Metastatic CA Flashcards
Persistent tumor/ Direct extention
PERSISTENTTUMOR Lymphatic extension and hematogenous spread.
DIRECTEXTENSION Pagetdiseaseandextramam- mary Paget disease.
Special paterns of cutaneous involvement in Breast CA.
Inf ammatory metastatic carcinoma (carci- noma erysipelatodes): Erythematous patch
or plaque with an active spreading border
Telangiectatic metastatic carcinoma (carcinoma telangiectaticum): Breast cancer appearing as pinpoint telangiectases with dilated capillaries within carcinoma erysipelatodes. Violaceous papules or papulovesicles resembling lymphan- giomacircumscriptum
En cuirasse metastatic carcinoma:Diffuse mor- phea-like induration of skin
is a malignant neoplasm that unilaterally involves the nipple or areola and simulates a chronic eczematous dermatitis
Mammary paget disease
Mammary pagets disease.
age
gender
> 50
Female
Mammary pagets disease.
Skin lesions.
red, scaling plaque, rather sharply marginated, oval with irregular borders.
Whenscaleisremoved,thesuraceismoistandoozing(Fig.19-8).Lesionsrangeinsize rom0.3to 15cm
Mamarry paget disease.
% survival rate if mass is palpable or not
breast mass is not palpable,
92% of patients survive 5years after excision;
82%survive10years.
When breast mass is palpable,
38% survive 5 years;
22% survive 10 years.
Prognosis is worse when there is lymphadenopathy.
neoplasm o the anogenital and axillary skin, histologically identical, and clinically similar to Paget disease of the breast
Extramammary paget disease
extramammary paget disease, assoc w cancer?
No
EXxtramammary paget
Skin lesions
Thelesionpresentsaserythematousplaque,plusscaling, plus erosion (Fig. 19-10), plus crusting, plus exudation; eczematous-appearing lesions, but borders aresharplyde ned(Fig.19-10),geographiccon guration.Lesionsshouldalwaysbebiopsied
rare, autosomal-dominant heritable cancer syndrome with variable expressivity in a number o systems in the form of multiple hamartomatous neoplasmso ectodermal,mesodermal,and endodermal origin
Cowden syndrome
Gene mutation of cowden syndrome.
Germ-line mutations in the tumor-suppressor gene PTEN are located on chromosome 10q22–23 in most cases.
Cowden syndrome.
Skin and mucous lesions.
lesions may appear first in childhood and develop over time. They consist of trichilemmomas, skin-colored, pinkor brown papules and have the appearance of flat warts on the central area of the face,lips,and the ears;
translucent punctate keratoses of the palms and soles;and hyperkeratotic, attopped papules on the dorsa of the hands and forearms.
Mucousmembranes: papules of the gingival,labial and palatal suraces that coalesce,givinga“cobblestone” appearance.Papillomas of the buccal mucosa and the tongue
Cancer assoc w cowden sydrome
Breast and thyroid
a familial (autosomal dominant, spontaneous mutation in 40%) polyposis characterized by many small, pigmented brown macules (lentigines) on the lips, oral mucous mem- branes(browntobluishblack),and on the bridge of the nose,palms,andsoles. ■ The gene has been mapped to 19p13.3.
peutz Jeghers syndrome
Sine qua non for the diagnosis of Peutz jegher
Macules on the lips may disappear over time, but not the pigmentation of the mouth; therefore, the
mouth pigmentation is the sine qua non or the diagnosis
