Week Eight - Squamous Cell Carcinoma and Malignant Melanoma Flashcards
Most SCCs that occur in sun-exposed areas of the skin have a very ____ rate of metastasis
- Low
Where do SCCs typically arise in darker-skinned people, and what are they typically associated with?
- Non sun-exposed areas (legs and anus)
- Chronic inflammation, chronic wounds, or scarring
What are genetic risk factors for SCCs?
- Fair skin
- Light-colored eyes
- Red hair
- Northern European origin
Cumulative UVB sun exposure in the last ____ years of a person’s life increases the likelihood of SCC in the presence of other risk factors
- 5-10 years
Sites of what in the body are susceptible to the development of SCC?
- Chronic inflammation
- Chronic wounds
- Scars
A lesion where is SCC until proven otherwise?
- Vermillion border
What percentage of SCCs metastasize? Where do they go? Is the outcome good or poor?
- 5-10% (in contrast to 0.003% of BCCs)
- Metastasize to the regional lymph nodes or more distant sites (lungs, liver, brain, skin, or bone)
- Relatively poor outcome
What are the features of SCC that correlate with high risk for reoccurrence and regional or distant metastasis?
- Perineural involvement
- Intravascular invasion
Lesser %
- Size greater than or equal to 2 cm
- On ear, lip, or genitals
- Arising within scar, sinus tract, chronic ulcer, or burn
- Locally recurrent
- Immunosuppressed
- Depth greater than or equal to 4 mm
- Poorly differentiated
What is considered the best option for identifying suspicious lesions, since there is no uniform agreed upon screening protocol for malignant melanoma in the US?
- Skin survey
Individuals with atypical nevi have a _____ fold elevated risk of developing malignant melanoma
- 3 - 20
There is a strong association between high nevus counts (more than ____) and malignant melanoma
- 25
Studies demonstrate higher rates of malignant melanoma in adults with _____ or ______ _______ exposure to sunlight
- Extensive
- Repeated intense
Case studies found the strongest association for malignant melanoma for _____ sun exposure and ______ in adolescence or childhood
- Intermittent
- Sunburn
During the ______ growth phase a malignant melanoma is almost always curable by surgical excision alone
- Radial
Nodular melanomas have no identifiable ______ growth phase and enter the _____ growth phase almost from their inception
- Radial
- Vertical
Over 60% of superficial spreading malignant melanomas are diagnosed as thin, highly curable tumors of less than ___mm thickness
- 1 mm
Nodular malignant melanomas are the most difficult to diagnose at an early stage - at least half are greater than ___mm in thickness when diagnosed
- 2 mm
The great majority of lentigo maligna melanomas are diagnosed at less than ____mm of thickness
- 1 mm
The most common type of malignant melanoma among Asians and in Africa-Americans is the _____ ______ ______ which arise most commonly on palmar, plantar, and subungual surfaces
- Acral lentiginous melanoma
______ ______ is the single most important determinant of prognosis for a malignant melanoma
- Tumor thickness
Stage T1: less than or equal to 1mm malignant melanomas have a ten-year survival of ____ %
- 92%
The definitive “initial” surgical treatment for primary cutaneous melanoma is a ______ ______ ______ down to the deep fascia
- Wide local excision
Because of the potential of metastasis and possible death, any biopsy that comes back positive for malignant melanoma needs to be referred for additional surgery via ______ surgery
- Mohs
