{"id":3129,"date":"2024-12-24T01:46:03","date_gmt":"2024-12-23T22:46:03","guid":{"rendered":"https:\/\/marmarapatoloji.com\/?p=3129"},"modified":"2026-05-07T03:58:16","modified_gmt":"2026-05-07T03:58:16","slug":"melanom","status":"publish","type":"post","link":"https:\/\/marmarapatoloji.com\/en\/2024\/12\/24\/melanom\/","title":{"rendered":"Melanoma (Malignant Mole)"},"content":{"rendered":"\n<h4 class=\"wp-block-heading\">Melanom derideki melanosit ad\u0131 verilen h\u00fccrelerden geli\u015fir. Melanositler deriye rengini veren melanin pigmenti \u00fcretirler. Melanom, di\u011fer deri kanserleri olan bazal veya skuam\u00f6z h\u00fccreli karsinomdan daha az s\u0131kl\u0131kta g\u00f6r\u00fcl\u00fcr. Ancak \u00e7ok daha \u00f6l\u00fcmc\u00fcld\u00fcr.<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">Bildirilen melanom insidans\u0131 (g\u00f6r\u00fclme s\u0131kl\u0131\u011f\u0131), son 20-30 y\u0131lda \u00f6nemli \u00f6l\u00e7\u00fcde artm\u0131\u015ft\u0131r. Bu durum k\u0131smen risk alt\u0131ndaki bireylerin <strong><em>UV \u0131\u015f\u0131\u011f\u0131na<\/em><\/strong> maruz kalmas\u0131n\u0131n artmas\u0131 ve k\u0131smen de s\u0131k\u0131 g\u00f6zetim nedeniyle erken lezyonlar\u0131n daha fazla tespit edilmesi nedeniyledir.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">G\u00fcn\u00fcm\u00fczde, cilt melanomlar\u0131n\u0131n en erken belirtilerine ili\u015fkin artan kamu fark\u0131ndal\u0131\u011f\u0131n\u0131n bir sonucu olarak, \u00e7o\u011fu melanom erken evrede yakalanmakta ve cerrahi olarak tedavi edilebilmektedir.<\/p>\n\n\n\n<h5 class=\"wp-block-heading\">PATOGENEZ (OLU\u015eUM MEKAN\u0130ZMASI)<\/h5>\n\n\n\n<p class=\"wp-block-paragraph\">Derinin di\u011fer k\u00f6t\u00fc huylu t\u00fcm\u00f6rlerinde oldu\u011fu gibi, melanom da esas olarak <strong><em>UV \u0131\u015f\u0131\u011f\u0131 kaynakl\u0131 DNA hasar\u0131ndan<\/em><\/strong> kaynaklan\u0131r. UV h\u00fccre mutasyonlar\u0131n\u0131n kademeli olarak edinilmesine yol a\u00e7ar.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">G\u00f6r\u00fclme s\u0131kl\u0131\u011f\u0131 g\u00fcne\u015fe maruz kalan ciltte, g\u00fcne\u015fe maruz kalman\u0131n y\u00fcksek oldu\u011fu ve n\u00fcfusun \u00e7o\u011funun a\u00e7\u0131k tenli oldu\u011fu co\u011frafi b\u00f6lgelerde en y\u00fcksektir. <strong><em>Erken ya\u015fta yo\u011fun aral\u0131kl\u0131 g\u00fcne\u015fe maruz kalma<\/em><\/strong> en y\u00fcksek riski ta\u015f\u0131maktad\u0131r. Kal\u0131tsal yatk\u0131nl\u0131k da vakalar\u0131n tahmini %5 ila %10&#8217;unda rol oynar. Nadir g\u00f6r\u00fclen ailevi melanom sendromuna sahip bireylerin incelenmesi bize bu t\u00fcm\u00f6r\u00fcn geli\u015fimi a\u00e7\u0131s\u0131ndan de\u011ferli bilgiler vermektedir.