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Tumoren der Kopfhaut

Besondere Aspekte ausgewählter Beispiele

Tumors of the scalp

Special aspects of selected examples

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Zusammenfassung

Hintergrund

Tumore der Kopfhaut zeigen einige klinische, histologische und prognostische Besonderheiten. Durch die dichte Behaarung ist eine Früherkennung erschwert, wodurch es zur verspäteten Diagnosestellung kommen kann.

Material und Methode

Es werden das atypische Fibroxanthom, das kutane Angiosarkom, das maligne Melanom der Kopfhaut, einige Adnextumoren einschließlich des proliferierenden trichilemmalen Tumors sowie Hautmetastasen viszeraler Tumore unter Berücksichtigung aktueller Literatur besprochen.

Ergebnisse

Da beginnende Tumore der behaarten Kopfhaut klinisch häufig nicht auffallen, werden sie oft erst in einem späten Stadium diagnostiziert. Angiosarkome gehören zu den aggressivsten Hauttumoren und zeigen ein schnelles Wachstum und eine schlechte Prognose. Auch das maligne Melanom am Capillitium weist im Vergleich zu anderen Lokalisationen eine ernstere Prognose auf. Hautmetastasen sind meist Ausdruck eines fortgeschrittenen Tumorleidens mit oft infauster Prognose. Die vielen verschiedenen Hautadnextumore sind meist gutartig. Schnelles Wachstum und Ulzeration können Hinweise auf den seltenen Fall eines Adnexkarzinoms sein. An der Kopfhaut sind Tumore, die Schweißdrüsen imitieren, viel häufiger als Tumore mit follikulärer Differenzierung. Dies widerlegt die allgemeine Annahme, dass Adnextumore von ortsständigen Adnexen ihren Ausgang nehmen.

Schlussfolgerung

Veränderungen der Kopfhaut mit unklarer Dignität sollten frühzeitig biopsiert bzw. exzidiert werden. Das Ergebnis der histologischen Untersuchung bestimmt die weitere Therapie.

Abstract

Background

Tumors of the scalp display some clinical, histological and prognostic characteristics. Early recognition of tumors is hampered by dense hair growth which can result in delayed diagnosis.

Material and methods

Taking current literature into consideration atypical fibroxanthoma, cutaneous angiosarcoma, melanoma of the scalp, some adnexal tumors including the proliferating trichilemmal tumor as well as cutaneous metastases from visceral malignancies will be discussed.

Results

Based on the fact that early scalp tumors are clinically difficult to recognize, they are often diagnosed at a late stage. Angiosarcomas belong to the most aggressive skin tumors and show a rapid growth with unfavorable prognosis. Malignant melanoma on the head has a more serious prognosis in comparison to other locations of the body. Cutaneous metastases are mostly a sign of an advanced tumor stage with a fatal prognosis. The various types of adnexal tumors are mostly benign. In exceptional cases rapid growth and ulceration may be an indicator for the development of an adnexal carcinoma. On the scalp tumors with sweat gland differentiation are more frequent than tumors with follicular differentiation. This shows that the general view that adnexal tumors develop from local adnexal structures is wrong.

Conclusion

Scalp lesions in which the diagnosis is unclear should be biopsied or excised early. Based on the result of the histological examination further therapy can be determined.

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C. Rose gibt an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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  1. Dermatopathologie Lübeck, Maria-Goeppert-Str. 5, 23562, Lübeck, Deutschland

    C. Rose

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Rose, C. Tumoren der Kopfhaut. Hautarzt 65, 1030–1036 (2014). https://doi.org/10.1007/s00105-014-3531-7

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