-histocompatibility complex (MHC) protein kwi-APC kunye ne-CD28 ebopha kwi-B7-1 / B7-2 kwi-APC, iseli ye-T inokusebenza. Nangona kunjalo, ukubopha kwe-B7-1 / B7-2 ukuya kwi-CTLA-4 kugcina iiseli ze-T zikwimeko yokungasebenzi ukuze bangakwazi ukubulala iiseli zethumba emzimbeni (iphaneli yasekhohlo). Ukuthintela ukubopha kwe-B7-1 / B7-2 ukuya kwi-CTLA-4 nge-immune checkpoint inhibitor (anti-CTLA-4 antibody) ivumela iiseli ze-T ukuba zisebenze kwaye zibulale iiseli zesisu (iphaneli esekunene).

• I-PD-1 inhibitor: I-PD-1 yiprotein kumphezulu weeseli ze-T ezinceda ukugcina iimpendulo zomzimba zomzimba zijongiwe. Xa i-PD-1 incamathele kwenye iprotein ebizwa ngokuba yi-PDL-1 kwiseli yomhlaza, iyeka i-T cell ekubulaleni iseli yomhlaza. PD-1 inhibitors zinamathele kwi-PDL-1 kwaye zivumele iiseli ze-T ukuba zibulale iiseli zomhlaza. I-Nivolumab luhlobo lwe-PD-1 inhibitor efundwayo kunyango lwe-angiosarcoma yethishu ethambileyo.

Isithinteli sokujonga ukungasebenzi komzimba. Iiproteni zokujonga, ezinje nge-PD-L1 kwiiseli zethumba kunye ne-PD-1 kwiiseli ze-T, zinceda ukugcina iimpendulo ze-immune zitshekishwe. Ukubopha kwe-PD-L1 ukuya kwi-PD-1 kugcina iiseli ze-T ekubulaleni iiseli zethumba emzimbeni (iphaneli yasekhohlo). Ukuthintela ukubopha kwe-PD-L1 ukuya kwi-PD-1 nge-immune checkpoint inhibitor (anti-PD-L1 okanye anti-PD-1) ivumela iiseli ze-T ukuba zibulale iiseli zesisu (iphaneli esekunene).

Olunye unyango lweziyobisi

Amanye amachiza asetyenziselwa ukunyanga amathumba e-vascular ebuntwaneni okanye ukulawula iziphumo zawo kubandakanya oku kulandelayo:

• Unyango lwe-Steroid: I-Steroids zihomoni ezenziwe ngokwendalo emzimbeni. Kananjalo zinokwenziwa elebhu kwaye zisetyenziswe njengeziyobisi. Iziyobisi zeSteroid zinceda ukuncipha ezinye izicwili zemithambo. Iicorticosteroids, ezinje nge-prednisone kunye ne-methylprednisolone, zisetyenziselwa ukunyanga usana lwe-hemangioma.

• Izidakamizwa ezingekho-steroidal ezichasayo (i-NSAID): Ii-NSAID ziqhelekileyo zisetyenziselwa ukunciphisa umkhuhlane, ukuvuvukala, intlungu kunye nokubomvu. Imizekelo yee-NSAID zi-aspirin, ibuprofen, kunye ne-naproxen. Xa kunyangwa izicubu ze-vascular, ii-NSAID zinokunyusa ukuhamba kwegazi ngokusebenzisa izicubu kwaye zinciphise ithuba lokuba i-clot yegazi engafunekiyo iyenze.

• Unyango lwe-Antifibrinolytic: La machiza anceda igazi ekugubungekeni kwizigulana ezine-Kasabach-Merritt syndrome. I-Fibrin yiprotein ephambili yegazi elinceda ukuyeka ukopha nokupholisa amanxeba. Amanye amathumba emithambo-luvo abangela ukuba i-fibrin idilike kwaye igazi lesigulana alihlali ngokwesiqhelo, libangela ukopha okungalawulekiyo. I-Antifibrinolytics inceda ukuthintela ukonakala kwe-fibrin.

Ukujonga

Ukujongwa kujongwa ngononophelo kwimeko yesigulana ngaphandle kokunika unyango de kuvele iimpawu okanye utshintsho.

Iindidi ezintsha zonyango ziyavavanywa kuvavanyo lweklinikhi.

Ulwazi malunga novavanyo lweklinikhi luyafumaneka kwiwebhusayithi yeNCI.

Izigulana zinokufuna ukucinga ngokuthatha inxaxheba kuvavanyo lweklinikhi.

Kwezinye izigulana, ukuthatha inxaxheba kuvavanyo lweklinikhi kunokuba lolona khetho lonyango lufanelekileyo. Uvavanyo lwezonyango luyinxalenye yenkqubo yophando. Uvavanyo lwezonyango luyenziwa ukufumanisa ukuba ngaba unyango olutsha lukhuselekile kwaye luyasebenza okanye lungcono kunonyango oluqhelekileyo.

Uninzi lonyango oluqhelekileyo lwanamhlanje lusekwe kuvavanyo lweklinikhi lwangaphambili. Izigulana ezithatha inxaxheba kuvavanyo lweklinikhi zingafumana unyango olusemgangathweni okanye zibe phakathi kwabokuqala ukufumana unyango olutsha.

Izigulana ezithatha inxaxheba kuvavanyo lweklinikhi zikwanceda ekuphuculeni indlela eziza kunyangwa ngayo izifo kwixesha elizayo. Nokuba uvavanyo lwezonyango alukhokeleli kunyango olusebenzayo, bahlala bephendula imibuzo ebalulekileyo kwaye bancedisa ukuqhubela phambili uphando.

Izigulana zinokungena kuvavanyo lweklinikhi ngaphambi, ngexesha, okanye emva kokuqala unyango lomhlaza.

Olunye uvavanyo lwezonyango lubandakanya kuphela izigulana ezingekafumani unyango. Olunye uvavanyo lokuvavanywa kunyango kwizigulana ezinamathumba angakhange abengcono. Kukwakho novavanyo lweklinikhi oluvavanya iindlela ezintsha zokumisa amathumba ekuphindweni (ekubuyeni) okanye ekunciphiseni iziphumo ebezingalindelekanga zonyango.

