Head And Neck Skin Cancer Flashcards
What’s the clinical staging of melanoma?
Stage 1-local tumour. 81% 10 year survival rate.
Stage 2-involvement of local lymph nodes (47%survival rate)
Stage 3- disseminated disease 0%
What are the melanoma subtypes?
Superficial spreading (radial growth) Nodular (vertical growth) Lentigo maligna melanoma Amelanotic Acral Mucosal Occular
What’s Breslow thickness?
A measurement in mm of the actual thickness of the melanoma which is a reflection of the depth of penetration of the tumour into the skin. Less than 1mm is low risk. 1-3.99 intermediate and above 4 is high risk.
What’s Clark’s level? (But as skin levels vary it’s more a qualitative than a quantitative measure)
5 layers melanoma skin cancer: Level 1- preinvasive. The outermost epidermis. Level 2- thinly invasive. Level 3-4 moderately invasive Level 5 deeply invasive (underlying fat)
What are the recommended surgical excision margins? (Based on Breslow thickness)
In situ: 5 mm margins Less than 1 mm : 1cm margins 1.01-2mm: 1-2cm margins 2.1-4mm: 2-3cm margins >4mm: 3cm margins
What are the different types of skin cancer?
Melanoma-begins in the skin (often a mole) and can spread to other organs in the body
Squamous cell carcinoma
Basal cell carcinoma
Squamous cell carcinoma
What is basal cell carcinoma?
A slow growing locally invasive malignant epidermal skin tumour which mainly affects Caucasians. It infiltrated tissue in a 3D continuous pattern. Metastasis is rare. It’s the most common skin cancer in the USA and UK
What’s the clinical appearance of BCC?
Nodular, cystic, ulcerating, superficial, sclerosing, keratotic, pigmented.
What are the surgical techniques for BCC?
Destructive and excisional (could be by mohs’ micrographics surgery ESP if around the central face, eyes, nose lips and ears)
What is mohs’ surgery?
Tissue is cut in a saucer shape and cut into sections , stained and marked on a mohs’ map. Upon microscopic examination if residual cancer is going the map is used to direct the removal of additional tissue. Process is repeated as many times as necessary to locate any remaining cancerous areas within the tissue specimen. When no more revealed the surgical defect is ready for repair.
What are non surgical techniques for removal of BCC?
Radiotherapy, topical therapy, intralesion interferon, photodynamic therapy, chemotherapy, palliative therapy, retinoids
What is squamous cell carcinoma?
Second most common skin cancer. Arises from the epidermis and resembles the squamous cells. Chronic exposure to sunlight is the most common cause so most often appear in sun exposed parts of the body or where skin has suffered certain kinda of injury. Occasionally arises on healthy non damaged skin.
What factors affect the metastatic potential of cutaneous SCC?
Site
Size:diameter
Size:depth and level of invasion
Histological differentiation (more differentiated equals better prognosis) and subtype
Host immunosuppression
Previous treatment and treatment modality
What are premalignant conditions called? (Progression to SCC occurs slowly and affects about 10% and cost effectiveness of treating these people is questionable as usually low aggression and distant metasteses are rare)
Acitinic or solar keratosis: rough scaly slightly raised growths
Acitinic cheilitis: type of Acitinic keratosis that occurs on the lips.
What are the forms of treatment for skin cancer?
Curettage and electrodesiccation Excisional surgery X-ray MOHs micrographic surgery Cryosurgery Laser surgery Photodynamic therapy Imiquimod
