Clinical spectrum of the Skin Tumour Centre (HTZ)

Diagnosis

The diagnosis of a skin tumour is based on the patient's medical history (anamnesis) and a detailed clinical examination. If necessary, the reflected light microscope, in special cases digital reflected light microscopy and high-resolution ultrasound are used for this purpose. The diagnosis of a skin tumour often requires a tissue sample to be taken from the tumour (biopsy). This is carried out at our clinic promptly after the initial examination and the histological findings are also analysed at our clinic. This enables us to compare the clinical picture and the histological picture and thus arrive at a precise diagnosis. Definitive treatment of the skin tumour is only possible once this precise diagnosis has been made.

Treatment of malignant melanoma, epithelial tumours and rare malignant skin tumours

The treatment of most forms of skin cancer consists of surgical removal. As skin tumours often occur in cosmetically relevant areas, particularly on the face, it is not only necessary to remove the tumour but also to perform plastic reconstruction of the resulting tissue defect.

Depending on the clinical findings, there are also alternatives to surgery. In some cases, X-ray soft tissue therapy is a successful treatment method comparable to surgery.

Malignant skin tumours such as malignant melanoma, skin sarcomas or other rare malignant tumours of the skin require a therapeutic approach that often goes beyond surgical removal of the tumour. The therapy is based on the guidelines for the treatment of skin tumours published by the Working Group of Dermatological Oncology (ADO) and based on the system of the American Joint Committee on Cancer (AJCC). According to the currently valid guidelines, a safety margin of healthy tissue around the tumour must be removed with these tumours (so-called safety margin) in order to reliably prevent the tumour from recurring at its original location or in the immediate vicinity. In the case of melanomas with a tumour thickness of more than 1 mm, the so-called sentinel lymph node is also removed. This is the first lymph node in the drainage area of the previously surgically removed melanoma. The excision (surgical removal) of the sentinel lymph node serves as diagnostic staging in order to detect micrometastases and thus represents an important prognostic parameter for planning further therapy. Following surgery, supportive (adjuvant) procedures are considered for high-risk primary tumours (greater tumour thickness) and if lymph node metastases are detected. Modern, so-called targeted or immunotherapies are used here. These aim to activate the body's own immune system and fight remaining tumour cells and suppress their spread.

If it turns out that the malignant skin tumour is more advanced, surgery to remove secondary tumours, radiotherapy or systemic therapy may be necessary. In addition to conventional chemotherapy procedures (monochemotherapy, combination chemotherapy), modern therapies with immune checkpoint inhibitors and targeted tumour therapy are also available. These are initiated, carried out and monitored at our centre. Most immune and targeted therapies can be carried out as part of an inpatient stay or on an outpatient basis. We offer innovative, drug-based procedures as part of controlled, mostly international studies. The treatment regimen will be discussed with you on a case-by-case basis and tailored to your disease. Within the Skin Tumour Centre, all cases of patients with advanced skin cancer are discussed within the interdisciplinary tumour board, which is also attended by representatives of other surgical disciplines, specialists in internal medicine and oncology, radiotherapists, radiologists, nuclear medicine specialists and pathologists. Every patient with an advanced skin tumour requires an individual treatment concept.

Cutaneous lymphoma therapy

For patients with lymphomas of the skin, we offer patient-specific treatment tailored to the findings and stage. The treatment options are either localised to the skin, phototherapy or can be administered systemically. Here, too, we offer the entire range of modern therapies, as well as innovative treatment within the framework of therapy studies. Special and advanced cases are discussed on an interdisciplinary basis as part of the haemato-oncological lymphoma board.

In the event of special problem situations, professional help from psycho-oncology, cancer counselling and social services is available to you throughout the course of treatment.

Tumour aftercare

Every skin tumour is followed up according to a fixed schedule. These close follow-up checks, which are carried out at our clinic in close cooperation with the referring dermatologist, serve on the one hand to detect any recurrence of the original skin tumour. On the other hand, follow-up care serves to detect newly occurring skin tumours in other locations at an early stage.

High-risk patients

We also offer patients with a high risk of developing skin cancer, such as after organ or stem cell transplants, interdisciplinary therapy optimisation and regular dermatological check-ups in order to prevent or detect certain skin cancers at an early stage.