Flashcards in PP Exam 3 Deck (31):
Mycosis Fungoides is.a neoplasia of ___
What is the occurrence of MF?
What age is MF diagnosed?
Incidence increases with age and an average of around 50 years
MF is most common in what populations?
Male and African Americans
Sezary syndrome is a variant of what cancer?
MF, leukemic varient with a more rapid course and prognosis of 2-5 years
Diagnosis of MF
Patch phase, covers less then 10% of skin
Plaque phase, covers greater than or equal to 10% of skin surface
Tumor phase, frequently undergoes necrotic ulceration
erythroderma phase and peripheral blood involvement
topical chemo, TSI, photophoresis
Low energy electrons, 6 field position, 30-36 Gy
Epidemiology soft tissue sarcoma
10,500 cases/year, slightly more males, African American, peaks around 5th decade, 45% occur in lower extremity
risk factors for soft tissue sarcomas
Past radiation exposure, Li-Fraumeni, RB1, Gardner syndorme
Histology soft tissue sarcomas
Malignant Fibrous histocytoma is most common. Also Lipsarcoma and leimyosarcoma and rhabdomyosarcoma is most common in children
Clinical presentation for soft tissue sarcoma
painless mass, weakness, increased pressure, edema
Diagnostic work-up STS
biopsy, MRI, CT of chest to look for dirt mets, functional of contralateral kidney
STS prognostic factors
Histology, respectability, large tumor, high grade, how deep
invade longitudinal, most common dist mets is lung
Stand of care for STS?
surgery with wide excision
Inscidence of endocrine cancer?
59,000 - 57,000 of which are thyroid cancers
Inscidence of thyroid cancer?
57,000 of which are thyroid cancers
Etiology of thyroid cancer
pre-pubescent radiation exposure
signs and symptoms fo thyroid cancer
palpable nde (95% are benign) hoarseness
Detection and diagnostic thyroid cancer
ultrasound to determine if nodule is solid or cystic (FNA), CT/MRI, radionuclide imaging (cold spots indicate cancer)
Most common histology if thyroid malignancies?
Papillary, moat common in previous radiation exposure cases, slow growing and non aggressive, 2-4 times more common in women, 3-5th decade of life, regional LN spread (cervical)
Follicular thyroid cancer
12-17%, 50-60 year olds, 2-4x more common in women, rare LN spread, distant mets to bone, lung, liver, and brain
Medullary Thyroid cancer
1-4%, arises from parafollicular or C cells, secrete calcitonin, spreads regional spread, cervical LN, Lung liver and bone
Most aggressive thyroid histology?
Anaplastic, 2-3%, 4x more common in women, median survival is 3 months
Treatment for thyroid cancer
surgery, adjacent RT, definitive RT if not a surgical candidate (60-70 Gy with portal field)