Cedirian Stephano, Rapparini Luca, Sechi Andrea, Piraccini Bianca Maria, Starace Michela
Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy.
Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, 40138 Bologna, Italy.
Diagnostics (Basel). 2024 Jul 30;14(15):1638. doi: 10.3390/diagnostics14151638.
Scalp metastases (SMs) are particularly noteworthy, representing around 4-7% of cutaneous neoplasms in this region of the body, possibly due to its rich blood supply. Diagnosis of SMs involves a systematic approach encompassing oncologic history, clinical examination, dermoscopy, imaging, and histopathological assessment. Clinical presentations of SM can vary, but dermoscopy reveals unique vascular patterns aiding in diagnosis. Imaging, particularly MRI and CT, and histopathological evaluation are mandatory for definitive diagnosis. Treatment strategies vary depending on tumor characteristics and staging, ranging from surgical excision to systemic therapies like chemotherapy or radiotherapy. Multimodal approaches tailored to individual cases yield optimal outcomes. The diagnostic tools available do not always allow SMs to be diagnosed, and often the lack of knowledge on the part of oncologists in suspecting SMs can delay an early diagnosis. This review provides clinicians with a practical guide for the timely diagnosis and management of SM, emphasizing the importance of a multidisciplinary approach and personalized treatment strategies for improved patient outcomes.
头皮转移瘤(SMs)尤为值得关注,约占身体该部位皮肤肿瘤的4%-7%,这可能归因于其丰富的血液供应。SMs的诊断需要采用系统方法,包括肿瘤病史、临床检查、皮肤镜检查、影像学检查和组织病理学评估。SM的临床表现可能各异,但皮肤镜检查可发现有助于诊断的独特血管模式。影像学检查,尤其是磁共振成像(MRI)和计算机断层扫描(CT),以及组织病理学评估对于明确诊断必不可少。治疗策略因肿瘤特征和分期而异,范围从手术切除到化疗或放疗等全身治疗。针对个体病例的多模式方法可产生最佳效果。现有的诊断工具并不总能诊断出SMs,而且肿瘤学家在怀疑SMs方面往往缺乏认识,这可能会延迟早期诊断。本综述为临床医生提供了一份关于SMs及时诊断和管理的实用指南,强调了多学科方法和个性化治疗策略对改善患者预后的重要性。