Norton Part 2

Question 1

what is the most common subtype of melanoma

Answer 1

superficial spreading

25% arise from preexisting lesion

Question 2

where is one typically going to find superficial spreading melanoma

Answer 2

sun-exposed skin

typically backs of men and lower legs of women

Question 3

evolved lesions of superficial spreading melanoma may show what?

Answer 3

multiple shades of red, tan, brown, blue, black, grey, and white

Question 4

buckshot scatter of atypical melanocytes within the epidermis (pagetoid spread) is seen in what?

Answer 4

superficial spreading melanoma

Question 5

lentigo maligna/lentigo maligna melanoma is typically found where

Answer 5

face of old men

Question 6

lentigo maligna/lentigo maligna melanoma is what type of lesion

Answer 6

indolent, slow-growing

broad lesion on sun-damaged skin

Question 7

what phase of lentigo maligna/lentigo maligna melanoma is long and how long

Answer 7

radial growth phase

10-50 years

Question 8

lentigo maligna/lentigo maligna melanoma starts how and progresses to what

Answer 8

starts as tan-brown macule, gradually enlarges
develops darker
asymmetric foci

Question 9

what is the difference between lentigo maligna and lentigo maligna melanoma

Answer 9

lentigo maligna melanoma has a vertical growth phase

Question 10

what are the histological features of lentigo maligna

Answer 10

broad lesion on sun-damages skin
predominantly junctional growth of atypical melanocytes
cytologic atypia

Question 11

what are the distinguishing features of lentigo maligna

Answer 11

malignant melanoma in situ
poorly nested and confluent melanocytes at dermal-epidermal junction
adnexal extension
heavily sun-damages skin

Question 12

what is the least common melanoma

Answer 12

acral lentiginous

Question 13

what is the most common melanoma of African American and Asians

Answer 13

acral lentiginous

Question 14

were is acral lentiginous melanoma found

Answer 14

palms, soles, beneath the nail plate

Question 15

nodular melanoma can be found where

Answer 15

anywhere on the body

Question 16

what melanoma can be amelanotic

Answer 16

nodular melanoma

Question 17

what melanoma has a vertical growth phase but no apparent radial growth phase

Answer 17

nodular melanoma

Question 18

what has a radial growth phase but no vertical growth phase

Answer 18

lentigo meligna

Question 19

what is seen histologically in nodular melanoma

Answer 19

dermal growth occurring in isolation or occasionally with an epidermal component
mitoses are frequent and often atypical

Question 20

what are the two measurements of melanoma

Answer 20

breslow and clark measurements

Question 21

what is the actual measurement form the skin surface of melanoma

Answer 21

Breslow measurement

Question 22

the clark level of measurement is based off of what

Answer 22

how many layers of skin the tumor has penetrated (I-V)

Question 23

what are the clarks levels (I-V)

Answer 23

I: epidermis
II: papillary dermis, not yet papillary-reticular junction
III: fills papillary dermis
IV: reticular dermis
V: subcutaneous tissues

Question 24

what measurement of melanoma most closely correlates with survival statistics

Answer 24

Breslow’s measurement

Question 25

lentigo malign can transform into what and what signals this

Answer 25

lentigo maligna melanoma | intraepidermal lesions evolving to become clinically palpable signaling dermal invasion and transformation

Question 26

if the melanoma is larger than 4mm how large should the margin be when reexcision

Answer 26

at least 2cm

Question 27

melanoma tumor inset how large should the margin be when reexcision

Answer 27

0.5cm

Question 28

what are some prognostic factors of melanoma

Answer 28

``` tumor thickness mitotic rate ulceration lymph node involvement satellite lesions distant metastases ```

Question 29

what sex has a better prognosis of melanoma

Answer 29

females

Question 30

what is used in a sentinal node biopsy

Answer 30

lymphoscintigraphy, radioactive racer and a gamma probe

Question 31

sentinal node biopsy is recommended for what kind of tumors

Answer 31

intermediate tumors (1-4 mm) or high-risk thin tumors

Question 32

sentinal node biopsy is used why?

Answer 32

minimally invasive technique that has been shown to help accurately stage the regional nodal basin with a lower associated rate of complications and costs compared to ELND

Question 33

stage I and II melanoma have what kind of 5-year survival rate

Answer 33

50-90+%

Question 34

stage III melanoma has what kind of 5-year survival rate

Answer 34

depending on nodal involvement and ulceration: 40-80%

Question 35

Stage IV melanoma has what kind of 5-year survival rate

Answer 35

15-25%