Ua ʻike anei ʻoe i ka Giant Cell Tumor (GCT)? E kamaʻilio kākou e pili ana i ia mea!

Ua ʻike anei ʻoe i kahi ʻeha palupalu, kahi pehu iki, a i ʻole kahi puʻupuʻu ma kou lima, ʻoi aku hoʻi ma kou kuli, ʻūhā, poʻohiwi, a i ʻole ka pulima lima? Inā pēlā, he manaʻo maikaʻi e hopohopo iki. No ka mea, he hōʻailona paha ia o kahi maʻi a mākou e kamaʻilio ai i kēia lā i kapa ʻia ʻo 'Giant Cell Tumor (GCT)'. Mai hopohopo, e kamaʻilio mākou e pili ana i kēia me nā kikoʻī.

He aha maoli ka Giant Cell Tumor (GCT)?

I ka ʻōlelo maʻalahi, ʻo ka "Giant Cell Tumor (GCT)" he puʻupuʻu ʻaʻole ia he maʻi kanesa (a pinepine he benign) . Hoʻokumu pinepine lākou ma nā wēlau o nā iwi lōʻihi o kou kino. ʻO ke kikoʻī, loaʻa pinepine lākou ma lalo o kou iwi ʻūhā "femur" a i ʻole ka piko o kou iwi shin "tibia", aia a puni ke kuli . Eia naʻe, hiki iā lākou ke hana ma nā wahi e like me ka ʻūhā, poʻohiwi, pulima, a me ka iwi huelo. Ua kapa ʻia kēia mau mea he "Osteoclastomas".

ʻO kēia kūlana i kapa ʻia ʻo `(GCT)` he mea kākaʻikahi loa ia . Loaʻa ia ma kahi o hoʻokahi a ʻelua paha kānaka i kēlā me kēia haneli tausani. Eia nō naʻe, ma waena o nā puʻupuʻu ʻaʻole kanesa e hoʻomaka ana i nā iwi, ʻo `(GCT)` ka helu ma waena o 15% a me 21% o nā hihia āpau.

I kekahi manawa, ʻaʻole ulu kēia mau puʻupuʻu cell nunui i loko o nā iwi, akā, i loko o nā ʻiʻo palupalu a puni nā hono. A laila ua kapa ʻia lākou he "Nā puʻupuʻu cell nui Tenosynovial".

ʻO ka mea nui, ʻoiai ʻaʻole kēia mau '(Nā Puʻupuʻu Kelepona Nui)' he maʻi kanesa, hiki iā lākou ke ulu koke a hōʻino i nā ʻiʻo olakino a puni . Eia kekahi, loaʻa iā lākou kahi manawa kiʻekiʻe o '(e hana hou)' ʻoiai ma hope o ka mālama ʻana. No laila he mea nui e ʻike koke i ke kauka inā ʻike ʻoe i kekahi mau hōʻailona o kahi puʻupuʻu e like me kēia.

He aha nā hōʻailona o kēia? E nānā inā loaʻa iā ʻoe kēia mau mea pū kekahi...

ʻO ka hōʻailona nui a maʻamau o kahi puʻupuʻu cell nunui (GCT) ʻo ia ka ʻeha . ʻOiai he ʻoluʻolu paha ka ʻeha i ka wā mua, piʻi aʻe ia i ka ulu ʻana o ka puʻupuʻu. E noʻonoʻo, ala ʻoe i kekahi kakahiaka a manaʻo i kahi ʻeha iki kokoke i kou kuli. I ka wā mua, hoʻowahāwahā ʻoe iā ia. Akā ma hope o kekahi manawa, piʻi aʻe ka ʻeha, a i kou hoʻopā ʻana iā ia, manaʻo ia he puʻupuʻu liʻiliʻi. ʻO ia ka manawa e makaʻu iki ai ʻoe, ʻeā?

Aia kekahi mau hōʻailona ʻē aʻe:

• ʻIke ʻia kahi puʻupuʻu a pehu paha i ʻike ʻia ma ka lima ma ia wahi.
• ʻO ka hiki ʻole ke hoʻoneʻe pono i ka hono ma kahi o ka puʻupuʻu, ʻo ia hoʻi, ua kaupalena ʻia ka neʻe ʻana o ka hono.
• ʻEha nā hono , ʻoiai i ka wā e hoʻoneʻe ai i ke hono.
• Pehu ʻana .
• Hiki i ka puʻupuʻu ke hoʻonāwaliwali i nā iwi a hana i nā haki .

