Vulvar basal cell carcinoma

　　First, Etiology

　　Vulvar basal cell carcinoma is a malignant tumor originating from the basal cells of the vulvar epithelium. The true cause of vulvar basal cell carcinoma is unknown. Some reports suggest that it may be related to local radiotherapy. However, basal cell carcinomas in other parts of the body, such as those on the head and face, may be related to sunlight, but this does not fully explain the cause of all vulvar basal cell carcinomas.

　　Second, Pathogenesis

　　The tumor is located in the large labia, develops slowly, and rarely invades lymph nodes. There are three basic types. The three types can exist alone or in combination.

　　1. The nodular ulcerative type manifests as a solid nodule; a deep ulcer forms in the middle, with elevated edges forming a dam-like elevation, which is an aggressive ulcer.

　　2. Flat-type lesions are superficial, flat, with a rough, waxy, papular, or erythematous surface, with melanin or faint red color, and a harder texture.

　　3. Polypoid polypoid neoplasms have a complete surface.

　　Under the microscope, the tumor tissue originates from the basal layer of the epidermis, extending into the dermis or stroma, with a shape like a rod or irregular map-like distribution. The outer layer of the cell clusters is arranged in a lattice-like pattern, forming a columnar shape, elongated rod-like, dark, with the long axis arranged in a lattice-like pattern, equivalent to the basal cells of the epidermis. In the central part of the cells, the nucleus is oval, and the cytoplasm is not abundant; some contain more pigment and appear dark. The tissue structure is diverse, some are in the form of clusters, with keratinization beads in the clusters; some have adenocavity-like spaces in the clusters; some cell clusters are connected to the basal layer of the epidermis, and some are close to the shape of hair follicles. Regardless of which type, the tumor tissue always has a characteristic of a layer of basal cells arranged in a lattice-like pattern at the edge. Some tumor tissues are compressed into cord-like shapes by surrounding fibrous tissue, known as the sclerosing type. This type of cancer has local infiltrative behavior, but generally does not metastasize and is of low malignancy. If part of the cancer focus is squamous cell carcinoma, it is called basal squamous cell carcinoma, and its degree of malignancy is determined by the differentiation degree of this part of squamous cell carcinoma. In histology, basal cell carcinoma should be distinguished from skin sweat gland cancer and hair cancer. Sweat gland tumors have a characteristic of two layers of cell arrangement, and hair cancer has the structure of primordial hair follicles. Both lack the characteristic of basal cells arranged in a lattice-like pattern at the edge. In addition, it should be differentiated from basaloid cell carcinoma, which has a younger onset age, contains empty cells in histology, and shows positive results for HPV DNA detection, which are lacking in basal cell carcinoma.

　　This disease rarely metastasizes. If only one lesion is seen in the vulva, it should be checked whether there are basal cell tumors in the skin of the whole body. This disease is also often accompanied by other primary malignant tumors such as breast, stomach, rectum, lung, cervix, endometrial, and ovarian cancer. About 20% of vulvar basal cell carcinomas are associated with other cancers, such as vulvar squamous cell carcinoma, malignant melanoma, breast cancer, cervical cancer, or skin cancer.

　　1. Symptoms

　　The primary lesion of vulvar basal cell carcinoma is usually solitary, occasionally multiple. The disease has a long history, with no自觉 symptoms initially. Subsequently, the main symptoms are vulvar itching and burning sensation. Ulcers may form, causing pain or bleeding, with exudation and a bloody odor. There may also be a history of basal cell carcinoma in other parts of the body.

　　2, Signs

　　It often manifests as small foci located on the labia majora, and can also appear on the labia minora, clitoris, and labial ligament. The early lesions are gray, almost translucent, located under the thin skin, and the diameter of the small nodules is often

　　Self-diagnosis: The disease is rarely metastatic. If only one focus is seen in the vulva, it should be checked whether there is a basal cell tumor in the whole body. The disease is also often accompanied by other primary malignant tumors such as breast, stomach, rectum, lung, cervix, endometrium, and ovarian cancer, etc. It should be distinguished from Bartholin's gland carcinoma. Women with small lumps on the labia majora should seek medical attention in time, and biopsy is necessary if necessary. After diagnosis, it is necessary to pay attention to a full physical examination to exclude other malignant tumors. Follow-up prognosis should be done well:

　　The prognosis is good, with a 5-year survival rate of 80% to 95%, however, due to improper treatment, there may be a recurrence rate of 10% to 20%. The recurrent focus should be resected, and the prognosis is still good.

