Types/soft-tissue-sarcoma/patient/child-vascular-tumors-treatment-pdq

Ukwelashwa Kwe-Vascular Tumors Treatment (®) –Patient Version

Imininingwane ejwayelekile Mayelana Nezimila Zemithambo Yezingane

AMAPHUZU ASEMQOKA

• Izicubu zemithambo yobuntwana ezisuka kumaseli enza imithambo yegazi noma imithambo yegazi.

• Ukuhlolwa kusetshenziselwa ukuthola (ukuthola) nokuxilonga izicubu zemithambo yezingane.

• Izicubu zemithambo yobuntwana zingahlukaniswa ngamaqembu amane.

• Izimila ze-Benign

• Izimila eziphakathi nendawo (ezinolaka endaweni)

• Izicubu eziphakathi (ezingavamile ukugcizelela)

• Izimila ezimbi

Izicubu zemithambo yobuntwana ezisuka kumaseli enza imithambo yegazi noma imithambo yegazi.

Izicubu zemithambo yegazi zingakheka emithanjeni yegazi engajwayelekile noma kumaseli e-lymph umkhumbi noma yikuphi emzimbeni. Bangaba nobungozi (hhayi umdlavuza) noma ababi (umdlavuza). Kunezinhlobo eziningi zezicubu zemithambo yegazi. Uhlobo oluvame kakhulu lwesimila semithambo yobuntwana yi-infantile hemangioma, okuyisimila esiyingozi esivame ukuzihambela sodwa.

Ngoba izicubu ezinemithambo emibi azivamile ezinganeni, alukho ulwazi oluningi mayelana nokuthi yiluphi ukwelashwa olusebenza kahle kakhulu.

Ukuhlolwa kusetshenziselwa ukuthola (ukuthola) nokuxilonga izicubu zemithambo yezingane.

Lezi zivivinyo nezinqubo ezilandelayo zingasetshenziswa:

• Ukuhlolwa komzimba kanye nomlando: Ukuhlolwa komzimba ukuhlola izimpawu ezijwayelekile zempilo, kufaka phakathi nokuhlola izimpawu zezifo, njengezigaxa, izilonda, noma yini enye ebonakala ingajwayelekile. Kuzothathwa nomlando wemikhuba yezempilo yesiguli kanye nokugula nokwelashwa kwangaphambilini.

• Ukuhlolwa kwe-Ultrasound: Inqubo lapho amaza omsindo wamandla aphezulu (i-ultrasound) ehlaselwa izicubu zangaphakathi noma izitho bese enza ama-echoes. Ama-echoes akha isithombe sezicubu zomzimba esibizwa nge-sonogram. Isithombe singaphrintwa ukuze sibhekwe ngokuhamba kwesikhathi.

I-ultrasound yesisu. I-ultrasound transducer exhunywe kwikhompyutha icindezelwa esikhunjeni sesisu. I-transducer igxilisa amaza omsindo ezithweni zangaphakathi nezicubu zayo ukuze yenze ama-echoes akha isithombe (sekhompyutha).

• I-CT scan (i-CAT scan): Inqubo eyenza uchungechunge lwezithombe ezinemininingwane yezindawo ezingaphakathi komzimba, ezithathwe ezinhlangothini ezahlukene. Izithombe zenziwa yikhompyutha exhunywe kumshini we-x-ray. Idayi ingajovwa emthanjeni noma igwinywe ukusiza izitho noma izicubu zivele kahle. Le nqubo ibizwa nangokuthi i-computed tomography, i-computerized tomography, noma i-computer axial tomography.

Iskena se-computed tomography (CT) sesisu. Ingane ilele etafuleni elishibilika ngesithwebuli se-CT, esithatha izithombe ze-x-ray zangaphakathi kwesisu.

• I-MRI (imaging resonance imaging): Inqubo esebenzisa uzibuthe, amagagasi omsakazo, nekhompyutha ukwenza uchungechunge lwezithombe ezinemininingwane yezindawo ezingaphakathi komzimba. Le nqubo ibizwa nangokuthi i-nuclear magnetic resonance imaging (i-NMRI).

I-Magnetic resonance imaging (MRI) yesisu. Ingane ilele etafuleni elingena kuskena seMRI, esithwebula izithombe zangaphakathi komzimba. Iphedi esiswini sengane isiza ukwenza izithombe zicace bha.

• I-Biopsy: Ukususwa kwamaseli noma izicubu ukuze kubhekwe ngaphansi kwesibonakhulu ngudokotela wezifo ukuhlola izimpawu zomdlavuza. I-biopsy ayidingeki ngaso sonke isikhathi ukuxilonga isimila semithambo.

Izicubu zemithambo yobuntwana zingahlukaniswa ngamaqembu amane.

Izimila ze-Benign

Izicubu ze-Benign akuwona umdlavuza. Lesi sifinyezo sinemininingwane mayelana nezicubu zemithambo elandelayo ezinobungozi:

• I-hemangioma yezinsana.

• I-hemangioma yokuzalwa.

• Izimila zemithambo yegazi yesibindi.

• Uthi lokuphotha cell hemangioma.

• I-Epithelioid hemangioma.

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

• I-Angiofibroma.

• I-angiofibroma yentsha ye-nasopharyngeal.

Izimila eziphakathi nendawo (ezinolaka endaweni)

Izicubu eziphakathi ezinolaka endaweni zivame ukusakazeka endaweni ezungeze isimila. Lesi sifinyezo sinemininingwane mayelana nezicubu zemithambo ezilandelayo ezinolaka:

• I-Kaposiform hemangioendothelioma kanye ne-angioma eshaywayo.

Izicubu eziphakathi (ezingavamile ukugcizelela)

Izicubu eziphakathi (ezingavamile ukugcizelela) kwesinye isikhathi zisakazekela kwezinye izingxenye zomzimba. Lesi sifinyezo sinemininingwane mayelana nezicubu zemithambo yegazi ezilandelayo ezingavamisile ukusasazeka:

• Pseudomyogenic hemangioendotheliomaoma.

• I-Retiform hemangioendothelioma.

• I-papillary intralymphatic angioendothelioma.

• I-hemangioendothelioma eyinhlanganisela.

• Kaposi sarcoma.

Izimila ezimbi

Izicubu eziyingozi ngumdlavuza. Lesi sifinyezo sinemininingwane mayelana nezicubu zemisipha ezimbi ezilandelayo:

• I-Epithelioid hemangioendotheliomaoma.

• I-Angiosarcoma yezicubu ezithambile.

Uhlolojikelele lwenketho yokwelashwa

AMAPHUZU ASEMQOKA

• Kunezinhlobo ezahlukahlukene zokwelashwa kwezimila zemithambo ebuntwaneni.

• Izingane ezinezimila zemithambo yobuntwana kufanele zihlelelwe ukwelashwa kwazo yiqembu labahlinzeki bezempilo abangongoti ekwelapheni umdlavuza ezinganeni.

• Ukwelashwa kwezimila zemithambo ebuntwaneni kungadala imiphumela emibi.

• Izinhlobo eziyishumi nanye zokwelashwa okujwayelekile zisetshenzisiwe:

• Ukwelashwa kwe-beta-blocker

• Ukuhlinzwa

• I-Photocoagulation

• Ukuhlanganisa

• Ukwelashwa ngamakhemikhali

• I-Sclerotherapy

• Ukwelashwa ngemisebe

• Ukwelashwa okuhlosiwe

• I-Immunotherapy

• Olunye ukwelashwa kwezidakamizwa

• Ukuqaphela

• Izinhlobo ezintsha zokwelashwa ziyahlolwa ezivivinyweni zokwelashwa.

• Iziguli zingafuna ukucabanga ngokubamba iqhaza esivivinyweni somtholampilo.

• Iziguli zingangena ezivivinyweni zokwelashwa ngaphambi, ngesikhathi, noma ngemuva kokuqala ukwelashwa kwazo komdlavuza.

• Ukuhlolwa kokulandelela kungadingeka.

Kunezinhlobo ezahlukahlukene zokwelashwa kwezimila zemithambo ebuntwaneni.

Izinhlobo ezahlukene zokwelashwa ziyatholakala ezinganeni ezinezicubu zemithambo yegazi. Ezinye izindlela zokwelapha zijwayelekile (indlela esetshenziswa njengamanje), kanti ezinye ziyahlolwa ezivivinyweni zokwelashwa. Isivivinyo somtholampilo sokwelashwa isifundo socwaningo esenzelwe ukusiza ukuthuthukisa ukwelashwa kwamanje noma ukuthola ulwazi ngezindlela ezintsha zokwelapha. Lapho izivivinyo zokwelashwa zibonisa ukuthi ukwelashwa okusha kungcono kunokwelashwa okujwayelekile, ukwelashwa okusha kungaba ukwelashwa okujwayelekile.

Ngoba izicubu zemithambo ezinganeni ziyivelakancane, ukubamba iqhaza esivivinyweni somtholampilo kufanele kubhekwe. Ezinye izivivinyo zokwelashwa zivulekele kuphela iziguli ezingakaqali ukwelashwa.