Inā loaʻa iā ʻoe kekahi a ʻoi aku paha o kēia mau hōʻailona, ​​​​e ʻoluʻolu e ʻimi i ke kōkua lapaʻau.

No ke aha e hana ʻia ai kekahi mea e like me kēia? He aha ke kumu?

ʻO kaʻoiaʻiʻo, ʻaʻole maopopo i nā kānaka noiʻi lapaʻau ke kumu o nā puʻupuʻu cell nunui. Eia nō naʻe, ua ʻike ʻia kekahi poʻe me ke ʻano he mau loli (mutations) i loko o kā lākou mau genes. Eia nō naʻe, ua manaʻoʻiʻo ʻia i kēia manawa ʻaʻole kēia he mea i hoʻoilina ʻia, a i ʻole kekahi mea i hoʻokumu ʻia e kou wahi a i ʻole kou nohona .

Aia kekahi mau mea pilikia?

ʻAe, ma lalo o kekahi mau kūlana, hiki ke hoʻonui iki ʻia ka manawa kūpono o ka hoʻomohala ʻana i kēia `(GCT)`:

• Inā loaʻa iā ʻoe kahi maʻi i kapa ʻia ʻo `(Hyperparathyroidism)` (kahi āu e hana ai i ka nui o ka hormone parathyroid), hiki i ka `(GCT)` ke ulu ma nā wahi he nui o kou kino.
• He mea kākaʻikahi loa, hiki i ka poʻe me ka maʻi iwi i kapa ʻia ʻo "ka maʻi o Paget o ka iwi" ke loaʻa i kēia mau puʻupuʻu cell nunui.

Hiki ke lilo i mea weliweli kēia? He aha nā pilikia?

ʻOiai ʻaʻole kēia mau puʻupuʻu he maʻi kanesa, he kakaikahi, ʻo ia hoʻi, he kakaikahi loa, hiki i kēia mau puʻupuʻu cell nunui ke "pālahalaha" i nā māmā . Eia naʻe, ʻaʻole ia e like me ka laha ʻana o ke kanesa, a inā paha e pālahalaha ia ma kēia ʻano, ʻaʻole ia he mea hoʻoweliweli i ke ola.

ʻOi aku ka kakaikahi, ma kahi o 4% o ka poʻe me GCT, hiki i kēia mau puʻupuʻu ke lilo i maʻi kanesa (malignant) . No laila, e nānā mau kāu kauka i kou kūlana e ʻike inā he mau loli weliweli i loko o ka puʻupuʻu. ʻO ia ke kumu he mea nui e ʻike pinepine i kāu kauka a loaʻa ka ʻōlelo aʻoaʻo.

Pehea e ʻike ai nā kauka i kēia?

No ka hōʻoia ʻana inā he puʻupuʻu cell nui kou (GCT) , hana ʻia kahi biopsy . Pili kēia i ka lawe ʻana i kahi laʻana liʻiliʻi o ka ʻiʻo mai ka puʻupuʻu a nānā iā ia ma lalo o kahi microscope. Hana ʻia kēia hoʻāʻo e kahi pathologist, he kauka loea i nā ʻiʻo. E nānā ʻo ia e ʻike inā he "mau cell nui" nā cell, a i ʻole he mau ʻano o kahi GCT.

Eia kekahi, hiki ke hana ʻia nā hoʻokolohua kiʻi e like me kēia e nānā i ka ʻōpū i loko o kou kino:

• Nā kukuna-X : E nānā i ke kūlana o nā iwi.
• CT scan : E ʻike pono i ka nui a me ke ʻano o ka puʻupuʻu.
• MRI : Nānā i nā ʻiʻo palupalu, ka iwi iwi, a pēlā aku.
• Nā scan iwi : E nānā i nā pilikia ma nā wahi ʻē aʻe o nā iwi.
• Nā scan PET : No ka ʻike ʻana inā he mau hōʻailona e lilo ana ka puʻupuʻu i ka maʻi kanesa.

Hana ʻia kēia mau hoʻokolohua a pau e loaʻa ai kahi ʻike piha o kou kūlana a hoʻoholo i ka lāʻau lapaʻau maikaʻi loa.

