epithelial malignancies 1 and 2 Flashcards
what is the most common form of skin cancer?
how many people are diagnosed with this form per year?
Basal Cell Carcinoma
nearly 3 million cases diagnosed annually
what population groups are at the highest risk for Basal Cell Carcinoma (BCC)?
Affected patients are typically over 40 years of age, have a fair complexion and a history of chronic sun exposure
what percent of BCC’s are found on the head/neck region?
80%
most basal cell carcinomas develop in what region?
middle third of the face
what is the most common type of clinical presentation of basal cell carcinoma?
Nodulo-ulcerative
what are the clinical features of a Nodulo-ulcerative BCCa?
Umbilicated pearly papule that may show central ulceration
Lack of adnexal skin structures (hair)
what are the histopathological finding for Basal cell carcinoma?
A) Basaloid cells that appear to “drop off” of the basal cell layer of the epidermis
B) Nodulo-ulcerative - large lobules of tumor cells are characteristic
T/F: Pigmentation of Basal cell carcinoma is relatively rare
False
Pigmented lesions are not rare
Pigmented BCCa lesions can resemble what other type of lesion?
Resemble melanocytic nevi due to the presence of benign melanocytic colonization
how can a pigmented BCCa be differentiated from a melanocytic nevus?
History of relatively short (weeks-months) duration and lack of hair should help distinguish this lesion from a nevus
Most Basal cell carcinomas have a nodulo-ulcerative pattern, with large lobules of tumor cells invading what layer of the dermis?
the superficial connective tissue
why do some BCCa’s become pigmented?
activation of benign melanocytes
what is the most aggressive (and most rare) form of basal cell carcinoma?
Sclerosing (morpheaform) basal cell carcinoma
what do Sclerosing (morpheaform) Basal cell carcinomas resemble clinically?
Clinically resemble a scar
- due to the induction of collagen formation by the tumor cells
what are the histological characteristics of Sclerosing BCCa?
characterized by tiny infiltrative nests of tumor cells in a collagenous background
T/F: it is difficult to clinically determine the borders of a Sclerosing BCCa
True
Very difficult to assess borders clinically because of this infiltrative growth pattern
what treatments are available for BCCa?
Scalpel excision Electrocautery and curettage Cryotherapy Topical agents (5-FU, imiquimod) Mohs micrographic surgery
over __% of patients with Basal cell carcinoma are cured after the first treatment
95%
when would you perform Mohs surgery on a Basal cell carcinoma patient?
Larger lesions, recurrent lesions and tumors in areas of embryonic fusion
what is the most common oral malignancy?
Squamous Cell Carcinoma
T/F: Squamous Cell Carcinoma is the second most common cutaneous malignancy
true
from what cell type do SCCa’s arise? in what areas of the face are UV related SCCa’s found?
Arises from surface epithelial cells
Skin and lower vermilion zone of the lip cancers are due to UV light exposure
Cutaneous SCCa’s often arise from what type of pre-existing lesions?
Actinic Keratosis
Due to chronic sun (ultraviolet light) exposure
what areas of the body are at highest risk for developing SCCa?
Face, helix of ear, dorsum of hands and arms are common sites
T/F: actinically-induced squamous cell carcinomas are well-differentiated and grow slowly
true
what % of Oral Squamous Cell Carcinomas are associated with smoking?
75-80%
what areas in the mouth are at risk for SCCa in people with NO identifiable risk factors?
lateral tongue of younger people or gingiva of older women
Oral squamous cell carcinoma accounts for about _____% of all cancers in the US
3-4
what population groups are at highest risk for SCCa?
Most occur in adults over 45 years
Men outnumber women by a 2.5:1 margin
clinical features of Squamous cell carcinoma lesions:
A) Irregular shape, mixture of red and white clinically
B) Often ulcerated
C) Exophytic (growing out) or endophytic (growing in) growth pattern
D) Often much firmer than surrounding tissues
T/F: Oral SCCa is usually asymptomatic until late stages
True
when would a Squamous cell carcinoma show a ragged radiolucency?
characteristic of lesions that involve underlying bone
Characteristics of SCCa of the LIP:
1) Commonly involved site
2) Secondary to chronic sun (UV) exposure
3) Arises in the setting of actinic cheilitis
4) Slow-growing, well-differentiated lesions usually
what is the most common location of an oral SCCa?
Lateral tongue
its almost always the location in patients under 40
a history of smoking will increase the risk of oral SCCa in what areas?
A) lateral tongue
B) floor of mouth