Uvavanyo lwezonyango lwenzeka kwiindawo ezininzi zelizwe. Ulwazi malunga novavanyo lweklinikhi oluxhaswe yi-NCI lunokufumaneka kwiphepha lewebhu le-NCI. Uvavanyo lwezonyango oluxhaswa yiminye imibutho lunokufumaneka kwiwebhusayithi yeClinicalTrials.gov.

Iimvavanyo zokulandelela zisenokufuneka.

Ezinye zeemvavanyo ezenziweyo zokufumanisa ithumba le-vascular zinokuphindwa. Olunye uvavanyo luya kuphindwa ukuze kubonwe ukuba lusebenza njani unyango. Izigqibo malunga nokuqhubeka, ukutshintsha, okanye ukuyeka unyango zinokusekwa kwiziphumo zolu vavanyo.

Ezinye zeemvavanyo ziya kuqhubeka ukwenziwa amaxesha ngamaxesha emva kokuba unyango luphelile. Iziphumo zolu vavanyo zingabonisa ukuba imeko yomntwana wakho itshintshile okanye ukuba eli thumba liphinde labuya (buyela). Olu vavanyo ngamanye amaxesha lubizwa ngokuba luvavanyo olulandelayo okanye ukuhlolwa.

Izibilini zeBenign

Kweli Candelo

• Usana lweHemangioma

• I-Hemangioma yokuzalwa

• I-Benign Vascular Tumors yesibindi

• I-Spindle Cell Hemangioma

• Epithelioid Hemangioma

• IPyogenic Granuloma

• I-Angiofibroma

• Ulutsha lweNasopharyngeal Angiofibroma

Ngolwazi malunga nonyango oludweliswe ngezantsi, jonga kwiCandelo loKhetho ngokujonga uKhetho.

Usana lweHemangioma

I-hemangiomas ye-infantile lolona hlobo luqhelekileyo lwe-tumor yamathambo e-benign ebantwaneni. Iifom hemangiomas zeentsana xa iiseli ezingakhuliyo ezenzelwe ukwenza imithambo yegazi yenze ithumba endaweni yoko. I-hemangioma ebusaneni nayo ingabizwa ngokuba "luphawu lwamaqunube."

Ezi tumors zihlala zingabonwa xa kuzalwa kodwa ziyavela xa usana luneeveki ezi-3 ukuya kwezi-6 ubudala. Uninzi lwe-hemangiomas lukhula ngakumbi malunga neenyanga ezintlanu kwaye luyeke ukukhula. I-hemangiomas icotha kancinci kwiminyaka eliqela ezayo, kodwa uphawu olubomvu okanye ulusu oluvulekileyo okanye olushwabeneyo lungahlala. Kunqabile ukuba i-hemangioma yentsana ibuye.

I-hemangiomas zeentsana zinokuba kulusu, kwizicubu ezingaphantsi kwesikhumba, kunye / okanye kwilungu. Zihlala zisentloko nasentanyeni kodwa zinokuba naphi na emzimbeni okanye emzimbeni. IHemangiomas inokubonakala njengesilonda esinye, enye okanye nangaphezulu inwenwa kwindawo enkulu yomzimba, okanye izilonda ezininzi kwilungu elinye lomzimba. Izilonda ezisasazeke kwindawo enkulu yomzimba okanye izilonda ezininzi kunokubangela iingxaki.

I-Infantile hemangioma enokukhula okuncinci okanye ukubanjwa (IH-MAG) luhlobo oluthile lwe-hemangioma yeentsana ebonwa ekuzalweni kwaye ayithandi ukukhula. Isilonda sibonakala njengeendawo ezikhanyayo nezimnyama kubomvu kulusu. Izilonda zihlala kumzimba ongezantsi kodwa zinokuba sentloko nasentanyeni. Iihemangiomas zolu hlobo zihamba ixesha ngaphandle konyango.

Izinto zomngcipheko

Nantoni na eyandisa umngcipheko wokufumana isifo ibizwa ngokuba yingozi. Ukuba nomngcipheko akuthethi ukuba uyakufumana esi sifo; ukungabinabungozi akuthethi ukuba awuzukufumana sifo. Thetha nogqirha wakho ukuba ucinga ukuba umntwana wakho usengozini.

I-hemangiomas yeentsana zixhaphake kakhulu kwezi zilandelayo:

• Amantombazana.

• Abamhlophe.

• Iintsana ezizelwe ngaphambi kwexesha.

• Amawele, amawele amathathu, okanye ezinye izinto ezininzi zokuzalwa.

• Iintsana zoomama abadala ngexesha lokukhulelwa okanye abaneengxaki ngeplacenta ngexesha lokukhulelwa.

Eminye imingcipheko ye-hemangiomas yeentsana ibandakanya oku kulandelayo:

• Ukuba nembali yosapho lwe-hemangioma yintsana, ihlala ikumama, utata, udade, okanye umntakwabo.

• Ukuba ne-syndromes ezithile.

• I-PHACE syndrome: Isifo apho i-hemangioma isasazeka kwindawo enkulu yomzimba (ngesiqhelo intloko okanye ubuso). Ezinye iingxaki zempilo ezichaphazela imithambo yegazi emikhulu, intliziyo, amehlo, kunye / okanye nengqondo zinokwenzeka.

• I-LUMBAR / PELVIS / SACRAL syndrome: Isifo apho i-hemangioma isasazeka kwindawo enkulu yomqolo ongezantsi. Ezinye iingxaki zempilo ezichaphazela inkqubo yokuchama, izitho zangasese, i-rectum, i-anus, ingqondo, intambo yomgogodla kunye nokusebenza kwemithambo zinokwenzeka.

Ukuba ne-hemangioma engaphezulu kwesinye okanye indlela yomoya okanye i-ophthalmic hemangioma yonyusa umngcipheko wokuba nezinye iingxaki zempilo.

