Other tumors Flashcards
What is the subclinical percent of spread for DSFP at 1cm 2cm 3cm and 5cm margins.
1 cm 75% 2cm 40% 3cm 15% 5cm 5%
what is the standard excision margin for DFSP
2-4 cm
How much of a layer should you take with each subsequent layer of MMS for DFSP
1 cm
What is a Bednar variant of DFSP which is about 5% of DFSPs
They have melanin producing cells with melanocyte or melanocyte-schwannian differentiation.
Where does DFSP most likely metastasis to?
hematogenous to the lungs
What is the Borst Jadassohn effect?
presence of sharply defined nests of morphologically distinct cells within the epidermis
What three growths can show the Borst Jadassohn effect.
Bowens disease
Clonal seb kers
Hidroacanthoma simplex
What are the four histologic signs of a wart?
- intoeing of rete ridges
- Koilocytes- big pale nuclei with keratohyline granules
- Church spire parakeratosis over papillary protrusions
- Hypergranulosis
In Merkel cell carcinoma which patients do better. With polyoma virus or without polyomavirus.
With polyomavirus.
what is the diagnosis
dermoid sinus cyst of the nose
What study should be ordered with this lesion.
MRI to r/o intercranial connections with a midline dermoid cyst.
what glove will not be penetrated by nickel sulfate
vinyl
Granulomatous slack skin is associated with what?
MF
erythematous indrated plaques on the flexural surfaces
Epidermodysplasia Verruciformis an autosomal recessive disorder that is immuno suppressive is associated with what HPV viruses?
5 and 8
What melanogen drives pigmentation in seborrheic keratosis
edothelin-1
Oral hairy leukoplakia is associated with what virus?
Epstein Barr virus EBV
Lipshutz ulcers and Extranodal T cell lymphoma (T cell type) are associated with what virus that can cause oral hairly leukoplakia?
Epstein-Barr virus
Lipshutz ulcers are non sexually related genital ulcers in females
Mutations of what gene are associated with malignant pilomatrixoma
Beta-catenin
Beta-catenin gene mutation is associated with what tumor
Pilomatrixoma.
Basal cell carcinomas only arise in skin that contains what?
Pilosebaceous units
What is the difference between primary and secondary Extramammary Padgets disease
Primary is more apocrine in origin
Secondary is spread from an underlying malignancy (usually GI or GU cancers)
What stain is usually + in primary extramammary padgets disease but is negative in secondary padgets?
GCDFP
gross cystic disease fluid protien
What is the most common site for mucinous carcinoma?
Eyelid/canthous/brow area
List 4 key features of MAC Microcystic Adenxal Carcinoma
asymetrical
horn cysts in superficial part of lesion
infiltrative basoloid strands with small lumina
infiltrative growth extends deep into the reticular dermis, sub Q fat and muscle
bonus
may also see perineural invasion and solar elastosis
sclerotic plaque on nose and lip of women that look like a sclerosing bcc
What is this tumor
Microcystic Adenexal Carcinoma
asymetrical
horn cysts in superficial part of lesion
infiltrative basoloid strands with small lumina
infiltrative growth extends deep into the reticular dermis, sub Q fat and muscle
bonus
may also see perineural invasion and solar elastosis
sclerotic plaque on nose and lip of women that look like a sclerosing bcc
What is this tumor and it’s features
Tricholemmoma
growing down of epidermis with glycogen filled keratinocytes
centers appear clear
there is a rim of palisaded basal cells
What is tricholemmoma associated with?
Cowden’s disease
palmar planter keratosis
oral mucosal papillomatosus
pigmented macules on penis
Breast cancer, Thyroid cancer, Endometrial cancer, multiple GI hamartomas
What are the two most common tumors associatied with nevus sebaceous?
- Trichoblastoma
- syringocystandoma papilliferum
What mutation of MAKP pathway can be the same in nevus sebaceous, trichoblastoma, and sryringocystadenoma pappilliferum
HRAS
What is the risk of a secondary carcinoma developing in a nevus sebaceous?
<1%
What is Schimmelpenning syndrome and Phacomatosis pigmentokeratotica
both rare varients of the epidermal nevus syndrome
both can be associated with nevus sebaceous
What is the cure rate for DFSP by mohs surgery?
97%
What is the recurrance rate of DFSP by wide excision?
approximately 30%
What are the surgical margins for DFSP by NCCN guidelines
2-4 cm to facia
beside the lips where else can you see fordyce spots (a form of free sebaceous glands)
buccal mucosa
what are #3 called
Montgomery tubercles
free sebacous glands
what are these called
Tyson glands
free sebaceous glands
What are these?
Meibomium gland openings
free sebaceeous glands inside the tarsal plate
when inflammed are Chalazion
the free sebaceous gland at the base of the eyelids are known as what.
zies glands
when inflammed they are a sty
what are the glands of Moll
apocrine glands that are right next to the glands of zeis at the base of the eyelashes
where do desmoplastic trichoepitheliomas usually arise
cheeks of women
a plaque with a central dell
What is the NCCN recommendation for F/U of completely excised DFSP
6-12 months
What type of primary cutaneous lymphoma can you not treat with surgery alone.
Primary cutaneous large cell B lymphoma (leg type)
TX with Rituximab, CHOP, + radiation
You can excise follicle center and marginal lymphomas
