Part 1- Malignancies of surface epithelial origin (test 1)

Question 1

Basal cell carcinoma arises from where?

Answer 1

the uh, basal cells.

Question 2

What is the most common skin caner?

Answer 2

Basal cell carcinoma

Question 3

Who is at the highest risk for basal cell carcinoma?

Answer 3

40+ yrs old, fair complexion, chronic sun exposure.

Question 4

T/F any cutaneous area of the head and neck may be affected?

Answer 4

True

Question 5

What is the most common clinical presentation for basal cell carcinoma?

Answer 5

Nodulo-ulcerative

Question 6

What is basal cell carcinoma often confused with?

Answer 6

sebaceous hyperplasia, however basal cell carcinoma often has an ulceration at the center

Question 7

The key word for basal cell carcinoma is “nodule-ulcerative”

Answer 7

it’s come up a couple times

Question 8

Are pigmented basal cell carcinomas rare?

Answer 8

No, they are common and they look like a nevus

Question 9

What helps distinguish pigmented basal cell carcinomas from melanocytic nevi?

Answer 9

they show up all of a sudden and they have no hair! Hairy moles are good!

Question 10

Why can basal cell carcinomas be pigmented?

Answer 10

It’s due to colonization by benign melanocytes

Question 11

What is the most aggressive, but least common form of basal cell carcinomas? What does it resemble?

Answer 11

Sclerosing/morpheaform

It resembles a scar due to collagen induction

Question 12

How do you treat basal cell carcinoma?

Answer 12

excision
electrodesiccation and currettage
Moms micro graphically controlled surgery
Cryotherapy
Radiation therapy

Question 13

What is the prognosis of basal cell?

Answer 13

Generally excellent. 95% are cured after first tx.

Question 14

What is the most common oral malignancy?

Answer 14

Squamous cell carcinoma

Question 15

Where is squamous cell carcinoma usually found and what causes it?

Answer 15

the skin and lower vermillion zone. squamous cell carcinoma is due to UV light exposure

Question 16

Cutaneous squamous cell carcinoma arises most often from what?

Answer 16

pre-existing actinic keratosis

Question 17

Where are some common sites for squamous cell carcinoma?

Answer 17

face, helix of ear, dorsum of hands and arms are common sites

Question 18

T/F actinically-induced squamous cell carcinomas are generally poorly differentiated and grow rapidly?

Answer 18

False- well-differentiated and slowly growing

Question 19

Intraoral squamous cell carcinomas are usually associated with _____. But 25% aren’t associated with anything.

Answer 19

tobacco with or without alcohol

Question 20

High-risk HPV type ____ is implicated in oropharyngeal squamous cell carcinoma.

Answer 20

type 16

Question 21

HPV + oropharyngeal squamous cell carcinoma have a better/worse prognosis then HPV - oropharyngeal squamous cell carcinoma?

Answer 21

better. HPV + positive is better!

Question 22

Mouthwashes with greater than 25% alcohol used excessive can cause a grayish buccal mucosa and plaques but there are not leukoplakias

Answer 22

Cool stuff.

Question 23

What does oral squamous cell carcinoma look like?

Answer 23

irregular shape, mixture of red and white- think candy canes- where do you put them? in your mouth.
The lesions are often ulcerated and can have either a growing in or growing out pattern (exophytic/endophytic)

Question 24

T/F pain is usually an early feature of oral squamous cell carcinoma.

Answer 24

False, pain is a late feature

Question 25

squamous cell carcinoma of the lip is secondary to ______ and arises in the setting of _______.

Answer 25

secondary to ultraviolet let exposure

in the setting of actinic cheilitis

Question 26

What’s the prognosis for squamous cell carcinoma of the lower lip?

Answer 26

Pretty good, but the upper lip has a high risk for lymph node metastasis, but squamous cell carcinoma on the upper lip is pretty rare

Question 27

Oral squamous cell carcinoma develops from what three things?

Answer 27

Leukoplakia
Erythroplakia
Proliferative verrucous leukoplakia

Question 28

What is proliferative verrucous leukoplakia?

Answer 28

It’s a leukoplakia that grows laterally and involves multiple sites
it has a heavy female predilection (4:1) and usually occurs in older people

Question 29

Oral squamous cell carcinoma most commonly occurs where?

Answer 29

Freaking everywhere in the mouth except the soft palate.

Question 30

Let’s talk about squamous cell carcinoma of the tongue. Where does it most often occur?

Answer 30

The lateral tongue

Question 31

Most people who have squamous cell carcinoma of the tongue have a history of what?

Answer 31

cigarette smoking and alcohol abuse