• Ii-hemangiomas ezininzi: Ukuba ne-hemangiomas engaphezulu kwesihlanu kulusu luphawu lokuba kunokubakho ii-hemangiomas kwilungu. Isibindi sichaphazeleka rhoqo. Iingxaki zentliziyo, izihlunu, kunye nedlala lengqula nazo zinokwenzeka.

• I-Airway hemangiomas: I-Hemangiomas kwindlela yomoya ihlala yenzeka kunye nendawo enkulu, emile okweendevu ye-hemangioma ebusweni (ukusuka ezindlebeni, ejikeleze umlomo, isilevu esezantsi, naphambi kwentamo). Kubalulekile ukuba i-hemangiomas yomoya inyangwe ngaphambi kokuba umntwana abe nengxaki yokuphefumla.

• I-Ophthalmic hemangiomas: I-Hemangiomas ebandakanya iso inokubangela iingxaki kumbono okanye ukungaboni. I-hemangiomas ye-infantile inokwenzeka kwi-conjunctiva (inwebu ebeka umphezulu wangaphakathi wejwabu leso kwaye igubungele indawo engaphambili yamehlo). Ezi hemangiomas zinokudibaniswa nezinye iimeko ezingaqhelekanga zamehlo. Kubalulekile ukuba abantwana abane-ophthalmic hemangioma bahlolwe ngugqirha wamehlo.

Iimpawu kunye neMpawu

I-hemangiomas yeentsana inokubangela nayiphi na imiqondiso kunye neempawu zilandelayo. Jonga kugqirha womntwana wakho ukuba umntwana wakho unayo nayiphi na kwezi zinto zilandelayo:

• Izilonda zesikhumba: Indawo yemithambo ye-spidery okanye isikhumba esikhanyisiweyo okanye esikhanyayo sinokuvela ngaphambi kokuba i-hemangioma yenze. IHemangiomas yenzeka iqinile, ifudumele, ibomvu ngokuqaqambileyo kwizilonda ezibomvu eluswini okanye inokubonakala ngathi kukugruzuka. Izilonda ezakha izilonda nazo zibuhlungu. Emva kwexesha, njengoko iihemangiomas zihamba, ziqala ukubuna embindini ngaphambi kokucaba kunye nokulahleka kombala.

• Izilonda ezingaphantsi kwesikhumba: Izilonda ezikhula phantsi kolusu kumanqatha zinokubonakala ziluhlaza okwesibhakabhaka okanye zimfusa. Ukuba izilonda zinzulu ngokwaneleyo phantsi komphezulu wolusu, azinakubonwa.

• Izilonda kwilungu: Kungangabikho miqondiso yokuba iihemangiomas zenziwe kwilungu.

Nangona uninzi lweentsana zehemangiomas olungenalo ixhala malunga nalo, ukuba umntwana wakho uvelisa nawaphi na amaqhuma okanye amanqaku abomvu okanye aluhlaza kulusu lokujonga kugqirha womntwana wakho. Angamthumela umntwana kwiingcali xa kufuneka njalo.

Uvavanyo lokuchonga

Uvavanyo lomzimba kunye nembali zihlala ziyinto yonke efunekayo ukufumanisa i-hemangiomas yeentsana. Ukuba kukho into malunga nethumba ebonakala ingaqhelekanga, kungenziwa i-biopsy. Ukuba i-hemangioma inzulu ngaphakathi emzimbeni kungekho tshintsho kulusu, okanye izilonda zisasazeka kwindawo enkulu yomzimba, i-ultrasound inokwenziwa. Jonga icandelo loLwazi ngokubanzi malunga nenkcazo yezi mvavanyo kunye neenkqubo.

Ukuba iihemangiomas ziyinxalenye yesifo, iimvavanyo zinokwenziwa, njenge-echocardiogram, i-MRI, i-magnetic resonance angiogram, kunye novavanyo lwamehlo.

Unyango

Uninzi lwe-hemangiomas luyaphela luze lucuthe ngaphandle konyango. Ukuba i-hemangioma inkulu okanye ibangela ezinye iingxaki zempilo, unyango lunokubandakanya oku kulandelayo:

• Ipropranolol okanye olunye unyango lwe-beta-blocker.

• Unyango lwe-Steroid, ngaphambi kokuba unyango lwe-beta-blocker luqale okanye xa i-beta-blockers ingasetyenziswa.

• Utyando lotyando lwe-laser yedayi, yehemangiomas enezilonda okanye engakhange ihambe kwaphela.

• Utyando (ukusikwa) kweehemangiomas ezinezilonda, kubangele iingxaki kumbono, okanye kungahambi ngokupheleleyo. Utyando lunokusetyenziselwa izilonda ebusweni ezingaphenduliyo kolunye unyango.

• Unyango lwe-beta blocker lonyango lwe-hemangiomas ezikummandla wolusu.

• Unyango oluhlanganisiweyo, olunje ngepropranolol kunye nonyango lwe-steroid okanye ipropranolol kunye nonyango lwe-beta blocker.

• Uvavanyo lweklinikhi yonyango lwe-beta-blocker (nadolol kunye nepropranolol).

• Uvavanyo lweklinikhi yonyango lwe-beta-blocker yonyango (timolol).

I-Hemangioma yokuzalwa

I-hemangioma ye-Congenital sisifo esibuhlungu semithambo esiqala ukubakho ngaphambi kokuzalwa kwaye senziwe ngokupheleleyo xa umntwana ezalwa. Zihlala zolusu kodwa zinokuba kwelinye ilungu. I-hemangioma yokuzalwa ingenzeka njengokugqabhuka kwamabala amfusa kunye nolusu olujikeleze indawo lube lula.

Zintathu iintlobo hemangiomas lokuzalwa:

• Ngokukhawuleza ukubandakanyeka kwi-hemangioma yokuzalwa: Ezi zilonda zihamba zodwa kwiinyanga ezili-12 ukuya kwezi-15 emva kokuzalwa. Banokwenza izilonda, bophe, kwaye babangele iingxaki zentliziyo kunye nokujiya kwegazi okwexeshana. Ulusu lunokubonakala luhluke kancinci nasemva kokuba iihemangiomas zihambile.

