Other tumors

Question 1

What is the subclinical percent of spread for DSFP at 1cm 2cm 3cm and 5cm margins.

Answer 1

1 cm 75% 2cm 40% 3cm 15% 5cm 5%

Question 2

what is the standard excision margin for DFSP

Answer 2

2-4 cm

Question 3

How much of a layer should you take with each subsequent layer of MMS for DFSP

Answer 3

1 cm

Question 4

What is a Bednar variant of DFSP which is about 5% of DFSPs

Answer 4

They have melanin producing cells with melanocyte or melanocyte-schwannian differentiation.

Question 5

Where does DFSP most likely metastasis to?

Answer 5

hematogenous to the lungs

Question 6

What is the Borst Jadassohn effect?

Answer 6

presence of sharply defined nests of morphologically distinct cells within the epidermis

Question 7

What three growths can show the Borst Jadassohn effect.

Answer 7

Bowens disease
Clonal seb kers
Hidroacanthoma simplex

Question 8

What are the four histologic signs of a wart?

Answer 8

• intoeing of rete ridges
• Koilocytes- big pale nuclei with keratohyline granules
• Church spire parakeratosis over papillary protrusions
• Hypergranulosis

Question 9

In Merkel cell carcinoma which patients do better. With polyoma virus or without polyomavirus.

Answer 9

With polyomavirus.

Question 11

what is the diagnosis

Answer 11

dermoid sinus cyst of the nose

Question 12

What study should be ordered with this lesion.

Answer 12

MRI to r/o intercranial connections with a midline dermoid cyst.

Question 13

what glove will not be penetrated by nickel sulfate

Answer 13

vinyl

Question 14

Granulomatous slack skin is associated with what?

Answer 14

MF

erythematous indrated plaques on the flexural surfaces

Question 15

Epidermodysplasia Verruciformis an autosomal recessive disorder that is immuno suppressive is associated with what HPV viruses?

Answer 15

5 and 8

Question 16

What melanogen drives pigmentation in seborrheic keratosis

Answer 16

edothelin-1

Question 17

Oral hairy leukoplakia is associated with what virus?

Answer 17

Epstein Barr virus EBV

Question 18

Lipshutz ulcers and Extranodal T cell lymphoma (T cell type) are associated with what virus that can cause oral hairly leukoplakia?

Answer 18

Epstein-Barr virus

Lipshutz ulcers are non sexually related genital ulcers in females

Question 19

Mutations of what gene are associated with malignant pilomatrixoma

Answer 19

Beta-catenin

Question 20

Beta-catenin gene mutation is associated with what tumor

Answer 20

Pilomatrixoma.

Question 21

Basal cell carcinomas only arise in skin that contains what?

Answer 21

Pilosebaceous units

Question 22

What is the difference between primary and secondary Extramammary Padgets disease

Answer 22

Primary is more apocrine in origin

Secondary is spread from an underlying malignancy (usually GI or GU cancers)

Question 23

What stain is usually + in primary extramammary padgets disease but is negative in secondary padgets?

Answer 23

GCDFP

gross cystic disease fluid protien

Question 24

What is the most common site for mucinous carcinoma?

Answer 24

Eyelid/canthous/brow area

Question 25

List 4 key features of MAC Microcystic Adenxal Carcinoma

Answer 25

asymetrical horn cysts in superficial part of lesion infiltrative basoloid strands with small lumina infiltrative growth extends deep into the reticular dermis, sub Q fat and muscle bonus may also see perineural invasion and solar elastosis sclerotic plaque on nose and lip of women that look like a sclerosing bcc

Question 26

What is this tumor

Answer 26

Microcystic Adenexal Carcinoma asymetrical horn cysts in superficial part of lesion infiltrative basoloid strands with small lumina infiltrative growth extends deep into the reticular dermis, sub Q fat and muscle bonus may also see perineural invasion and solar elastosis sclerotic plaque on nose and lip of women that look like a sclerosing bcc

Question 27

What is this tumor and it's features

Answer 27

Tricholemmoma growing down of epidermis with glycogen filled keratinocytes centers appear clear there is a rim of palisaded basal cells

Question 28

What is tricholemmoma associated with?

Answer 28

Cowden's disease palmar planter keratosis oral mucosal papillomatosus pigmented macules on penis Breast cancer, Thyroid cancer, Endometrial cancer, multiple GI hamartomas

Question 29

What are the two most common tumors associatied with nevus sebaceous?

Answer 29

1. Trichoblastoma 2. syringocystandoma papilliferum

Question 30

What mutation of MAKP pathway can be the same in nevus sebaceous, trichoblastoma, and sryringocystadenoma pappilliferum

Answer 30

HRAS

Question 31

What is the risk of a secondary carcinoma developing in a nevus sebaceous?

Answer 31

\<1%

Question 32

What is Schimmelpenning syndrome and Phacomatosis pigmentokeratotica

Answer 32

both rare varients of the epidermal nevus syndrome both can be associated with nevus sebaceous

Question 34

What is the cure rate for DFSP by mohs surgery?

Answer 34

97%

Question 35

What is the recurrance rate of DFSP by wide excision?

Answer 35

approximately 30%

Question 36

What are the surgical margins for DFSP by NCCN guidelines

Answer 36

2-4 cm to facia

Question 39

beside the lips where else can you see fordyce spots (a form of free sebaceous glands)

Answer 39

buccal mucosa

Question 40

what are #3 called

Answer 40

Montgomery tubercles free sebacous glands

Question 41

what are these called

Answer 41

Tyson glands free sebaceous glands

Question 42

What are these?

Answer 42

Meibomium gland openings free sebaceeous glands inside the tarsal plate when inflammed are Chalazion

Question 43

the free sebaceous gland at the base of the eyelids are known as what.

Answer 43

zies glands when inflammed they are a sty

Question 44

what are the glands of Moll

Answer 44

apocrine glands that are right next to the glands of zeis at the base of the eyelashes

Question 45

where do desmoplastic trichoepitheliomas usually arise

Answer 45

cheeks of women a plaque with a central dell

Question 46

What is the NCCN recommendation for F/U of completely excised DFSP

Answer 46

6-12 months

Question 47

What type of primary cutaneous lymphoma can you not treat with surgery alone.

Answer 47

Primary cutaneous large cell B lymphoma (leg type) TX with Rituximab, CHOP, + radiation You can excise follicle center and marginal lymphomas