What is primary cancer of unknown origin?

June 3, 2021

Cancer occurs when cells begin to grow uncontrollably. Cells of almost any organ can acquire this feature. In addition, as the tumor grows, they can be transported through the blood or lymph to other areas of the body, settle there and give rise to the growth of new lesions. Such foci are called secondary cancer, or metastases, and the initial tumor, respectively, is called primary cancer.

Metastases in any organs are classified depending on which organ the tumor initially originates from. For example, a secondary focus of lung cancer in the liver will still be called lung cancer, it will just receive the prefix “secondary”. Sometimes it is not possible to determine in which organ the tumor first appeared. However, the study reveals its metastases in other parts of the body. If their primary focus cannot be determined, then doctors talk about primary cancer of unknown origin, or hidden primary cancer.

Causes of skin cancer

Currently, there is no clear answer to the question of what causes skin cancer. Like many other oncological diseases, skin tumors are considered a multi-etiological pathology. There are several predisposing factors, the presence of which increases the risk of developing a tumor focus. These include:

• Excessive exposure to ultraviolet rays on the skin. A similar situation occurs with prolonged and frequent exposure to sunlight, visiting a solarium, or working outside. Residents of the southern regions are at risk of developing skin cancer.
• Having light skin. Lack of melanin production increases the likelihood of skin tumors.
• Skin burn. A high degree of burn is accompanied by scarring of the skin. This process contributes to the emergence of latent carcinogenesis.
• Irradiation. Exposure to radioactive, ionizing rays has a detrimental effect on the skin. The risk of radiation dermatitis increases.
• Presence of skin contact with toxic substances. This group of carcinogens includes arsenic, aluminum, titanium, nickel and other heavy metals.
• Immunodeficiency. Conditions in which the body's protective functions decrease predispose to the formation of a tumor focus.
• Age. Most often, skin tumors affect people over 50 years of age.
• Concomitant systemic diseases. Doctors identify a group of pathologies in which the risk of developing skin cancer increases significantly. These include systemic lupus erythematosus, leukemia, and chronic skin diseases.
• Heredity. The presence of a skin tumor in previous generations of relatives is not a major risk factor. However, family history in combination with other predisposing conditions increases the possibility of developing skin cancer.
• Tattooing. In this case, there are two risk factors. This is a violation of the integrity of the skin and the introduction of paint with carcinogenic substances. Cheap tattoo ink may contain impurities of aluminum, titanium, and arsenic.
• A large number of nevi. Doctors urge you to monitor the condition of moles and contact a specialist if there is the slightest change. Traumatization of nevi increases the possibility of developing skin cancer.
• Excessive alcohol consumption, smoking. Chronic intoxication has a detrimental effect on the body as a whole. Against this background, the risk of tumor formation increases several times.
• Eating foods high in nitrates.

Oncologists identify several precancerous conditions, the presence of which significantly increases the risk of developing skin cancer. These include:

• Xeroderma pigmentosum.
• Bowen's disease.
• Paget's disease.
• Hyperkeratosis.
• Cutaneous horn.
• Late stage radiation sickness.
• Dermatitis and dermatoses.

About the disease

The mucous membrane of the final portion of the colon is covered with columnar epithelium with a large number of glands. Their cells produce mucus. Under the influence of risk factors, pathological cells appear with uncontrolled division and loss of the apoptosis mechanism - programmed death. Gradually, a tumor of the rectum is formed from them.

Presumably the causes of rectal cancer have been established:

1. Poor nutrition. The predominance of meat foods and animal fats in the diet with a simultaneous deficiency of plant fiber impairs the passage of feces, contributes to constipation and the development of colorectal tumors.
2. The role of heredity has been noticed in the occurrence of certain forms of neoplasms.
3. Precancerous pathologies - polyps, Crohn's disease, ulcerative colitis.
4. Immunodeficiency conditions, carcinoma of the genital organs or breast in women.

Symptoms and signs of skin cancer

The clinical picture of skin cancer development depends on its type. Often the first signs of a tumor are mistaken for other skin diseases. This results in untimely consultation with a doctor and the spread of the malignant process. Common signs for all types of skin cancer are:

• The appearance of a small spot or lump on the skin. The color of the formation can be pinkish, gray-yellow. It is noteworthy that the color of the neoplasm differs from moles and freckles.
• Uneven shape and asymmetric contours of the pathological focus.
• The appearance of itching and slight discomfort in the area of ​​the tumor process. This symptom appears some time after the formation of cancer.
• Progressive growth of the tumor.
• Fatigue, weakness, sudden loss of strength.
• Decreased appetite, resulting in sudden weight loss.
• As cancer develops, regional lymph nodes are affected.

