Mock Boards - Pathology

Question 15

MRONJ staging

Question 17

Low risk

High risk

Answer 17

Low risk

• <2cm all locations except facial mask
• Nodular/superficial subtypes
• No prior tx

High risk

• >2cm all locations
• Any size, facial mask
• Morpheaform, other rare subtypes
• PNI

Question 18

High risk features?

Key size factor?

Answer 18

AJCC 7th edition cSCC tumor staging system

Tis Carcinoma in situ

T1 Tumor ≤ 2 cm in greatest dimension with < 2 high-risk features

T2Tumor > 2 cm in greatest dimension with or without one additional high-risk feature, or any size with ≥ 2 high-risk features

T3Tumor with invasion of maxilla, mandible, orbit, or temporal bone

T4Tumor with invasion of skeleton (axial or appendicular) or perineural invasion of skull base.

1) In the absence of nodal or distant metastasis, Tis = Stage 0, T1 = Stage I, and T2 = Stage II.
2) High-risk features incude depth >2mm or Clark level ≥ 4, perineural invasion, location on the ear or lip, and poor differentiation.

Question 19

When to do Moh’s?

What margins if doing WLE?

Recurrence rates for + margin, - margin

Answer 19

• Moh’s for critical areas
• Otherwise 4mm margin
• • margin has 40% recurrence rate within 24 months
• • margin has 14% recurrence rate within 5 yrs

Question 30

• 4mm margin:
• 5mm margin:
• 1 cm margin:
• 2cm margin:

Answer 30

• 4mm margin: BCCa, cutaneous SCCa
• 5mm margin : Melanotic neuro-ectodermal tumor of infancy,
• 2cm margin: All sarcomas

Question 31

• Avg Age
• Classic finding of widened PDL known as ?
• Other 2 classic rad findings
• Route of metasis
• Role of radiation
• Role of chemotherapy
• Role of surgery
• Negative prognostic indicators
• Prognosis 5 years

Answer 31

• 27yo
• Garrington Sign
• Sunburst (bone formation at right angle to cortex), floating teeth
• No radiation
• Neoadjuvant chemo has no added benefit. However, adjuvant chemo commonly given
• Resection 2cm margins
• Myxomatous, necrosis, giant cells, pain, abundant calcification, non-mandibular location
• 50% 5 year survival