Izingane ezinezimila zemithambo yobuntwana kufanele zihlelelwe ukwelashwa kwazo yiqembu labahlinzeki bezempilo abangongoti ekwelapheni umdlavuza ezinganeni.

Ukwelashwa kuzobhekwa ngudokotela wezingane oncologist, udokotela ogxile ekwelapheni izingane ezinomdlavuza. I-oncologist yezingane isebenza nabanye abahlinzeki bezokunakekelwa kwempilo yezingane abangongoti ekwelapheni izingane ezinomdlavuza futhi abagxile ezindaweni ezithile zemithi. Lokhu kungafaka ongoti abalandelayo:

• Isazi semithi ye-vascular anomaly (uchwepheshe wokwelapha izingane ezinamathumba emithambo yegazi).

• Udokotela ohlinzayo wezingane.

• Udokotela ohlinzayo wamathambo.

• I-radiation oncologist.

• Umhlengikazi ongumhlengikazi.

• Uchwepheshe wokuvuselelwa.

• Isazi sokusebenza kwengqondo.

• Usonhlala kahle.

Ukwelashwa kwezimila zemithambo ebuntwaneni kungadala imiphumela emibi.

Ngemininingwane ngemiphumela emibi eqala ukwelashwa komdlavuza, bheka ikhasi lethu le-Side Effects.

Ezinye izindlela zokwelapha, njenge-chemotherapy kanye ne-radiation therapy, zidala imiphumela emibi eqhubekayo noma evela izinyanga noma iminyaka ukwelashwa kuphelile. Lokhu kubizwa ngemiphumela yesikhathi esedlule. Imiphumela yokwelashwa engemuva kwesikhathi ingafaka okulandelayo:

• Izinkinga zomzimba.

• Izinguquko zemizwa, imizwa, ukucabanga, ukufunda, noma inkumbulo.

• Umdlavuza wesibili (izinhlobo ezintsha zomdlavuza).

Eminye imiphumela yesikhashana ingalashwa noma ilawulwe. Kubalulekile ukukhuluma nodokotela bengane yakho ngemiphumela engaba khona sekwephuzile ebangelwe ukwelashwa okuthile. (Bheka isifinyezo se- ngemiphumela yamuva yokwelashwa komdlavuza wezingane ukuthola eminye imininingwane).

Izinhlobo eziyishumi nanye zokwelashwa okujwayelekile zisetshenzisiwe:

Ukwelashwa kwe-beta-blocker

Ama-beta blockers yimithi eyehlisa umfutho wegazi nokushaya kwenhliziyo. Uma isetshenziswa ezigulini ezinamathumba emithambo yegazi, ama-beta-blockers angasiza ekunciphiseni izicubu. Ukwelashwa kwe-beta-blocker kunganikezwa nge-vein (IV), ngomlomo, noma ngokubekwa esikhumbeni (esihlokweni). Indlela okunikezwa ngayo ukwelashwa kwe-beta-blocker kuncike ohlotsheni lwezimila zemithambo yegazi nalapho i-tumor yaqala khona khona.

I-beta-blocker propranolol imvamisa iyindlela yokuqala yokwelashwa kwama-hemangiomas. Izinsana eziphathwe nge-IV propranolol zingadinga ukuthi ukwelashwa kwazo kuqale esibhedlela. I-Propranolol nayo isetshenziselwa ukwelapha isimila semithambo esiyingozi sesibindi ne-kaposiform hemangioendothelioma.

Amanye ama-beta-blockers asetshenziselwa ukwelapha izicubu zemithambo yegazi afaka i-atenolol, nadolol, ne-timolol.

I-Infantile hemangioma nayo ingalashwa nge-propranolol kanye ne-steroid therapy noma i-propranolol kanye ne-topical beta-blocker therapy.

Bona isifinyezo solwazi lwezidakamizwa kwiPropranolol Hydrochloride ukuthola eminye imininingwane.

Ukuhlinzwa

Izinhlobo ezilandelayo zokuhlinzwa zingasetshenziswa ukususa izinhlobo eziningi zamathumba ezinemithambo yegazi:

• Ukuzikhandla: Ukuhlinzwa kususwe lonke isimila nezinye izicubu ezinempilo ezizungezile.

• Ukuhlinzwa nge-Laser: Inqubo yokuhlinza esebenzisa umsebe we-laser (ugongolo oluncane wokukhanya okukhulu) njengommese ukusika ngaphandle kwezicubu emzimbeni noma ukususa isilonda sesikhumba esifana nesimila. Ukuhlinzwa nge-pulsed dye laser kungasetshenziselwa amanye ama-hemangiomas. Lolu hlobo lwe-laser lusebenzisa umsebe wokukhanya ohlose imithambo yegazi esikhunjeni. Ukukhanya kuguqulwa kube ukushisa kanti imithambo yegazi ibhujiswa ngaphandle kokulimaza isikhumba esiseduze.

• I-Curettage: Inqubo lapho kukhishwa khona izicubu ezingajwayelekile kusetshenziswa ithuluzi elincane elimise okwezipuni elibizwa ngokuthi yi-curette.

• Ukufakelwa okuphelele kwe-hepatectomy nesibindi: Inqubo yokuhlinza ukususa sonke isibindi elandelwa ukufakelwa kwesibindi esinempilo kusuka kumnikeli.

Uhlobo lokuhlinzwa olusetshenzisiwe luxhomeke ohlotsheni lwesimila semithambo futhi lapho kwakhiwa khona isimila emzimbeni.

Kwezimila ezibulalayo, ngemuva kokuthi udokotela esuse wonke umdlavuza ongabonakala ngesikhathi sokuhlinzwa, ezinye iziguli zinganikezwa i-chemotherapy noma i-radiation therapy ngemuva kokuhlinzwa ukubulala noma yimaphi amangqamuzana omdlavuza asele. Ukwelashwa okunikezwe ngemuva kokuhlinzwa, ukwehlisa ubungozi bokuthi umdlavuza uzobuya, kubizwa ngokuthi yi-adjuvant therapy.

I-Photocoagulation

I-Photocoagulation ukusetshenziswa kwesibani esikhulu sokukhanya, njenge-laser, ukuvala imithambo yegazi noma ukubhubhisa izicubu. Isetshenziselwa ukwelapha i-pyogenic granuloma.

Ukuhlanganisa

Ukuhlanganiswa inqubo esebenzisa izinhlayiya, njengezipanji ezincane ze-gelatin noma ubuhlalu, ukuvimba imithambo yegazi esibindi. Ingasetshenziselwa ukwelapha ezinye izicubu ezinobungozi zesibindi kanye ne-kaposiform hemangioendothelioma.

Ukwelashwa ngamakhemikhali

I-Chemotherapy yindlela yokwelapha esebenzisa izidakamizwa ukuvimba ukukhula kwamangqamuzana ama-tumor, kungaba ngokubulala amaseli noma ngokuwavimba ekuhlukaneni. Kunezindlela ezahlukahlukene zokunikeza i-chemotherapy:

• I-chemotherapy ehlelekile: Uma i-chemotherapy ithathwa ngomlomo noma ifakwa emthanjeni noma emisipheni, izidakamizwa zingena egazini futhi zingafinyelela kumaseli ezinwele emzimbeni wonke. Kwesinye isikhathi kunikezwa imishanguzo engaphezu kweyodwa ye-anticancer. Lokhu kubizwa ngokuthi inhlanganisela yamakhemikhali.

• I-topical chemotherapy: Lapho i-chemotherapy isetshenziswa esikhunjeni ukhilimu noma i-lotion, imishanguzo ithinta kakhulu amaseli wesimila endaweni elashwa.

• I-chemotherapy yesifunda: Lapho i-chemotherapy ifakwa ngqo ku-cerebrospinal fluid, isitho, noma umgodi womzimba njengesisu, izidakamizwa zithinta kakhulu amaseli wesimila kulezo zindawo.

Indlela i-chemotherapy enikezwa ngayo incike ohlotsheni lwesimila semithambo eselaphwayo. I-chemotherapy ehlelekile neyihloko isetshenziselwa ukwelapha ezinye izicubu zemithambo yegazi.

I-Sclerotherapy

I-Sclerotherapy yindlela yokwelapha esetshenziselwa ukubhubhisa umthambo wegazi oholela kwisimila nesimila. Kufakwa uketshezi emthanjeni wegazi, lubangele isibazi bese lonakala. Ngokuhamba kwesikhathi, isitsha segazi esonakele singena ezicutshini ezijwayelekile. Igazi ligeleza ngemithambo eseduze enempilo esikhundleni salokho. I-Sclerotherapy isetshenziswa ekwelapheni i-epithelioid hemangioma.

