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FITZPATRICK'S DERMATOLOGY 9TH EDITION (SHAMMY) > 20 - 112 - SQUAMOUS CELL CARCINOMA AND KERATOACANTHOMA > Flashcards

20 - 112 - SQUAMOUS CELL CARCINOMA AND KERATOACANTHOMA Flashcards

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Dermatology Board Prep flashcards
1
Q

What is the most common skin cancer in immunocompetent white individuals?

A. SCC

B. BCC

C. Melanoma

D. Keratoacanthoma

A

Answer B p 1901

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2
Q

What is the most common skin cancer in immunosuppressed organ transplant recepients?

A. SCC

B. BCC

C. Melanoma

D. Keratoacanthoma

A

Answer A p 1901

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3
Q

Metastases in SCC are predominantly ________ .

A. Pulmonary

B. Hepatic

C. Cutaneous

D. Nodal

A

Answer D p 1901

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4
Q

Which of the following is not at higher risk of acquiring SCC?

A. Red hair

B. Blue eyes

C. High latitude

D. High altitude

A

Answer C p 1902

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5
Q

Which of the following photosensitizing drugs increase the risk for SCC?

A. Fluoroquinolones

B. Isoniazid

C. Lithium

D. Terbinafine

A

Answer A p 1905

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6
Q

Which of the following is mismatched?

A. Oral cavity: oral florid papillomatosis

B. Genitoanal region: giant condyloma acuminatum Buschke-Lowenstein

C. Plantar skin: epithelioma cuniculatum

D. Amputation stump: stump papillomatosis

A

Answer D p 1908

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7
Q

High risk features of SCC inludes the following except _______ .

A. >2 mm

B. Clark level >II

C. Perineural invasion

D. Primary site at the lip

A

Answer B p 1911

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8
Q

The primary mode of therapy for SCC is ______ .

A. Wait for spontaneous resolution

B. Conventional standard excision

C. Mohs surgery

D. Radiation therapy

A

Answer C p1912

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9
Q

Which of the following is false regarding keratoacanthoma?

A. It is regarded as a subtype of poorly differentiated SCC

B. It usually erupts rapidly within a few weeks

C. It has the ability to spontaneously regress

D. It clinically presents as a sharply circumscribed firm nodule with a central horn-filled crater that typically arises on the head and sun-exposed areas of the extremities

A

Answer A p1908

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10
Q

The histopathologic hallmark of invasive SCC is __________ .

A. pleomorphic nuclei with a high degree of atypia

B. frequent mitoses

C. the growth of atypical keratinocytes beyond the basement membrane into the dermis

D. very few areas of keratinization

A

Answer C p1909

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11
Q

second most common skin cancer in immunocompetent white individuals

A

SCC

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12
Q

most common skin cancer in immunocompetent white individuals

A

BCC

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13
Q

most common skin cancer in immunosuppressed organ transplantation recipients worldwide

A

SCC

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14
Q

Risk factors for SCC

A
  • ultraviolet (UV) radiation
  • genetic predisposition
  • physical and chemical carcinogens
  • immunosuppression
  • drugs
  • viral infection
  • chronic inflammation
  • chronic injury of the skin
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15
Q

Precursor lesions of SCC

A

Actinic keratosis, bowen disease, bowenoid papulosis, erythroplasia of Queyrat

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16
Q

High-risk features for local recurrence and the development of metastatic disease for SCC

A
  • > 2 mm thickness;
  • Clark level higher than IV;
  • perineural invasion;
  • lip or ear as primary site;
  • poorly or undifferentiated tumor
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17
Q

risk of developing metastasis from SCC is generally low, with a 5-year metastatic rate of ?

A

5%

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18
Q

Major route of SCC metastasis

A

Nodal metastasis

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19
Q

predominant etiologic risk factor for skin carcinogenesis in SCC

A

cumulative lifetime exposure to UVR

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20
Q

Sun-sensitive individuals with ______ hair, ____ eyes, and ______ complexion are at higher risk for developing SCC than individuals with darker pigmentation.

A

red hair, blue eyes, and fair complexion

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21
Q

most important environmental risk factor for SCC

A

UVR

  • class I carcinogen, sufficient for the initiation, promotion, and progression of squamous carcinogenesis of the skin
22
Q

UVB-induced mutagenesis of the skin gives rise to specific UV signature mutations (ie, characteristic _______________ dipyrimidine transitions), which constitute the majority of mutations found in SCC. 2

A

C-T and CC-TT dipyrimidine transitions

23
Q

Syndromes associated with a predisposition for keratoacanthoma

A
  • Muir-Torre syndrome
  • Multiple self-healing squamous epithelioma (Ferguson–Smith syndrome)
24
Q
A
25
Q

Risk Factors for the Development of Squamous Cell Carcinoma

A
26
Q

Oral SCC may arise on apparently normal mucosa but are usually preceded by

A

leukoplakia, erythroplakia, or leukoerythroplakia,

27
Q

SCC of the lip occurs more often where?

