Ocular Oncology Flashcards

1
Q

What is basal cell carcinoma?

A

The most common type non melanomas skin cancer

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2
Q

What is the incidence of BCC?

A

3 million worldwide

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3
Q

What causes BCC?

A

UV exposure

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4
Q

What the risk factor for BCC?

A
Fair skin
Sun exposure 
Previous BCC
Rarely hereditary 
Elderly
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5
Q

What are the different BCC subtypes?

A
  1. Nodular
  2. Superficial
  3. Morphoic/infiltrative
  4. Pigmented
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6
Q

What are the signs to look out for in BCC?

A
  1. Rolled pearly edges
  2. Loss of lashes
  3. Ectropian/entropic
  4. Misdirected lashes
  5. Loss of normal lid margin
  6. Medial cantus popular location
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7
Q

Which is the worst type of BCC?

A

Pigmented. Can be mistaken for melanoma

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8
Q

What is the main treatment for BCC?

A

Surgical incision

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9
Q

What other BCC treatments are there?

A

Radiotherapy
Cryotherapy
Topical

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10
Q

Which treatment option for BCC gives a better cute rate?

A

Radiotherapy

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11
Q

What is the management for BCC?

A

Non urgent referral, seen in 3/12

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12
Q

What is another common non melanoma skin cancer?

A

Squamous cell carcinoma (SCC)

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13
Q

Where can SCC progress from?

A

De novo (Anew)
Untx actinic keratosis
Bowens disease

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14
Q

What is the cause of SCC?

A

Cumulative UV exposure
Immune suppression
Xerdema pigmentosa
Oculocutaneous albinism

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15
Q

What are the signs of SCC?

A
Thick, rough scaly patches 
Bleed
Warts
Produces keratin 
Increase rapidly in size
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16
Q

What big risk does SCC have?

A

Metastasize

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17
Q

What are the risk factors for mets?

A

Sun exposed area
Size >2mm
Depth >4mm

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18
Q

What is the treatment for SCC?

A

Excision and reconstruction

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19
Q

What is the management for SCC?

A

Urgent referral to oculoplastics- 2/52 wait. If neglected can turn into BCC

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20
Q

Name a type of malignant tumor found on the eyelid?

A

Sebaceous gland carcinoma

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21
Q

What does SGC resemble?

A

Blepharitis

22
Q

Which glands are in question with SGC?

A

Glands of zeiss

Meibomian glands

23
Q

What are the signs of SGC?

A

Madarosis
Nodular
Yellow colour

24
Q

How is SGC managed?

A

Urgently referred to oculoplastics for excision- 2/52 wait

25
Q

Where does conjunctival melanoma arise from?

A
  1. PAM (primary acquired melanosis)
  2. Naevis
  3. De novo
26
Q

What are the signs of conjunctival melanoma?

A

Raised mass
Amelanotic, usually pigmented
Feeder vessel

27
Q

Where can the conjunctival melanoma matestasize to?

A

Lymph nodes and brain

28
Q

Why is dry technique used in surgery for SGC?

A

As to not spread the melanoma cells. Could spread

29
Q

How is conjunctival melanoma managed?

A

Referred urgently= HES 2/52 wait

30
Q

What surgical intervention is used to tx conjunctival melanoma?

A

Surgical excision

Cryotherapy

31
Q

When does a conjunctival melanoma have a poor prognosis?

A

When its recurrent

32
Q

What’s the key difference between PAM and a naevi?

A

PAM- Middle age

Naevi- 1st and 2nd decade

33
Q

What is a reassuring sign of a naevi?

A

Clear cysts

34
Q

If the naevi turned out to be a PAM, how would you know and what action would you take?

A
Documented growth 
Refer urgently (1/12) if hx suggests PAM
35
Q

Where is a uveal melanoma located?

A

Uveal tract- commonest primary intraocular malignancy

36
Q

What is the incidence of uveal melanoma?

A

5-7 mill population/yr

37
Q

Where is the main site of a uveal melanoma?

A

Choroid (65%)
Ciliary body (30%)
Iris (5%)

38
Q

What are the risk factors for iris melanoma?

A

Caucasian

39
Q

What are the signs of iris melanoma?

A

Circumscribed, diffuse or amelontic
Deeply pigmented
Hyperchromic heterochromia

40
Q

If an iris melanoma is suspected what action is taken?

A

Refer directly to HES

41
Q

What different posterior uveal melanomas are there?

A

Ciliary body melanoma
Choroidal melanoma
Choroidal naevi
Intermediate melanocytic lesios (ILM)

42
Q

What sign in particular would indicate a ciliary body melanoma?

A

Mass in red reflex

43
Q

What other conditions that can followed by a ciliary body melanoma?

A

Cataracts
Retinal detachment
Lenti astigmatism

44
Q

What 4 sxs are present in a choroidal melanoma?

A

Asymptomatic
Vision loss
Metamorphopsia
Photopsia

45
Q

What are the signs of choridal melanoma?

A
Elevated lesion
Pigmented
Ret detach
Breach in BM
Subret fluid
46
Q

How prevalent is a choroidal neavi?

A

Common prev of 5-10%

47
Q

What are the signs of choroidal neavi?

A

Slate grey
Flat
Ill defined border
Surface druesen

48
Q

What type melanoma is not considered to be a melanoma

A

ILM intermediate melanocytic lesions has low malignant potential

49
Q

What is a common intraocular tumour especially in children?

A

Retinoblastoma

50
Q

What key signs are found in reinoastoma?

A

Leukocoria
Strabismus
2nd glaucoma

Iris neovasc
Vit haemm
Pseudohypopyon
Orbital cellulitis

51
Q

What are the early presentation of retinoblastoma?

A
52
Q

What are the late and advanced signs of retinoblastoma?

A