Ukwelashwa ngemisebe

Ukwelashwa ngemisebe ukwelashwa okusebenzisa amandla amakhulu ama-x-ray noma ezinye izinhlobo zemisebe ukubulala amangqamuzana e-tumor noma ukuwagcina ekukhuleni. Kunezinhlobo ezimbili zokwelashwa ngemisebe:

• Ukwelashwa kwemisebe kwangaphandle kusebenzisa umshini ongaphandle komzimba ukuthumela imisebe maqondana nesimila.

• Ukwelashwa kwemisebe yangaphakathi kusebenzisa into enemisebe eboshwe ngezinaliti, imbewu, izintambo, noma ama-catheters abekwa ngqo ngaphakathi noma eduze kwesimila.

Indlela yokwelashwa ngemisebe enikezwa ngayo incike ohlotsheni lwesimila semithambo elashwa. Imisebe yangaphandle isetshenziselwa ukwelapha ezinye izicubu zemithambo yegazi.

Ukwelashwa okuhlosiwe

Ukwelashwa okuhlosiwe uhlobo lwezokwelapha olusebenzisa izidakamizwa noma ezinye izinto ukuhlasela amangqamuzana athile we-tumor. Izindlela zokwelashwa ezihlosiwe zivame ukudala ukulimala okuncane kumaseli ajwayelekile kunokwelashwa ngamakhemikhali noma ukwelashwa ngemisebe. Izinhlobo ezahlukene zokwelashwa okuqondisiwe ziyasetshenziswa noma ziyafundwa ukwelapha izicubu zemithambo yezingane:

• Ama-Angiogenesis inhibitors: Ama-Angiogenesis inhibitors yimithi evimba amaseli ukuthi angahlukani futhi avimbele ukukhula kwemithambo yegazi emisha okudingeka ukuthi izimila zikhule. Imithi yokwelashwa ehlosiwe i-thalidomide, i-sorafenib, i-pazopanib, ne-sirolimus yi-angiogenesis inhibitors esetshenziselwa ukwelapha izicubu zemithambo yezingane.

• Umgomo waseMammalia we-rapamycin (mTOR) inhibitors: i-mTOR inhibitors ivimba iprotheni ebizwa ngokuthi i-mTOR, engagcina amangqamuzana omdlavuza angakhuli futhi avimbele ukukhula kwemithambo yegazi emisha okudingeka ukuthi izimila zikhule.

• Ama-Kinase inhibitors: Ama-Kinase inhibitors avimba amasiginali adingekayo ukuze izimila zikhule. I-Trametinib ifundelwa ukwelapha i-epithelioid hemangioendothelioma.

I-Immunotherapy

I-Immunotherapy yimithi esebenzisa amasosha omzimba esiguli ukulwa nezifo. Izinto ezenziwe ngumzimba noma ezenziwe elabhorethri zisetshenziselwa ukukhulisa, ukuqondisa, noma ukubuyisa izivikelo zemvelo zomzimba ezifweni.

Izinhlobo ezilandelayo ze-immunotherapy zisetshenziswa ekwelapheni izicubu zemithambo yengane:

• I-Interferon uhlobo lwe-immunotherapy esetshenziselwa ukwelapha izicubu zemithambo yezingane. Iphazamisa ukuhlukaniswa kwamangqamuzana e-tumor futhi inganciphisa ukukhula kwesimila. Isetshenziswa ekwelapheni i-juvenile nasopharyngeal angiofibroma, kaposiform hemangioendothelioma, ne-epithelioid hemangioendothelioma.

• Ukwelashwa kwe-immune checkpoint inhibitor therapy: Ezinye izinhlobo zamaseli omzimba, njengama-T cell, namanye amangqamuzana omdlavuza anamaprotheni athile, abizwa ngokuthi amaprotheni wokuhlola, ebusweni bawo agcina izimpendulo zomzimba zibheke. Lapho amangqamuzana omdlavuza enenqwaba yalawa maprotheni, ngeke ahlaselwe futhi abulawe ngamaseli we-T. Amasosha omzimba okuhlola izivikeli mzimba avimba lawa maprotheni futhi kwanda ikhono lamaseli T ukubulala amangqamuzana omdlavuza.

Kunezinhlobo ezimbili zokwelashwa kwama-immune checkpoint inhibitor therapy:

• I-CTLA-4 inhibitor: I-CTLA-4 yiprotheni ebusweni bamaseli we-T asiza ukugcina izimpendulo zomzimba womzimba zihloliwe. Lapho i-CTLA-4 inamathela kwenye iphrotheni ebizwa nge-B7 esitokisini somdlavuza, iyamisa i-T cell ekubulaleni iseli lomdlavuza. I-CTLA-4 inhibitors inamathela ku-CTLA-4 futhi ivumela amaseli we-T ukuthi abulale amangqamuzana omdlavuza. I-Ipilimumab uhlobo lwe-CTLA-4 inhibitor efundwayo ekwelapheni i-angiosarcoma yezicubu ezithambile.

Isithiyo sokuhlola izivikeli mzimba. Amaprotheni e-Checkpoint, afana ne-B7-1 / B7-2 kumaseli we-antigen-presenting (APC) kanye ne-CTLA-4 kuma-T cell, asiza ukugcina izimpendulo zomzimba womzimba zibheke. Lapho i-T-cell receptor (TCR) ibophezela kuma-antigen kanye namaprotheni amakhulu we-histocompatibility complex (MHC) ku-APC naku-CD28 ibopha ku-B7-1 / B7-2 ku-APC, i-T cell ingasebenza. Kodwa-ke, ukubopha kwe-B7-1 / B7-2 kuya ku-CTLA-4 kugcina amaseli we-T esesimweni sokungasebenzi ngakho-ke awakwazi ukubulala amangqamuzana e-tumor emzimbeni (iphaneli langakwesobunxele). Ukuvimba ukubopha kwe-B7-1 / B7-2 kuya ku-CTLA-4 nge-immune checkpoint inhibitor (anti-CTLA-4 antibody) kuvumela ama-T cell ukuthi asebenze futhi abulale amangqamuzana wesimila (iphaneli lesokudla).

• I-PD-1 inhibitor: I-PD-1 yiprotheni ebusweni bamaseli we-T asiza ukugcina izimpendulo zomzimba womzimba zihloliwe. Lapho i-PD-1 inamathela kwenye iprotheni ebizwa nge-PDL-1 kuseli lomdlavuza, iyeka i-T cell ekubulaleni iseli lomdlavuza. Ama-PD-1 inhibitors anamathisela ku-PDL-1 futhi avumela amaseli we-T ukuthi abulale amangqamuzana omdlavuza. INivolumab uhlobo lwe-PD-1 inhibitor efundwayo ekwelapheni i-angiosarcoma yezicubu ezithambile.

Isithiyo sokuhlola izivikeli mzimba. Amaprotheni wokuhlola, njenge-PD-L1 kumaseli we-tumor ne-PD-1 kumaseli we-T, asiza ukugcina izimpendulo ze-immune zihlolwe. Ukubopha kwe-PD-L1 kuya ku-PD-1 kugcina amaseli we-T ekubulaleni amangqamuzana omzimba emzimbeni (iphaneli engakwesobunxele). Ukuvimba ukubopha kwe-PD-L1 kuya ku-PD-1 nge-immune checkpoint inhibitor (i-anti-PD-L1 noma i-anti-PD-1) ivumela amaseli we-T ukuthi abulale amangqamuzana wesimila (iphaneli elifanele).

Olunye ukwelashwa kwezidakamizwa

Eminye imishanguzo esetshenziselwa ukwelapha izicubu zemithambo yengane noma ukuphatha imiphumela yayo ifaka okulandelayo:

• Ukwelashwa kwe-Steroid: I-Steroid ngamahomoni enziwa ngokwemvelo emzimbeni. Futhi zingenziwa elebhu futhi zisetshenziswe njengezidakamizwa. Izidakamizwa ze-steroid zisiza ukunciphisa ezinye izicubu zemithambo yegazi. I-Corticosteroids, efana ne-prednisone ne-methylprednisolone, isetshenziselwa ukwelapha i-hemileoma yezinsana.

• Izidakamizwa ezingezona ukuvuvukala (ama-NSAID): Ama-NSAID asetshenziselwa ukunciphisa umkhuhlane, ukuvuvukala, ubuhlungu nokubomvu. Izibonelo zama-NSAID yi-aspirin, ibuprofen, ne-naproxen. Ekwelapheni izicubu zemithambo yegazi, ama-NSAID angakhuphula ukugeleza kwegazi ngezimila futhi anciphise nethuba lokuthi i-clot yegazi engafuneki izokwakhiwa.

• Ukwelashwa kwe-Antifibrinolytic: Le mithi isiza ukujiya kwegazi ezigulini ezine-Kasabach-Merritt syndrome. I-Fibrin yiprotheni eyinhloko egazini elisiza ukumisa ukopha nokupholisa amanxeba. Ezinye izicubu zemithambo yegazi zidala ukuthi i-fibrin yehle futhi negazi lesiguli alihlanganisi ngokujwayelekile, lidale ukopha okungalawuleki. I-Antifibrinolytics isiza ukuvimbela ukuwohloka kwe-fibrin.

