Malignant Melanoma #Checklist

Question 1

Stem; 56 year old man referred to an outpatient clinic by a GP asked for a skin biopsy presented with forearm lesion whose report showed proliferation non pigmented epithelioid melanocyte.

1.What is the Basic difference between malignant melanoma and basal cell carcinoma.

Answer 1

Melanoma is tumor of melanocytes
SCC is a tumor of epithelial cells

Question 2

2.What ttt is indicated if a pathology as a consequence of pathology erupted?

Answer 2

Surgery to achieve complete excision

Question 3

3. Describe 3 histopathological features.That indicate the aggressive potential of Melanoma.And the likely poor prognosis?

Answer 3

-Invasion of lymphatic, perineural and vascular
-Ulceration
-Deep dermal tissue invasion that present expressed on breslow sickness.

Question 4

4. What’s satellite lesion?

Answer 4

A Focus of melanoma separate from main tumor mass usually visible on the skin surface and often arises as a result of lymphatic spread and then grows of the tumor embolus locally

Question 5

5. What pathological features might be regarded as good prognosis features from the histology prospective?

Answer 5

Limited tumor depth and no lymphovascular invasion

Question 6

6. Why is sun exposure a risk factor for melanoma?

Answer 6

High energy radiation in UV band can damage DNA directly causing mutations

Question 7

7. Name 2 inherited conditions with increase risk of melanoma?

Answer 7

1.Xeroderma pigmentosa
2.Dysplastic navus syndrome

Question 8

8. Pt underwent complete excision of 1.1 mm thick melanoma with a clear 0.5 mm margin. What is the most likely next step?

Answer 8

A wide excision
With additional boundry to be determined by pathologist according to breslow thickness.

Question 9

9. Which intraoperative invx will assess for the margins?

Answer 9

Frozen section

Question 10

10. Pt seen again 18 months later with a third painless swelling in the axilla. Which simple test will you do for pt?

Answer 10

FNAC

Question 11

13. Two reasons why axillary vein thrombosis is more likely in this post op setting?

Answer 11

. Surgery to metastatic melanoma with local tissue injury increased local thromboembolic tendency and alterd blood flow can occured in post-op setting in this site.

Question 12

14. What’s the regression phenomenon?

Answer 12

Regression phenomenona chchc by partial or complete replacement of melonama by fibrosis as a result of local host immune response

Question 13

15. Name of classification used for breslow thickness?

Answer 13

American association of dermatology recommendation.
NCCN

Question 14

11. When considering additional cancer therapy what gene mutation commonly tested?

Answer 14

BRAF gene

Question 15

12. Pt has the axillary tissue resected but after 24 hrs developed tense swelling and red arm with distal Edema. Dx?

Answer 15

Axillary vein thrombosis