Chordoma

I-Chordoma

I-Chordoma uhlobo oluyimfihlo lomdlavuza wamathambo oluvela kakhulu emathanbeni omgogodla noma emathanbeni engqondo. Ngokuvamile liqala lapho ingqondo ihleli phezu komgogodla (isisekelo sengqondo) noma ngezansi komgogodla (isacrum).

I-Chordoma iqala ezintweni ezazakha iqembu leziseli embotshweni ophambili oziya kuba ama-disks omgogodla. Iningi lalezi ziseli liyaphela ngesikhathi uzalwa noma ngokushesha ngemva kwalokho. Kodwa ngezinye izikhathi ezimbalwa zalezi ziseli zihlala, futhi, ngokungavamile, zingaba yomdlavuza.

I-Chordoma ivela kakhulu kubantu abadala abaphakathi kweminyaka engama-40 no-60, yize ingaba khona kunoma iyiphi iminyaka.

I-Chordoma ivame ukukhula kancane. Kungaba nzima ukuyilapha ngoba ivame ukuba eduze kakhulu komgogodla namanye amalungu abalulekile, njengamithambo yegazi, izinzwa noma ingqondo.

Izivivinyo nezinqubo ezisetshenziswa ekutholeni i-chordoma zihlanganisa:

• Ukususa isampula yeziseli ukuze kuvivinywe elabhoratri (i-biopsy). I-biopsy inqubo yokususa isampula yeziseli ezimangalisayo ukuze kuvivinywe elabhoratri. Elabhoratri, odokotela abaqeqeshwe ngokukhethekile ababizwa ngokuthi yi-pathologists bahlola iziseli ngaphansi kwama-microscopes ukuze baqonde ukuthi iziseli zomdlavuza zikhona yini.

  Ukuqonda ukuthi i-biopsy kufanele yenziwe kanjani kudinga ukuhlelwa ngokucophelela yiqembu lezokwelapha. Odokotela kudingeka benze i-biopsy ngendlela engayikuphazamisi ukuhlinzwa kwesikhathi esizayo ukususa umdlavuza. Ngenxa yalesi sizathu, cela udokotela wakho ukuba akuphathise iqembu lochwepheshe abanawo okuhlangenwe nakho okuningi ekwelapheni i-chordoma.

• Ukuthola izithombe ezinemininingwane eminingi. Udokotela wakho angakuncoma ukuhlolwa kwezithombe ukuze akusize ukubona i-chordoma yakho nokuqonda ukuthi isakazeke ngaphandle komgogodla noma isisekelo sengqondo. Izivivinyo zingafaka i-MRI noma i-CT scan.

Ukususa isampula yeziseli ukuze kuvivinywe elabhoratri (i-biopsy). I-biopsy inqubo yokususa isampula yeziseli ezimangalisayo ukuze kuvivinywe elabhoratri. Elabhoratri, odokotela abaqeqeshwe ngokukhethekile ababizwa ngokuthi yi-pathologists bahlola iziseli ngaphansi kwama-microscopes ukuze baqonde ukuthi iziseli zomdlavuza zikhona yini.

Ukuqonda ukuthi i-biopsy kufanele yenziwe kanjani kudinga ukuhlelwa ngokucophelela yiqembu lezokwelapha. Odokotela kudingeka benze i-biopsy ngendlela engayikuphazamisi ukuhlinzwa kwesikhathi esizayo ukususa umdlavuza. Ngenxa yalesi sizathu, cela udokotela wakho ukuba akuphathise iqembu lochwepheshe abanawo okuhlangenwe nakho okuningi ekwelapheni i-chordoma.