• Inxalenye ye-hemangioma ye-congenital congenital: Ezi tumors azihambi kwaphela.

• I-hemangioma engazalwanga ngokuzalwa: Ezi tumors azisoze zahamba zodwa.

Uvavanyo lokuchonga

Jonga icandelo loLwazi ngokubanzi malunga nenkcazo yeemvavanyo kunye neenkqubo, ezinje nge-ultrasound, esetyenziselwa ukufumanisa isifo sehemangioma.

Unyango

Unyango lwe-hemangioma ye-congenital ekhawulezayo yokuzibandakanya kunye ne-hemangioma yokuzalwa engabandakanyi inokubandakanya oku kulandelayo:

• Ukuqwalaselwa kuphela.

Unyango lwe-hemangioma yokuzalwa engabandakanyi inokubandakanya oku kulandelayo:

• Utyando lokususa ithumba, kuxhomekeke ekubeni liphi kwaye nokuba libangela iimpawu.

I-Benign Vascular Tumors yesibindi

Izibilini ze-Benign ze-vascular zesibindi zingaba zizilonda ze-vascular focal (isilonda esisodwa kwindawo enye yesibindi), izilonda ezininzi zesibindi (izilonda ezininzi kwindawo enye yesibindi), okanye ukusabalalisa izilonda zesibindi (izilonda ezininzi kwiindawo ezingaphezu kweyodwa isibindi).

Isibindi sinemisebenzi emininzi, kubandakanya ukucoca igazi kunye nokwenza iiproteni ezifunekayo ekunqandeni igazi. Ngamanye amaxesha, igazi elihlala lihamba phakathi kwesibindi liyavalwa okanye licothiswe lithumba. Oku kuthumela igazi ngokuthe ngqo entliziyweni ngaphandle kokuya kwesibindi kwaye kubizwa ngokuba yi-shunt yesibindi. Oku kunokubangela ukusilela kwentliziyo kunye neengxaki ekunqandeni igazi.

Izilonda zeVascular Focal

Izilonda ze-vascular focal zihlala zixhuma ngokukhawuleza kwi-hemangiomas ye-congenital okanye i-hemangiomas ye-congenital.

Uvavanyo lokuchonga

Jonga icandelo loLwazi ngokubanzi malunga nenkcazo yeemvavanyo kunye neenkqubo ezisetyenziselwa ukufumanisa izilonda zesibindi ezijolise kwisibindi.

Unyango

Unyango lwezilonda zesibindi ezijolise kwisibindi luxhomekeke ekubeni ngaba zikhona iimpawu kwaye zinokubandakanya oku kulandelayo:

• Ukujonga.

• Iziyobisi zokunyanga iimpawu, kubandakanya ukusilela kwentliziyo kunye neengxaki zokunqanda igazi.

• Ukudityaniswa kwesibindi ukunyanga iimpawu.

• Utyando, kwizilonda ezingaphenduliyo kolunye unyango.

Amanxeba amaninzi kunye nokusasazeka kwesibindi

Izilonda ezininzi zesibindi zihlala ziintsana zehemangiomas. Izilonda ezinobunzima besibindi zinokubangela iziphumo ezibi, kubandakanya iingxaki kwi-thyroid gland kunye nentliziyo. Isibindi sinokwandisa, sicinezele amanye amalungu, kwaye sibangele iimpawu ezingakumbi.

Uvavanyo lokuchonga

Jonga icandelo leNgcaciso ngokuBanzi malunga nenkcazo yeemvavanyo kunye neenkqubo ezisetyenziselwa ukuxilonga izilonda zemithambo-luvo emininzi.

Unyango

Unyango lwezilonda zesibindi ezininzi lunokubandakanya oku kulandelayo:

• Ukuqwalaselwa kwezilonda ezingabangeli zimpawu.

• Unyango lwe-beta-blocker (propranolol) kwizilonda eziqala ukukhula.

Unyango lwezilonda zesibindi ezinokubakho kunokubandakanya oku kulandelayo:

• Unyango lwe-beta-blocker (propranolol).

• Unyango ngamayeza.

• Unyango lwe-Steroid.

• Iyonke i-hepatectomy kunye nokufakelwa kwesibindi, xa izilonda zingaphenduli kunyango lweziyobisi. Oku kwenziwa kuphela xa izilonda zisasazeke ngokubanzi esibindini kwaye ngaphezulu kwelinye ilungu liye lasilela.

Ukuba isilonda sesibindi asiphenduli unyango oluqhelekileyo, i-biopsy ingenziwa ukuze ibone ukuba i-tumor ibe yingozi.

I-Spindle Cell Hemangioma

I-spindle cell hemangiomas iqulethe iiseli ezibizwa ngokuba yi-spindle cell. Ngaphantsi kwemicroscope, iiseli zokujija zibukeka zide kwaye zibhityile.

Izinto zomngcipheko

Nantoni na eyandisa umngcipheko wokufumana isifo ibizwa ngokuba yingozi. Ukuba nomngcipheko akuthethi ukuba uyakufumana esi sifo; ukungabinabungozi akuthethi ukuba awuzukufumana sifo. Thetha nogqirha wakho ukuba ucinga ukuba umntwana wakho usengozini. I-spindle cell hemangiomas inokwenzeka ukuba yenzeke kubantwana abanezi syndromes zilandelayo:

• Isifo seMaffucci, esichaphazela intlala kunye nolusu.

• I-Klippel-Trenaunay syndrome, echaphazela imithambo yegazi, izicubu ezithambileyo kunye namathambo.

Iimpawu

I-spindle cell hemangiomas ivela okanye phantsi kolusu. Zizilonda ezibomvu-ntsundu okanye luhlaza okwesibhakabhaka ezihlala zivela ezingalweni okanye emilenzeni. Banokuqala njengesilonda esinye kwaye bakhule babe zizilonda ngaphezulu kweminyaka.

Uvavanyo lokuchonga

Jonga icandelo loLwazi ngokubanzi malunga nenkcazo yeemvavanyo kunye neenkqubo ezisetyenziselwa ukufumanisa isalfind cell hemangioma.

