Malignant Cutaneous Neoplasms1

Question 1

What is the most common skin cancer in white people

Answer 1

Basal Cell Carcinoma

Question 2

What percentage of BCC develop in sun exposed areas?

Answer 2

80%

Question 3

True/False: The link between UV radiation exposure and squamous cell carcinoma is stronger than that for basal cell carcinoma

Answer 3

TRUE

Question 4

What is the most common subtype of BCC

Answer 4

Nodular

Question 5

Pearly, telangiectatic , and ﾓrolled borderﾔ are common descriptors of what malignant cutaneous neoplasm?

Answer 5

Basal Cell Carcinoma

Question 6

Superficial basal cell carcinomas are most commonly found in what distribution?

Answer 6

Trunk and extremities

Question 7

What are the subtypes of basal cell carcinoma?

Answer 7

Nodular, superficial, infiltrating, morpheaform or sclerosing

Question 8

Where are infiltrating basal cell carcinomas most often found?

Answer 8

Head and neck of older patient

Question 9

What is the importance of recognizing basosquamous carcinoma?

Answer 9

It has metastatic potential closer to squamous cell carcinoma, as opposed to basal cell carcinoma

Question 10

What is the hallmark of basosquamous carcinoma

Answer 10

Mature, atypical keratinizing squamous component on histology

Question 11

What is the primary treatment goal for basal cell carcinoma?

Answer 11

Complete excision of the primary tumor to reduce treat of local tissue destruction

Question 12

What are the potential treatment options for basal cell carcinoma?

Answer 12

Excision with 4mm margins (tumors under 2cm), Mohs microsurgery, radiation (large lesions, poor surgical candidates, challenging anatomy, and cancer invading neurovascular structures

Question 13

Which types of squamous cell carcinomas are more indolent, cutaneous or mucocutaneous?

Answer 13

Cutaneous

Question 14

What are the recommended margins for excision of squamous cell carcinoma?

Answer 14

4mm

Question 15

What are the potential treatments for squamous cell carcinoma?

Answer 15

Excision with 4mm margin, Mohs microsurgery, radiation

Question 16

True/False: Squamous cell carcinoma in situ typically progress to invasive carcinoma?

Answer 16

False - 26% invade dermis, but only 16% metastasize

Question 17

Bowenﾒs disease is similar to squamous cell carcinoma in situ, except for what finding

Answer 17

Bowen’s disease involves hair follicles and predispose to invasive adnexal carcinoma

Question 18

Where is Erythroplasia of Queyrat generally distributed?

Answer 18

Male genitalia (glans of uncircumcised penis)

Question 19

What are the treatment options for Bowen’s disease

Answer 19

Electrodissection and curettage, total chemotherapy, immune modulators

Question 20

What normal adnexal cell types give rise to adnexal tumors?

Answer 20

Appendageal skin cells of hair follicles and glandular cells (sebaceous, apocrine, and eccrine)

Question 21

What treatment is needed in adnexal tumors if histology reveals hamartoma

Answer 21

No further treatment

Question 22

Adnexal mass that grow rapidly, ulcerate, or bleed require evaluation for what diagnosis?

Answer 22

Adnexal adenocarcinoma

Question 23

Why is surgical excision recommended in microcystic adnexal carcinoma, even when classified low grade?

Answer 23

There is a (small) risk of metastasis

Question 24

True/False: Microcystic adnexal carcinoma are more common in women than men.

Answer 24

TRUE

Question 25

What are the subtypes of sebaceous carcinoma

Answer 25

Ocular and extra ocular

Question 26

Red periorbital nodules/plaques with ulceration or crusting suggest what diagnosis?

Answer 26

Sebaceous Carcinoma

Question 27

What is the curative treatment for atypical fibroxanthoma?

Answer 27

Surgical excision

Question 28

Dermatofibrosarcoma protuberans is a disease associated with what age group?

Answer 28

Young and middle aged

Question 29

What is the most common distribution of dermatofibroxanthoma protuberans?

Answer 29

50-60% on the trunk

Question 30

True/False: dermatofibroxanthoma is characterized by the absence of local invasion.

Answer 30

False - it shows local invasion and a tendency to recur, which is by complete excision is recommended

Question 31

Merkel cell carcinoma is an aggressive malignancy with what 5 yr. survival?

Answer 31

30%

Question 32

What percentage of patients develop distant metastasis from Merkel cell carcinoma?

Answer 32

40%

Question 33

What are the available treatments for Merkel cell carcinoma?

Answer 33

Primarily surgical, but also adjuvant chemotherapy, immunotherapy, and radiation

Question 34

70% of angiosarcomas occur in what age group?

Answer 34

40 and above, with a peak at 70

Question 35

What is the most common location for angiosarcomas?

Answer 35

50% involve the face and scalp

Question 36

What is the male to female ratio of angiosarcomas?

Answer 36

2 to 1

Question 37

How does an angiosarcoma present?

Answer 37

Ecchymmotic patch (with possible facial edema) which expands to large size

Question 38

What is the 5 year survival of angiosarcoma?

Answer 38

15%

Question 39

Angiosarcoma is closely associated with what pre-disease surgery?

Answer 39

Axillary lymph node dissection, leading to lymphedema; notably, congenital lymphedema is also a risk

Question 40

What is the margin needed for angiosarcoma?

Answer 40

5cm

Question 41

Why are the recurrence rate and chance of metastasis high, even after appropriate excision of angiosarcoma?

Answer 41

The tumor demonstrates significant multifocality

Question 42

What is the utility of chemotherapy and radiation in angiosarcoma?

Answer 42

Palliative, but they do not improve survival