Ngemva kokuthola ukuxilongwa kwe-chordoma, udokotela wakho uzokwakha uhlelo lokwelapha olufanele izidingo zakho ngokubonisana nochwepheshe bezokwelapha izindlebe, izimpondo nomlomo (i-otolaryngology), umdlavuza (i-oncology), nokwelashwa ngomgqomo (i-radiation oncology) noma ukuhlinzwa. Iqembu lakho lokunakekelwa lingafaka nochwepheshe bezokwelapha i-endocrinology, i-ophthalmology nokwelashwa kabusha, uma kudingeka.

Ukwelashwa kwe-chordoma kuncike ebukhoneni nendawo yomdlavuza, kanye nokuthi ufake izinzwa noma ezinye izicubu yini. Izinketho zingafaka ukuhlinzwa, ukwelashwa ngomgqomo, i-radiosurgery kanye nezinye izindlela zokwelapha.

Uma i-chordoma ithonya ingxenye engezansi yomgogodla (isacrum), izinketho zokwelapha zingafaka:

• Ukuhlinzwa. Umgomo wokuhinzwa komdlavuza womgogodla wesacral ukususa wonke umdlavuza nezinye izicubu ezempilo eziwuqongqoselayo. Ukuhlinzwa kungaba nzima ukuwenza ngoba umdlavuza useduze kwizakhiwo ezibalulekile, njengezinzwa namithambo yegazi. Uma umdlavuza ungasuswa ngokuphelele, ochwepheshe bokuhlinzwa bangazama ukususa okuningi ngangokunokwenzeka.

• Ukwelashwa ngomgqomo. Ukwelashwa ngomgqomo kusebenzisa imisebe yamandla aphezulu, njenge-X-rays noma amaprotoni, ukubulala iziseli zomdlavuza. Phakathi nokwelashwa ngomgqomo, ulela etafuleni njengoba umshini uhamba-hamba ngawe, uqondisa imisebe yomgqomo ezintweni ezithile emzimbeni wakho.

  Ukwelashwa ngomgqomo kungasetshenziswa ngaphambi kokuhlinzwa ukunciphisa umdlavuza nokwenza kube lula ukuususwa. Kungasetshenziswa futhi ngemva kokuhlinzwa ukubulala noma yiziphi iziseli zomdlavuza ezihlala khona. Uma ukuhlinzwa kungelona ithuba, ukwelashwa ngomgqomo kungase kunconywe esikhundleni salokho.

  Ukwelashwa ngezinhlobo ezintsha zokwelashwa ngomgqomo, njenge-proton therapy, kuvumela odokotela ukuba basebenzise amazinga aphezulu omgqomo ngenkathi bevikela izicubu ezempilo, okungase kube nomphumela omuhle ekwelapheni i-chordoma.

• I-Radiosurgery. I-Stereotactic radiosurgery isebenzisa imisebe eminingi yomgqomo ukubulala iziseli zomdlavuza endaweni encane kakhulu. Umgqomo ngamunye awunamandla kakhulu, kodwa indawo lapho yonke imisebe ihlangana khona — e-chordoma — ithola umthamo omkhulu womqomo ukubulala iziseli zomdlavuza. I-Radiosurgery ingasetshenziswa ngaphambi noma ngemva kokuhlinzwa kwe-chordoma. Uma ukuhlinzwa kungelona ithuba, i-radiosurgery ingase kunconywe esikhundleni salokho.

• Ukwelashwa okuqondiswe. Ukwelashwa okuqondiswe kusebenzisa imithi eqondisa izinto ezingavamile ezikhona ngaphakathi kweziseli zomdlavuza. Ngokuhlaselwa kwalezi zinto ezingavamile, ukwelashwa ngemithi okuqondiswe kungabangela ukufa kweziseli zomdlavuza. Ukwelashwa okuqondiswe ngezinye izikhathi kusetshenziswa ekwelapheni i-chordoma esakazeke kwamanye amaqembu omzimba.