If any of the above symptoms appear, it is recommended to seek medical help. Depending on the type of skin cancer, the following symptoms are distinguished:

1. Basalioma. It is the most common form of skin tumor. It is characterized by a favorable prognosis when detected at the initial stage. Appears in the form of a nodule, painless on palpation. It has a grayish-pink color. The surface of the nodule is usually smooth. Scale formation is possible. As the tumor process spreads, the affected area increases. The neoplasm is covered with a bloody film. The predominant localization of basal cell carcinoma is the face, neck, and arm area. Basalioma does not cause a significant change in condition. This is the reason for late seeking medical help.

2. Squamous cell carcinoma. At an early stage, it looks like a dense red or brown nodule. A tumor of this type is prone to rapid decay, and therefore, as the process progresses, an ulcer forms. Its edges are heterogeneous, the ulcer often bleeds. Squamous cell carcinoma quickly grows into nearby tissues. If detected at a late stage, metastasis to regional lymph nodes or organs is possible.

3. Melanoma. Refers to an aggressive type of tumor. Most often, melanoma occurs at the site of an injured nevus, which increases in size, changes color and acquires uneven contours. A characteristic feature of this type of cancer is the asymmetric form of formation, as well as a tendency to bleed. The malignant neoplasm itches and increases in size. As the process progresses, the tumor turns into an ulcer. Melanoma progresses rapidly and often metastasizes.

4. Adenocarcinoma. At the initial stage of development, it looks like a dense nodule. It is most often localized in the armpit area, under the breast. With the development of the tumor process, adenocarcinoma grows into nearby tissues. This type of tumor is detected extremely rarely and is characterized by slow growth.

Tumor atypia

Any tumor consists of stroma and parenchyma. The stroma consists of the extracellular matrix, blood vessels, and nerve endings. Parenchyma is the tumor cells themselves. Their structure, as a rule, differs from normal cells - this is atypia. The difference may lie not only in the structure of the cells themselves, but also in their functioning, metabolism, etc. Therefore, there are several types of atypia:

1. Morphological atypia. Can be cellular or tissue. In the first case, tumor cells lose the ability to mature and differentiate, as a result of which they acquire a large nucleus, irregular shape, and other characteristics that distinguish them from normal cells. With tissue atypia, the ratio of various tissue elements changes, for example, the ratio of the thickness of the epidermis and dermis.
2. Biochemical atypia. Characterized by changes in tumor metabolism. It is this feature that plays an important role in the uncontrolled growth of newly formed tissue. In tumor cells, almost all types of metabolism change, but the most significant is the change in carbohydrate metabolism, which increases several tens of times. Other features include the predominance of protein synthesis over its breakdown, increased absorption of amino acids and water, accumulation of potassium ions and loss of calcium ions.
3. Immunological atypia. Tumors are characterized by changes in antigenic structure. For this reason, the immune system cannot effectively “attack” the changed cells, as a result of which the latter can multiply and grow uncontrollably.
4. Functional atypia. This is a consequence of the changes described above. Changes in the structure and metabolism of tumor cells inevitably lead to changes in their functions. This may be increased secretion of hormones, loss of the ability to phagocytose, production of substances that are not normally formed, etc.

Some types of atypia have made it possible to develop specific antitumor drugs. In particular, some cytotoxic drugs used during chemotherapy block the uptake of glutamine and glucose. These substances are used by certain tumors in large quantities and are necessary for the growth and division of pathological cells. Immunological atypia formed the basis for cancer immunotherapy. With the help of special drugs, it is possible to eliminate the “defense mechanisms” of the tumor, which make it “invisible” to the immune system.

