dermatologic- soft tissue tumours Flashcards Preview

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Flashcards in dermatologic- soft tissue tumours Deck (11):
1

What is squamous cell carcinoma?

  • A malignant soft tissue tumour found in older pts
  • location
    • dorsum hand/ forearm
    • most common subungual malignancy
  • Risk factors
    • excessive exposure to UV radiation
    • actinokeratosis
    • chronic osteomyelitis
      • Marjolin's ulcer is a SCC from chronic draining wounds or burn scars

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2

What is the prognosis of  squamous cell carcinoma?

  • Mets
    • Lymph node mets & high histologic grade- confer poor prognosis
    • Higher metastatic potential than basal cell carcinoma

3

What are the symptoms of  squamous cell carcinoma?

  • Pain

4

What is seen on xrays of  squamous cell carcinoma?

  • Lytic lesion

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5

What is the tx of  squamous cell carcinoma?

Operative

  • Wide surgical resection +/- Skin graft+/- radiation
    • standard tx
    • + radiotherapy if
      • >2cm wide
      • 4mm deep
      • perineural invasion
      • lymph node mets
  • Mohs microsurgery
    • becoming more popular
    • smaller lesions
    • highest cure rate
    • lymph node biopsy maybe necessary

6

What is a glomus tumour?

  • A rare benign tumour of the glomus body, often occuring in subungual region
  • amy involve either soft tissue + bone
  • assoc w delay in dx
  • aka paraganglioma
  • pts 20-40yrs
  • location
    • hand 75%
    • 50% subungual
    • 50% erosions of distal phalanx
    • less common palm,wrist , forearm,foot

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7

What is a glomus body?

  • A perivascular temperature regulating structure 
  • frequently located at tip of a digit or beneath the nail

8

What is the presentation of a glomus tumour?

symptoms- classical triad

  • paroxysmal pain
  • equisite tenderness to touch
  • cold intolerance

o/E

  • Small bluish nodule
  • often difficult to see, esp in subungual region
  • nail ridging or discolouration is common

9

What is seen on imaging of glomus tumour?

  • xrays
    • glomus tumour can produce pressure erosion os the underlying bone & assoc with deformity of the bone cortex
  • ​MRI
    • useful for dx
    • ​low on T1, high signal T2

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10

What is seen on histology of glomus tumour?

  • Gland like nest structures
  • small round cells with dark nuclei

11

What is the tx of glomus tumour?

Operative

  • Marginal excision is curative
    • symptoms affecting quality of life
    • recurrence uncommon
    • several cases of malignant glomus tumour have been reported