Basal and Squamous Cell CA Flashcards Preview

Specialty Medicine > Basal and Squamous Cell CA > Flashcards

Flashcards in Basal and Squamous Cell CA Deck (89):
1

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

Basal cell carcinoma
Squamous cell carcinoma

2

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

True

3

Which is more common: BCC or SCC?

BCC

4

True or false: BCC rarely mets

True

5

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

capable of local aggression and tissue destruction

6

What areas of the skin are affected with BCC?

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

7

What are the skin findings of BCC?

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

8

Pearly papules with telangiectasia = ?

BCC

9

What is the treatment for BCC?

Excision/ destruction or topical 5FU

10

What is the MOA of 5FU?

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

11

What is the morpheaform variants of BCC?

Scarred appearing area that is much more malignant

12

What does the superficial variant of BCC look like?

Eczema

13

What does the pigmented variant of BCC look like?

Seborrheic keratosis or melanoma

14

What are the histological characteristics of BCC?

Nodules that fill up the epidermis, with peripheral palisading cells

15

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

BCC

16

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

Cord or small nests of that infiltrate everywhere

17

What is Gorlin syndrome?

AD mutation of PTCH gene on chromosome 9
-PTCH is a tumor suppressor gene, that predisposes to BCC

18

What are the features of Gorlin syndrome?

-BCCs
-Epidermal cysts
-Odontogenic keratocysts of jaw
-Palmoplantar pits
-Rib and vertebral abnormality
-Ovarian fibromas

19

What are some of the causes of SCC?

-UV exposure
-HPV
-Burn scars
-Chronic irritation

20

When particularly should SCC be monitored for?

Immunosuppressed patients

21

What are the skin characteristics of SCC?

firm, hyperkeratotic plaques with erosions and crusts

22

firm, hyperkeratotic plaques with erosions and crusts = ?

SCC

23

SCC often arises in or associated with what disease?

Actinic keratoses

24

What is the usual course of SCC?

Locally destructive

25

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

Ear
Lip
Genitalia

26

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

Low: 0.5%

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

27

What is the treatment for SCC?

Excision or radiation

28

What are the histological characteristics of SCC?

Eosinophilic papillae that invade into the dermis

29

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

Melanoma = melanocytes
SCC = spinous layer
BCC = Basal cells

30

What happens when SCC wraps around nerves?

Follow the course of the nerve in the perineural sheath

31

What are the four major prognostic factors for SCC?

-Size
-Depth of invasion
-Neurotropism
-Acantholytic pattern

32

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

More than 4 cm

33

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

-Depth of invasion
-Acantholytic pattern

34

What is Verrucous carcinoma?

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

35

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

Sole of foot or sinus tract

36

What is the anogenital verrucous carcinoma?

Condyloma variant of HPV infection (usually 6 and 11)

37

How hard is it to control anogenital verrucous carcinoma?

Hard

38

Is verrucous carcinoma endophytic or exophytic?

Either

39

What is keratoacanthoma?

Rapidly developing neoplasm that clinically and histologically resembles well differentiated SCC

40

What are the skin findings of keratoacanthoma?

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

41

What is the treatment for keratoacanthoma?

Surgical excision

42

How fast does keratoacanthoma progress?

Very fast

43

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

keratoacanthoma

44

Who usually gets keratoacanthoma?

Old people chronically exposed to the sun

45

What are the histological characteristics of keratoacanthoma?

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

46

What is actinic keratosis?

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

47

What are the skin findings of actinic keratosis?

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

48

How do you prevent and treat actinic keratosis?

Prevent : sunscreen
Treat: cryosurgery or 5FU

49

What is the premalignant lesion for SCC?

Actinic keratosis

50

What are the histological characteristics of AK?

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

51

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

-AK= not full thickness dysplasia
-SCC in situ = full thickness dysplasia without BM penetration
-SCC = above + penetration

52

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

-Anogenital variant of SCCIS, that usually occurs in sexuallary active adults
-Multiple small, reddish brown papule

53

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

Bowenoid papulosis

54

What xeroderma pigmentosum? Inheritance pattern? Skin findings?

-AR defect in nucleotide excision repair
-Sunburn with minimal sun exposure, and AKs at early age

55

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

8 yo

56

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

-Light touch sensors
-Neural crest cells

57

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

head and neck or extremities on old people

58

What does merkel cell carcinoma resemble?

metastatic small cell CA from lung or certain lymphomas

59

What is the prognosis for merkel cell carcinoma?

Aggressive CA--poor survival rates, with high recurrences

60

What is the treatment for merkel cell carcinoma?

Aggressive surgery with sentinel lymph node bx

61

What are the skin findings of merkel cell carcinoma?

Reddish papules

62

What are the histological characteristic of merkel cell carcinoma?

Sheets of small, basophilic cells

63

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

-Lung
-colon

64

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

Breast CA

65

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

-Peau d'orange
-inflammatory cells in the lymphatics tethers the skin down

66

What is the sister mary joseph nodule?

Umbilical nodule, usually related to stomach of pancreatic malignancy

67

What are the histological findings of metastatic RCC?

Nodules of clear cells separated by thin capillaries

68

What is mammary Paget's disease associated with?

Underlying mammary ductal CA

69

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

Eczema or psoriasis

70

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

Anogenital region

71

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

female

72

What are the histological findings of EMPD?

Large, clear cells that percolate through the epidermis

73

What is atypical fibroxanthoma?

Cutaneous pleomorphic undifferentiated sarcoma

74

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

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

75

What are the skin findings of atypical fibroxanthoma?

Firm, solitary nodule +/- ulcerations

76

What are the histological characteristics of AFX?

Pleomorphic spindle cell tumor with increased mitotic activity

77

True or false: AFX is a diagnosis of exclusion

True

78

How do you treat AFX?

Cut it out

79

True or false: AFX usually does not met

True

80

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

-Idiopathic
-Lymphedema associated
-Post-irradiation

81

All forms of angiosarcoma have what mortality rate?

80%

82

What are the skin characteristics of angiosarcomas?

Black, vascular lesion

83

What is Stewart Treves syndrome?

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

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

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

85

What are the histological characteristics of angiosarcoma?

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

86

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

-Classic
-AIDS related
-Immunosuppressed
-African / sub saharan

87

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

HHV 8

88

What are the skin findings of Kaposi's sarcoma?

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

89

What are the histological characteristics of Kaposi's sarcoma?

Vessels within vessels as well as eosinophilic bodies of cells