Ukwelashwa ngomgqomo. Ukwelashwa ngomgqomo kusebenzisa imisebe yamandla aphezulu, njenge-X-rays noma amaprotoni, ukubulala iziseli zomdlavuza. Phakathi nokwelashwa ngomgqomo, ulela etafuleni njengoba umshini uhamba-hamba ngawe, uqondisa imisebe yomgqomo ezintweni ezithile emzimbeni wakho.

Ukwelashwa ngomgqomo kungasetshenziswa ngaphambi kokuhlinzwa ukunciphisa umdlavuza nokwenza kube lula ukuususwa. Kungasetshenziswa futhi ngemva kokuhlinzwa ukubulala noma yiziphi iziseli zomdlavuza ezihlala khona. Uma ukuhlinzwa kungelona ithuba, ukwelashwa ngomgqomo kungase kunconywe esikhundleni salokho.

Ukwelashwa ngezinhlobo ezintsha zokwelashwa ngomgqomo, njenge-proton therapy, kuvumela odokotela ukuba basebenzise amazinga aphezulu omgqomo ngenkathi bevikela izicubu ezempilo, okungase kube nomphumela omuhle ekwelapheni i-chordoma.

Ithubi elide, elincinyane (i-endoscope) lisetshenziswa ukususa i-tumor ngenkathi, ngaphandle kokusika isikhumba.

Uma i-chordoma ithonya indawo lapho umgogodla uhlangana khona nengqondo (isisekelo sengqondo), izinketho zokwelapha zingafaka:

• Ukuhlinzwa. Ukwelashwa ngokuvamile kuqala ngokuhlinzwa ukususa okuningi komdlavuza ngangokunokwenzeka ngaphandle kokulimaza izicubu ezempilo eziseduze noma ukubangela izinkinga ezintsha, njengokulimala kwengqondo noma umgogodla. Ukususwa ngokuphelele kungase kungenzeki uma umdlavuza useduze kwizakhiwo ezibalulekile, njenge-carotid artery.

  Kwezinye izimo, ochwepheshe bokuhlinzwa bangase basebenzise amasu akhethekile, njengokuhlinzwa kwe-endoscopic ukufinyelela umdlavuza. Ukuhlinzwa kwe-endoscopic skull base kuyindlela encane yokuhlasela ehilela ukusebenzisa ithubi elide, elincinyane (i-endoscope) elikhonjiswe ngenkathi ukufinyelela umdlavuza. Amathuluzi akhethekile angadluliselwa ngethubi ukususa umdlavuza.

  Ngokungavamile, ochwepheshe bokuhlinzwa bangase bancome ukuhlinzwa okwengeziwe ukuze basuse okuningi komdlavuza ngangokunokwenzeka noma ukuqinisa indawo lapho umdlavuza wawukhona.

• Ukwelashwa ngomgqomo. Ukwelashwa ngomgqomo kusebenzisa imisebe yamandla aphezulu, njenge-X-rays noma amaprotoni, ukubulala iziseli zomdlavuza. Ukwelashwa ngomgqomo kuvame ukunconywa ngemva kokuhlinzwa kwe-chordoma yesisekelo sengqondo ukubulala noma yiziphi iziseli zomdlavuza ezingase zihlale khona. Uma ukuhlinzwa kungelona ithuba, ukwelashwa ngomgqomo kungase kunconywe esikhundleni salokho.

  Amasu okwelashwa ngomgqomo aqondisa ukwelashwa ngokuqondile avumela odokotela ukuba basebenzise amazinga aphezulu omgqomo, okungase kube nomphumela omuhle kwe-chordoma. Lokhu kuhlanganisa i-proton therapy ne-stereotactic radiosurgery.

• Izinqubo ezintsha. Izivivinyo zeklinikhi zifunda izinqubo ezintsha zokwelapha i-chordoma yesisekelo sengqondo, kuhlanganise izinqubo ezintsha ezibheka ubuthakathaka obubalulekile ezintweni ze-chordoma. Uma unesithakazelo sokuzama lezi zinqubo ezintsha, xoxa ngezinketho nodokotela wakho.