Types of skin cancer

Depending on the type of cells from which the tumor is formed, there are several main types of skin cancer. Determining the structure of the tumor is necessary to clarify the diagnosis and carry out appropriate treatment. In addition, the speed of its spread and further prognosis depend on the type of cancer. Oncologists distinguish the following types of skin cancer:

1. Basal cell (basalioma). Basal cell carcinoma is the most common form of skin cancer. It originates from the basal cells of the epithelium. Basalioma is characterized by slow, sudden development and a relatively favorable course. Unlike other types of skin cancer, it rarely metastasizes. Basal cell carcinoma is usually localized in the area of ​​the nose, bridge of the nose, eyebrow, upper lip and nasolabial fold. A rare location for this type of cancer is the neck and ears. There are several forms of basal cell carcinoma:

• Nodal. The most common location of nodular basal cell carcinoma is the head and neck area. At an early stage it looks like nodules up to 5 mm in size. As the tumor process develops, the nodules merge with each other. At a late stage, nodular basalioma is a deep ulcer with necrotic areas.

• Superficial. This type of basal cell carcinoma is located on the trunk and limbs. The tumor looks like a round pink spot with ulcerations. Superficial basal cell carcinoma is considered the most favorable and non-aggressive form of skin cancer.

• Scleroderma-like. Refers to an aggressive type of cancer. Located in the deep layers of the skin. The most common location for this type of tumor is the head and neck. Basalioma has the appearance of a plaque, which in the later stages of the process has the appearance of a depressed scar.

• Cystic. A rarely detected form of basal cell carcinoma, externally similar to a cyst.

• Fibroepithelial. Located in the lumbar region. Basal cell carcinoma has the appearance of a pedunculated polyp. The fibroepithelial form is extremely rare and has a favorable course and prognosis.

2. Melanoma. Refers to an aggressive type of skin cancer that originates from melanocytes. Melanoma is characterized by rapid growth and invasion into neighboring tissues. This type of skin cancer metastasizes not only to regional lymph nodes, but also to organs. A favorable prognosis for melanoma is only possible if the tumor is diagnosed at an early stage. Women with fair skin are at risk for developing skin cancer.

3. Squamous. Squamous cell carcinoma is the 3rd most common type of skin cancer. It develops from the outer layers of the skin. It is characterized by slow development, which increases the possibility of detecting a tumor at an early stage. At the initial stage, squamous cell skin cancer looks like a red lump up to 2 cm in diameter.

The above forms of skin cancer are diagnosed most often. They account for about 90% of all detected oncological processes of the skin. In addition, there is skin appendage cancer, which is extremely rare. This type of tumor includes:

• Adenocarcinoma. Comes from the sweat and sebaceous glands. Characterized by slow growth. Outwardly it looks like a dark blue node, localized in the groin and chest area. Adenocarcinoma does not tend to grow into adjacent tissues, and metastasis rarely occurs. The tumor is removed surgically.
• Verrucous carcinoma. Refers to a very rare form of squamous cell carcinoma. Outwardly it resembles a wart, so detection at an early stage is difficult. A distinctive feature of verrucous carcinoma is its bleeding.

Table of contents

1. Dermatofibrosarcoma protuberans
2. Angiosarcoma
3. Merkel cell carcinoma
4. Sebaceous gland carcinoma
5. Diagnostic imaging of non-melanocytic skin cancer

Non-melanocytic skin cancer (non-melanoma skin cancer) are all types of skin cancers that do not develop from melanocytes. Today, dermatology identifies about 200 such neoplasms, the most common of which are:

• Basal cell carcinoma
• Squamous cell carcinoma
• Cutaneous B-cell lymphoma
• Cutaneous T-cell lymphoma
• Dermatofibrosarcoma protuberans
• Angiosarcoma
• Merkel cell carcinoma
• Sebaceous gland carcinoma

In our company you can purchase the following equipment for diagnosing non-melanocytic skin cancer:

• FotoFinder dermoscope Vexia (FotoFinder)
• FotoFinder ATBM bodystudio (FotoFinder)
• FotoFinder (FotoFinder)
• Handyscope (FotoFinder)

What does the initial stage look like?

Symptoms of a skin tumor depend on its type. Growth rate, color, and tendency to metastasize are characteristic of each form of cancer. However, at the initial stage, several symptoms are common to all types of tumor. These include:

• The presence of a formation on the surface of the skin with unclear shapes and asymmetrical contours.
• The appearance of itching and changes in the color of the lesion as the process progresses.
• A sharp loss of strength, increased fatigue.
• Loss of appetite, sudden weight loss.
• The presence of pain in the area of ​​the tumor.