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Ailevi ge\u00e7i\u015fli melanomlar\u0131n %40 kadar\u0131nda h\u00fccrenin mitotik b\u00f6l\u00fcnmesini durdurabilen <strong>CDKN2A<\/strong> lokusunda germ hatt\u0131 mutasyonlar bulunur. Bu karma\u015f\u0131k lokus iki t\u00fcm\u00f6r bask\u0131lay\u0131c\u0131 geni kodlar. <strong>p16<\/strong>, retinoblastom adl\u0131 t\u00fcm\u00f6r bask\u0131lay\u0131c\u0131 proteini aktif durumda tutarak h\u00fccre d\u00f6ng\u00fcs\u00fcn\u00fcn <strong>G1-S<\/strong> ge\u00e7i\u015fini d\u00fczenleyen bir siklin ba\u011f\u0131ml\u0131 kinaz inhibit\u00f6r\u00fcd\u00fcr. Yani <strong>p16<\/strong> normal durumda mitozun <strong>G1-S<\/strong> faz\u0131n\u0131n kontrol edilmesinde g\u00f6rev al\u0131r. <strong>p14 <\/strong>ise yine bir t\u00fcm\u00f6r bask\u0131lay\u0131c\u0131s\u0131 olan <strong>p53<\/strong>\u2019\u00fcn degradasyonunu (par\u00e7alanmas\u0131n\u0131) \u00f6nleyerek aktivitesini art\u0131r\u0131r.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Melanom geli\u015fiminin temel evreleri <em><strong>yatay ve dikey<\/strong><\/em> b\u00fcy\u00fcmedir. Melanom geli\u015fiminin en erken tan\u0131nabilir evresinin dermoepidermal ba\u011flant\u0131 boyunca melanositlerin lateral geni\u015flemesinden olu\u015ftu\u011fu ileri s\u00fcr\u00fclmektedir. (lentijin\u00f6z hiperplazi ve junctional nev\u00fcs).<\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter size-full\"><img fetchpriority=\"high\" decoding=\"async\" width=\"727\" height=\"800\" class=\"wp-image-3139\" src=\"https:\/\/marmarapatoloji.com\/wp-content\/uploads\/2024\/12\/melanom-1.jpg\" alt=\"melanom\" srcset=\"https:\/\/marmarapatoloji.com\/wp-content\/uploads\/2024\/12\/melanom-1.jpg 727w, https:\/\/marmarapatoloji.com\/wp-content\/uploads\/2024\/12\/melanom-1-273x300.jpg 273w\" sizes=\"(max-width: 727px) 100vw, 727px\" \/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Bu lezyon daha sonra, genellikle uzun bir s\u00fcre boyunca <em>epidermis i\u00e7inde radyal bir b\u00fcy\u00fcme evresiyle<\/em> erken melanomaya ilerler. Bu evrede, melanom h\u00fccreleri <em><strong>invazyon ve metastaz<\/strong><\/em> yapma kapasitesine sahip de\u011fildir.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Zamanla, t\u00fcm\u00f6r\u00fcn h\u00fccresel olgunla\u015fmadan yoksun geni\u015fleyen bir kitle olarak daha derin dermal katmanlara do\u011fru a\u015fa\u011f\u0131 do\u011fru b\u00fcy\u00fcd\u00fc\u011f\u00fc dikey bir b\u00fcy\u00fcme evresi ba\u015flar. Bu olay genellikle daha \u00f6nce d\u00fcz bir lezyondan, nod\u00fcl\u00fcn geli\u015fmesidir. Metastatik potansiyelin ortaya \u00e7\u0131kmas\u0131yla ili\u015fkilidir. \u0130yi huylu nev\u00fcslerden kaynakland\u0131\u011f\u0131 g\u00f6r\u00fclen vakalar da dahil olmak \u00fczere ailevi ve sporadik vakalar\u0131n DNA dizilimi, melanomun molek\u00fcler patogenezine ili\u015fkin \u00f6nemli bilgiler sa\u011flam\u0131\u015ft\u0131r.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Ba\u015flat\u0131c\u0131 olay, <strong>BRAF<\/strong> veya (daha az yayg\u0131n olarak) <strong>RAS<\/strong>&#8216;ta aktive edici bir mutasyon gibi g\u00f6r\u00fcnmektedir. Vakalar\u0131n b\u00fcy\u00fck \u00e7o\u011funlu\u011funda, di\u011fer mutasyonlar \u00fcst \u00fcste gelmedi\u011fi s\u00fcrece bu yaln\u0131zca <em><strong>iyi huylu bir nev\u00fcs \u00fcretir.