Skin Neoplasms Flashcards
what are some indications of malignancy?
- sore or lump that bleeds or develops a crust or a scab
- flat red spot that is rough, dry, or scaly and may become itchy or tender
- red or brown patch that is rough and scaly
stages of skin cancer are based on what?
size and depth of involvement
what is the most common malignant cutaneous neoplasm (among caucasians)
basal cell CA
occurs over sun-exposed areas
describe the malignancy potential of basal cell CA.
- locally invasive, rarely metastasizes
- slow growing destructive lesion
which form of basal cell CA is most aggressive? least aggressive?
nodular form- (large nests of tumor cells); least
morpheaform- (small nests of tumor cells); more aggressive
what is the most common form of BCC?
nodular basal cell CA (BCC)
a patient presents with a small, white dome shaped nodule that has telangiectatic vessels that make appearance “erythematous”. which neoplasm is this?
nodular BCC
what is the least aggressive of BCC?
superficial BCC
what is the most common BCC of LE and feet?
superficial BCC
*appears very smooth and red!
whicn neoplasm is the second-most prevalent malignant tumor of the skin? (and is most common among AA and Asian-Indians)?
squamous cell CA
describe the malignancy potential of squamous cell carcinoma.
DANGEROUS TUMOR, CAN METASTASIZE TO LYMPH NODES
between basal cell CA and squamous cell CA, which will metastasize?
squamous cell CA will metastasize to lymph nodes
which neoplasm is NOT pearly (unlike basal cell CA)?
squamous cell CA
amount of margins during excisional skin surgery depends on what?
type of lesion
depth of lesion
is radiation therapy a common treatment for skin cancer?
no
-it can be used for areas that are difficult for surgery or leave a bad scar
what is the most serious type of cancer of the skin?
melanoma
what are the risk factors for developing melanoma?
- dysplastic nevi
- 50+ ordinary moles
- fair skin
- personal hx of melanoma or skin cancer
- FMHx of melanoma
- weakened immune system
- sever, blistering sunburns
- UV radiation
where does malignant melanoma metastasize to?
any organ; brain and heart
do melanomas cause pain?
no
what are the ABCDEs of malignant melanoma?
- asymmetry
- irregular borders
- color variation
- diameter enlargmenet
- evolution/elevated
what is the clark staging for malignant melanoma based on?
level of invasion of the skin
what is the Breslow’s staging for malignant melanoma based on?
layer of skin involved AND depth of the lesion
what are the 2 staging systems for malignant melanoma that we discussed and which is more accurate?
Clark
Breslow’s depth- more accurate
Using Breslow’s depth staging, classify tumors into their 4 categories.
4mm (Clarks 5)
classify this according to Clark: all tumor cells above the basement mb (in situ)
Clarks Level 1
classify this according to Clark: tumor extends to papillary dermis
Clarks Level 2
classify this according to Clark: tumor extends to interface btwn papillary and reticular dermis
Clarks Level 3
classify this according to Clark: tumor extends btwn bundles of collagen and reticular dermis
Clarks Level 4
classify this according to Clark:tumor invasion of SC tissue
Clarks Level 5
The American Joint Commiission on Cancer published a cancer staging manual that is based on what?
T-tumor thickness
N-nodes (lymph) involvement
M-metastasis
how do you diagnose melanoma?
excisional biopsy
what are the 4 main types of malignant melanoma?
- superficial spreading
- lentigo maligna
- nodular
- acral lentiginous
which type of growth phase (radial or vertical) is more aggressive?
vertical growth phase- penetrates dermis
superficial spreading melanoma has what type of spread (vertical or radial)?
radial spread- therefore is the least aggressive of the malignant melanomas
which type of melanoma occurs over sun-exposed areas usually in elderly and on the face?
lentigo maligna melanoma
which type of melanoma is least aggressive? which is most malignant?
least- superficial spreading melanoma
most malignant- nodular melanoma
what is Hutchinson’s sign ? what does this indicate?
sudden apeparance of subungual pigmented band at proximal nail fold
(suspect acral lentiginous melanoma)
acral lentiginous melanoma affects where in the body mostly?
palms, soles and nail beds
what are the pre-malignant lesions?
- acitinic keratosis
- cutaneous horns