Unyango

Akukho lunyango lusemgangathweni lwe-spindle cell hemangiomas. Unyango lunokubandakanya oku kulandelayo:

• Utyando lokususa ithumba.

I-spindle cell hemangiomas inokubuya emva kotyando.

Epithelioid Hemangioma

I-Epithelioid hemangiomas zihlala zibumba okanye kulusu, ngakumbi entloko, kodwa zinokwenzeka kwezinye iindawo, ezinje ngethambo.

Iimpawu kunye neMpawu

Ngamanye amaxesha i-epithelioid hemangiomas ibangelwa kukonzakala. Kwisikhumba, zinokubonakala ngathi ziipinki eziqinileyo kumaqhuma abomvu kwaye zinokurhawuzelela. I-Epithelioid hemangioma yethambo inokubangela ukudumba, iintlungu, kunye nethambo elibuthathaka kwindawo echaphazelekayo.

Uvavanyo lokuchonga

Jonga icandelo loLwazi ngokubanzi malunga nenkcazo yeemvavanyo kunye neenkqubo ezisetyenziselwa ukufumanisa i-epithelioid hemangioma.

Unyango

Akukho lunyango lusemgangathweni lwe-epithelioid hemangiomas. Unyango lunokubandakanya oku kulandelayo:

• Ugqirha (unyango okanye unyango kwakhona).

• Sclerotherapy.

• Unyango ngemitha kwiimeko ezinqabileyo.

I-Epithelioid hemangiomas zihlala zibuya emva konyango.

IPyogenic Granuloma

I-Pyogenic granuloma ikwabizwa ngokuba yi-lobular capillary hemangioma. Ixhaphake kakhulu kubantwana abadala nakubantu abadala abancinci kodwa inokwenzeka nakweyiphi na iminyaka.

Izilonda ngamanye amaxesha zibangelwa kukwenzakala okanye kukusetyenziswa kwamayeza athile, kubandakanya iipilisi zokulawula ukuzalwa kunye neerinoid. Banokungenzi ngaphandle kwesizathu esaziwayo ngaphakathi kwii-capillaries (ezona mithambo zincinci zegazi), imithambo, imithambo, okanye ezinye iindawo emzimbeni. Ngokwesiqhelo iba sisilonda esinye kuphela, kodwa ngamanye amaxesha amanxeba amaninzi avela kwindawo enye okanye izilonda zisasazeka kwezinye iindawo zomzimba.

Iimpawu

Ii-granulomas ze-Pyogenic ziphakanyisiwe, izilonda ezibomvu eziqaqambileyo ezinokuba zincinci okanye zikhulu kwaye zigudise okanye zibe bumpy. Zikhula ngokukhawuleza kwiiveki ukuya kwiinyanga kwaye zisopha kakhulu. Ezi zilonda zihlala ebusweni besikhumba, kodwa zingenza izicubu ezingaphantsi kwesikhumba kwaye zibukeke njengezinye izilonda ze-vascular.

Uvavanyo lokuchonga

Jonga icandelo loLwazi ngokubanzi malunga nenkcazo yeemvavanyo kunye neenkqubo ezisetyenziselwa ukufumanisa isifo se-pyogenic granuloma.

Unyango

Ezinye ii-pyogenic granulomas zihamba ngaphandle konyango. Ezinye ii-pyogenic granulomas zifuna unyango olunokubandakanya oku kulandelayo:

• Ugqirha (ukucoca okanye ukunyanga) ukususa isilonda.

• Ifotokoko.

• Unyango lwe-beta blocker.

Ii-granulomas zepyogenic zihlala zibuya emva konyango.

I-Angiofibroma

Ii-angiofibromas zinqabile. Zizilonda ezinobungozi ezinobungozi eziqhelekileyo zivela kwimeko ebizwa ngokuba yi-tuberous sclerosis (isifo esizuze ilifa esibangela izilonda zesikhumba, ukuxhamla kunye nokukhubazeka kwengqondo).

Iimpawu

I-Angiofibromas ibonakala njengamaqhuma abomvu ebusweni.

Uvavanyo lokuchonga

Jonga icandelo loLwazi ngokubanzi malunga nenkcazo yeemvavanyo kunye neenkqubo ezisetyenziselwa ukufumanisa isifo se-angiofibroma.

Unyango

Unyango lwe-angiofibromas lunokubandakanya oku kulandelayo:

• Utyando (ukusikwa) ukususa ithumba.

• Unyango lweLaser.

• Unyango ekujoliswe kulo (sirolimus).

Ulutsha lweNasopharyngeal Angiofibroma

I-juvenile nasopharyngeal angiofibromas zizidumba ezinobungozi kodwa zinokukhula zibe ziithishu ezikufutshane. Ziqala kwimpumlo yempumlo kwaye zinokusasazeka ziye kwi-nasopharynx, kwizono ze-paranasal, kwithambo elijikeleze amehlo, kwaye ngamanye amaxesha ziye kwingqondo.

Uvavanyo lokuchonga

Jonga icandelo loLwazi ngokubanzi malunga nenkcazo yeemvavanyo kunye neenkqubo ezisetyenziselwa ukufumanisa isifo se-angiofibroma yolutsha.

Unyango

Unyango lwe-angiofibromas yolutsha lwe-nasopharyngeal lunokubandakanya oku kulandelayo:

• Utyando (ukusikwa) ukususa ithumba.

• Unyango ngemitha.

• Unyango ngamayeza.

• Unyango lwe-Immunotherapy (interferon).

• Unyango ekujoliswe kulo (sirolimus).

Amathumba aphakathi asasazeka ekuhlaleni

Kweli Candelo

• I-Kaposiform Hemangioendothelioma kunye ne-Tufted Angioma

Ngolwazi malunga nonyango oludweliswe ngezantsi, jonga kwiCandelo loKhetho ngokujonga uKhetho.