<\/strong><\/em> Melanom ve b\u00fcy\u00fcmenin radyal faz\u0131ndaki melanomlar\u0131 d\u00fc\u015f\u00fcnd\u00fcren <em>\u201catipik\u201d <\/em>morfolojik \u00f6zelliklere sahip nev\u00fcslerin dizilenmesi, bunlar\u0131n genellikle <em>telomeraz ekspresyonunu aktive eden<\/em> ve ya\u015flanmay\u0131 (iyi huylu nev\u00fcslerin ola\u011fan kaderi) durdurdu\u011fu \u00f6ne s\u00fcr\u00fclen mutasyonlara sahip oldu\u011funu g\u00f6stermi\u015ftir.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Yani melanomlarda h\u00fccrelerin \u00e7o\u011falmas\u0131 ile birlikte \u00e7o\u011falan h\u00fccrelerin ya\u015flanmamas\u0131 da t\u00fcm\u00f6r olu\u015fumunda etkilidir. <strong>CDNK2A<\/strong> ve <strong>p16<\/strong>&#8216;n\u0131n kayb\u0131na yol a\u00e7an ek mutasyonlar veya epigenetik sapmalarla t\u00fcm\u00f6r, invaziv dikey b\u00fcy\u00fcme faz\u0131na kayar. T\u00fcm\u00f6r evriminin kutan\u00f6z faz\u0131 boyunca, UV \u0131\u015f\u0131\u011f\u0131na maruz kalma mutasyon y\u00fck\u00fcn\u00fc art\u0131r\u0131r. T\u00fcm\u00f6r ilerlemesi \u015fans\u0131n\u0131 art\u0131r\u0131r.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Son olarak, <strong>TP53 <\/strong>ve <strong>PTEN<\/strong> gibi t\u00fcm\u00f6r bask\u0131lay\u0131c\u0131 genlerdeki ek mutasyonlarla t\u00fcm\u00f6r metastaz kapasitesi kazan\u0131r. Bu fazda, aneuploidi ve genomik kopya say\u0131s\u0131 de\u011fi\u015fiklikleri ortaya \u00e7\u0131kar. Bu da evrimle\u015fen t\u00fcm\u00f6r\u00fcn genetik heterojenli\u011fine katk\u0131da bulunur.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">G\u00fcne\u015fe maruz kalmayan akral ve mukozal b\u00f6lgelerde ortaya \u00e7\u0131kan melanomalar daha az s\u0131kl\u0131kta g\u00f6r\u00fcl\u00fcr. Bu tip melanomlar farkl\u0131 molek\u00fcler seyirler izler. Bu t\u00fcm\u00f6rlerde yayg\u0131n bir ba\u015flat\u0131c\u0131 olay, <em><strong>KIT resept\u00f6r tirozin kinaz<\/strong><\/em> genindeki bir fonksiyon kazan\u0131m\u0131 mutasyonudur. Benzer \u015fekilde, g\u00f6z\u00fcn \u00fcveas\u0131nda ortaya \u00e7\u0131kan melanomlarda da bir dizi belirgin driver gen mutasyonu vard\u0131r. Bunlar\u0131n en dikkat \u00e7ekeni, <strong>GTP<\/strong> ba\u011flay\u0131c\u0131 proteinler olan <strong>GNAQ<\/strong> veya <strong>GNA11<\/strong>&#8216;i aktive eden mutasyonlard\u0131r.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">G\u00fcne\u015fe maruz kalan b\u00f6lgelerde geli\u015fen melanomlar, y\u00fcksek bir mutasyon y\u00fck\u00fcne sahiptir. Bunlardan baz\u0131lar\u0131 neoantijenler olu\u015fturan UV \u0131\u015f\u0131\u011f\u0131 taraf\u0131ndan ind\u00fcklenir. Buradan, melanomun geli\u015fmesi i\u00e7in t\u00fcm\u00f6r h\u00fccrelerinin konak imm\u00fcn tepkisini bast\u0131rma (<strong>PD-1, PDL-1 <\/strong>ve <strong>CTLA-4<\/strong>) veya ondan ka\u00e7ma yetene\u011fi kazanmas\u0131 gerekti\u011fi sonucu \u00e7\u0131kar.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Bir\u00e7ok ileri evre melanomlar imm\u00fcn check point inhibit\u00f6rlerine yan\u0131t verirler. Bu ajanlar susturulmu\u015f melanom-spesifik T h\u00fccrelerini serbest b\u0131rakarak t\u00fcm\u00f6re sald\u0131rmalar\u0131na izin verirler. Bu da t\u00fcm\u00f6r geli\u015fiminde imm\u00fcn sistemden ka\u00e7\u0131\u015f\u0131n \u00f6nemini g\u00f6sterir.