Ukuqaphela

Ukuqaphelisisa kusibhekisisa isimo sesiguli ngaphandle kokunikeza ukwelashwa kuze kuvele izimpawu noma izimpawu noma ushintsho.

Izinhlobo ezintsha zokwelashwa ziyahlolwa ezivivinyweni zokwelashwa.

Imininingwane mayelana nokuhlolwa kwemitholampilo iyatholakala kuwebhusayithi ye-NCI.

Iziguli zingafuna ukucabanga ngokubamba iqhaza esivivinyweni somtholampilo.

Kwezinye iziguli, ukubamba iqhaza esivivinyweni somtholampilo kungaba yindlela engcono kakhulu yokwelashwa. Ukuhlolwa kwemitholampilo kuyingxenye yenqubo yocwaningo. Ukuhlolwa komtholampilo kuyenziwa ukuthola ukuthi ngabe ukwelashwa okusha kuphephile futhi kuyasebenza yini noma kungcono kunokwelashwa okujwayelekile.

Eziningi zezindlela zokwelapha ezijwayelekile zanamuhla zisuselwa ezivivinyweni zokwelashwa zangaphambili. Iziguli ezibamba iqhaza esivivinyweni somtholampilo zingathola ukwelashwa okujwayelekile noma zibe phakathi kwabokuqala ukuthola ukwelashwa okusha.

Iziguli ezibamba iqhaza ezivivinyweni zokwelashwa zisiza nokwenza ngcono indlela izifo ezizolashwa ngayo ngokuzayo. Noma izilingo zomtholampilo zingaholeli ekwelashweni okusha okusebenzayo, zivame ukuphendula imibuzo ebalulekile futhi zisize ukuqhubela phambili ucwaningo.

Iziguli zingangena ezivivinyweni zokwelashwa ngaphambi, ngesikhathi, noma ngemuva kokuqala ukwelashwa kwazo komdlavuza.

Ezinye izivivinyo zokwelashwa zifaka kuphela iziguli ezingakatholi ukwelashwa. Ezinye izilingo zivivinya ukwelashwa kweziguli ezinamathumba angcono. Kukhona nokuhlolwa komtholampilo okuvivinya izindlela ezintsha zokumisa izicubu ekubuyeleni (ekubuyeni) noma ukunciphisa imiphumela emibi yokwelashwa.

Ukuhlolwa kwemitholampilo kuyenzeka ezingxenyeni eziningi zezwe. Imininingwane mayelana nokuhlolwa kwemitholampilo esekelwa yi-NCI ingatholakala ekhasini lewebhu le-NCI lokuhlolwa kokuhlolwa kwemitholampilo. Izivivinyo zomtholampilo ezisekelwa ezinye izinhlangano zingatholakala kuwebhusayithi yeClinicalTrials.gov.

Ukuhlolwa kokulandelela kungadingeka.

Olunye uvivinyo olwenziwe ukuxilonga isimila semithambo lungaphindwa. Olunye uvivinyo luzophindwa ukuze kubonakale ukuthi umuthi usebenza kanjani. Izinqumo mayelana nokuthi uqhubeke, ushintshe, noma umise ukwelashwa zingasuselwa emiphumeleni yalezi zivivinyo.

Ezinye zezivivinyo zizoqhubeka ukwenziwa ngezikhathi ezithile ngemuva kokuphela kokwelashwa. Imiphumela yalezi zivivinyo ingakhombisa ukuthi ngabe isimo sengane yakho sishintshile noma uma isimila sesiphindile (buyela emuva). Lezi zivivinyo kwesinye isikhathi zibizwa ngokuthi izivivinyo zokulandelela noma ukuhlolwa.

Izicubu zikaBenign

Kulesi Sigaba

• I-Hemangioma Yezinsana

• I-Hemangioma yokuzalwa

• Izicubu zeBenign Vascular zesibindi

• Uthi lokuphotha Cell Hemangioma

• I-Epithelioid Hemangioma

• I-Pyogenic Granuloma

• I-Angiofibroma

• IJuvenile Nasopharyngeal Angiofibroma

Ngemininingwane mayelana nokwelashwa okubalwe ngezansi, bheka isigaba se-Treatment Option Overview section.

I-Hemangioma Yezinsana

Ama-hemangiomas wezinsana awuhlobo oluvame kakhulu lwesimila semithambo enobungozi ezinganeni. Amafomu e-infantile hemangiomas lapho amaseli angavuthiwe enzelwe ukwakha imithambo yegazi akha isimila esikhundleni salokho. I-hemangioma yezinsana nayo ingabizwa ngokuthi "uphawu lwe-sitrobheli."

Lezi zicubu azivamile ukubonwa lapho kuzalwa kodwa ziyavela lapho usana lunamasonto amathathu kuya kwayisithupha ubudala. Ama-hemangiomas amaningi akhula cishe izinyanga ezinhlanu bese eyeka ukukhula. Ama-hemangiomas ayaphela kancane kancane eminyakeni eminingana elandelayo, kepha uphawu olubomvu noma isikhumba esivulekile noma esishwabeneyo singahlala. Akuvamile ukuthi i-hemangioma yezinsana ibuye.

Ama-hemangiomas ezingane angaba sesikhunjeni, ezicutshini ezingaphansi kwesikhumba, kanye / noma esithombeni. Imvamisa zisekhanda nasentanyeni kepha zingaba noma kuphi emzimbeni noma emzimbeni. Ama-hemangiomas angavela njengesilonda esisodwa, isilonda esisodwa noma ngaphezulu sisakazeke endaweni enkulu yomzimba, noma izilonda eziningi ezingxenyeni ezingaphezu kweyodwa zomzimba. Izilonda ezisakazeka endaweni enkulu yomzimba noma izilonda eziningi kungenzeka zidale izinkinga.

I-infantile hemangioma enokukhula okuncane noma okuboshiwe (IH-MAG) wuhlobo oluthile lwe-hemangioma yezinsana olubonakala lapho kuzalwa futhi olungathandi ukukhula. Isilonda sibonakala njengezindawo ezikhanyayo nezimnyama zokubomvu esikhumbeni. Izilonda zivame ukuba semzimbeni ongezansi kepha zingaba senhloko nasentanyeni. Ama-hemangiomas alolu hlobo ahamba ngokuhamba kwesikhathi ngaphandle kokwelashwa.

Izici Zengozi

Noma yini enyusa ubungozi bokuthola isifo ibizwa ngokuthi ingozi. Ukuba nengcuphe akusho ukuthi uzosithola lesi sifo; ukungabi nezici zobungozi akusho ukuthi ngeke usithole lesi sifo. Khuluma nodokotela wengane yakho uma ucabanga ukuthi ingane yakho ingaba sengcupheni.

Ama-hemangiomas wezinsana avame kakhulu kokulandelayo:

• Amantombazane.

• Abamhlophe.

• Izingane ezizalwe ngaphambi kwesikhathi.

• Amawele, amawele amathathu, noma okunye ukuzalwa okuningi.

• Izingane zomama asebekhulile ngesikhathi sokukhulelwa noma abanezinkinga nge-placenta ngesikhathi sokukhulelwa.

Ezinye izinto eziyingozi kuma-hemangiomas ezingane zihlanganisa okulandelayo:

• Ukuba nomlando womndeni we-infantile hemangioma, imvamisa kumama, ubaba, udadewabo, noma umfowabo.

• Ukuba nama-syndromes athile.

• I-PHACE syndrome: Isifo lapho i-hemangioma isakazeka khona endaweni enkulu yomzimba (imvamisa ikhanda noma ubuso). Ezinye izinkinga zempilo ezithinta imithambo yegazi emikhulu, inhliziyo, amehlo, kanye / noma ubuchopho nazo zingavela.

• I-LUMBAR / PELVIS / SACRAL syndrome: Isifo lapho i-hemangioma isakazeka khona endaweni enkulu yomhlane ongezansi. Ezinye izinkinga zempilo ezithinta uhlelo lomchamo, izitho zangasese, i-rectum, i-anus, ubuchopho, umgogodla kanye nokusebenza kwemizwa nakho kungavela.

Ukuba ne-hemangioma engaphezu kweyodwa noma i-airway noma i-ophthalmic hemangioma yandisa ingozi yokuba nezinye izinkinga zempilo.

• Ama-hemangiomas amaningi: Ukuba nama-hemangiomas angaphezu kwamahlanu esikhunjeni kuyisibonakaliso sokuthi kungenzeka kube nama-hemangiomas esithweni. Isibindi sithinteka kaningi. Izinkinga zenhliziyo, imisipha, nezindlala ze-thyroid nazo zingenzeka.

• I-Airway hemangiomas: Ama-hemangiomas asemoyeni avamise ukwenzeka kanye nendawo enkulu emise okwentshebe ye-hemangioma ebusweni (kusuka ezindlebeni, emlonyeni, emlonyeni wesilevu, nangaphambi kwentamo). Kubalulekile ukuthi i-airway hemangiomas yelashwe ngaphambi kokuba ingane ibe nenkinga yokuphefumula.

