General
Sarcoma
Non-melanoma skin cancer
Melanoma
True or False
100
Marjolin ulcer is a risk factor for which skin cancer
Squamous cell carcinoma
100
Most common location along an extremity to be afflicted by sarcoma
Proximal (thigh is most common)
100
Actinic keratosis or cutaneous horn are precursors for which type of NM skin cancer
Squamous cell carcinoma
100
Margins of 0.5-1cm is appropriate for what depth of melanoma
Melanoma in situ (Tis)
100
Sarcomas do not need SLNbx
True- they have hematogenous spread
200
Risk of non-melanoma skin cancer is increased up to 250x in these patients
Transplant recipients on immunosuppression
200
lymphangiosarcoma secondary to lymphedema
Stewart- Treves syndrome
200
Margins needed in excision
4 mm (Squamous Cell carcinoma)
200
Name of operation for positive nodes in the nodal basin for right thigh melanoma
therapeutic ilioinguinal lymphadenectomy
200
BCC with low-risk features requires 8mm margins
False
low risk-4mm, high risk-8mm
300
Gene target(s) for melanoma immunotherapy
CTLA-4 (ipilimumab)
BRAF (Vemurafenib, dabrafenib)
300
Image-guided core needle biopsy is non-diagnostic, what is the next step? Describe.
Incisional biopsy- should be done by the surgeon who will perform the ultimate operation and oriented alog the axis of symmetry with limited dissection
300
Reasons for adjuvant radiation to primary tumor site after excision of Merkel Cell carcinoma
tumor >1cm, inabiliaty to re-excise positive margins, salvage for recurrent disease
300
Name of the study performed BEFORE undergoing SLN bx in melanoma
lymphoscintigraphy with out without SPECT CT
300
Subungal melanoma is treated with Mohs micrographic surgery
False; It requires amputation of digit
400
Name high-risk features of an SCC
>2cm on trunk or >1cm on sensitive areas, hx immunosuppression or radiation, perineural or perivascular involvement, rapid growth, >6mm invasion beyond subQ
400
What are the ideal margins in resection of a sarcoma?
2cm of normal tissue
*Unless a critical neurovascular structure is close (not involved), then a more narrow margin is acceptable
400
Soft tissue sarcoma arising from dermal fibroblasts
Dermatofibrosarcoma protuberans
400
Options for (nodal) treatment in patient with positive SLNbx of lower extremity melanoma
lymphadenectomy or ultrasound surveillance q4 months for 2 years, then q6 months for years 3-5, then annually
400
node of Calot is the uppermost lymph node in the groin
false- node of Cloquet
(Calot's node is at the cystic triangle!)
500
Target for immunotherapy in locally advanced BCC
hedgehog (Vismodegib)
500
Name T stages of sarcoma of the trunk and extremities
T1 tumor <5cm in greatest dimension
T2 5-10cm
T3 10-15cm
T4 >15cm
500
Histologic appearance of Merkel Cell carcinoma on H&E
small, round blue cells
500
Describe important anatomy for SLN dissection for a patient with melanoma on the scalp
Can go to the cervical nodal basins or parotid gland
IJV, Carotid, SCM and spinal accessory nerve
Parotid- identify facial nerve
500
Sarcomas of the finger or toe do not require amputation
True; excision is undertaken without oncologic approach; preservation of function and margin clearance with primary closure is ideal. If there is invasion into neurovascular structures, then amputation or radical excision is warranted