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Specialty Medicine > Basal and Squamous Cell CA > Flashcards

Basal and Squamous Cell CA Flashcards

1
Q

What are the two major types of non-melanoma skin cancer?

A

Basal cell carcinoma

Squamous cell carcinoma

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2
Q

True or false: BCC and SCC is rare in darkly pigmented ethnicities

A

True

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3
Q

Which is more common: BCC or SCC?

A

BCC

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4
Q

True or false: BCC rarely mets

A

True

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5
Q

What are the issues that arise from BCC, since only rarely does it metastasize?

A

capable of local aggression and tissue destruction

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6
Q

What areas of the skin are affected with BCC?

A

Sun exposed areas of the skin, usually the head and neck

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7
Q

What are the skin findings of BCC?

A

Pearly papules or raised bordered ulcerations, often containing prominent, dilated subepidermal blood vessels (telangiectasias)

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8
Q

Pearly papules with telangiectasia = ?

A

BCC

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9
Q

What is the treatment for BCC?

A

Excision/ destruction or topical 5FU

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10
Q

What is the MOA of 5FU?

A

Inhibits thymidylate synthase, interrupting the action of the synthesis of thymidine

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11
Q

What is the morpheaform variants of BCC?

A

Scarred appearing area that is much more malignant

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12
Q

What does the superficial variant of BCC look like?

A

Eczema

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13
Q

What does the pigmented variant of BCC look like?

A

Seborrheic keratosis or melanoma

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14
Q

What are the histological characteristics of BCC?

A

Nodules that fill up the epidermis, with peripheral palisading cells

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15
Q

Histology of: Nodules that fill up the epidermis, with peripheral palisading cells, and stromal retraction = ?

A

BCC

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16
Q

What are the histological characteristics of the morpheaform variant of BCC?

A

Cord or small nests of that infiltrate everywhere

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17
Q

What is Gorlin syndrome?

A

AD mutation of PTCH gene on chromosome 9

-PTCH is a tumor suppressor gene, that predisposes to BCC

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18
Q

What are the features of Gorlin syndrome?

A
  • BCCs
  • Epidermal cysts
  • Odontogenic keratocysts of jaw
  • Palmoplantar pits
  • Rib and vertebral abnormality
  • Ovarian fibromas
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19
Q

What are some of the causes of SCC?

A
  • UV exposure
  • HPV
  • Burn scars
  • Chronic irritation
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20
Q

When particularly should SCC be monitored for?

A

Immunosuppressed patients

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21
Q

What are the skin characteristics of SCC?

A

firm, hyperkeratotic plaques with erosions and crusts

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22
Q

firm, hyperkeratotic plaques with erosions and crusts = ?

A

SCC

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23
Q

SCC often arises in or associated with what disease?

A

Actinic keratoses

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24
Q

What is the usual course of SCC?

A

Locally destructive

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25
Q

Is what areas of the body is SCC more likely to metastasize? (3)?

A

Ear
Lip
Genitalia

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26
Q

What is the metastatic potential of most SCC? What increases the risk of metastases?

A

Low: 0.5%

If in burn scars of osteomyelitis, then 20-60% chance

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27
Q

What is the treatment for SCC?

A

Excision or radiation

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28
Q

What are the histological characteristics of SCC?

A

Eosinophilic papillae that invade into the dermis

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29
Q

What are the cells that gives rise to melanoma, SCC, and BCC respectively?

A 
Melanoma = melanocytes
SCC = spinous layer
BCC = Basal cells
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30
Q

What happens when SCC wraps around nerves?

A

Follow the course of the nerve in the perineural sheath

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31
Q

What are the four major prognostic factors for SCC?

A
  • Size
  • Depth of invasion
  • Neurotropism
  • Acantholytic pattern
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32
Q

A size greater than how many cm is a poor prognostic indicator for SCC?

A

More than 4 cm

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33
Q

What type of histological findings are a poor prognostic indicator for SCC? (2)

A
  • Depth of invasion

- Acantholytic pattern

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34
Q

What is Verrucous carcinoma?

A

Low grade variant of SCC that recurrs commonly, but rarely metastasizes

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35
Q

What areas of the body are particularly affected with verrucous carcinoma?

A

Sole of foot or sinus tract

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36
Q

What is the anogenital verrucous carcinoma?

A

Condyloma variant of HPV infection (usually 6 and 11)

37
Q

How hard is it to control anogenital verrucous carcinoma?

A

Hard

38
Q

Is verrucous carcinoma endophytic or exophytic?

A

Either

39
Q

What is keratoacanthoma?

A

Rapidly developing neoplasm that clinically and histologically resembles well differentiated SCC

40
Q

What are the skin findings of keratoacanthoma?

A

Flesh colored, dome shaped nodules with a central, keratin-filled plug with a crater like topography

41
Q

What is the treatment for keratoacanthoma?

A

Surgical excision

42
Q

How fast does keratoacanthoma progress?

A

Very fast

43
Q

Flesh colored, dome shaped nodules with a central, keratin-filled plug with a crater like topography = ?

A

keratoacanthoma

44
Q

Who usually gets keratoacanthoma?

A

Old people chronically exposed to the sun

45
Q

What are the histological characteristics of keratoacanthoma?

A

Keratin filled crater that pushes into the dermis, often with glassy cells

46
Q

What is actinic keratosis?