Ukuhlinzwa. Ukwelashwa ngokuvamile kuqala ngokuhlinzwa ukususa okuningi komdlavuza ngangokunokwenzeka ngaphandle kokulimaza izicubu ezempilo eziseduze noma ukubangela izinkinga ezintsha, njengokulimala kwengqondo noma umgogodla. Ukususwa ngokuphelele kungase kungenzeki uma umdlavuza useduze kwizakhiwo ezibalulekile, njenge-carotid artery.

Kwezinye izimo, ochwepheshe bokuhlinzwa bangase basebenzise amasu akhethekile, njengokuhlinzwa kwe-endoscopic ukufinyelela umdlavuza. Ukuhlinzwa kwe-endoscopic skull base kuyindlela encane yokuhlasela ehilela ukusebenzisa ithubi elide, elincinyane (i-endoscope) elikhonjiswe ngenkathi ukufinyelela umdlavuza. Amathuluzi akhethekile angadluliselwa ngethubi ukususa umdlavuza.

Ngokungavamile, ochwepheshe bokuhlinzwa bangase bancome ukuhlinzwa okwengeziwe ukuze basuse okuningi komdlavuza ngangokunokwenzeka noma ukuqinisa indawo lapho umdlavuza wawukhona.

Ukwelashwa ngomgqomo. Ukwelashwa ngomgqomo kusebenzisa imisebe yamandla aphezulu, njenge-X-rays noma amaprotoni, ukubulala iziseli zomdlavuza. Ukwelashwa ngomgqomo kuvame ukunconywa ngemva kokuhlinzwa kwe-chordoma yesisekelo sengqondo ukubulala noma yiziphi iziseli zomdlavuza ezingase zihlale khona. Uma ukuhlinzwa kungelona ithuba, ukwelashwa ngomgqomo kungase kunconywe esikhundleni salokho.

Ukwelashwa ngomgqomo amasu aqondisa ukwelashwa ngokuqondile avumela odokotela ukuba basebenzise amazinga aphezulu omgqomo, okungase kube nomphumela omuhle kwe-chordoma. Lokhu kuhlanganisa i-proton therapy ne-stereotactic radiosurgery.

Ukuvuvukala komgogodla kungabangela izimpawu ezahlukene, ikakhulukazi njengoba iziphumu zikhula. Iziphumu zingathinta umgogodla wakho noma imizuzu yethumbu, imithambo yegazi noma amathambo omgogodla wakho. Izimpawu zingafaka: Ubuhlungu endaweni yesiphumu ngenxa yokukhula kwesiphumu Ubuhlungu emhlane, oluvame ukuya kwezinye izingxenye zomzimba wakho Ukuzwa ubuhlungu obuncane, ubushushu nobuqandayo Ukwehluleka kokusebenza kwesisu noma kwesisu Ukukhubazeka ekuhambeni, ngezinye izikhathi kuholela ekuweni Ubuhlungu emhlane obukhulu ebusuku Ukwehluleka kokuzwa noma ubuthakathaka bemisipha, ikakhulukazi ezandleni noma emilenzeni Ubuthakathaka bemisipha, obungaba buthambile noma obukhulu, ezingxenyeni ezahlukene zomzimba Ubuhlungu emhlane yisikhathi esivamile sokuqala sesiphumu somgogodla. Ubuhlungu bungase buqhubekele ngaphezu komhlane wakho kuya ezinqeni, emilenzeni, ezinyaweni noma ezandleni futhi bungase bube sibi ngokuhamba kwesikhathi - ngisho nangokwelashwa. Iziphumu zomgogodla ziqhubeka ngezilinganiso ezahlukene kuye ngohlobo lwesiphumu. Kunezizathu eziningi zokubuhlungu emhlane, futhi iningi lobuhlungu emhlane alibangelwa yisifumu. Kodwa ngenxa yokuthi ukuxilongwa kwasekuqaleni nokuphathwa kubalulekile kweziphumu zomgogodla, bheka udokotela wakho mayelana nobuhlungu bakho emhlane uma: Luyaqhubeka futhi luyaqhubeka Aluhambisani nomsebenzi Luya sibi ebusuku Unembali yomdlavuza futhi uthola ubuhlungu obusha emhlane Unezinye izimpawu zomdlavuza, njengokuphefumula, ukugabha noma ukukhungatheka Funani usizo lwezokwelapha ngokushesha uma uhlangabezana noku: Ubuthakathaka bemisipha obuqhubekayo noma ukungabi namandla ezinyaweni noma ezandleni Ukushintsha kokusebenza kwesisu noma kwesisu

