Mock Boards - Pathology Flashcards
MRONJ staging
Low risk
High risk
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
High risk features?
Key size factor?
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.
When to do Moh’s?
What margins if doing WLE?
Recurrence rates for + margin, - margin
- Moh’s for critical areas
- Otherwise 4mm margin
- margin has 40% recurrence rate within 24 months
- margin has 14% recurrence rate within 5 yrs
- 4mm margin:
- 5mm margin:
- 1 cm margin:
- 2cm margin:
- 4mm margin: BCCa, cutaneous SCCa
- 5mm margin : Melanotic neuro-ectodermal tumor of infancy,
- 2cm margin: All sarcomas
- 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
- 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