A

Squamous dysplasia of the skin, usually as a result of chronic exposure to sunlight and associated with build up of excess keratin

47
Q

What are the skin findings of actinic keratosis?

A

Papules less than 1 cm, tan-brown, red or skin colored lesions that has a sandpaper quality

48
Q

How do you prevent and treat actinic keratosis?

A

Prevent : sunscreen

Treat: cryosurgery or 5FU

49
Q

What is the premalignant lesion for SCC?

A

Actinic keratosis

50
Q

What are the histological characteristics of AK?

A

Dysplasia along the base or the epidermis, without involving the full thickness

51
Q

What are the histological differences between AK, SCC in situ, and SCC?

A
  • AK= not full thickness dysplasia
  • SCC in situ = full thickness dysplasia without BM penetration
  • SCC = above + penetration
52
Q

What is bowenoid papulosis? Who does it occur in? Skin findings?

A
  • Anogenital variant of SCCIS, that usually occurs in sexuallary active adults
  • Multiple small, reddish brown papule
53
Q

Multiple small, reddish brown papules in the anogenital area = ?

A

Bowenoid papulosis

54
Q

What xeroderma pigmentosum? Inheritance pattern? Skin findings?

A
  • AR defect in nucleotide excision repair

- Sunburn with minimal sun exposure, and AKs at early age

55
Q

What is the median age of skin cancer with xeroderma pigmentosum?

A

8 yo

56
Q

What is the role of Merkel cells in the skin? What cells are they derived from?

A
  • Light touch sensors

- Neural crest cells

57
Q

What are the areas of body that are affected with merkel cell carcinoma?

A

head and neck or extremities on old people

58
Q

What does merkel cell carcinoma resemble?

A

metastatic small cell CA from lung or certain lymphomas

59
Q

What is the prognosis for merkel cell carcinoma?

A

Aggressive CA–poor survival rates, with high recurrences

60
Q

What is the treatment for merkel cell carcinoma?

A

Aggressive surgery with sentinel lymph node bx

61
Q

What are the skin findings of merkel cell carcinoma?

A

Reddish papules

62
Q

What are the histological characteristic of merkel cell carcinoma?

A

Sheets of small, basophilic cells

63
Q

What are the most common cancers that met to the skin in males? (2)

A
  • Lung

- colon

64
Q

What is the most common cancer that mets to the skin in females?

A

Breast CA

65
Q

What are the skin findings of inflammatory breast carcinoma? What causes this?

A
  • Peau d’orange

- inflammatory cells in the lymphatics tethers the skin down

66
Q

What is the sister mary joseph nodule?

A

Umbilical nodule, usually related to stomach of pancreatic malignancy

67
Q

What are the histological findings of metastatic RCC?

A

Nodules of clear cells separated by thin capillaries

68
Q

What is mammary Paget’s disease associated with?

A

Underlying mammary ductal CA

69
Q

What does paget’s disease of the breast look like?

A

Eczema or psoriasis

70
Q

What is the area of the body that is commonly affected with extramammary Paget’s disease?

A

Anogenital region

71
Q

Which gender is more commonly affected with extramammary Paget’s disease?

A

female

72
Q

What are the histological findings of EMPD?

A

Large, clear cells that percolate through the epidermis

73
Q

What is atypical fibroxanthoma?

A

Cutaneous pleomorphic undifferentiated sarcoma

74
Q

What areas of the body are usually affected with atypical fibroxanthoma?

A

Sun exposed areas and actinically damaged areas, (head and neck)

75
Q

What are the skin findings of atypical fibroxanthoma?

A

Firm, solitary nodule +/- ulcerations

76
Q

What are the histological characteristics of AFX?

A

Pleomorphic spindle cell tumor with increased mitotic activity

77
Q

True or false: AFX is a diagnosis of exclusion

A

True

78
Q

How do you treat AFX?

A

Cut it out

79
Q

True or false: AFX usually does not met

A

True

80
Q

What are the three major situations where you will see angiosarcomas?

A
  • Idiopathic
  • Lymphedema associated
  • Post-irradiation
81
Q

All forms of angiosarcoma have what mortality rate?

A

80%

82
Q

What are the skin characteristics of angiosarcomas?

A

Black, vascular lesion

83
Q

What is Stewart Treves syndrome?

A

A lymphangiosarcoma, a rare complication that forms as a result of chronic, long-standing lymphedema, commonly seen in breast cancer patient that had lymph nodes removed

84
Q

How do you differentiate between radiation related lymphedema, and Stewart treves syndrome?

A

radiation related will present much sooner–Stewart treves syndrome takes years to develop

85
Q

What are the histological characteristics of angiosarcoma?

A

Irregular blood vessels that infiltrate throughout the dermis, and are lined by pleomorphic cells

86
Q

What are the 4 major types of kaposi’s sarcoma?

A
  • Classic
  • AIDS related
  • Immunosuppressed
  • African / sub saharan
87
Q

What is the infectious agent that is related to Kaposi’s sarcoma?

A

HHV 8

88
Q

What are the skin findings of Kaposi’s sarcoma?

A

nodules or blotches that may be red, purple, brown, or black, and are usually papular

89
Q

What are the histological characteristics of Kaposi’s sarcoma?

A

Vessels within vessels as well as eosinophilic bodies of cells

Specialty Medicine (36 decks)

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