I-Kaposiform Hemangioendothelioma kunye ne-Tufted Angioma

I-Kaposiform hemangioendotheliomas kunye ne-angiomas e-tufted zizidumba zemithambo yegazi eyenzeka kwiintsana okanye kubantwana abancinci. Ezi tumors zinokubangela imeko ye-Kasabach-Merritt, imeko apho igazi lingakwaziyo ukugoba kunye nokuphuma kakhulu egazini. Kwi-Kasabach-Merritt phenomenon, ithumba libamba lize lonakalise iiplatelets (iiseli eziqinisa igazi). Ke azikho iiplatelets ezaneleyo egazini xa kufuneka ziyeke ukopha. Olu hlobo lwe-vascular tumor aluhambelani ne-Kaposi sarcoma.

Iimpawu kunye neMpawu

I-Kaposiform hemangioendotheliomas kunye ne-angiomas e-tufted zihlala zenzeka kulusu lweengalo nemilenze, kodwa zinokuvela nakwizicubu ezinzulu, ezinje ngemisipha okanye ithambo, okanye esifubeni okanye esiswini.

Iimpawu kunye neempawu zingabandakanya oku kulandelayo:

• Iindawo eziqinileyo, ezibuhlungu zolusu ezibonakala zonzakele.

• Imibala ebomvu okanye emdaka ebomvu.

• Ukutyumza okulula.

• Ukopha ngaphezu kwesixa esiqhelekileyo kwiimbumba ezinamanqatha, amanxeba, kunye nezinye izicwili.

Izigulana ezine-kaposiform hemangioendothelioma kunye ne-tufted angioma zinokuba ne-anemia (buthathaka, ziziva zidiniwe, okanye zikhangeleka zimthubi).

Uvavanyo lokuchonga

Jonga icandelo loLwazi ngokubanzi malunga nenkcazo yeemvavanyo kunye neenkqubo ezisetyenziselwa ukufumanisa i-kaposiform hemangioendothelioma.

Ukuba uvavanyo lomzimba kunye neMRI lubonisa ngokucacileyo ukuba ithumba yi-kaposiform hemangioendothelioma okanye i-angioma enesifo, i-biopsy isenokungafuneki. I-biopsy ayisoloko isenziwa kuba ukuphuma kwegazi okunzulu kunokwenzeka.

Unyango

Unyango lwe-kaposiform hemangioendotheliomas kunye ne-angiomas efakwe kuxhomekeke kwiimpawu zomntwana. Usulelo, ukulibaziseka kunyango, kunye notyando kunokubangela ukopha okusongela ubomi. I-Kaposiform hemangioendotheliomas kunye ne-angiomas e-tufted ziphathwa kakuhle yingcali ye-vascular anomaly.

Unyango kunye nokhathalelo lokuxhasa ukopha kunokubandakanya oku kulandelayo:

• Unyango lwe-Steroid olunokuthi lulandelwe yi-chemotherapy.

• Izidakamizwa ezingekho-steroidal ezichasayo (i-NSAID), ezifana ne-aspirin.

• Unyango lwe-Immunotherapy (interferon).

• Unyango lwe-Antifibrinolytic ukuphucula ukopha kwegazi.

• I-Chemotherapy ngeyeza elinye okanye nangaphezulu.

• Unyango lwe-beta-blocker (propranolol).

• Utyando (ukusikwa) ukususa ithumba, kunye okanye ngaphandle kokudityaniswa.

• Unyango ekujoliswe kulo (sirolimus), kunye okanye ngaphandle kwonyango lwe-steroid.

• Uvavanyo lweklinikhi lwe-chemotherapy okanye unyango ekujolise kulo (sirolimus).

Nokuba kunyango, ezi tumors azihambi ngokupheleleyo kwaye zinokubuya. Iintlungu kunye nokudumba kunokuba mandundu ngokuguga, rhoqo malunga nexesha lokufikisa. Iziphumo zexesha elide zibandakanya iintlungu ezingapheliyo, ukusilela kwentliziyo, iingxaki zethambo, kunye ne-lymphedema (ukwakha i-lymph fluid kwizicubu).

Amathumba aphakathi aSasazeka ngokufuthi

Kweli Candelo

• Pseudomyogenic Hemangioendotheliomaoma

• I-Hemiformio ye-Hemangioendothelioma

• Ipapillary Intralymphatic Angioendothelioma

• I-Hemangioendothelioma edibeneyo

• IKaposi Sarcoma

Ngolwazi malunga nonyango oludweliswe ngezantsi, jonga kwiCandelo loKhetho ngokujonga uKhetho.

Pseudomyogenic Hemangioendotheliomaoma

I-Pseudomyogenic hemangioendothelioma inokwenzeka ebantwaneni, kodwa ixhaphake kakhulu phakathi kwamadoda aphakathi kweminyaka engama-20 nengama-50 ubudala. Ezi tumors zinqabile, kwaye zihlala zenzeka okanye phantsi kolusu, okanye emathanjeni. Zingasasazeka nakwizicubu ezikufutshane, kodwa zihlala zingasasazeki kwamanye amalungu omzimba. Kwiimeko ezininzi, kukho amathumba amaninzi.

Iimpawu kunye neMpawu

I-Pseudomyogenic hemangioendotheliomas inokubonakala njengeqhuma kwizihlunu ezithambileyo okanye inokubangela iintlungu kwindawo echaphazelekayo.

Uvavanyo lokuchonga

Jonga icandelo loLwazi ngokubanzi malunga nenkcazo yeemvavanyo kunye neenkqubo ezisetyenziselwa ukuxilonga i-pseudomyogenic hemangioendothelioma.

Unyango

Unyango lwe-pseudomyogenic hemangioendotheliomas inokubandakanya oku kulandelayo:

• Ugqirha lokususa ithumba xa kunokwenzeka. Ukuncitshiswa kunokudingeka xa kukho amathumba amaninzi kwithambo.

• Unyango ngamayeza.

• Unyango ekujoliswe kulo (mTOR inhibitors).

Ngenxa yokuba i-pseudomyogenic hemangioendothelioma inqabile ebantwaneni, ukhetho kunyango lusekwe kuvavanyo lweklinikhi kubantu abadala.