Izimbangela zezinhlungu zehlombe ziningi, futhi izinhlungu eziningi zehlombe azibangelwa yi-tumor. Kodwa ngenxa yokuthi ukutholakala kwangaphambi kwesikhathi nokuphathwa kubalulekile kuma-tumor asehlombe, vakashela udokotela wakho mayelana nobuhlungu bakho behlombe uma: Buhlala bukhona futhi buyaqhubeka Akuhambelani nomsebenzi Buya kubi ebusuku Unembali yomdlavuza futhi uthola ubuhlungu obusha behlombe Unezinye izimpawu zomdlavuza, njengokupukeka, ukugabha noma ukukhungatheka Funani usizo lwezokwelapha ngokushesha uma uhlangabezana nalokhu okulandelayo: Ubuthakathaka bemisipha obuyaqhubeka noma ukungabi namandla ezinyaweni noma ezingalweni Ukushintsha kokusebenza kwamabele noma kwesisu

Akuqondakali ukuthi kungani iningi lezinhlungu zomgogodla zikhula. Ochwepheshe bacabanga ukuthi ama-jini aneziphoso adlala indima. Kodwa ngokuvamile akuwazi ukuthi lezo ziphoso ze-genetic zidluliselwa ezizukulwaneni noma nje zikhula ngokuhamba kwesikhathi. Zingase zibangelwe yinto ethile endaweni, njengokubekwa ezingozini zezinto ezithile ezikhiqizwayo. Kodwa kwezinye izimo, izinhlungu zomgogodla zihambisana nezifo eziwaziwayo eziwumoya, njenge-neurofibromatosis 2 ne-von Hippel-Lindau disease.

Ukuqina komgogodla kuvame kakhulu kubantu abana: Neurofibromatosis 2. Kulesi sifo esidluliselwa ezizukulwaneni, izicubu ezingalimi zikhula phezu noma eduze kwemithambo yezinzwa ehambisana nokuzwa. Lokhu kungabangela ukulahleka kokuzwa okuqhubekayo endlebeni eyodwa noma zombili. Abanye abantu abane-neurofibromatosis 2 baphuthuma futhi ngezicubu ezikhula emgodleni womgogodla. Von Hippel-Lindau disease. Lesi sifo esingavamile, esithinta izici eziningi zomzimba, sihambisana nezinqubo zezicubu zegazi (hemangioblastomas) ebuchosheni, e-retina nasemgogodleni womgogodla kanye nezinye izinhlobo zezicubu ezinkinzini noma ezindlalweni ze-adrenal.

Izinhlungu zomgogodla zingacindezela izicubu zezinzwa zomgogodla, okuholela ekubeni kungabi khona ukuhamba noma ukuzwa ngaphansi kwendawo yomdlavuza. Lokhu ngezinye izikhathi kungabangela ukushintsha emisebenzini yomathumbu nangesibalo. Ukonakala kwezinzwa kungaba okuhlala njalo. Noma kunjalo, uma kubanjwa ngokushesha futhi kuphathwe ngokuqina, kungaba nokwenzeka ukuvimbela ukulahleka okwengeziwe komsebenzi nokubuyisela umsebenzi wezinzwa. Kuye ngendawo yalo, umdlavuza ocindezela i-spinal cord ngokwayo ungaba yingozi eyingozi ekuphileni.