Skin cancer develops through 4 stages. Each reflects the size of the lesion, its spread to surrounding tissues, and the presence or absence of metastases. Depending on this, the following symptoms of skin tumors are distinguished:

• First stage. At this stage of skin cancer formation, there are no specific signs. The size of the tumor focus is up to 2 mm. In this case, the general condition does not change. Detecting cancer at the first stage is possible only with a thorough self-examination of the skin.
• Second stage. The growth of the tumor leads to the appearance of the first subjective signs. These include itching and pain in the area of ​​the pathological focus. The cancer increases in size up to 4 mm.
• Third stage. The tumor focus has a diameter of more than 4 mm. At this stage of skin cancer, the process spreads to regional lymph nodes.
• Fourth stage. Late stage skin cancer is characterized by the appearance of metastases. The tumor grows into nearby tissues. The clinical picture is accompanied by the appearance of symptoms of tumor intoxication (cachexia, weakness, lack of appetite, headache).

Lack of medical care in the early stages of skin cancer leads to rapid progression of the process. As the tumor develops, nearby organs and lymph nodes are affected. The appearance of the lesion in the form of an ulcer contributes to the addition of a secondary bacterial infection. There are often deaths due to the development of sepsis.

Dermatofibrosarcoma protuberans

A malignant neoplasm that arises in the dermis and penetrates into deeper tissues - subcutaneous fat, fascia, muscles, bones. Its origin remains unclear, since dermatofibrosarcoma can belong to all 3 types of tumors: fibroblastic, histiocytic and neuroectodermal. This cancer accounts for less than 0.1% of all malignancies and approximately 1% of soft tissue sarcomas.

Dermatofibrosarcoma protuberans initially appears as a small, asymptomatic papule or plaque. Gradually it expands into a lumpy nodule or turns into an atrophic/sclerotic plaque ( Fig. 5 ).

The described signs are very nonspecific, so the tumor is often diagnosed at the time of its active growth. However, as it grows, it begins to aggressively penetrate the surrounding tissues, spreading tentacle-like outgrowths in front of itself - and this makes its complete removal very difficult. The presence of tumor remnants in soft tissues leads to a high rate of local relapses.

The most favorable moment for removing dermatofibrosarcoma protuberans is the early stage, during which it grows very slowly. Unfortunately, it is quite difficult to suspect this type of cancer during this period. This puts regular (and better automated) skin screening at the forefront of diagnostic importance.

Rice. 5. Dermatofibrosarcoma protuberans (Danish national service on dermato-venereology)

https://www.danderm-pdv.is.kkh.dk/atlas/7-198-1.html

Etiological factors of scalp cancer

The etiology of cancer is still not fully understood, but the following etiofactors are reliably known:

• Male gender. Skin cancer affects both men and women, but according to statistics, men are more likely to get it.
• Complicated family history. The risk of developing skin cancer increases when close relatives are diagnosed with this disease.
• Elderly age. Skin cancer is most often diagnosed in people after fifty years of age.
• Life history of exposure to UV rays and sunburn.
• Light skin and hair, blue eyes.
• Freckles and/or multiple nevi, etc.

Any neoplasm on the skin of the face can be dangerous, but it is necessary to undergo examination in case of asymmetry, unevenness of its edges, if its color is not uniform or it changes, and if there is a change in size.

Expert opinion

Author:

Alexey Andreevich Moiseev

Oncologist, chemotherapist, Ph.D.

Every year, 9,000 cases of newly diagnosed melanoma are registered in Russia. This aggressive malignant tumor is responsible for the death of 40% of patients. Such statistics indicate that the country's population is not sufficiently aware of the symptoms of melanoma. As a result, a visit to a doctor occurs in the later stages, when treatment is considered ineffective.

Doctors at the Yusupov Hospital determine the location of melanoma and prescribe treatment appropriate to the stage of tumor development. An individual approach to the problem of each patient allows us to reduce the number of deaths. A tumor detected in time is characterized by a favorable prognosis for recovery. The later melanoma is detected, the longer the treatment process will be. Its success depends on many factors. The main treatments for melanoma are surgery, radiation and chemotherapy. Depending on the condition, symptomatic therapy is carried out.

You can diagnose the presence of skin cancer yourself at home. Doctors recommend regularly examining the skin, especially nevi, for the appearance of pathological formations.