I-Hemiformio ye-Hemangioendothelioma

I-Retiform hemangioendotheliomas ziyakhula kancinci, amathumba athe tyaba afumaneka kubantu abadala abancinci kwaye ngamanye amaxesha abantwana. Ezi tumors zihlala zenzeka okanye phantsi kolusu lweengalo, imilenze, kunye nesiqu. Ezi tumors zihlala zingasasazeki kwamanye amalungu omzimba.

Uvavanyo lokuchonga

Jonga icandelo loLwazi ngokubanzi malunga nenkcazo yeemvavanyo kunye neenkqubo ezisetyenziselwa ukuxilonga i-retiform hemangioendothelioma.

Unyango

Unyango lwe-retiform hemangioendotheliomas inokubandakanya oku kulandelayo:

• Utyando (ukusikwa) ukususa ithumba. Ukulandela kuya kubandakanya ukubeka esweni ukubona ukuba ithumba liyabuya na.

• Unyango lwe-radiation kunye ne-chemotherapy xa utyando lungenakwenziwa okanye xa kubuye ithumba.

I-Retiform hemangioendothelioma inokubuya emva konyango.

Ipapillary Intralymphatic Angioendothelioma

I-Papillary intralymphatic angioendotheliomas ikwabizwa ngokuba ziidumba zeDabska. Ezi tumors zenza ngaphakathi okanye phantsi kolusu naphina emzimbeni. Iimpawu ze-lymph ngamanye amaxesha zichaphazeleka.

Iimpawu

I-Papillary intralymphatic angioendotheliomas inokubonakala ngathi iqine, iphakanyisiwe, inamaqhuma amancinci, anokuba mancinci okanye makhulu.

Uvavanyo lokuchonga

Jonga icandelo leNgcaciso ngokuBanzi malunga nenkcazo yeemvavanyo kunye neenkqubo ezisetyenziselwa ukufumanisa isifo se-angioendothelioma sepillary intralymphatic.

Unyango

Unyango lwe-angioendotheliomas ye-intralymphatic angioendotheliomas inokubandakanya oku kulandelayo:

• Utyando (ukusikwa) ukususa ithumba.

I-Hemangioendothelioma edibeneyo

I-hemangioendotheliomas edibeneyo ineempawu zombini ezinobunzima kunye nezidumbu ezinobungozi. Ezi zivumba zihlala zikhona okanye ngaphantsi kwesikhumba kwiingalo okanye emilenzeni. Kungenzeka kwakhona entloko, entanyeni, okanye esifubeni. I-hemangioendotheliomas edibeneyo ayinakulinganiswa (isasazeka) kodwa inokubuyela kwindawo enye. Xa amathumba ehlangana, ahlala esasazeka kwii-lymph node ezikufutshane.

Uvavanyo lokuchonga

Jonga icandelo loLwazi ngokubanzi malunga nenkcazo yeemvavanyo kunye neenkqubo ezisetyenziselwa ukuxilonga i-hemangioendothelioma edityanisiweyo kwaye ufumanise ukuba ithumba lisasazekile na.

Unyango

Unyango lwe-hemangioendotheliomas edibeneyo inokubandakanya oku kulandelayo:

• Utyando lokususa ithumba.

• Unyango lwe-radiation kunye ne-chemotherapy yamathumba athe saa.

IKaposi Sarcoma

I-Kaposi sarcoma ngumhlaza obangela ukuba izilonda zikhule eluswini; inwebu yangaphakathi efakwe emlonyeni, empumlweni nasemqaleni; ithumba; okanye amanye amalungu. Kubangelwa yintsholongwane yeKaposi sarcoma herpes virus (KSHV). E-United States, kwenzeka kakhulu kubantwana abanamajoni omzimba abuthathaka abangelwa kukunqongophala kwamajoni omzimba, usulelo lwe-HIV, okanye iziyobisi ezisetyenziselwa ukufakelwa komzimba.

Iimpawu

Iimpawu kubantwana zinokubandakanya oku kulandelayo:

• Izilonda kulusu, emlonyeni, okanye emqaleni. Izilonda zesikhumba zibomvu, zimfusa, okanye zimdaka kwaye ziyatshintsha ukusuka kwiflethi, ziye phezulu, ziye kwiindawo ezinamaxolo ezibizwa ngokuba ngamacwecwe, ziye kumaqhuqhuva.

• I-lymph nodes ezidumbileyo.

Uvavanyo lokuchonga

Jonga icandelo loLwazi ngokubanzi malunga nenkcazo yeemvavanyo kunye neenkqubo ezisetyenziselwa ukufumanisa isifo seKaposi sarcoma.

Unyango

Unyango lweKaposi sarcoma inokubandakanya oku kulandelayo:

• Unyango ngamayeza.

• Unyango lwe-Immunotherapy (interferon).

• Unyango ngemitha.

Ngenxa yokuba iKaposi sarcoma inqabile ebantwaneni, ezinye iindlela zonyango zisekwe kwizilingo zonyango kubantu abadala. Jonga isishwankathelo se kunyango lweKaposi Sarcoma ngolwazi malunga neKaposi sarcoma kubantu abadala.

Amathumba amabi

Kweli Candelo

• Epithelioid Hemangioendothelioma

• I-Angiosarcoma yeZicubu eziSoft

Ngolwazi malunga nonyango oludweliswe ngezantsi, jonga kwiCandelo loKhetho ngokujonga uKhetho.

Epithelioid Hemangioendothelioma

I-Epithelioid hemangioendotheliomas inokwenzeka ebantwaneni, kodwa ixhaphake kakhulu kubantu abadala abaphakathi kweminyaka engama-30 ukuya kwengama-50 ubudala. Zidla ngokwenzeka esibindini, emiphungeni, okanye ethanjeni. Zingakhula ngokukhawuleza okanye zikhule kancinci. Malunga nesinye kwisithathu samatyala, ithumba lisasazeka kakhulu kwamanye amalungu omzimba.

Iimpawu kunye neMpawu

Iimpawu kunye neempawu zixhomekeke apho ikhoyo ithumba:

• Kwisikhumba, amathumba anokuphakanyiswa kwaye ajikelezwe okanye acabalele, amabala abomvu-mdaka aziva eshushu.