• I-Ophthalmic hemangiomas: Ama-hemangiomas afaka iso angadala izinkinga zombono noma ubumpumputhe. Ama-hemangiomas ezingane angenzeka ku-conjunctiva (ulwelwesi olugxilisa ingaphakathi lejwabu leso futhi lumboze ingxenye engaphambili yeso). Lawa ma-hemangiomas angaxhunyaniswa nezinye izimo ezingajwayelekile zeso. Kubalulekile ukuthi izingane ezine-ophthalmic hemangioma zihlolwe ngudokotela wezifo zamehlo.

Izimpawu Nezimpawu

Ama-hemangiomas ezingane angadala noma yiziphi zalezi zimpawu nezimpawu ezilandelayo. Buza kudokotela wengane yakho uma ingane yakho inokunye kwalokhu okulandelayo:

• Izilonda zesikhumba: Indawo yemithambo ye-spidery noma isikhumba esikhanyisiwe noma esikhanyisiwe ingavela ngaphambi kwe-hemangioma. Ama-hemangiomas avela njengamaqina abomvu, afudumele, abomvu ngokukhanyayo kuya ezibomvu esikhunjeni noma angahle abukeke njengokulimala. Izilonda ezakha izilonda nazo zibuhlungu. Kamuva, njengoba ama-hemangiomas ehamba, aqala ukubuna maphakathi nendawo ngaphambi kokuthamba nokulahleka kombala.

• Izilonda ezingezansi kwesikhumba: Izilonda ezikhula ngaphansi kwesikhumba emafutheni zingavela ziluhlaza okwesibhakabhaka noma nsomi. Uma izilonda zijule ngokwanele ngaphansi kwesikhumba, kungenzeka zingabonakali.

• Izilonda esithweni somzimba: Kungahle kungabikho zimpawu zokuthi ama-hemangiomas akhekile esithweni.

Yize ama-hemangiomas amaningi wezinsana engeyona into okufanele akhathazeke ngayo, uma ingane yakho iba nezigaxa noma amamaki abomvu noma aluhlaza esikhumbeni hlola nodokotela wengane yakho. Angadlulisela ingane kochwepheshe uma kudingeka.

Izivivinyo Zokuxilonga

Ukuhlolwa ngokomzimba nomlando imvamisa kuyikho konke okudingekayo ukuxilonga ama-hemangiomas wezinsana. Uma kukhona okuthile ngesimila okubukeka kungajwayelekile, kungenziwa i-biopsy. Uma i-hemangioma ijule ngaphakathi emzimbeni kungabikho ushintsho esikhunjeni, noma izilonda zisakazeka endaweni enkulu yomzimba, i-ultrasound ingenziwa. Bheka isigaba solwazi jikelele ukuthola incazelo yalezi zivivinyo nezinqubo.

Uma ama-hemangiomas ayingxenye yesifo, ukuhlolwa okuningi kungenziwa, njenge-echocardiogram, i-MRI, i-magnetic resonance angiogram, nokuhlolwa kwamehlo.

Ukwelashwa

Ama-hemangiomas amaningi ayaphela futhi anciphe ngaphandle kokwelashwa. Uma i-hemangioma inkulu noma ibangela ezinye izinkinga zempilo, ukwelashwa kungafaka okulandelayo:

• I-Propranolol noma enye i-beta-blocker therapy.

• Ukwelashwa nge-steroid, ngaphambi kokuqala kwe-beta-blocker therapy noma lapho i-beta-blockers ingasetshenziswa.

• Ukuhlinzwa ngopende we-laser, wama-hemangiomas anezilonda noma okungasekho ngokuphelele.

• Ukuhlinzwa (ukusikwa) kwama-hemangiomas anezilonda, kubangele izinkinga zokubona, noma kungasekho ngokuphelele. Ukuhlinzwa kungasetshenziselwa izilonda ebusweni ezingaphenduli kolunye ukwelashwa.

• Ukwelashwa kwe-beta-blocker ngezihloko kwama-hemangiomas asendaweni eyodwa yesikhumba.

• Ukwelashwa okuhlanganisiwe, okufana nepropranolol ne-steroid therapy noma i-propranolol kanye ne-topical beta-blocker therapy.

• Isivivinyo somtholampilo sokwelashwa kwe-beta-blocker (nadolol nepropranolol).

• Isivivinyo somtholampilo sokwelashwa kwe-topical beta-blocker therapy (timolol).

I-Hemangioma yokuzalwa

I-Congenital hemangioma iyisigaxa semithambo esiyingozi esiqala ukwakheka ngaphambi kokuzalwa futhi sakhiwa ngokuphelele lapho umntwana ezalwa. Imvamisa isikhumba kepha ingaba kwesinye isitho. I-hemangioma yokuzalwa ingavela njengokuqubuka kwamabala ansomi futhi isikhumba esiseduze nendawo singakhanya.

Kunezinhlobo ezintathu zama-hemangiomas azalwe nawo:

• Ukuxhuma ngokushesha i-hemangioma yokuzalwa: Lezi zicubu ziyahamba zodwa ezinyangeni eziyi-12 kuya kwezingu-15 ngemuva kokuzalwa. Bangakha izilonda, bopha, futhi babangele izinkinga zesikhashana zenhliziyo nokuvimba igazi. Isikhumba singabukeka sehluke kancane noma ngabe ama-hemangiomas esehambile.

• I-hemangioma yokuzalwa engavumelani nengxenye ethile: Lezi zicubu azipheli ngokuphelele.

• I-hemangioma yokuzalwa engahlanganisi: Lezi zicubu azipheli zodwa.

Izivivinyo Zokuxilonga

Bona isigaba soLwazi Jikelele ukuze uthole incazelo yezivivinyo nezinqubo, njenge-ultrasound, esetshenziselwa ukuxilonga i-hemangioma yokuzalwa.

Ukwelashwa

Ukwelashwa kwe-hemangioma yokuzalwa okungaxhunyiwe ngokushesha kanye ne-hemangioma yokuzalwa engathinteki ingafaka okulandelayo:

• Ukuqaphela kuphela.

Ukwelashwa kwe-hemangioma yokuzalwa okungabandakanyi kungabandakanya okulandelayo:

• Ukuhlinzwa ukukhipha isimila, kuya ngokuthi sikuphi nokuthi ngabe sidala izimpawu.

Izicubu zeBenign Vascular zesibindi

Izicubu zeBenign semithambo yesibindi zingaba izilonda zemithambo egxile kakhulu (isilonda esisodwa endaweni eyodwa yesibindi), izilonda eziningi zesibindi (izilonda eziningi endaweni eyodwa yesibindi), noma ukusabalalisa izilonda zesibindi (izilonda eziningi endaweni engaphezu kweyodwa isibindi).

Isibindi sinemisebenzi eminingi, kufaka phakathi ukuhlunga igazi nokwenza amaprotheni adingekayo ekunqandeni igazi. Kwesinye isikhathi, igazi elijwayele ukugeleza phakathi kwesibindi liyavinjwa noma lehliswe yisimila. Lokhu kuthumela igazi ngqo enhliziyweni ngaphandle kokudlula esibindini futhi kubizwa nge-shunt yesibindi. Lokhu kungadala ukwehluleka kwenhliziyo nezinkinga ngokuqina kwegazi.

Izilonda ze-Focal Vascular

Izilonda zemithambo yegazi imvamisa zivamise ukuxhuma ngokushesha i-hemangiomas yokuzalwa noma i-hemangiomas yama-congenital.

Izivivinyo Zokuxilonga

Bheka isigaba soLwazi Jikelele ukuze uthole incazelo yezivivinyo nezinqubo ezisetshenziselwa ukuxilonga izilonda zemithambo yegazi yesibindi.

Ukwelashwa

Ukwelashwa kwezilonda zemisipha egxile esibindini kuya ngokuthi izimpawu zenzeka yini futhi zingafaka okulandelayo:

• Ukuqaphela.

• Izidakamizwa zokwelapha izimpawu, kufaka phakathi ukwehluleka kwenhliziyo nezinkinga zokuvala igazi.

• Ukuhlanganiswa kwesibindi ukwelapha izimpawu.

• Ukuhlinzwa, ngezilonda ezingaphenduli kolunye ukwelashwa.

Izilonda zesibindi eziningi nezisakazekayo

Izilonda eziningi zesibindi zivame ukuba yinsana yama-hemangiomas. Izilonda ezinzima zesibindi zingadala imiphumela emibi, kufaka phakathi izinkinga ngendlala yegilo nenhliziyo. Isibindi singakhulisa, sicindezele kwezinye izitho, futhi sidale izimpawu eziningi.

Izivivinyo Zokuxilonga

Bheka isigaba soLwazi Olujwayelekile ukuthola incazelo yezivivinyo nezinqubo ezisetshenziswayo ukuxilonga izilonda zemithambo yegazi eningi.