Sebaceous gland carcinoma

This is a malignant tumor of the cells of the meibomian glands and Zeiss glands located on the eyelids. It is more common in older people, especially women over 70 years of age. However, this carcinoma also occurs in relatively young patients who have been exposed to the sun a lot. The average incidence is 3.2% of all malignant tumors and 0.8% of eyelid tumors. The mortality rate of patients is at 22%.

The clinical manifestations of sebaceous gland carcinoma vary greatly. This tumor can simulate various benign conditions - chalazion (inflammation of the edge of the eyelid), blepharoconjunctivitis, keratitis, etc. The classic manifestation of carcinoma is a hard, painless compacted mass or ulceration on the eyelid, in the area of ​​which eyelashes fall out ( Fig. 8 ).

Sebaceous gland carcinoma is prone to metastasis, so timely diagnosis is of great importance to improve the prognosis of the disease.

Rice. 8. Sebaceous gland carcinoma (American Academy of Dermatology)

Diagnosis of skin cancer

An integrated approach to diagnosing skin cancer is the key to timely detection of the tumor process. In order to determine the presence of skin cancer, it is necessary to conduct an examination. The first signs of skin cancer can be detected on your own. For this purpose, the ACORD principle is used.

• A – asymmetry. A lesion that has an uneven and asymmetrical shape requires close attention from a doctor.
• K – edge. A malignant neoplasm of the skin is characterized by jagged edges. The appearance of such a sign requires immediate contact with a dermatologist.
• O – coloring. Skin cancer is characterized by the appearance of a red, dark blue, or black lesion.
• R – size. The tumor process often has a diameter greater than 6 mm.
• D – dynamics. The growth of education in size requires a visit to a doctor.

The appearance of any of the above symptoms requires immediate medical attention. At the appointment, the specialist examines the formation using an epiluminescent microscope, which allows him to differentiate various skin diseases.

• Collecting anamnesis of illness and life. At the doctor's appointment, complaints are collected, the time of occurrence of the pathological formation, and the presence of predisposing factors. Precancerous diseases are determined, and the rate of development of the lesion is determined.
• General analysis of urine and blood. Laboratory diagnostics allows us to determine the presence of an inflammatory process in the body.
• Blood test for tumor markers. Specific markers for the presence of skin cancer are TA 90 and SU 100. Their determination is diagnosed already in the early stages of the tumor process.
• Tissue biopsy of pathological formation. It is one of the most important methods for diagnosing skin cancer. Histological examination makes it possible to differentiate the neoplasm, determine its stage and type. In cases where there is a metastatic lesion, a biopsy of the affected areas is performed.
• MRI and CT diagnostics. Instrumental research methods are carried out to identify metastases.
• PET-CT. This diagnostic method allows you to determine the localization of metastases. The study is carried out using a contrast agent injected into the body before tomography.
• Ultrasound. Ultrasound diagnostics helps to identify damage to the lymph nodes, as well as changes in other organs if metastases are suspected.

Detection of skin cancer at the initial stage of development allows for timely treatment and provides a favorable prognosis. Therefore, if you have the first signs of the disease, you should seek medical help.

Angiosarcoma

A malignant neoplasm of blood vessel cells, characterized by rapid proliferation and active spread. The term angiosarcoma applies to a wide range of vascular endothelial cancers that affect various areas of the body.

There are currently 4 known variants of cutaneous angiosarcoma:

1. Angiosarcoma of the scalp and face (senile angiosarcoma)
2. Lymphangiosarcoma (Stewart-Treves syndrome)
3. Angiosarcoma caused by ionizing radiation
4. Epithelioid angiosarcoma

The most common variant is angiosarcoma of the scalp and face, which usually occurs in older people. The tumor appears as a large blue area, a blue-black nodule, or a non-healing ulceration ( Figure 6 ). Initially, these lesions can be confused with simple bruising, swelling or infection, making diagnosis difficult.

The death rate from angiosarcoma is high, with a 5-year patient survival rate of only 20–35%. Early diagnosis is critical to the prognosis of the disease.

Rice. 6. Large angiosarcoma on the scalp (Holloway L., et al. Cutaneous angiosarcoma of the scalp: A case report of sustained complete response following liposomal doxorubicin and radiation therapy. Sarcoma 2005; 9: 29–31)

Surgery

Surgical removal of the tumor is the most affordable method of treating skin cancer. Surgery is most effective in the early stages of cancer development due to the lack of tumor growth into nearby tissues. The surgeon removes the tumor and all affected areas. In the presence of metastatic lesions of the lymph nodes, their removal is indicated. If an aggressive form of the tumor develops, surgical intervention alone is not enough to completely get rid of the pathological focus.