ʻAe, he aha nā lāʻau lapaʻau no kēia?

Hoʻōla pinepine ʻia nā puʻupuʻu cell nunui me ke ʻoki kino . Wehe ke kauka i ka puʻupuʻu mai ka iwi (curettage). A laila, kau ʻia kahi graft iwi ma kahi hakahaka.Hoʻoikaika ʻia ka iwi ma o ke kāpili ʻana (kahi ʻāpana iwi i lawe ʻia mai kahi ʻē aʻe a i ʻole kahi mea hana). I kekahi manawa, inā nui loa ka puʻupuʻu, pono paha e wehe ʻia ka iwi holoʻokoʻa e loaʻa ana ka puʻupuʻu. I kēlā hihia, hiki ke hoʻokomo ʻia kahi hui hana a i ʻole ka iwi "prosthesis" ma kona wahi.

Eia nō naʻe, i nā hihia kahi hiki ʻole i ke ʻoki kino ke wehe loa i ka puʻupuʻu, a inā he pilikia ke ʻoki kino, aia kekahi mau lāʻau lapaʻau ʻole. ʻO kēia mau mea:

• Denosumab (Denosumab - Xgeva®) : He ʻano lāʻau lapaʻau kēia i kapa ʻia he monoclonal antibody. Hoʻēmi ia i ka puʻupuʻu a hoʻoikaika i ka iwi a puni.
• Embolization : Pili kēia i ke ālai ʻana i nā kīʻaha koko e hoʻolako ana i ke koko i ka puʻupuʻu. Hoʻonele kēia i ke koko o ka puʻupuʻu a make mālie.
• Lapaʻau ablation : Hoʻohana kēia i kahi mea e like me ka ikehu microwave e hoʻopau ai i ka puʻupuʻu.
• Lapaʻau radiation : Hoʻohana kēia i nā kukuna X-ikehu kiʻekiʻe e hoʻēmi i ka puʻupuʻu a luku i nā cell.

Na kāu kauka e hoʻoholo i ka lāʻau lapaʻau kūpono loa iā ʻoe.

ʻEhia ka lōʻihi e hoʻōla ai ma hope o ka lāʻau lapaʻau?

ʻO ka manawa e hoʻōla ai ʻoe ma muli o ka lāʻau i loaʻa iā ʻoe. Inā ua hana ʻia ʻoe i ke ʻoki kino, pono ʻoe e ʻaʻahu i nā kāʻei no kekahi mau pule i ka wā e ho'ōla ai ka ʻeha. Pono paha ʻoe e hoʻohana i nā crutches i loko o ia manawa. Inā he mea hana prosthetic kāu, pono ʻoe e hana pū me kahi mea hoʻōla kino e hoʻomaʻamaʻa iā ia.

E wehewehe kāu kauka i kēia mau mea a pau iā ʻoe, no laila ʻaʻohe mea e hopohopo ai.

ʻAʻohe ala e pale aku ai i kēia mai ka hana ʻana? He aha ka pōmaikaʻi o ka ʻike mua ʻana?

ʻOiai ʻaʻole ʻike ʻia ke kumu kikoʻī o nā puʻupuʻu cell nunui, ʻaʻohe ala e pale aku ai iā lākou mai ka ulu ʻana . Eia nō naʻe, ʻo ka mea maikaʻi loa hiki iā ʻoe ke hana, ʻo ia ke ʻimi i ka ʻōlelo aʻoaʻo lapaʻau i ka wā e ʻike ai ʻoe i nā hōʻailona . Inā ʻike ʻoe i ka ʻeha, ka pehu ʻana, a i ʻole kahi puʻupuʻu i kekahi o kou mau iwi a i ʻole nā ​​​​hui, mai hoʻowahāwahā iā ia a e ʻike koke i ke kauka. Inā ʻike mua ʻia nā puʻupuʻu e like me `(GCT)`, ʻoi aku ka maʻalahi o ka mālama ʻana a emi iho nā pilikia.

Inā hiki, ʻoi aku ka maikaʻi o ka ʻike ʻana i ke kauka loea i nā maʻi ʻaʻai e pili ana i ka iwi, he oncologist orthopedic .

No laila pehea ʻoe e noho ai me kēia maʻi? Pono anei ʻoe e ʻike pinepine i ke kauka?