Izimila ze-spinal ngezinye izikhathi zingase zidedelwe ngoba azivamile futhi izimpawu zazo zifana nezimo ezivamile. Ngenxa yalokho, kubaluleke kakhulu ukuthi udokotela wakho azi umlando wakho ophelele wezokwelapha futhi enze kokubili ukuhlolwa komzimba jikelele kanye nokuhlolwa kwe-neurological.

Uma udokotela wakho enesizathu sokuthi ungaba ne-spinal tumor, lezi zivivinyo zingasiza ekuqinisekiseni ukuxilongwa nokuqondisa indawo yomdlavuza:

• Ukuthwebula kwe-magnetic resonance imaging (MRI) ye-Spinal. I-MRI isebenzisa insimu enamandla ye-magnetic namaza omsakazo ukukhiqiza izithombe ezinembile ze-spine yakho, i-spinal cord nezinzwa. I-MRI ngokuvamile iyivivinyo elikhethwayo lokuthola izimila ze-spinal cord nezinsimbi ezizungezile. I-agent contrast enikeza usizo ekukhanyiseni izicubu ezithile nezindawo zingase zifakwe emithanjeni esandleni sakho noma engalweni yakho ngesikhathi sokuhlolwa.

Abanye abantu bangase bazizwe bevaleleke ngaphakathi kwe-MRI scanner noma bathole umsindo olukhulu olukhulu oluyenza ukhubazeke. Kodwa ngokuvamile ubani uthola ama-earplugs ukuze asize ngomsindo, futhi ezinye izikrini zine-thelevishini noma ama-headphone. Uma ukhathazekile kakhulu, buza nge-sedative ephansi ukuze ikuncedise ukuzola. Ezimweni ezithile, i-anesthetic ejwayelekile ingadingeka.

Ukuthwebula kwe-magnetic resonance imaging (MRI) ye-Spinal. I-MRI isebenzisa insimu enamandla ye-magnetic namaza omsakazo ukukhiqiza izithombe ezinembile ze-spine yakho, i-spinal cord nezinzwa. I-MRI ngokuvamile iyivivinyo elikhethwayo lokuthola izimila ze-spinal cord nezinsimbi ezizungezile. I-agent contrast enikeza usizo ekukhanyiseni izicubu ezithile nezindawo zingase zifakwe emithanjeni esandleni sakho noma engalweni yakho ngesikhathi sokuhlolwa.

Abanye abantu bangase bazizwe bevaleleke ngaphakathi kwe-MRI scanner noma bathole umsindo olukhulu olukhulu oluyenza ukhubazeke. Kodwa ngokuvamile ubani uthola ama-earplugs ukuze asize ngomsindo, futhi ezinye izikrini zine-thelevishini noma ama-headphone. Uma ukhathazekile kakhulu, buza nge-sedative ephansi ukuze ikuncedise ukuzola. Ezimweni ezithile, i-anesthetic ejwayelekile ingadingeka.

• I-Computerized tomography (CT). Lo vi vinyo usebenzisa i-beam encane yemisebe ukukhiqiza izithombe eziningi ze-spine yakho. Ngezinye izikhathi ihlanganiswe ne-dye contrast efakwe ukuze kwenze ukushintsha okungavamile endleleni ye-spinal noma i-spinal cord kube lula ukubona. I-CT scan isebenziswa kancane nje ukuze isize ekutholeni izimila ze-spinal.
• I-Biopsy. Indlela kuphela yokunquma uhlobo oluqondile lomdlavuza we-spinal ukubheka isampula encane yesicubu (i-biopsy) ngaphansi komkhiqizo. Imiphumela ye-biopsy izosisiza ekutholeni izinketho zokwelapha.