More about Spinaliom
How and where is spinaliom detected?
How does spinaliom grow?
What is important to know before and after an operation?
What kinds of therapy are used?
Possible complications and side-effects
Costs involved in an operation
Most spinaliomas occur in the sun-exposed areas of the skin, such as on the head and neck area, on the lower lip, back of the hand or other places, but less often on the mid-section. In the initial stage, spinaliomas usually look like a scab that does not heal or appear like a red nodule in the skin. Typically, they do not cause any discomfort and are often only noticed when they develop a small ulcer that bleeds.
A spinalioma usually grows very quickly, usually over a few months, and may also grow into and destroy surrounding tissue (e.g., muscles, bones). Spinalioma grows aggressively, a sign of malignancy. Basically, spinalioma can be called metastases, in other words, they form settlements (they spread). The risk depends on the size and depth of penetration of the spinalioma and is between 0% and 20%. The adjacent lymph nodes, the liver and the lungs are typical target structures that are examined by palpation and sonography. Since the risk for different patients varies greatly, you need to be well informed about the situation you are experiencing. The surgeon will discuss this in detail with you.
This information is important to you, because after complete local removal of the spinalioma, the primary treatment dermatologist or dermatology clinic will discuss further therapeutic options and steps with you. If you have been diagnosed with metastases (secondary tumors), your responsible dermatologist or the responsible dermatological clinic will discuss with you the optimal and adequate treatment options.
A person who has developed a spinalioma has a significantly increased risk of getting a second spinalioma or other type of skin cancer. Therefore, careful physical examination prior to the operation (to detect any existing additional skin anomalies) and completion of treatment in the form of regular follow-up / control is required from the referring physician.
Since spinaliomas and especially their precursors (actinic keratoses) are very difficult for the patient to recognize, you should show every skin change that you notice to your dermatologist.
Prerequisites for spinalioma surgery
• Diagnostics by a dermatologist (skin specialist)
• A general physical examination and so-called ’staging’
You have been diagnosed with spinalioma due either to observance of symptoms or as the result of tissue sampling.
The safest therapy of the spinalioma is the surgical removal with sufficient safety distance (radial cutting distance around the afflicted area), this is also planned for you. In some cases, alternative treatment options are available, these are discussed on an individual basis.
We usually proceed with surgical removal in two steps:
- Step 1: Removal of the spinalioma: All parts of the tumor must be removed. Complete removal is ensured by histological examination of the tissue removed, usually after 24 hours. If the spinalioma is not completely removed in the first operation, then a follow-up operation must be done. When removing the spinalioma, muscles, nerves and vessels may be affected.
- Step 2: Closure of the wound defect: The closure of the wound takes place by stretching the surrounding skin, a skin shift (flap-plasty) or a skin graft. The appropriate surgical technique will be explained in detail before the operation.
In spinalioma on the lower lip, the wound defect is usually closed immediately. Smaller spinaliomas are operated in local anesthesia, possibly supplemented by a circulatory monitoring and / or the administration of sedatives, larger spinaliomas may be removed under general anesthesia.
Pain can occur after surgery, but painkillers can control it well. Immediately after surgery, the surgical site is swollen, bruising may occur, and the wound dressings are conspicuous. This changes quickly within a short time. The wound care is performed by your surgeon. After the discharge, the referring physician can (partially) take care of the wound in your local area.
The same applies to the removal of any necessary wound drainage and the stitches. The scars resulting from the surgery become more and more inconspicuous in the course of time, in the ideal case you hardly see anything after a few months. If unsightly scars remain, then a correction surgery may be useful. The decision on this is usually only possible after 6 - 12 months.
The costs for diagnosed spinalioma are usually covered by your health insurance provider.