ʻAʻole pinepine nā puʻupuʻu cell nunui e hoʻoweliweli i ke ola. Eia nō naʻe, hiki iā lākou ke hōʻino i kou mau iwi a me nā ʻiʻo e pili ana, ʻo ia ke kumu he mea nui ka mālama mua ʻana.

ʻO ka nūhou maikaʻi, inā e wehe ʻia nā ʻāpana āpau o ka puʻupuʻu ma ke ʻoki ʻana, hiki ke ho'ōla loa ʻia kēia maʻi. Eia nō naʻe, he ʻano puʻupuʻu paʻakikī iki ka GCT a hiki ke ulu hou .

Ma hope o ka lāʻau lapaʻau, e nānā mau kāu kauka iā ʻoe no nā manawa hoʻopaʻa . ʻO kēia ke nānā inā ua hoʻi mai ka puʻupuʻu. ʻO ka hapa pinepine, hoʻi mai kēia mau puʻupuʻu i loko o nā makahiki ʻelua a ʻelima mua ma hope o ke ʻoki ʻana. Eia nō naʻe, pono paha ʻoe e hana i nā nānā mau i kou ola a pau. E haʻi aku kāu kauka iā ʻoe i ka pinepine o kou hele ʻana mai no kēia mau nānā.

Āhea ʻoe e pono ai e ʻike hou i ke kauka?

Inā loaʻa iā ʻoe kekahi mau hōʻailona e hoʻi mai ana kāu puʻupuʻu cell nui, e ʻike koke i kāu kauka. E makaʻala i kekahi ʻeha iwi a hui paha a pehu paha. ʻOiai inā nānā pinepine kāu kauka iā ʻoe, inā ʻike ʻoe i kekahi mau loli, ʻoi aku ka maikaʻi o ke kāhea koke ʻana i kāu kauka me ka kali ʻole i kāu manawa e hiki mai ana.

He aha kāu e makemake ai e nīnau aku i ke kauka?

Ke ʻike ʻoe i ke kauka, he mea maikaʻi ke nīnau i kēia mau nīnau:

• Pehea ka ikaika o kēia puʻupuʻu?
• He aha nā koho lapaʻau e loaʻa iaʻu?
• He aha nā pono a me nā pilikia e pili ana i kēlā me kēia o kēia mau lāʻau lapaʻau?
• He aha ka manawa kūpono e hoʻi hou mai ai kēia puʻupuʻu cell nui ma hope o ka mālama ʻia?
• ʻEhia pinepine e pono ai iaʻu e hele mai no nā hālāwai hoʻomaʻamaʻa ?

ʻO ka ʻike ʻana i nā pane i kēia mau nīnau e kōkua iā ʻoe e hoʻomaopopo maikaʻi i ke kūlana a e maʻalahi hoʻi ka hoʻomanawanui ʻana i ka lāʻau lapaʻau.

No laila, he aha nā mea nui e pono ai kākou e hoʻomanaʻo mai kēia moʻolelo?

ʻOiai he "benign" kahi puʻupuʻu cell nui (GCT) ʻaʻole ia he manaʻo ʻaʻole ia e hōʻeha. Inā ʻaʻole mālama ʻia, hiki i kēia mau GCT ke hōʻeha nui i kou mau iwi.

ʻO ka mea maikaʻi loa, hiki iā ʻoe ke hoʻopau iā lākou me ke ʻoki ʻana e wehe i nā koena āpau o ka puʻupuʻu. Eia nō naʻe, he paʻakikī iki kēia mau `(GCT)` a hiki ke ulu hou. ʻO ia ke kumu e nānā pono ai kāu kauka iā ʻoe ma hope o ka mālama ʻana. ʻO ka wehe ʻana i ka puʻupuʻu ʻoiai he liʻiliʻi ia hiki ke pale i ka hōʻino lōʻihi i nā iwi.

No laila, inā loaʻa iā ʻoe kekahi o kēia mau hōʻailona, ​​mai kānalua e ʻike i ke kauka a loaʻa ka ʻōlelo aʻoaʻo. ʻO ka mālama mua ke ala maikaʻi loa i ke ola olakino!

ʻO ka puʻupuʻu kelepona nui, GCT, osteoclastoma, puʻupuʻu maikaʻi ʻole, puʻupuʻu iwi, ʻeha iwi, mālama ʻana i ka puʻupuʻu