Basal and Squamous Cell CA Flashcards
What are the two major types of non-melanoma skin cancer?
Basal cell carcinoma
Squamous cell carcinoma
True or false: BCC and SCC is rare in darkly pigmented ethnicities
True
Which is more common: BCC or SCC?
BCC
True or false: BCC rarely mets
True
What are the issues that arise from BCC, since only rarely does it metastasize?
capable of local aggression and tissue destruction
What areas of the skin are affected with BCC?
Sun exposed areas of the skin, usually the head and neck
What are the skin findings of BCC?
Pearly papules or raised bordered ulcerations, often containing prominent, dilated subepidermal blood vessels (telangiectasias)
Pearly papules with telangiectasia = ?
BCC
What is the treatment for BCC?
Excision/ destruction or topical 5FU
What is the MOA of 5FU?
Inhibits thymidylate synthase, interrupting the action of the synthesis of thymidine
What is the morpheaform variants of BCC?
Scarred appearing area that is much more malignant
What does the superficial variant of BCC look like?
Eczema
What does the pigmented variant of BCC look like?
Seborrheic keratosis or melanoma
What are the histological characteristics of BCC?
Nodules that fill up the epidermis, with peripheral palisading cells
Histology of: Nodules that fill up the epidermis, with peripheral palisading cells, and stromal retraction = ?
BCC
What are the histological characteristics of the morpheaform variant of BCC?
Cord or small nests of that infiltrate everywhere
What is Gorlin syndrome?
AD mutation of PTCH gene on chromosome 9
-PTCH is a tumor suppressor gene, that predisposes to BCC
What are the features of Gorlin syndrome?
- BCCs
- Epidermal cysts
- Odontogenic keratocysts of jaw
- Palmoplantar pits
- Rib and vertebral abnormality
- Ovarian fibromas
What are some of the causes of SCC?
- UV exposure
- HPV
- Burn scars
- Chronic irritation
When particularly should SCC be monitored for?
Immunosuppressed patients
What are the skin characteristics of SCC?
firm, hyperkeratotic plaques with erosions and crusts
firm, hyperkeratotic plaques with erosions and crusts = ?
SCC
SCC often arises in or associated with what disease?
Actinic keratoses
What is the usual course of SCC?
Locally destructive
Is what areas of the body is SCC more likely to metastasize? (3)?
Ear
Lip
Genitalia
What is the metastatic potential of most SCC? What increases the risk of metastases?
Low: 0.5%
If in burn scars of osteomyelitis, then 20-60% chance
What is the treatment for SCC?
Excision or radiation
What are the histological characteristics of SCC?
Eosinophilic papillae that invade into the dermis
What are the cells that gives rise to melanoma, SCC, and BCC respectively?
Melanoma = melanocytes SCC = spinous layer BCC = Basal cells
What happens when SCC wraps around nerves?
Follow the course of the nerve in the perineural sheath
What are the four major prognostic factors for SCC?
- Size
- Depth of invasion
- Neurotropism
- Acantholytic pattern
A size greater than how many cm is a poor prognostic indicator for SCC?
More than 4 cm
What type of histological findings are a poor prognostic indicator for SCC? (2)
- Depth of invasion
- Acantholytic pattern
What is Verrucous carcinoma?
Low grade variant of SCC that recurrs commonly, but rarely metastasizes
What areas of the body are particularly affected with verrucous carcinoma?
Sole of foot or sinus tract