Melanoma

Question 1

Where are most melanomas?

Answer 1

Cutaneous

Question 2

High risk sites for melanoma

Answer 2

BANS: Back, Arms, Neck, Scalp

Question 3

Clinical features of melanoma

Answer 3

ABCDE’s: Asymmetry, Border irregularity, Color variation, Diameter greater than 6 mm, Evolving (enlarging/changing color)

Question 4

What direction is radial growth

Answer 4

Lateral

Question 5

What direction is vertical growth

Answer 5

Extends deeper into the connective tissue

Question 6

Precursor to melanoma

Answer 6

Lentigo maligna

Question 7

4 types of melanoma

Answer 7

1. Lentigo maligna melanoma
2. Superficial spreading melanoma
3. Nodular melanoma
4. Acral lentiginous melanoma

Question 8

Also called “Hutchinson’s freckle”

Answer 8

Lentigo maligna

Question 9

Lentigo maligna is melanoma in a purely ____ growth phase

Answer 9

Radial

Question 10

Lentigo maligna is a large ____ lesion with ____ borders and ____ pigmentation

Answer 10

Macular, irregular, uneven

Question 11

What signals the vertical growth phase and lentigo maligna melanoma?

Answer 11

Nodularity in a previously flat lentigo maligna

Question 12

Most common type of melanoma

Answer 12

Superficial spreading melanoma

Question 13

Superficial spreading melanoma can be found in the ____ area of men and the __________ of women

Answer 13

Interscapular, back of the legs

Question 14

What does superficial spreading melanoma begin as?

Answer 14

A macule or plaque

Question 15

Histology of superficial spreading melanoma: clusters of atypical _____ along the ____ layer

Answer 15

Melanocytes, basal

Question 16

Nodular melanoma has almost an immediate ____ phase, little if any ____ growth

Answer 16

Vertical, radial

Question 17

Most common form of oral melanoma

Answer 17

Acral lentiginous melanoma

Question 18

Most common form of melanoma in persons of color

Answer 18

Acral lentiginous melanoma

Question 19

Which form of melanoma is more aggressive than cutaneous melanoma?

Answer 19

Acral lentiginous melanoma

Question 20

Locations of Acral lentiginous melanoma

Answer 20

Palms, Soles, Subungual, Mucous membranes

Question 21

Oral Acral lentiginous melanoma can be ___

Answer 21

Amelanotic

Question 22

Acral lentiginous melanoma is typically in ____

Answer 22

Males

Question 23

High risk sites for Acral lentiginous melanoma

Answer 23

Hard palate/maxillary alveolar mucosa

Question 24

Where does oral Acral lentiginous melanoma usually metastasize

Answer 24

Cervical lymph node

Question 25

What does oral Acral lentiginous melanoma appear as on a radiograph

Answer 25

Irregular radiolucency or mixed lesion

Question 26

Surgical excision of ____ cm margin for cutaneous lesions of melanoma

Answer 26

1-2 cm

Question 27

Prognosis is better if < ____ mm and worse if > ____ mm

Answer 27

Better if < 0.75 mm and worse if > 3.6 mm

Question 28

Which sex has a better prognosis for melanoma? What age?

Answer 28

Females under 50

Question 29

Which cutaneous lesions have the worst prognosis?

Answer 29

Trunk, H&N

Question 30

Which area has a worse prognosis than cutaneous?

Answer 30

Mucosal

Question 31

In general, melanoma has a ___ prognosis

Answer 31

Poor

Question 32

Routes of metastasis for melanoma

Answer 32

Lymphatics, Blood (Brain, Liver, Bone)