A

Lower lip

28
Q

Typical locations of verrucous SCC

A
  • oral cavity: oral florid papillomatosis
  • genitoanal region: giant condyloma acuminatum Buschke-Löwenstein
  • plantar skin: epithelioma cuniculatum
  • amputation stumps
29
Q

hallmark of invasive SCC

A

growth of atypical keratinocytes beyond the basement membrane into the dermis

30
Q

Basic Features of Histopathology Report of Cutaneous Squamous Cell Carcinoma Diagnosis

A
31
Q

This variant of SCC bears an increased propensity for metastasis. The main histologic characteristic is extensive acantholysis of the atypical keratinocytes leading to pseudoglandular structures within the tumor area

A

ACANTHOLYTIC (ADENOID) SQUAMOUS CELL CARCINOMA

32
Q

a well-differentiated variant of SCC that slowly grows and is locally destructive, but with only low metastatic potential

A

VERRUCOUS SQUAMOUS CELL CARCINOMA

33
Q

Distinct variant of SCC that shows a highly infiltrative growth pattern with abundant mucinous stroma surrounding the tumor cells.

This often is associated with perineural or perivascular infiltration, and reveals a high rate of recurrence and metastases

A

DESMOPLASTIC SQUAMOUS CELL CARCINOMA

34
Q
A
35
Q

What are the histologic variants of SCC

A
  • SPINDLECELL SQUAMOUS CELL CARCINOMA
  • ACANTHOLYTIC (ADENOID) SQUAMOUS CELL CARCINOMA
  • VERRUCOUS SQUAMOUS CELL CARCINOMA
  • DESMOPLASTIC SQUAMOUS CELL CARCINOMA
  • KERATOACANTHOMA
36
Q

What are the margins for conventional standard excision of SCC

A

4 - 6 mm margins

  • may be acceptable as primary treatment of local, low-risk SCCs
37
Q

A prospective Phase II trial has demonstrated the efficacy of monotherapy with ___________ as a first-line treatment of unresectable SCC (a 29% response rate).

A

cetuximab

38
Q

frequently found to be the first indicator of aggressive biologic behavior in SCC

A

Local recurrence at the site of the primary lesion

39
Q

High risk areas for SCC

A

“mask areas” of face (central face, eyelids, eyebrows, periorbital, nose, lips [cutaneous and vermilion], chin, mandible, preauricular and postauricular skin/sulci, temple, ear), genitalia, hands, and feet.

40
Q

Moderate risk areas for SCC

A

cheeks, forehead, scalp, neck, and pretibia

41
Q

Low risk areas for SCC

A

trunk and extremities (excluding pretibia, hands, feet, nail units, and ankles)

42
Q
A
43
Q

A metaanalysis and systematic review on all published data found that tumor depth (ie, Breslow thickness exceeding _______ mm and invasion beyond subcutaneous fat) is associated with the highest relative risk of local recurrence and metastasis of SCC.

A

2 mm

44
Q

A tumor diameter exceeding ________mm is associated with the highest relative risk for disease-specific death of SCC

A

20 mm

45
Q

Tumors larger than________ mm are associated with a high risk of metastasis and local recurrence.

A

6 mm

46
Q

independent risk factor for local recurrence

A

Desmoplastic growth

47
Q

Another prospective study found that lesion size equal to or greater than _______ cm and histologic evidence of perineural invasion and deep invasion beyond subcutaneous structures were the factors most significantly associated with disease-specific mortality in cutaneous SCC

A

4 cm

48
Q

Overall, the 3-year cumulative risk of a subsequent SCC after an index SCC is ____%, at least a 10-fold increase in incidence compared with the incidence of first tumors in a comparable general population

A

18%

49
Q

Vitamin B suitable fir chemoprevention of NMSC

A

niacinamide (Vitamin B3) 500 mg twice daily

50
Q

Although there were numerous side effects, this treatment was the first demonstration of effective chemoprevention of cancer in humans.

A

Systemic retinoids (Vitamin A)

FITZPATRICK'S DERMATOLOGY 9TH EDITION (SHAMMY) (122 decks)

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