　　Health care:

　　1, Do not stay or stay as little as possible in the sun, and those who must work in the sun should do a good job of skin protection.

　　2, People engaged in work involving X-ray or thermal radiation should do a good job of labor protection.

　　3, Avoid direct contact of the skin with petroleum, asphalt, tar, and arsenic and other chemical substances.

　　4, Actively treat chronic skin diseases such as ulcers, inflammation, burn scars, solar keratosis, seborrheic keratosis, vitiligo, and others.

　　5, Often eat food with anti-cancer and anti-tumor effects.

　　The diagnosis of vaginal basal cell carcinoma depends not only on clinical manifestations, but also on the necessary auxiliary examinations. The examination methods are as follows:

      1, Routine blood test, secretion examination, tumor marker examination.

　　2, Tissue pathological examination.

　　I. Dietetic recipe for vaginal basal cell carcinoma

　　1, 300 grams of meat, 1 fresh river fish (500 grams), 1 white radish. Cut the mutton into large pieces and put it in boiling water, boil with sliced radish for 15 minutes, discard the soup and radish. Put the mutton in the pot, add water (about 2/3 of the pot capacity), scallion, ginger, and wine, and cook until tender. If the soup is too little, add some boiling water. After the fish is fried with soybean oil, put it in the pot with the mutton and cook for 30 minutes. Add salt, coriander, green onion, and scallion to the soup, and it becomes a delicious mutton and fish soup. It is mainly used for postoperative recuperation after vaginal basal cell carcinoma.

　　2, Quail eggs 20 pieces, half an onion, carrot 80 grams, asparagus 80 grams, tomato 4 pieces, green pepper 1 piece. Boil the eggs and use the shell. Cut the vegetables into small pieces. Boil the carrots until just cooked. Put 200 milliliters of soup material, 40 grams of sugar, 45 milliliters of vinegar, 15 milliliters of wine, 20 grams of tomato sauce, 5 milliliters of sesame oil, 10 grams of flour, and mix into a sauce. Heat 30 milliliters of oil in a pot, stir-fry the eggs and vegetables, pour in the sauce and cook for a while, then it can be eaten. It is mainly used to treat anemia caused by chronic hemorrhage due to vaginal basal cell carcinoma.

　　Two, what foods are good for vulvar basal cell carcinoma patients

　　1. Eat more foods with anti-vulvar tumor effects, such as sesame, almonds, wheat, barley, cucurbita, black-bone chicken, cuttlefish, Chinese rat snake, pork pancreas, chrysanthemum, umeboshi, peach, lychee, plantain, amaranth, chicken blood, eel, abalone, crab, horseshoe crab, sardine, clam, and tortoise.

　　1. For pain, eat horseshoe crabs, red crabs, lobsters, clams, sea cucumber, tiger fish, beetroot, mung beans, radish, and chicken blood.

　　2. For itching, eat amaranth, cabbage, rapeseed, taro, kelp, nori, chicken blood, snake meat, and pangolin.

　　3. To enhance physical fitness and prevent metastasis, eat silver ear, black fungus, mushrooms, hedgehog mushrooms, gizzards, sea cucumber, Job's tears, walnuts, crabs, lizards, and needlefish.

　　4. Supply easily digestible protein foods such as milk, eggs, fish, and soy products, which can improve the body's cancer-fighting ability. Milk and eggs can improve protein disorder after radiotherapy.

　　5. Consume an appropriate amount of carbohydrates to supplement calories. For patients undergoing high-dose radiotherapy, it can destroy the sugar metabolism in their bodies, causing a sharp decrease in glycogen and an increase in lactic acid in the blood, which can no longer be utilized; and insufficient insulin function will worsen. Therefore, the effect of glucose supplementation is better, and it is advisable to eat more sugar-rich foods such as honey, rice, flour, potatoes, etc. to supplement calories.

