Surgical Registar Tut #1 Melanoma

Question 1

Melanoma major gene?

Answer 1

9p TSG

Question 2

melanoma describe

Answer 2

ABCDE

asymmetry
border - irregular, changing
colour
Diameter >6mm
Elevated
Firm
Growing

Site: satellite lymphatic spread

Question 3

4 types of melanoma?

Answer 3

superficial spreading (70%): horizontal growth then vertical
Nodular: aggressive: vertical growth
Lentigo maligna: older ppl with sun damage (in situ melanoma)
acral lentiginous

Question 4

where do acral lentiginous melanomas? who gets it?

Answer 4

palms
soles
subungal
poor prognosis

Asians and Africans more likely

Question 5

prognostic factors for melanoma?

Answer 5

1. thickness - vertical
   - Breslow (better measurement)
   - Clarks (thin skin)
2. Ulceration
3. mitotic count (per square mm)
4. lymph node involvement?
5. vascular spread

Question 6

epidemiological prognostic factors?

Answer 6

anatomical

age: increasing with age
sex: female better than male

Question 7

what is neurotropism?

Answer 7

cancer travelling along nerve

Question 8

what size considered micrometasis in breast cancer?

Question 9

what is in-transit metastasis?

Answer 9

lump between melanoma and the nodes

Question 10

melanoma biopsy diagnostic

Answer 10

2mm margin

along long axis to limb

Question 11

risk factors for melanoma

Answer 11

sun exposure, history of burns
fair skin, red heads, blue eyes
family history
tanning beds
prev hx of melanoma
>100 benign naevi
immunosuppressed