Ukwelashwa

Ukwelashwa kwezilonda zesibindi eziningi kungafaka okulandelayo:

• Ukuqaphela izilonda ezingabangeli izimpawu.

• Ukwelashwa kwe-beta-blocker (propranolol) yezilonda eziqala ukukhula.

Ukwelashwa kwezilonda zesibindi ezingafani kungafaka okulandelayo:

• Ukwelashwa kwe-beta-blocker (propranolol).

• Ukwelashwa ngamakhemikhali.

• Ukwelashwa kwama-steroid.

• Ukufakelwa okuphelele kwe-hepatectomy nesibindi, lapho izilonda zingaphenduli ekwelashweni kwezidakamizwa. Lokhu kwenziwa kuphela lapho izilonda zisabalale kakhulu esibindini futhi izitho ezingaphezu kwesisodwa zehlulekile.

Uma isilonda semisipha sesibindi singaphenduli ekwelashweni okujwayelekile, kungenziwa i-biopsy ukubona ukuthi isimila sesibe sibi yini.

Uthi lokuphotha Cell Hemangioma

I-spindle cell hemangiomas iqukethe amaseli abizwa ngama-spindle cells. Ngaphansi kwesibonakhulu, amaseli wokuphotha abukeka made futhi ezacile.

Izici Zengozi

Noma yini enyusa ubungozi bokuthola isifo ibizwa ngokuthi ingozi. Ukuba nengcuphe akusho ukuthi uzosithola lesi sifo; ukungabi nezici zobungozi akusho ukuthi ngeke usithole lesi sifo. Khuluma nodokotela wengane yakho uma ucabanga ukuthi ingane yakho ingaba sengcupheni. I-Spindle cell hemangiomas kungenzeka ivele ezinganeni ezinama-syndromes alandelayo:

• I-Maffucci syndrome, ethinta uqwanga nesikhumba.

• I-Klippel-Trenaunay syndrome, ethinta imithambo yegazi, izicubu ezithambile namathambo.

Izimpawu

I-Spindle cell hemangiomas ivela ngaphakathi noma ngaphansi kwesikhumba. Ziyizilonda ezibuhlungu nsundu noma eziluhlaza okwesibhakabhaka ezivame ukuvela ezingalweni noma emilenzeni. Zingaqala njengesilonda esisodwa futhi zikhule zibe izilonda eziningi ngokuhamba kweminyaka.

Izivivinyo Zokuxilonga

Bheka isigaba soLwazi Olujwayelekile ukuthola incazelo yezivivinyo nezinqubo ezisetshenziselwa ukuxilonga i-spindle cell hemangioma.

Ukwelashwa

Akukho ukwelashwa okujwayelekile kwe-spindle cell hemangiomas. Ukwelashwa kungafaka okulandelayo:

• Ukuhlinzwa ukukhipha isimila.

I-spindle cell hemangiomas ingabuya ngemuva kokuhlinzwa.

I-Epithelioid Hemangioma

I-Epithelioid hemangiomas ivame ukwakheka noma esikhumbeni, ikakhulukazi ikhanda, kepha ingenzeka kwezinye izindawo, njengamathambo.

Izimpawu Nezimpawu

I-Epithelioid hemangiomas kwesinye isikhathi ibangelwa ukulimala. Esikhumbeni, zingahle zibonakale ziphinki ngokuqinile kumaqhubu abomvu futhi zingalunywa. I-Epithelioid hemangioma yethambo ingadala ukuvuvukala, ubuhlungu, namathambo abuthakathaka endaweni ethintekile.

Izivivinyo Zokuxilonga

Bheka isigaba soLwazi Jikelele ukuthola incazelo yezivivinyo nezinqubo ezisetshenziselwa ukuxilonga i-epithelioid hemangioma.

Ukwelashwa

Akukho ukwelashwa okujwayelekile kwama-epithelioid hemangiomas. Ukwelashwa kungafaka okulandelayo:

• Ukuhlinzwa (i-curettage noma i-resection).

• I-Sclerotherapy.

• Ukwelashwa ngemisebe ezimweni ezingavamile.

I-Epithelioid hemangiomas ivame ukubuya ngemuva kokwelashwa.

I-Pyogenic Granuloma

I-pyogenic granuloma ibizwa nangokuthi i-lobular capillary hemangioma. Kuvame kakhulu ezinganeni ezindala nasebasha kodwa zingavela noma ngasiphi isikhathi.

Izilonda kwesinye isikhathi zibangelwa ukulimala noma ukusetshenziswa kwemithi ethile, kufaka phakathi amaphilisi okulawula ukubeletha kanye nama-retinoids. Zingahle futhi zenze ngaphandle kwesizathu esaziwayo ngaphakathi kwama-capillaries (imithambo yegazi emincane kakhulu), imithambo yegazi, imithambo, noma ezinye izindawo emzimbeni. Imvamisa kuba nesilonda esisodwa kuphela, kepha kwesinye isikhathi izilonda eziningi zenzeka endaweni efanayo noma izilonda zingasabalala ziye kwezinye izindawo zomzimba.

Izimpawu

Kuphakanyiswa ama-granulomas e-Pyogenic, izilonda ezibomvu ngokugqamile ezingaba mncane noma zikhulu futhi zibushelelezi noma zibe namabhomu. Zikhula ngokushesha ngaphezu kwamasonto kuya ezinyangeni futhi zingopha kakhulu. Lezi zilonda zivame ukuba ngaphezulu kwesikhumba, kepha zingakheka ezicutshini ezingaphansi kwesikhumba futhi zibukeke njengezinye izilonda zemithambo yegazi.

Izivivinyo Zokuxilonga

Bona isigaba soLwazi Olujwayelekile ukuthola incazelo yezivivinyo nezinqubo ezisetshenziselwa ukuxilonga i-pyogenic granuloma.

Ukwelashwa

Amanye ama-granulomas e-pyogenic ahamba ngaphandle kokwelashwa. Amanye ama-pyogenic granulomas adinga ukwelashwa okungafaka okulandelayo:

• Ukuhlinzwa (ukukhishwa noma ukwelashwa) ukususa isilonda.

• I-Photocoagulation.

• Ukwelashwa kwezihloko ze-beta-blocker.

Ama-granulomas e-pyogenic ngokuvamile abuya ngemuva kokwelashwa.

I-Angiofibroma

Ama-angiofibromas ayivelakancane. Ziyizilonda zesikhumba ezinobungozi ezivame ukwenzeka ngesimo esibizwa nge-tuberous sclerosis (isifo esizuzwe njengefa esidala izilonda zesikhumba, ukuqubuka nokukhubazeka kwengqondo).

Izimpawu

Ama-angiofibromas avela njengamaqhubu abomvu ebusweni.

Izivivinyo Zokuxilonga

Bheka isigaba soLwazi Jikelele ukuthola incazelo yezivivinyo nezinqubo ezisetshenziselwa ukuxilonga i-angiofibroma.

Ukwelashwa

Ukwelashwa kwama-angiofibromas kungafaka okulandelayo:

• Ukuhlinzwa (ukukhipha) ukukhipha isimila.

• Ukwelashwa nge-Laser.

• Ukwelashwa okuhlosiwe (sirolimus).

IJuvenile Nasopharyngeal Angiofibroma

I-juvenile nasopharyngeal angiofibromas yizicubu ezinobungozi kepha zingakhula zibe izicubu eziseduze. Ziqala emgodini wamakhala futhi zingasabalala ziye ku-nasopharynx, ezonweni ze-paranasal, ithambo elizungeze amehlo, futhi kwesinye isikhathi ziye ebuchosheni.

Izivivinyo Zokuxilonga

Bheka isigaba solwazi jikelele ukuthola incazelo yezivivinyo nezinqubo ezisetshenziselwa ukuxilonga i-juvenile nasopharyngeal angiofibroma.

Ukwelashwa

Ukwelashwa kwe-angiofibromas yentsha ye-nasopharyngeal kungafaka okulandelayo:

• Ukuhlinzwa (ukukhipha) ukukhipha isimila.

• Ukwelashwa ngemisebe.

• Ukwelashwa ngamakhemikhali.

• I-Immunotherapy (i-interferon).

• Ukwelashwa okuhlosiwe (sirolimus).

Izimila Ezisemkhatsini Ezisakazeka Endaweni

Kulesi Sigaba

• I-Kaposiform Hemangioendothelioma ne-Tufted Angioma

Ngemininingwane mayelana nokwelashwa okubalwe ngezansi, bheka isigaba se-Treatment Option Overview section.

I-Kaposiform Hemangioendothelioma ne-Tufted Angioma

I-Kaposiform hemangioendotheliomas kanye nama-angiomas akhuphukile yizicubu zomthambo wegazi ezenzeka ezinganeni noma ezinganeni ezincane. Lezi zicubu zingadala isimanga seKasabach-Merritt, isimo lapho igazi lingakwazi ukumboza futhi ukuphuma kwegazi okunzima kungahle kwenzeke. Esimweni seKasabach-Merritt, isimila sibamba futhi sibhubhise ama-platelets (amaseli aqinisa igazi). Lapho-ke awekho amaplatelet anele egazini lapho edingeka ukumisa ukopha. Lolu hlobo lwesimila semithambo aluhlobene neKaposi sarcoma.