　　6. Vitamin A and C have the effect of preventing cell malignancy and spread, increasing the stability of epithelial cells; vitamin C can also prevent general symptoms of radiation injury and can increase the level of white blood cells; vitamin E can promote cell division, delay cell aging; vitamin B1 can promote the appetite of patients and alleviate symptoms caused by radiotherapy. The diet of basal cell carcinoma should include foods rich in the above vitamins, such as fresh vegetables, fruits, sesame oil, grains, beans, and animal internal organs.

　　8. For patients undergoing radiotherapy and chemotherapy, it is generally recommended to eat cold foods and cold drinks, but for patients with cold symptoms, it is advisable to eat hot foods.

　　Three, what foods should vulvar basal cell carcinoma patients avoid

　　1. Avoid stimulant drinks such as coffee.

　　2. Avoid spicy and刺激性 foods such as scallion, garlic, ginger, and cinnamon.

　　3. Avoid smoking and alcohol.

　　4. Avoid greasy, fried, moldy, and preserved foods.

　　5. Avoid stimulants such as rooster, goose, etc.

　　6. Avoid seafood and刺激性, allergenic foods when itching is severe.

　　Pre-treatment related information:

　　The cure rate of vulvar basal cell carcinoma is very high. Beijing Chaoyang Hospital reported a case of vulvar basal cell carcinoma with metastasis and multiple recurrences in 1986. After the first surgery, local recurrence occurred six years later, and the surgery was performed again. Radiotherapy and cisplatin chemotherapy were performed after surgery. Seven years later, the ipsilateral inguinal lymph node recurred, and the surgery was performed again. Adjuvant chemotherapy and radiotherapy were used after surgery. After five years, there was lung metastasis with a tumor diameter of 1.7 cm. Pulmonary lobectomy was performed, and then cisplatin and 5-Fu chemotherapy were performed after surgery. The patient was still alive two and a half years after the last surgery. The patient's total course of disease was 20 years. It can be seen that although basal cell carcinoma may recur or metastasize, it has a good prognosis after active treatment.

　　First, Chinese medical treatment methods for vulvar basal cell carcinoma with verified formula and folk remedies:

　　1. Prescribed Formula:Gecko toad decoction: 15g of gecko, toad, 15g of Poria, 15g of Poria cocos, 15g of Codonopsis, 18g of Hedyotis diffusa, 18g of Coix, 18g of Semilophium, 10g of Trapa natans, 10g of Atractylodes macrocephala, 12g of Curcuma, 3g of Glycyrrhiza uralensis. Decocted 3 times, taken 3 times a day. If there is no obvious reaction, it can be taken continuously for 2-3 months or more.

　　2. Efficacy: Pan Mingji and others have achieved certain efficacy in the treatment of ovarian cancer with this formula.

　　3. Folk Remedy:30g of walnut branch, 30g of purple root, decocted in water.

　　Second, Western medical treatment methods for vulvar basal cell carcinoma

　　1. Surgical Treatment: Vulvar basal cell carcinoma is mainly treated by surgery, and the operation can adopt extensive resection of the lesion, without the need for radical vulva surgery and inguinal lymph node dissection. For more extensive lesions, extensive vulva resection should be performed. When the urethra, vagina, or anus is involved, resection of the corresponding part should be performed. If there is a suspicion of positive inguinal lymph nodes, a biopsy should be done. If pathological confirmation shows metastasis, inguinal lymph node dissection should be performed. For patients with negative deep inguinal lymph nodes, pelvic lymph node dissection should be performed. If recurrence occurs, surgery can be performed again. The specimen should be thoroughly examined by section pathology to ensure that it is completely resected.

　　2. Radiotherapy: Basal cell carcinoma is sensitive to radiotherapy, but due to the poor tolerance of normal skin in the vulva to radiation, it is easy to cause intolerable complications such as vulvar radiation inflammation, ulcers, and pain during treatment, so this method is only suitable for early and simple basal cell carcinoma.

　　3. Anti-cancer Chemotherapy: Currently, all anti-cancer drugs have little effect on basal cell carcinoma, but for later-stage cases, anti-cancer chemotherapy can be used as a supplement to comprehensive treatment.