MS - Path (Skin cancer)

Question 1

What are the 3 kinds of skin cancer?

Answer 1

(1) Basal cell carcinoma (2) Squamous cell carcinoma (3) Melanoma

Question 2

What is the most common skin cancer?

Answer 2

Basal cell carcinoma

Question 3

In what areas of the body is basal cell carcinoma found?

Answer 3

Found in sun-exposed areas of body

Question 4

What is the invasion/metastasis potential of basal cell carcinoma?

Answer 4

Locally invasive, but almost never metastasizes

Question 5

Describe the classic physical appearance of basal cell carcinoma. Include 2 other variants of appearance.

Answer 5

Pink, pearly nodules, commonly with telangiectasias, rolled borders, and central crusting or ulceration. BCCs also appear as nonhealing ulcers with infiltrating growth or as a scaling plaque (superficial BCC).

Question 6

What is a key histologic finding of basal cell carcinoma?

Answer 6

Basal cell tumors have “palisading” nuclei

Question 7

What is the second most common skin cancer?

Answer 7

Squamous cell carcinoma

Question 8

What are 3 causes/conditions to associated with squamous cell carcinoma?

Answer 8

Associated with excessive exposure to sunlight, immunosuppression, and occasionally arsenic exposure

Question 9

What are 4 body parts where squamous cell carcinoma commonly appears?

Answer 9

Commonly appears on face, lower lip, ears, and hands

Question 10

What is the potential for invasion/metastasis of squamous cell carcinoma?

Answer 10

Locally invasive, but may spread to lymph nodes and will rarely metastasize

Question 11

What is the classic physical appearance of squamous cell carcinoma? What is its classic finding on histology?

Answer 11

Ulcerative red lesions with frequent scale. Histopathology: keratin “pearls”

Question 12

With what other ailment is squamous cell carcinoma associated?

Answer 12

Associated with chronic draining sinuses

Question 13

What are 2 precursors/variants to squamous cell carcinoma?

Answer 13

(1) Actinic keratosis (2) Keratoacanthoma

Question 14

What defines Actinic keratosis? To which skin cancer is it related?

Answer 14

A scaly plaque, is a precursor to squamous cell carcinoma

Question 15

What defines Keratoacanthoma? To which skin cancer is it related?

Answer 15

A variant (of squamous cell carcinoma) that grows rapidly (4-6 weeks) and may regress spontaneously over months

Question 16

What is a common skin tumor with significant risk for metastasis?

Answer 16

Melanoma

Question 17

What is a tumor marker for melanoma?

Answer 17

S-100 tumor marker

Question 18

With what exposure is melanoma associated? What patient population is at increased risk?

Answer 18

Associated with sunlight exposure; fair-skinned persons at increased risk

Question 19

What correlates with risk of metastasis of melanoma?

Answer 19

Depth of tumor correlates with risk of metastasis

Question 20

What are the key criteria to look for in distinguishing melanoma?

Answer 20

Look for the ABCDEs: Asymmetry, Border irregularity, Color variation, Diameter > 6 mm, and Evolution over time

Question 21

At least how many types of melanoma are there? What are they?

Answer 21

At least 4 different types of melanoma. (1) Superficial spreading (2) Nodular (3) lentingo maligna melanoma (4) acrolentiginous melanoma

Question 22

What mutation often drives melanoma?

Answer 22

Often driven by activating mutation in BRAF kinase

Question 23

What is the primary treatment for melanoma? What is another possible treatment, for what type of melanoma, and in what patient population?

Answer 23

Primary treatment is excision with appropriately wide margins. Metastatic or unresectable melanoma in patients with BRAF V600E mutation may benefit from vemurafenib, a BRAF kinase inhibitor