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Aktuelle Diagnostik und Therapieempfehlungen beim Basalzellkarzinom am Auge

Current diagnostics and therapy recommendations for ocular basal cell carcinoma

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Zusammenfassung

Bei der Behandlung des Basalzellkarzinoms haben sich in neuester Zeit mit erfolgten bzw. anstehenden Zulassungen von Chemotherapeutika die Therapieoptionen erweitert. Ebenso sind zu der Erkrankung neue S2-Leitlinien formuliert worden. Ziel des Beitrags sind eine umfassende State-of-the-art-Darstellung des Krankheitsbildes sowie eine Übersicht der vielfältigen Therapieoptionen. Insbesondere werden die klinischen Zeichen sowie die diagnostische Sicherung von periokulären Basalzellkarzinomen sowie die Interpretation der histopathologischen Subformen am Auge besprochen. Stagingschritte, TNM-Klassifikation, interdisziplinäre Tumorkonferenz sowie ein psychoonkologisches Angebot nehmen einen wichtigen Stellwert bei Patienten mit ausgeprägten periokulären Basalzellkarzinomen ein. Mit der chirurgischen Sanierung des Basalzellkarzinoms wird ein wichtiger Bestandteil der Therapiemöglichkeiten angesprochen, der die mikrochirurgische Exzision im Gesunden sowie die anschließende Deckung des Defekts umfasst. Ein besonderer Fokus der Arbeit liegt auf der Behandlung lokal ausgedehnter und metastasierter Basalzellkarzinome.

Abstract

The treatment options for basal cell carcinoma (BCC) have recently been augmented with the introduction of novel chemotherapeutic drugs. New S2 guidelines on the disease have also been published. The aim of this article is to present a comprehensive state of the art description of the features of ocular BCC and an overview of the various therapeutic options. Particular emphasis is placed on the clinical signs, the diagnostic tools to identify periocular BCC and interpretation of the different histopathological subtypes. Tumor staging, TNM classification, interdisciplinary tumor conference reviews as well as psycho-oncological services play an important role in patients with pronounced periocular BCC. Surgical removal with a histological R0 resection is an important component of therapy options in this disease and includes the microsurgical excision into healthy tissue and the subsequent covering of the defect. A special focus of this article is the treatment of locally extensive and metastasized BCC.

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Authors and Affiliations

  1. Augenklinik – Universitätsklinikum Knappschaftskrankenhaus Bochum, Ruhr-Universität Bochum, In der Schornau 23–25, 44892, Bochum, Deutschland

    V. Kakkassery

  2. Augenklinik, Universitätsklinikum Bonn, Bonn, Deutschland

    K. U. Loeffler

  3. Klinik für Dermatologie, Venerologie und Allergologie – St. Josef-Hospital, Ruhr-Universität Bochum, Bochum, Deutschland

    M. Sand

  4. Klinik für Plastische Chirurgie, Katholische Kliniken, Ruhrhalbinsel Essen, Deutschland

    M. Sand

  5. Zentrum für Augenheilkunde, Universitätsklinikum zu Köln, Köln, Deutschland

    K. R. Koch, A. M. Lentzsch & L. M. Heindl

  6. Institut für Pathologie, Ruhr-Universität Bochum, Bochum, Deutschland

    A. C. Nick

  7. Radio-Onkologie, Ruhr-Universität Bochum, Bochum, Deutschland

    I. A. Adamietz

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  1. V. Kakkassery
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  3. M. Sand
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  4. K. R. Koch
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  5. A. M. Lentzsch
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Correspondence to V. Kakkassery.

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Interessenkonflikt

K.U. Loeffler, M. Sand, A.C. Nick, I.A. Adamietz, K.R. Koch, A.M. Lentzsch, und L.M. Heindl geben an, dass kein Interessenkonflikt besteht. V. Kakkassery: Beraterhonorar Roche Pharma AG, Vortragshonorar Roche Pharma AG, Novartis Pharma GmbH.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren. Alle Patienten, die über Bildmaterial oder anderweitige Angaben innerhalb des Manuskripts zu identifizieren sind, haben hierzu ihre schriftliche Einwilligung gegeben. Im Falle von nicht mündigen Patienten liegt die Einwilligung eines Erziehungsberechtigten oder des gesetzlich bestellten Betreuers vor.

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Kakkassery, V., Loeffler, K.U., Sand, M. et al. Aktuelle Diagnostik und Therapieempfehlungen beim Basalzellkarzinom am Auge. Ophthalmologe 114, 224–236 (2017). https://doi.org/10.1007/s00347-016-0370-1

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