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u00d6zetle t\u00fcm\u00f6r\u00fc olu\u015fturan basamaklar\u0131 engellemeye (<strong>BRAF, RAS, p16, p14, p53, PTEN<\/strong>) y\u00f6nelik tedaviler ak\u0131ll\u0131 ila\u00e7 tedavileri ve imm\u00fcn sistemimize t\u00fcm\u00f6r h\u00fccrelerini yok etme yetene\u011fi kazand\u0131rma (<strong>PD-1, PDL-1 ve CTLA-4<\/strong>) imm\u00fcn check point inhibit\u00f6rleri olarak bilinir. Cerrahi sonras\u0131 ya da cerrahi \u00e7ans\u0131 olmayan melanomlarda bu tedaviler yayg\u0131n olarak kullan\u0131lmaktad\u0131r. Bu tedavilerin kullan\u0131labilmesi i\u00e7in t\u00fcm\u00f6r h\u00fccresinin \u00f6zelliklerinin bilinmesi gerekmektedir. Bu \u00f6zellikler patoloji laboratuvarlar\u0131 taraf\u0131ndan yap\u0131lan bir tak\u0131m testler ile ortaya konmaktad\u0131r.<\/p>\n\n\n\n<h5 class=\"wp-block-heading\">MORFOLOJ\u0130 (G\u00d6R\u00dcNT\u00dc)<\/h5>\n\n\n\n<p class=\"wp-block-paragraph\">\u0130yi huylu nev\u00fcslerin aksine, melanomlar genellikle siyah, kahverengi, k\u0131rm\u0131z\u0131, koyu mavi ve gri tonlar\u0131 da dahil olmak \u00fczere pigmentasyonda de\u011fi\u015fik varyasyonlar sergiler. S\u0131n\u0131rlar\u0131 d\u00fczensizdir ve genellikle &#8220;\u00e7entiklidir.&#8221;<\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter size-full\"><img decoding=\"async\" width=\"800\" height=\"714\" class=\"wp-image-3143\" src=\"https:\/\/marmarapatoloji.com\/wp-content\/uploads\/2024\/12\/melanom-2.jpg\" alt=\"melanom\" srcset=\"https:\/\/marmarapatoloji.com\/wp-content\/uploads\/2024\/12\/melanom-2.jpg 800w, https:\/\/marmarapatoloji.com\/wp-content\/uploads\/2024\/12\/melanom-2-300x268.jpg 300w, https:\/\/marmarapatoloji.com\/wp-content\/uploads\/2024\/12\/melanom-2-768x685.jpg 768w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Mikroskobik olarak, atipik h\u00fccreler epidermisin t\u00fcm seviyelerinde (<em>pagetoid yay\u0131lma<\/em>) ve geni\u015fleyen dermal nod\u00fcllerde k\u00f6t\u00fc olu\u015fmu\u015f yuvalar veya tek h\u00fccreler olarak b\u00fcy\u00fcr. Bunlar s\u0131ras\u0131yla radyal (yatay) ve dikey b\u00fcy\u00fcme fazlar\u0131n\u0131 olu\u015fturur.<\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter size-full\"><img decoding=\"async\" class=\"wp-image-3147\" src=\"https:\/\/marmarapatoloji.com\/wp-content\/uploads\/2024\/12\/melanom-3.jpg\" alt=\"melanom\" \/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Y\u00fczeysel yay\u0131lan melanomlarda genellikle canl\u0131 bir lenfositik (ba\u011f\u0131\u015f\u0131kl\u0131k h\u00fccreleri) infiltrasyon vard\u0131r. Yani ba\u011f\u0131\u015f\u0131kl\u0131k h\u00fccreleri taraf\u0131ndan ku\u015fat\u0131lm\u0131\u015ft\u0131r. Bu \u00f6zellik t\u00fcm\u00f6r-spesifik antijenlere kar\u015f\u0131 bir konak yan\u0131t\u0131n\u0131 d\u00fc\u015f\u00fcnd\u00fcr\u00fcr.