4/ Skin Cancer Flashcards
What is the gross appearnace of basal cell carcinoma?
- enlarging annular plaque with focal ulceration and rolled out margin on the nose
What type of biopsy is required to diagnose each of the three skin cancers?
BCC/SCC = punch biopsy melanomas = skin excision biopsy
What is the histology of basal cell carcinoma?
- retraction artefact
- infiltrative pattern
- basaloid nests
- fibrotic stroma
- ?perineural invasion
What are the histological subtypes of BCC?
- nodular
- superficial - multifocal
- micronodular - aggressive, high recurrence
- infiltrative - aggressive, high recurrence
What is the gross appearance of squamous cell carcinoma?
ulcerated lesion, with hard, raised edges, in sun exposed areas
What is the histological appearance of SCC?
- keratin pearls and infiltrative nests of malignant squamous cells
What histological features are prognostically important in SCC?
- thickness of tumour >4mm - high risk
- depth if infiltration
- maximum diameter of tumour
- lymphovascular/perineural invasion
- completeness of excision , margins
What is the difference between in-situ and invasive melanoma?
In situ melanoma = melanoma limited to the epidermis/dermoepidermo junction –> no metastases if completely excised
Invasive melanoma = dermal invasion present –> risk of mets
What are the histological subtypes of melanoma?
- superficial spreading
- nodular
- lentigo maligna melanoma
- acral lentiginous melanoma
- other uncommon variants
What is Breslow’s thickness?
- thickness of tumour from superficial portion of granular cell layer to deepest tumour cell
What is the clinical significance of the Breslow’s thickness?
It correlates with prognosis
- <1mm - 5 year survival >90%
- > 4mm - 5 year survival <50%
What is features are associated with poor prognosis in melanoma
mitotic figures
lymphovascular invasion
microsatellites
What are Clark levels?
Another way of assessing the depth of tumour invasion in melanoma