• Emiphungeni, akunakubakho zimpawu zokuqala. Iimpawu kunye neempawu ezinokuthi zenzeke zibandakanya:

• Iintlungu zesifuba.

• Ukutshiza igazi.

• I-anemia (ubuthathaka, uziva udiniwe, okanye ujongeka ulusu).

• Ukuphefumla okunengxaki (ukusuka kwizicwili zemiphunga).

• Kwithambo, amathumba anokubangela ikhefu.

Izidumba ezenzeka esibindini okanye kwizicubu ezithambileyo zisenokubangela iimpawu kunye neempawu.

Uvavanyo lokuchonga

I-Epithelioid hemangioendotheliomas esibindini ifunyenwe nge-CT scan kunye neMRI scan. Jonga icandelo loLwazi ngokubanzi malunga nenkcazo yezi mvavanyo kunye neenkqubo ezisetyenziselwa ukuxilonga i-epithelioid hemangioendothelioma kwaye ufumanise ukuba ngaba eli thumba lisasazekile na. IX-reyi inokwenziwa.

Unyango

Unyango lwe-epithelioid hemangioendotheliomas ekhula kancinci kubandakanya oku kulandelayo:

• Ukujonga.

Unyango lwe-epithelioid hemangioendotheliomas ekhula ngokukhawuleza inokubandakanya oku kulandelayo:

• Ugqirha lokususa ithumba xa kunokwenzeka.

• I-Immunotherapy (interferon) kunye nonyango ekujoliswe kulo (thalidomide, sorafenib, pazopanib, sirolimus) yamathumba ekunokwenzeka ukuba asasazeke.

Unyango ngamayeza.

• Iyonke i-hepatectomy kunye nokufakelwa kwesibindi xa ithumba lisesibindi.

• Uvavanyo lweklinikhi yonyango ekujoliswe kulo (trametinib).

• Uvavanyo lweklinikhi lwe-chemotherapy kunye nonyango ekujoliswe kulo (pazopanib).

I-Angiosarcoma yeZicubu eziSoft

Ii-angiosarcomas ngamathumba akhula ngokukhawuleza enza kwimithambo yegazi okanye kwimithambo ye-lymph kuyo nayiphi na indawo yomzimba, ihlala ithambile. Uninzi lwe-angiosarcomas lukufuphi okanye kufutshane nolusu. Ezo zikwizithambo ezinzulu ezinzulu zingenza isibindi, udakada, kunye nemiphunga.

Ezi tumors zinqabile kakhulu ebantwaneni. Ngamanye amaxesha abantwana banesifo esingaphezulu kwesinye kulusu kunye / okanye kwisibindi.

Izinto zomngcipheko

Nantoni na eyandisa umngcipheko wokufumana isifo ibizwa ngokuba yingozi. Ukuba nomngcipheko akuthethi ukuba uyakufumana esi sifo; ukungabinabungozi akuthethi ukuba awuzukufumana sifo. Thetha nogqirha wakho ukuba ucinga ukuba umntwana wakho usengozini. Izinto ezinobungozi kwii-angiosarcomas zibandakanya oku kulandelayo:

• Ukuvezwa kwimitha.

• I-lymphedema engapheliyo (ixesha elide), imeko apho i-lymph fluid eyongezelelweyo yakha izicubu kwaye ibangela ukuvuvukala.

• Ukuba ne-tumor ebusayo ye-vascular. I-tumor enobungozi, njenge-hemangioma, ingaba yi-angiosarcoma kodwa oku kunqabile.

Iimpawu

Iimpawu ze-angiosarcoma zixhomekeke apho isisu sikhona kwaye sinokubandakanya oku kulandelayo:

• Amabala abomvu kulusu olopha ngokulula.

• Amathumba amfusa.

Uvavanyo lokuchonga

Jonga icandelo loLwazi ngokubanzi malunga nenkcazo yeemvavanyo kunye neenkqubo ezisetyenziselwa ukuxilonga i-angiosarcoma kwaye ufumanise ukuba ithumba lisasazekile na.

Unyango

Unyango lwe-angiosarcoma lunokubandakanya oku kulandelayo:

• Ugqirha lokususa ngokupheleleyo ithumba.

• Indibaniselwano yotyando, ichemotherapy, kunye nonyango lwemitha kwii-angiosarcomas esele zisasazekile.

• Unyango ekujoliswe kulo (i-bevacizumab) kunye ne-chemotherapy ye-angiosarcomas eyaqala njenge-hemangiomas yeentsana.

• Uvavanyo lweklinikhi lwe-chemotherapy kunye okanye ngaphandle kwonyango ekujolise kulo (pazopanib).

• Uvavanyo lweklinikhi lwe-immunotherapy (nivolumab kunye ne-ipilimumab).

Ukufunda ngakumbi ngeeNtloko zeVascular Tumors

Ngolwazi oluthe kratya malunga namathumba e-vascular ebuntwaneni, jonga oku kulandelayo:

• Iphepha lasekhaya leTissue Tissue Sarcoma

• Ikhompyuter yeTomography (CT) kunye noMhlaza

• Iithagethi zoMhlaza ezijolise kuko

• I-MyPART-Unxibelelwano lwam lwaBantwana kunye naBantu abaDala abaNinzi

Ngolwazi oluthe kratya lomhlaza wabantwana kunye nezinye izixhobo zomhlaza ngokubanzi, jonga oku kulandelayo:

• Malunga noMhlaza

• Umhlaza wabantwana

• Unyango lokuKhangela uMhlaza waBantwanaPhuma kwiNgcazelo yokuzihlangula

• Iziphumo zokugqibela zonyango lweCancer yoMntwana

• Abafikisayo kunye naBantu abaDala abaDala abanomhlaza

• Abantwana abanomhlaza: Isikhokelo sabazali

• Umhlaza kuBantwana nakwishumi elivisayo

• Ukuqokelela

• Ukujamelana noMhlaza

• Imibuzo yokubuza ugqirha wakho malunga neCancer

• Abasindileyo kunye nabaNonopheli