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Bu a\u015famada t\u00fcm\u00f6r h\u00fccrelerinde bulunan baz\u0131 proteinler, v\u00fccut taraf\u0131ndan zarar verici ajan olarak kabul edilerek ba\u011f\u0131\u015f\u0131kl\u0131k sistemi devreye girer. T\u00fcm\u00f6r\u00fcn artan kal\u0131nl\u0131\u011f\u0131 (dikey b\u00fcy\u00fcme), daha k\u00f6t\u00fc biyolojik davran\u0131\u015fla g\u00fc\u00e7l\u00fc bir \u015fekilde ili\u015fkilidir. Bu ve di\u011fer de\u011fi\u015fkenleri toplu olarak kaydetmek ve rapor alt\u0131na almak (patoloji raporu) t\u00fcm\u00f6r\u00fcn davran\u0131\u015f\u0131 hakk\u0131nda do\u011fru bilgileri vermektedir.<\/p>\n\n\n\n<h5 class=\"wp-block-heading\">M\u0130KROSKOP\u0130K G\u00d6R\u00dcNT\u00dc<\/h5>\n\n\n\n<p class=\"wp-block-paragraph\">Melanom h\u00fccreleri genellikle nev\u00fcs h\u00fccrelerinden \u00f6nemli \u00f6l\u00e7\u00fcde daha b\u00fcy\u00fckt\u00fcr. Tipik olarak d\u00fczensiz s\u0131n\u0131rl\u0131 b\u00fcy\u00fck \u00e7ekirdeklere, \u00e7ekirdek membran\u0131n \u00e7evresinde karakteristik olarak k\u00fcmelenmi\u015f kromatine ve belirgin &#8220;kiraz k\u0131rm\u0131z\u0131s\u0131&#8221; eozinofilik \u00e7ekirdek\u00e7iklere sahiptirler. \u0130mm\u00fcnohistokimyasal olarak HMB45 ile pozitif boyan\u0131rlar. Metastatik lezyonlar\u0131n tan\u0131mlanmas\u0131nda yard\u0131mc\u0131 olabilir.<\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter size-full\"><img decoding=\"async\" class=\"wp-image-3148\" src=\"https:\/\/marmarapatoloji.com\/wp-content\/uploads\/2024\/12\/melanom-4.jpg\" alt=\"melanom\" \/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">&nbsp;<\/p>\n\n\n\n<h5 class=\"wp-block-heading\">KL\u0130N\u0130K \u00d6ZELL\u0130KLER<\/h5>\n\n\n\n<p class=\"wp-block-paragraph\">Bu lezyonlar\u0131n \u00e7o\u011fu ciltte ortaya \u00e7\u0131kar. Ancak, oral ve anogenital mukozal y\u00fczeylerde, \u00f6zofagusda, meninkslerde ve g\u00f6zde de ortaya \u00e7\u0131kabilirler. Deri melanomun insidans\u0131 cilt pigmentasyonunun derecesi ile ters orant\u0131l\u0131d\u0131r. Melanom a\u00e7\u0131k cilt tiplerine sahip ki\u015filerde daha yayg\u0131nd\u0131r. Melanom daha koyu cilt tiplerine sahip ki\u015filerde, en s\u0131k ayak taban\u0131nda (akral melanom olarak adland\u0131r\u0131l\u0131r), avu\u00e7 i\u00e7inde veya t\u0131rnak yata\u011f\u0131nda ortaya \u00e7\u0131kar. \u00d6nemli klinik belirti, pigmentli bir lezyonun renginde veya boyutundaki de\u011fi\u015fikliktir.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Ba\u015fl\u0131ca klinik belirtileri \u015funlard\u0131r:<\/p>\n\n\n\n<ol class=\"wp-block-list\">\n<li>\u00d6nceden var olan bir nev\u00fcs\u00fcn h\u0131zl\u0131 b\u00fcy\u00fcmesi<\/li>\n\n\n\n<li>Lezyonda ka\u015f\u0131nt\u0131 veya a\u011fr\u0131 olmas\u0131,<\/li>\n\n\n\n<li>Eri\u015fkin ya\u015famda yeni bir pigmentli lezyonun geli\u015fimi<\/li>\n\n\n\n<li>Pigmentli bir lezyonun s\u0131n\u0131rlar\u0131n\u0131n d\u00fczensizli\u011fi<\/li>\n\n\n\n<li>Pigmentli bir lezyon i\u00e7inde renk \u00e7e\u015fitlili\u011fi<\/li>\n<\/ol>\n\n\n\n<p class=\"wp-block-paragraph\">Bu ilkeler, melanomun s\u00f6zde &#8220;<strong>ABCDE<\/strong>&#8216;lerinde&#8221; ifade