Existem diversos tipos de cirurgia para tratamento do carcinoma basocelular e espinocelular. A escolha da técnica cirúrgica dependerá do tamanho do tumor, da localização e do tipo do câncer de pele. A maioria das cirurgias pode ser feita em consultórios médicos ou clínicas especializadas. Se o tumor tiver risco elevado de disseminação, a cirurgia pode ser seguida por outros tratamentos, como radioterapia ou quimioterapia.
Excisão. Na excisão simples os tumores de pele são, geralmente, retirados com uma pequena margem de tecido normal. A excisão é realizada com anestesia local e pode deixar uma pequena cicatriz.
Curetagem e eletrodissecação. Este procedimento é utilizado para remover o tumor por raspagem com uma cureta e, em seguida, a área onde o tumor estava localizado é tratada com um eletrodo que emite uma corrente elétrica para destruir as células cancerígenas remanescentes. A curetagem acompanhada da eletrodissecação é utilizada para o tratamento tanto do câncer de pele basocelular quanto do espinocelular.
Cirurgia de Mohs. É usada quando existe alto risco de recidiva da doença após o tratamento, ou quando a extensão do tumor não é conhecida, ou quando o objetivo é poupar o máximo possível de pele saudável, como cânceres próximos aos olhos ou outras áreas importantes, como face central, orelhas ou dedos. Nesta técnica o cirurgião remove uma camada da pele que pode ter sido invadida pelo câncer e mapeia sua localização. A amostra de tecido removida é imediatamente analisada por um patologista e, se ainda existirem células cancerígenas, remove-se mais um pouco de tecido, que volta a ser analisado pelo patologista. O processo é demorado, mas permite o máximo controle histopatológico e preservação do tecido (pele) normal ao redor do tumor. Apesar de muito difundida na dermatologia, é de pouca aceitação pelos cirurgiões que preferem a excisão cirúrgica com mapeamento intraoperatório das margens e estudo patológico por congelação.
Cirurgia de linfonodo. Se os gânglios linfáticos próximos ao tumor estão aumentando, pode ser sinal de que o câncer atingiu esses linfonodos. Nesse caso, eles são removidos cirurgicamente e analisados por um patologista.
Reconstrução. Em casos em que o tumor é grande, pode ser necessário fazer um enxerto com um retalho de pele para ajudar na cicatrização e recuperar a aparência estética da região.
Para saber mais, consulte nosso conteúdo sobre Cirurgia Oncológica.
Fonte: American Cancer Society (10/05/2016)
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