MALIGNANT TUMORS

Question 1

MALIGNANT CUTANEOUS LESION

Answer 1

DUE TO ABNORMAL/ UNCONTROLLED GROWTH OF EPITHELIAL CELLS

Question 2

SIGNS + SYMPTOMS - MALIGNANT TUMORS

Answer 2

> more than 1 multiple visible cutaneous tumors
melanoma > can be non cutaneous too > ocular, mucosal

Question 3

DIAGNOSIS OF MALIGNANT TUMOR SKIN

Answer 3

HISTOLOGICAL ANALYSIS
> confirm dx
> find tumor grade

BIOPSY
> confirms dx
> find tumor grade

OTHER
> dermatological exmaination > dermatoscope
> TNM staging
> Breslow thickness > distance of tumor cell from basal layer of epidermis

Question 4

BRESLOW DEPTH/ THICKNESS

Answer 4

THICKNESS OF TUMOR FROM BASAL LAYER OF EPIDERMIS

IN SITU
95-100% 5 year survival

< 1mm
95-100% 5 year survival

1-2mm
80-96% 5 year survival

2.1-4mm
60-75% 5 year survival

Question 5

TREATMENT MALIGNANT TUMOR SKIN

Answer 5

MEDICATION
> immunomodulators

SURGERY
> surgical excision
> electrodesiccation
> curettage of lesion

OTHER
> radiation therapy

Question 6

SKIN CANCER

Answer 6

BASAL CELL CARCINOMAS

SQUAMOUS CELL CARCINOMAS

MALIGNANT MELANOMAS

Question 7

BASAL CELL CARCINOMA

Answer 7

SLOW GROWING INVASIVE MALIGNAT TUMOR OF EPIDERMAL KERATINOCYTES

Keratinocytes > produce keratin > protective barrier for skin
keratin > keeps moisture in + microbes out

Question 8

TYPES BCC

Answer 8

NODULAR > most common type

SUPERFICIAL

CYSTIC

MORPHEIC

KERATOTIC

PIGMENTED

Question 9

RISK FACTORS FOR BASAL CELL CARCINOMA

Answer 9

UV EXPOSURE > sun bed
SKIN TYPE 1 > skin never turns + always burns
MALE
HX OF FREQUENT SUN BURN
INCREASED AGE
PREVIOUS SKIN CANCER
FAMILY HX OF SKIN CANCER
IMMUNOSUPPRESSION > HIV

Question 10

DESCRIBE BCC LESION

Answer 10

SCAM

S > size/ shape > round
C > Colour > pearly pink
A > associated changes > telangiectasia, dry/ flaky
M > morphology > nodule/ papule/ central depression
M > margins > well defines + rolled edge

MOST COMMON > HEAD + NECK

Question 11

MANAGEMENT OF BASAL CELL CARCINOMA

Answer 11

> cyrotherapy
topical photodynamic therapy
topical imiquimod
surgical excision + histology
radiotherapy

Question 12

SQUAMOUS CELL CARCINOMA

Answer 12

FAST growing invasive malignant tumor of epidermal keratinocytes > can metastasise

Question 13

RISK FACTORS FOR SQUAMOUS CELL CARCINOMA

Answer 13

> sun exposure
genetics
hx of bowen disease > precancerous in-situ SCC

Question 14

DIAGNOSIS FOR SQUAMOUS CELL CARCINOMA

Answer 14

> surgical excision > for histology > confirm dx
sentinel node biopsy > if high risk > further dx due to risk of metastasis
imaging

Question 15

MANAGEMENT OF SQUAMOUS CELL CARCINOMA

Answer 15

> surgical excision
Mohs micrographic surgery > if high risk
radiotherapy > if lesion is large
chemotherpay > for metastatic

Question 16

MALIGNANT MELANOMAS

Answer 16

INVASIVE MALIGNANT TUMOURS OF THE EPIDERMAL MELANOCYTE

MELANOCYTES > found in basal layer > produce pigment > melanin > absorb UV + prevent skin burning

non cancerous growth of melanocytes > MOLES = bening melanocytic nevi + freckles

Question 17

TYPES OF MELANOMAS

Answer 17

SUPERFICIAL SPREADING
> young people
> arms, legs, back, chest

NODULAR
> erythamatous nodule
> red
> bleeds easily

LENTIGO MALIGNA
> less common
> older px
> sun exposure

ACRAL LENTIGINOUS
> rare
> pigmentation of nails, palms, soles of feet

Question 18

DIAGNOSIS MALIGNANT MELANOMA

Answer 18

ABCD
> asymmetry
> border iregularity
> colour iregulary
> diamter more than 7mm
> palpate lymph nodes > malignant melanomas > metastasise

Question 19

INVESTIGATION MALIGNANT MELANOMA

Answer 19

> surgical excision + histology
sentinel node biopsy
imaging

Question 20

MANAGEMENT MALIGNANT MELANOMA

Answer 20

> wide local excision
with/ without lymphadenoectomy
radiotherapy
chemotherapy > if metastatic disease