edilir:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><em>Asimetri, s\u0131n\u0131r (border), renk (color), \u00e7ap (diameter) ve mevcut bir nev\u00fcs\u00fcn de\u011fi\u015fimi (evrim-evolution)<\/em><\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Melanomlar\u0131 tan\u0131mak ve m\u00fcmk\u00fcn oldu\u011funca h\u0131zl\u0131 m\u00fcdahale etmek hayati \u00f6nem ta\u015f\u0131r. Y\u00fczeysel lezyonlar\u0131n b\u00fcy\u00fck \u00e7o\u011funlu\u011fu cerrahi olarak tedavi edilebilirken, metastatik melanom genellikle \u00f6l\u00fcmc\u00fcld\u00fcr.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Metastaz olas\u0131l\u0131\u011f\u0131, \u00fcstteki epidermisin gran\u00fcler h\u00fccre tabakas\u0131n\u0131n tepesinden dikey b\u00fcy\u00fcme faz\u0131 nod\u00fcl\u00fcn\u00fcn milimetre cinsinden invazyon derinli\u011finin \u00f6l\u00e7\u00fclmesiyle tahmin edilir. Breslow kal\u0131nl\u0131\u011f\u0131 (mikroskopik olarak \u00f6l\u00e7\u00fclmelidir) olarak adland\u0131r\u0131l\u0131r.<\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter size-full\"><img decoding=\"async\" class=\"wp-image-3149\" src=\"https:\/\/marmarapatoloji.com\/wp-content\/uploads\/2024\/12\/melanom-5.jpg\" alt=\"melanom\" \/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Metastaz riski, y\u00fcksek mitotik oranl\u0131 t\u00fcm\u00f6rlerde ve lokal bir ba\u011f\u0131\u015f\u0131kl\u0131k tepkisi olu\u015fturmayan t\u00fcm\u00f6rlerde de artar. Metastazlar yaln\u0131zca b\u00f6lgesel lenf d\u00fc\u011f\u00fcmlerine olmaz, karaci\u011fer, akci\u011ferler, beyin dahil olmak \u00fczere v\u00fccudun her b\u00f6lgesinde g\u00f6r\u00fclebilir.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Ameliyat s\u0131ras\u0131nda sentinel lenf d\u00fc\u011f\u00fcm\u00fc biyopsisi (birincil melanomun ilk drene olan d\u00fc\u011f\u00fcm\u00fcn\u00fcn [d\u00fc\u011f\u00fcmlerinin]) biyolojik sald\u0131rganl\u0131k hakk\u0131nda ek bilgi sa\u011flar. <strong>BRAF<\/strong> ve <strong>KIT&#8217;<\/strong>i se\u00e7ici olarak inhibe eden ajanlar, <strong>BRAF<\/strong> ve <strong>KIT <\/strong>mutasyonlar\u0131 olan metastatik t\u00fcm\u00f6rl\u00fc hastalarda dramatik gerileme sa\u011flar.<br \/>Ancak bir\u00e7ok t\u00fcm\u00f6r sonunda ila\u00e7 direncinin geli\u015fmesi nedeniyle tekrarlar.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Melanoma develops from cells in the skin called melanocytes. Melanocytes produce the pigment melanin, which gives skin its color. Melanoma is less common than other skin cancers, such as basal or squamous cell carcinoma, but it is much more deadly.<\/p>","protected":false},"author":1,"featured_media":3152,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11],"tags":[],"class_list":["post-3129","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-blog"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Melanom (K\u00f6t\u00fc Huylu Ben) - Marmara Patoloji<\/title>\n<meta name=\"description\" content=\"Melanom derideki melanosit ad\u0131 verilen h\u00fccrelerden geli\u015fir. 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