Skin and Soft Tissue

Question 1

What’s algorithm for Sarcoma?

Answer 1

Look for LAD
MRI mass
Core needle or incisional if >3 cm
CT C/A/P for staging

If vessel involvement, neoadj radiation

If SCARE, adjuvant chemo (Synovial, Clear cell, Angio, Rhabdo, Epithelial)

If nerve involvement or unable to preserve limb function, amputate

Surveillance:
H&P every 3 months, repeat MRI at 6 month with CT Chest/abdomen. Annually for 10 years

Question 2

Whats components of LRINEC score?

Answer 2

WBC, sodium, glucose, CRP, creatinine, Hgb

Question 3

What’s algorithm for Merkel Cell Carcinoma?

Answer 3

BIopsy, stage w CT C/A/P
< 2 cm - 1 cm margin
>=2 cm - 2 cm margin
Adjuvant radiation and SLNB
If SLNB+ completion node dissection

Surveillance:
PE q3-6 months x 3 years then q6-12 months after.