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Surgery Test 1 > Oncology > Flashcards

Oncology Flashcards

1
Q

What is carcinoma in situ?

A

Stage 0 cancer; not moving anywhere yet

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2
Q

What are some characteristics of malignant lesions?

A
  • Change in color
  • Lymphadenopathy
  • Raised borders
  • Painful, firm nodules
  • Bleeding and crusting
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3
Q

What are adnexal tumors?

A
  • Arise from cells of appendages, like hair follicles and sweat glands;
  • Also from fibrous or neural tissue
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4
Q

Most skin cancers are caused by what?

A
  • Ionizing radiation

- UVB rays

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5
Q

Besides UVB rays, what other carcinogens contribute to skin cancer?

A
  • Paraffin oil UVA chemotherapy
  • Creosote Fuel oil
  • Coal Pitch
  • Psoralens
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6
Q

Under what conditions can SCCs metastasize?

A
  • Large lesions
  • Lesions on transplant patients
  • Lesions associated with burn scars (Marjolin’s ulcers)
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7
Q

What are Marjolin’s ulcers?

A

Progressively growing, aggressive SSC lesions appearing on previously traumatized skin or scars.

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8
Q

What is nevoid BCC syndrome?

A
  • BCC in childhood
  • May not be in sun-exposed areas
  • Associated with medulloblastomas and reproductive tumors.
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9
Q

Cell of origin for BCC?

A

Pluripotential cell from pylosebaceous tissue

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10
Q

What do BCCs look like?

A
  • Waxy, translucent nodules
  • Telangiectasias
  • Umbilicated centers
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11
Q

Treatment of BCSS?

A
  • Less than 1 cm: may be removed by curettage, electro-dessication, cryotherapy, or excision
  • More than 1 cm: excision with minimum of 1 mm margins laterally and deep
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12
Q

What causes SCCs?

A
  • Sun exposure
  • Exposure to environmental carcinogens
  • Malignancy of untreated wounds
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13
Q

What are actinic keratosis?

A
  • Turn into Squamous cell carcinoma

- Involve epidermis and dermis

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14
Q

How do SCCs metastasize?

A

Regionally and systemically

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15
Q

What do SCCs look like?

A
  • Irregularly-shaped plaque or nodule

- Pink rolled edge with or without central ulceration

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16
Q

Treatment of SCCs?

A

Excision: 5mm margins laterally and deep

-Can use Moh’s procedure on face

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17
Q

Treatment of actinic keratoses?

A
  • Topical cytotoxic cream
  • Cryosurgery
  • Electrodessication
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18
Q

Treatment for adnexal tumors?

A
  • Excision
  • Possibly sentinel node sampling
  • Sebaceous carcinomas, cylindromas, and Merkel cell carcinoma
  • Prognosis varies with cell type
19
Q

What do melanomas arise from?

A

Benign nevi usually

20
Q

At what stage does melanoma become regional?

A

III

21
Q

At what stage is melanoma localized?

A

I-II

22
Q

At what stage is melanoma metastasis advanced and distant?

A

IV

23
Q

What are the four types of melanomas?

A
  1. Lentigo maligna
  2. Superficial spreading
  3. Nodular
  4. Acral lentiginous
24
Q

At what size do nevi become suspicious?

A

6 mm

25
Q

What should we do with atypical nevi?

A

Excise to clear margins

26
Q

What should we do if we suspect a lesion is a melanoma?

A

Full-thickness punch biopsy or excision:

-Wide margins

27
Q

How should we treat melanomas?

A
  • Stage I, II, III: surgery

- Stage IV: systemic therapy

28
Q

How is cancer staged?

A
  • Tumor: depth, regression, ulceration
  • Node status
  • Metastasis
29
Q

What size margins should we excise for melanoma lesions that are less than 1 mm thick?

A

1 cm

30
Q

What size margins should we excise for melanoma lesions that are 1-4 mm thick?

A

2 cm

31
Q

What size margins should we use for melanoma lesions that are more than 4 mm thick?

A

> 2 cm

32
Q

When should we take sentinel lymph node biopsies?

A
  • Tumors .76-1 thick or
  • with ulceration or
  • with positive deep margins or
  • with mitoses or with Clark’s IV
33
Q

From what sites do we biopsy lymph nodes?

A
  • Axillary: levels 1, 2, and 3
  • Inguinal
  • Iliac
  • Cervical
34
Q

From what tissues do soft tissue sarcomas develop?

A

Mesenchymal tissue

35
Q

Where are malignant soft tissue sarcomas found?

A

-Anywhere: bone, cartilage, connective tissue
-Usually extremities
-

36
Q

Who usually gets rhabdomyosarcomas?

A

Children

37
Q

Who usually gets histiocytomas?

A

Elderly

38
Q

Where does the underlying fundamental defect lie in soft tissue sarcomas?

A

Genetic origin

39
Q

Most common site of metastasis for sarcomas of the extremities?

A

Lungs

40
Q

Most common site of metastasis for sarcomas of the abdomen?

A

Liver

41
Q

What size sarcomas have a good prognosis?

A

Less then 5 cm

-Over 5 cm worse prognosis

42
Q

What imaging is most useful in diagnosing a sarcoma?

A

MRI

-CT and X-ray to assess chest and lungs

43
Q

Treatment of sarcomas?

A

Surgery: 1-2 cm margins

  • Limbs: surgery plus radiation
  • Chemotherapy
  • Radiation

Surgery Test 1 (7 decks)

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