Izimpawu Nezimpawu

I-Kaposiform hemangioendotheliomas kanye ne-angiomas e-tufted kuvame ukuvela esikhunjeni sezingalo nemilenze, kepha futhi kungakheka kwizicubu ezijulile, ezinjengemisipha noma ithambo, noma esifubeni noma esiswini.

Izimpawu nezimpawu zingafaka okulandelayo:

• Izindawo eziqinile, ezibuhlungu zesikhumba ezibukeka zilinyaziwe.

• Izindawo ezibomvu ngokunsomi noma nsundu.

• Ukulinyazwa okulula.

• Ukopha ngaphezu kwenani elijwayelekile kusuka kulwelwesi lwamafinyila, amanxeba, nezinye izicubu.

Iziguli ezine-kaposiform hemangioendothelioma ne-tufted angioma zingaba ne-anemia (buthakathaka, zizizwe zikhathele, noma zibukeka ziphaphathekile).

Izivivinyo Zokuxilonga

Bona isigaba soLwazi Jikelele ukuthola incazelo yezivivinyo nezinqubo ezisetshenziselwa ukuxilonga i-kaposiform hemangioendothelioma.

Uma ukuhlolwa ngokomzimba kanye ne-MRI kukhombisa ngokusobala ukuthi isimila kuyi-kaposiform hemangioendothelioma noma i-angioma enesifo, i-biopsy kungenzeka ingadingeki. I-biopsy ayenziwa njalo ngoba ukuphuma kwegazi okunzima kungenzeka.

Ukwelashwa

Ukwelashwa kwama-kaposiform hemangioendotheliomas nama-angiomas afuthwe kuncike ezimpawu zezingane. Ukutheleleka, ukubambezeleka ekwelashweni, nokuhlinzwa kungadala ukopha okusongela impilo. I-Kaposiform hemangioendotheliomas kanye nama-angiomas atholakalayo aphathwa kahle nguchwepheshe we-vascular anomaly.

Ukwelashwa nokunakekelwa okusekela ukuphatha ukopha kungafaka okulandelayo:

• Ukwelashwa nge-steroid okungalandelwa ukwelashwa ngamakhemikhali.

• Izidakamizwa ezingezona ukuvuvukala (ama-NSAID), njenge-aspirin.

• I-Immunotherapy (i-interferon).

• Ukwelashwa kwe-Antifibrinolytic ukuthuthukisa ukujiya kwegazi.

• I-Chemotherapy ngomuthi owodwa noma ngaphezulu we-anticancer.

• Ukwelashwa kwe-beta-blocker (propranolol).

• Ukuhlinzwa (ukukhipha) ukukhipha isimila, noma ngaphandle kokuhlanganiswa.

• Ukwelashwa okuhlosiwe (i-sirolimus), noma ngaphandle kwe-steroid therapy.

• Isivivinyo somtholampilo se-chemotherapy noma ukwelashwa okuhlosiwe (sirolimus).

Ngisho nangempatho, lezi zicubu azihambi ngokuphelele futhi zingabuya. Ubuhlungu nokuvuvukala kungahle kube kubi ngokukhula, imvamisa ngesikhathi sokuthomba. Imiphumela yesikhathi eside ifaka phakathi ubuhlungu obungapheli, ukwehluleka kwenhliziyo, izinkinga zamathambo, kanye ne-lymphedema (ukwakheka kwe-lymph fluid ezicutshini).

Izimila Eziphakathi Ezisakazeka Kancane

Kulesi Sigaba

• I-Pseudomyogenic Hemangioendothelioma

• I-Retiform Hemangioendothelioma

• I-Papillary Intralymphatic Angioendothelioma

• I-Hemangioendothelioma eyinhlanganisela

• UKaposi Sarcoma

Ngemininingwane mayelana nokwelashwa okubalwe ngezansi, bheka isigaba se-Treatment Option Overview section.

I-Pseudomyogenic Hemangioendothelioma

I-Pseudomyogenic hemangioendothelioma ingenzeka ezinganeni, kepha ivame kakhulu emadodeni aphakathi kweminyaka engama-20 nengama-50 ubudala. Lezi zicubu azivamile, futhi zivame ukuvela noma ngaphansi kwesikhumba, noma ethanjeni. Zingasakazeka ezicutshini eziseduze, kepha imvamisa azisabalali ziye kwezinye izitho zomzimba. Ezimweni eziningi, kunezimila eziningi.

Izimpawu Nezimpawu

I-Pseudomyogenic hemangioendotheliomas ingavela njengesigaxa sezicubu ezithambile noma ingadala ubuhlungu endaweni ethintekile.

Izivivinyo Zokuxilonga

Bheka isigaba soLwazi Jikelele ukuthola incazelo yezivivinyo nezinqubo ezisetshenziswayo ukuxilonga i-pseudomyogenic hemangioendothelioma.

Ukwelashwa

Ukwelashwa kwe-pseudomyogenic hemangioendotheliomas kungafaka okulandelayo:

• Ukuhlinzwa ukukhipha isimila lapho kungenzeka. Ukunqunywa kungadingeka lapho kunezimila eziningi ethanjeni.

• Ukwelashwa ngamakhemikhali.

• Ukwelashwa okubhekiswe (mTOR inhibitors).

Ngoba i-pseudomyogenic hemangioendothelioma ayivamile ezinganeni, izinketho zokwelashwa zisuselwa ekuhlolweni kwemitholampilo kubantu abadala.

I-Retiform Hemangioendothelioma

I-Retiform hemangioendotheliomas ikhula kancane, izicubu eziyizicaba ezenzeka kubantu abadala abasebasha futhi kwesinye isikhathi ezinganeni. Lezi zicubu zivame ukuvela noma ngaphansi kwesikhumba sezingalo, imilenze, nesiqu. Lezi zicubu ngokuvamile azisabalali ziye kwezinye izingxenye zomzimba.

Izivivinyo Zokuxilonga

Bheka isigaba soLwazi Jikelele ukuthola incazelo yezivivinyo nezinqubo ezisetshenziselwa ukuxilonga i-retiform hemangioendothelioma.

Ukwelashwa

Ukwelashwa kwe-retiform hemangioendotheliomas kungafaka okulandelayo:

• Ukuhlinzwa (ukukhipha) ukukhipha isimila. Ukulandelela kuzobandakanya ukuqapha ukubona ukuthi isimila siyabuya yini.

• Ukwelashwa ngemisebe nokwelashwa ngamakhemikhali lapho ukuhlinzwa kungenziwa noma lapho isimila sesibuyile.

I-Retiform hemangioendothelioma ingabuya emuva kokwelashwa.

I-Papillary Intralymphatic Angioendothelioma

I-Papillary intralymphatic angioendotheliomas ibizwa nangokuthi izicubu ze-Dabska. Lezi zicubu zenzeka ngaphakathi noma ngaphansi kwesikhumba noma kuphi emzimbeni. Ama-lymph node kwesinye isikhathi ayathinteka.

Izimpawu

Ama-papillary intralymphatic angioendotheliomas angavela njengamaqhubu aqinile, aphakanyisiwe, a-purplish, angahle abe mancane noma makhulu.

Izivivinyo Zokuxilonga

Bheka isigaba soLwazi Jikelele ukuthola incazelo yezivivinyo nezinqubo ezisetshenziswayo ukuxilonga i-papillary intralymphatic angioendothelioma.

Ukwelashwa

Ukwelashwa kwe-papillary intralymphatic angioendotheliomas kungafaka okulandelayo:

• Ukuhlinzwa (ukukhipha) ukukhipha isimila.

I-Hemangioendothelioma eyinhlanganisela

Ama-hemangioendotheliomas ahlanganisiwe anezici zombili izicubu ezinobungozi nezibi. Lezi zicubu zivame ukuvela noma ngaphansi kwesikhumba ezingalweni noma emilenzeni. Kungenzeka futhi nasekhanda, entanyeni, noma esifubeni. Ama-hemangioendotheliomas ahlanganisiwe akunakwenzeka ukuthi asakaze (asakaze) kepha angabuya endaweni efanayo. Lapho izimila zihlangana, zivame ukusakazeka kuma-lymph node aseduze.

Izivivinyo Zokuxilonga

Bheka isigaba soLwazi Jikelele ukuthola incazelo yezivivinyo nezinqubo ezisetshenziselwa ukuxilonga i-hemangioendothelioma eyinhlanganisela bese uthola ukuthi isimila sesisakazekile yini.

Ukwelashwa

Ukwelashwa kwama-hemangioendotheliomas ahlanganisiwe kungabandakanya okulandelayo:

• Ukuhlinzwa ukukhipha isimila.

