Melanoma
Not Melanoma
Technical
Potpourri
100
When do you need SLNB
T1b
-> anything greater than 0.8mm OR ulceration
100
Nivolumab/pembrolizumab MOA
PD-1 monoclonal antibodies
100
What separates the superficial and deep inguinal nodes?
Fascia lata
100
Best imaging modality for soft tissue sarcoma/tumor
MRI
200
Melanoma T staging (& Margins)
Tis (0.5-1cm)
T1 < 1 mm (1cm)
T2 1-2 (1-2cm)
T3 2-4 (2cm)
T4 >4 (2cm)
b = ulceration
200
Most common cancer in transplant patients?
Non-melanoma skin cancer
200
What is cloquet's node?
The upper most deep inguinal node under the inguinal ligment, last stop before the external iliac nodes - sort of a SLN
200
Method of spread of sarcoma
hematogenous
300
Major MSLT - I Findings
-Doubling of melanoma-specific survival in intermediate thickness melanomas compared to WLE alone
-SLN independently associated with prognosis
-Note: all patients with + node underwent CLND
300
Treatment of SCC of the nose, lip, eyelid
XRT alone
300
Appropriate extremity sarcoma biopsy techniques
Core needle biopsy
<5 cm excisional biopsy
> 5 cm incisional biopsy, longitudinal incision over scar (encompass in WLE later)
300
Most common benign salivary gland tumor / treatment
Pleomorphic adenoma / superficial parotidectomy
400
Major DeCOG-SLT Findings
Pts with + SLN randomized to obs vs CLND
-Underpowered
-equivalent survival between CLND/ultrasound with obs
-Set stage for MSLTII
400
Treatment for merkel cell cancer
neuroendocrine tumor of the dermis
WLE with 2cm margins, XRT to excision site and regional nodes
High locoregional recurrence
400
Which tracer can be used for SLNB in pregnancy?
radiolabeled colloid (can't use isosulfan blue)
400
Benefits of full thickness skin grafting
-Increased primary contraction with decreased secondary contraction
-Better color matching (face)
-better for joint coverage (trauma-resistant)
500
Major MSLT II Findings
Randomized to CLND vs US/Obs, appropriate power
-No difference in melanoma specific survival, small advantage of CLND in disease-free survival but 24% lymphedema (vs 6)
-No groups with benefit from CLND
-US every 4-6 months for 5 years
500
Most common malignant salivary tumor / treatment
mucoepidermoid
Low grade - total parotid
High grade - total parotid, neck dissection
500
When to perform a deep inguinal node dissection?
Positive cloquet node
> 4 positive superficial nodes
Palpable matted nodes
500
Most common site of unknown primary SCC
ipsilateral tonsil