Malignancies of Surface Epithelial Origin Flashcards
neoplasm
new and abnormal growth, specifically one in which cell multiplication is uncontrolled and progressive
T/F: neoplasms are benign
false; may be benign or malignant
malignancies of surface epithelial origin
- basal cell carcinoma
- cutaneous squamous cell carcinoma
- squamous cell carcinoma of the lip
- oral squamous cell carcinoma
- verrucous carcinoma
where does basal cell carcinoma arise from?
basal cells of the epidermis
what is the most common skin cancer?
basal cell carcinoma
how many basal cell carcinoma cases are diagnosed annually in the US?
over 1 million cases
risk factors of basal cell carcinoma
- age (esp. over 40 y.o.)
- fair complexion
- chronic and intermittent sun (UV) exposure
- frequent sunburns
- outdoor occupation or hobby
- tendency for freckling in childhood
- other: PUVA for psoriasis, tanning beds, immunosuppression
- basal cell carcinoma syndrome
T/F: females are more at risk for developing basal cell carcinoma
false; male>female
where does basal cell carcinoma affect?
any cutaneous site
what percent of the sites basal cell carcinoma affect is head and neck?
80%
which area on the head and neck is the most common location affected by basal cell carcinoma?
middle 1/3 of face (mask area)
what does the mask area include?
includes top of the eyebrows to top of upper lip; includes ears
types of basal cell carcinoma
- nodulo-ulcerative BCC
- pigmented BCC
- sclerosing (morpheaform) BCC
- others: superficial BCC, BCC associated with syndromes, fibroepithelioma
what is the most common type of BCC?
nodulo-ulcerative BCC
what is the least common type of BCC?
sclerosing (morpheaform) BCC
clinical features of nodulo-ulcerative BCC
- firm, painless papule
- slow enlargement
- central umbilication (depression) which often ulcerates
- rolled borders
- pearly, opalescent when pressed
- no hair
- telangiectasia
- hx of intermittent bleeding then healing
telangiectasia
collection of small blood vessels near surface
histopathologic features of nodulo-ulcerative BCC
- uniform, ovoid, dark-staining basaloid cells
- basaloid cells appear to “drop off”
- large lobules of basaloid tumor cells
- palisading basal cells
what does pigmented BCC resemble?
melanocytic nevi (moles)
clinical features of pigmented BCC
hx of short duration and lack of hair support BCC vs. nevus
histopathologic features of pigmented BCC
most are nodulo-ulcerative pattern, with large lobules of tumor cells invading the superficial CT
why are lesions of pigmented BCC pigmented?
colonization by BENIGN melanocytes
what is the most aggressive type of BCC?
sclerosing (morpheaform) BCC
clinical features of sclerosing BCC
- more firm than surrounding skin; resembles scar due to induction of collagen formation by tumor cells
- difficult to assess borders
- no hx of trauma or surgery
histopathologic features of sclerosing BCC
tiny infiltrative nests of tumor cells in a collagenous background
why is it difficult to clinically assess borders of sclerosing BCC?
due to the infiltrative growth pattern
treatment for BCC
- scalpel excision
- electrodesiccation and curettage
- cryotherapy
- radiation therapy
- Mohs micrographically controlled surgery; uses pathology and surgery
prognosis of BCC
generally excellent
what percent of patients are cured of BCC after their first treatment?
95%
T/F: larger BCC lesions, recurrent lesions and tumors in areas of embryonic fusion are more aggressive and require Mohs surgery
true
T/F: metastasis is often reported with BCC
false; metastasis is rarely
cicatrix
scar of a healed wound
types of squamous cell carcinoma (SCC)
- cutaneous (skin) SCC
- SCC of the lip
- oral squamous cell carcinoma (OSCC)
what is the most common oral malignancy?
SCC
what percent of oral malignancies are SCC?
90%
what is the 2nd most common cutaneous malignancy?
SCC
where does SCC arise from?
surface epithelium/epidermis
on rare occasions, SCC can arise from what?
salivary ductal epithelium
risk factors for cutaneous SCC
- chronic sun (UV) light exposure
- medical ionizing radiation
- pre-existing actinic keratosis
where does cutaneous SCC affect?
any sun-exposed site