• Ukwelashwa ngemisebe nokwelashwa ngamakhemikhali kwezimila ezisakazekile.

UKaposi Sarcoma

IKaposi sarcoma ngumdlavuza odala ukuthi izilonda zikhule esikhunjeni; ulwelwesi lwamafinyila oluvale umlomo, ikhala, nomphimbo; ama-lymph node; noma ezinye izitho. Kubangelwa igciwane leKaposi sarcoma herpes virus (KSHV). E-United States, kwenzeka kakhulu ezinganeni ezinamasosha omzimba abuthakathaka abangelwa ukuphazamiseka kwesistimu yomzimba okungajwayelekile, ukutheleleka nge-HIV, noma izidakamizwa ezisetshenziselwa ukufakelwa izitho zomzimba.

Izimpawu

Izimpawu ezinganeni zingafaka okulandelayo:

• Izilonda esikhumbeni, emlonyeni, noma emphinjeni. Izilonda zesikhumba zibomvu, zinsomi, noma nsundu futhi ziyashintsha zisuka emaflethini, ziye phezulu, ziye ezindaweni ezinamakhasi ezibizwa ngokuthi izingcwecwe, ziye kumaqhuqhuva.

• Ama-lymph node avuvukile.

Izivivinyo Zokuxilonga

Bheka isigaba solwazi jikelele ukuthola incazelo yezivivinyo nezinqubo ezisetshenziselwa ukuxilonga iKaposi sarcoma.

Ukwelashwa

Ukwelashwa kweKaposi sarcoma kungafaka okulandelayo:

• Ukwelashwa ngamakhemikhali.

• I-Immunotherapy (i-interferon).

• Ukwelashwa ngemisebe.

Ngoba iKaposi sarcoma ayivamile ezinganeni, ezinye izindlela zokwelashwa zisekelwe ekuhlolweni kwemitholampilo kubantu abadala. Bona isifinyezo se- ku-Kaposi Sarcoma Treatment ukuze uthole ulwazi mayelana ne-Kaposi sarcoma kubantu abadala.

Izimila Ezimbi

Kulesi Sigaba

• I-Epithelioid Hemangioendotheliomaoma

• I-Angiosarcoma Yethambo Elithambile

Ngemininingwane mayelana nokwelashwa okubalwe ngezansi, bheka isigaba se-Treatment Option Overview section.

I-Epithelioid Hemangioendotheliomaoma

I-Epithelioid hemangioendotheliomas ingenzeka ezinganeni, kepha zivame kakhulu kubantu abadala abaphakathi kweminyaka engama-30 nengama-50 ubudala. Imvamisa zenzeka esibindini, emaphashini, noma ethanjeni. Kungenzeka zikhule ngokushesha noma zikhule kancane. Cishe kokuthathu kwamacala, isimila sisakazekela kwezinye izingxenye zomzimba ngokushesha okukhulu.

Izimpawu Nezimpawu

Izimpawu nezimpawu zixhomeke lapho sikhona isimila:

• Esikhumbeni, izicubu zingaphakanyiswa futhi zizungezwe noma zibe yisicaba, amabala abomvu ansundu azizwa efudumele.

• Emaphashini, kungahle kungabikho zimpawu zokuqala. Izimpawu nezimpawu ezingenzeka zifaka:

• Ubuhlungu besifuba.

• Ukuchitha igazi.

• I-anemia (ubuthakathaka, ukuzizwa ukhathele, noma ubukeka uphaphathekile).

• Ukuphefumula okunenkinga (kusuka ezicutshini ezinamabala amaphaphu).

• Ethanjeni, izicubu zingadala ukuphuka.

Izimila ezenzeka esibindini noma ezicutshini ezithambile nazo zingadala izimpawu nezimpawu.

Izivivinyo Zokuxilonga

I-Epithelioid hemangioendotheliomas esibindini itholakala ngezikena ze-CT kanye nezikena ze-MRI. Bheka isigaba soLwazi Olujwayelekile ukuthola incazelo yalezi zivivinyo nezinqubo ezisetshenziswayo ukuxilonga i-epithelioid hemangioendothelioma bese uthola ukuthi isimila sesisakazekile yini. Ama-X-ray nawo angenziwa.

Ukwelashwa

Ukwelashwa kwama-epithelioid hemangioendotheliomas akhula kancane kufaka lokhu okulandelayo:

• Ukuqaphela.

Ukwelashwa kwe-epithelioid hemangioendotheliomas ekhula ngokushesha kungafaka okulandelayo:

• Ukuhlinzwa ukukhipha isimila lapho kungenzeka.

• I-Immunotherapy (i-interferon) kanye nokwelashwa okuhlosiwe (i-thalidomide, i-sorafenib, i-pazopanib, i-sirolimus) yamathumba okungenzeka asabalale.

Ukwelashwa ngamakhemikhali.

• Ukufakelwa okuphelele kwe-hepatectomy nesibindi lapho isimila sisesibindi.

• Isivivinyo somtholampilo sokwelapha okuhlosiwe (trametinib).

• Isivivinyo somtholampilo se-chemotherapy kanye nokwelashwa okuhlosiwe (pazopanib).

I-Angiosarcoma Yethambo Elithambile

Ama-angiosarcomas izicubu ezikhula ngokushesha ezakha emithanjeni yegazi noma emithanjeni ye-lymph kunoma iyiphi ingxenye yomzimba, imvamisa izicubu ezithambile. Ama-angiosarcomas amaningi aphakathi noma eduze kwesikhumba. Labo abasemathisheni athambile ajulile bangakha esibindini, ebunzimeni nasemaphashini.

Lezi zicubu azivamile ezinganeni. Izingane kwesinye isikhathi zinesimila esingaphezu kwesisodwa esikhunjeni kanye / noma esibindini.

Izici Zengozi

Noma yini enyusa ubungozi bokuthola isifo ibizwa ngokuthi ingozi. Ukuba nengcuphe akusho ukuthi uzosithola lesi sifo; ukungabi nezici zobungozi akusho ukuthi ngeke usithole lesi sifo. Khuluma nodokotela wengane yakho uma ucabanga ukuthi ingane yakho ingaba sengcupheni. Izici ezinobungozi bama-angiosarcomas zifaka okulandelayo:

• Ukuvezwa yimisebe.

• I-lymphedema engapheli (yesikhathi eside), isimo lapho i-lymph fluid eyengeziwe yakha khona izicubu futhi ibangele ukuvuvukala.

• Ukuba nesimila semithambo esiyingozi. Isimila esibi, njenge-hemangioma, singaphenduka i-angiosarcoma kepha lokhu akuvamile.

Izimpawu

Izimpawu ze-angiosarcoma zixhomeke lapho i-tumor ikhona futhi ingafaka okulandelayo:

• Amabala abomvu esikhumbeni esopha kalula.

• Izimila eziphephuli.

Izivivinyo Zokuxilonga

Bheka isigaba soLwazi Olujwayelekile ukuthola incazelo yezivivinyo nezinqubo ezisetshenziswayo ukuxilonga i-angiosarcoma bese uthola ukuthi isimila sesisakazekile yini.

Ukwelashwa

Ukwelashwa kwe-angiosarcoma kungafaka okulandelayo:

• Ukuhlinzwa ukususa ngokuphelele isimila.

• Inhlanganisela yokuhlinzwa, i-chemotherapy, kanye ne-radiation therapy yama-angiosarcomas asabalale.

• Ukwelashwa okuhlosiwe (i-bevacizumab) ne-chemotherapy yama-angiosarcomas aqala njengama-hemangiomas amancane.

• Isivivinyo somtholampilo se-chemotherapy noma ngaphandle kwokwelapha okuhlosiwe (pazopanib).

• Isivivinyo somtholampilo se-immunotherapy (nivolumab ne-ipilimumab).

Ukufunda Okwengeziwe Ngama-Tumors We-Vascular Childhood

Ukuthola eminye imininingwane ngamathumba emithambo ebuntwaneni, bona okulandelayo:

• Ikhasi lasekhaya le-Soft Tissue Sarcoma

• I-Computed Tomography (CT) Iskena Nomdlavuza

• Izindlela Zokwelapha Zomdlavuza

• I-MyPART - Inethiwekhi Yami Yezingane ne-Adult Rare Tumor Network

Ngemininingwane eminingi yomdlavuza wezingane nezinye izinsiza zomdlavuza ezijwayelekile, bheka okulandelayo:

• Mayelana Nomdlavuza

• Umdlavuza Wezingane

• I-CureSearch ye-Cancer YezinganePhuma Ukuzikhulula

• Imiphumela Emuva Yokwelapha Yomdlavuza Wezingane

• Intsha kanye nabantu abadala abancane abaneCancer

• Izingane Ezinomdlavuza: Umhlahlandlela Wabazali

• Umdlavuza Ezinganeni Nasebusheni

• Isiteji

• Ukubhekana Nomdlavuza

• Imibuzo Ongayibuza Udokotela Wakho mayelana Nomdlavuza

• Kwabasindile Nabanakekeli