A modern method of surgery to remove skin cancer is micrographic surgery using the MONS method. In this case, tumor cells are removed layer by layer under microscopic control. Each removed layer is sent for histological examination.

Types of oncology of the anal canal

Doctors identify several types of life-threatening tumors in this area of ​​the digestive system:

• Most cases are squamous cell carcinoma
  , which begins in the squamous cells lining much of the anal canal and rim.
• Much less common are adenocarcinomas
  that develop in the glands or cells lining the part of the anus located near the rectum.
• Basal cell carcinoma
  : Forms in the perianal region - the skin located around the anus.
• Melanoma
  : occurs in cells that produce pigment, the substance that colors the skin brown. Such neoplasms usually appear on exposed parts of the body, and only a tiny part of them begins in the anal canal.
• Gastrointestinal stromal tumors
  develop in the so-called Cajal cells, which set the rhythm of intestinal contractions. They usually affect the stomach or small intestine, and very rarely the anus.

Chemotherapy

It is carried out both as an independent method of treatment and in combination with surgical intervention. Prescribing chemotherapy before surgery is intended to reduce the pathological focus. The purpose of this method of treating skin cancer after surgery is designed to completely destroy cancer cells.

The disadvantage of this method is the inability to exclude the effects of drugs on healthy cells. The question of the need for chemotherapy is decided by the attending physician based on the individual characteristics of the development of the tumor process.

Where can I buy Israeli medicines?

1. In an Israeli pharmacy - after consulting a doctor.
   If you undergo examination at the oncology center, the doctor will prescribe you the necessary medications, which can be purchased in Israel.
2. At your place of residence - using a telemedicine program.
   As part of this program, you will also receive a consultation from an Israeli doctor - but remotely. You can order the medications prescribed by him and have them delivered to your home.

Drug treatment

As the tumor process progresses, corresponding clinical symptoms appear. The main ones include pain and itching. To symptomatically combat these symptoms, non-steroidal anti-inflammatory drugs are prescribed to relieve pain due to skin cancer.

Contraindications

The operation is contraindicated under the following conditions:

• severe chronic diseases of the patient - arterial hypertension, coronary heart disease, when it is impossible to give anesthesia;
• advanced age of the patient;
• advanced stages of cancer.

In case of a widespread process with metastasis to many organs, palliative resections are used, aimed at alleviating the patient’s condition. Symptomatic operations - the application of bypass anastomoses to relieve the intestines and avoid complications in the last stages of cancer.

Forecast

The average life expectancy of patients diagnosed with skin cancer depends on several factors. These include the type of cancer, its stage, and the presence or absence of metastases. Detection of a tumor focus at the initial stage contributes to timely treatment and minimal risk of complications. In addition, each type of cancer has its own prognosis. Squamous cell and basal cell carcinomas are characterized by a favorable course and prognosis. Melanoma is an aggressive type of tumor that tends to grow rapidly and metastasize. The average five-year survival rate after skin cancer is diagnosed is:

• 80-100% when skin surface cancer is detected in the first stages.
• Up to 50% when skin cancer is detected at a late stage.
• Up to 25% in the presence of metastases in regional lymph nodes and other organs.

In order to minimize the risk of developing a tumor, it is necessary to prevent skin cancer. It is recommended to limit the time spent under ultraviolet rays and avoid excessive consumption of alcohol and nicotine. If there is an occupational hazard, it is required to undergo an annual medical examination to detect pathology at an early stage. In addition, it is necessary to wear protective suits that limit skin contact with carcinogenic substances. One of the cancer prevention measures is self-examination of the skin. Any changes require immediate medical attention to diagnose the disease.

How is skin cancer treated?

The Moscow Yusupov Hospital has been diagnosing and treating skin tumors for many years. Thanks to modern equipment, skin cancer can be detected in the shortest possible time, and its type and stage can be accurately determined. This is necessary to determine further treatment tactics.

Highly qualified doctors of the medical institution select individual therapy, taking into account the obtained diagnostic data. In their work, specialists at the Yusupov Hospital use current recommendations for the treatment of skin cancer. You can make an appointment with an oncodermatologist and learn more about prices by phone.