This document discusses the evaluation and management of malignant skin lesions. It recommends that any clinically suspicious lesion undergo biopsy, with excisional biopsy preferred for small lesions and incisional biopsy for large lesions. For confirmed malignancies, further excision with appropriate margins is usually necessary. It then focuses on the two most common types of skin cancer: basal cell carcinoma and squamous cell carcinoma. For basal cell carcinoma, complete surgical excision with a 4mm margin is the main treatment. For squamous cell carcinoma, surgical margins of 6-10mm are recommended depending on risk factors, with lymph node assessment important for high-risk lesions.
Invasive Squamous Cell Carcinoma (SCC)
SCC of the skin is a malignant tumor of keratinocytes, arising in the epidermis.
SCC usually arises in epidermal precancerous lesions and, depending on etiology and level of differentiation, varies in its aggressiveness.
The lesion is a plaque or a nodule with varying degrees of keratinization in the nodule and/or on the surface.
Thumb rule:
Undifferentiated SCC: is soft and has no hyperkeratosis;
Differentiated SCC: is hard on palpation and has hyperkeratosis.
Exposure:
Sunlight. Phototherapy, PUVA (oral psoralen + UVA). Excessive photochemotherapy can lead to promotion of SCC, particularly in patients with skin phototypes I and II or in patients with history of previous exposure to ionizing radiation or methotrexate treatment for psoriasis.
Lesions :
Indurated papule, plaque, or nodule ; adherent thick keratotic scale or hyperkeratosis ; when eroded or ulcerated, the lesion may have a crust in the center and a firm, hyperkeratotic, elevated margin
Clark levels
level I, intra-epidermal;
level II, invades papillary dermis;
level III fills papillary dermis;
level IV, invades reticular dermis;
level V, invades subcutaneous fat.
This document discusses squamous cell carcinoma (SCC), a malignant skin tumor. It defines SCC as a cancer originating from keratinizing cells of the epidermis. The document then covers the epidemiology, pathology, spread/complications, clinical presentation, differential diagnosis, investigation, treatment, and prognosis of SCC. Key points include that SCC is the second most common skin cancer, affects sun-exposed skin of elderly males, and has varying malignancy depending on factors like depth of invasion and histological grade.
A detailed presentation on the clinical features, predisposing factors and treatment of skin cancers especially Squamous Cell Carcinoma. Pre - malignant conditions like Actinic keratosis, Bowen disease, Porokeratosis are also discussed. Also the presentation provides a detail of the various differential diagnoses of the skin cancers. Useful for medical students, post graduate trainees and nursing staff. Role of sunlight is also discussed.
Basal cell carcinoma is the most common type of skin cancer. It typically appears as a slow-growing bump or lesion on areas frequently exposed to sunlight, such as the face and scalp. While basal cell carcinoma rarely spreads to other parts of the body, it can cause significant tissue damage if left untreated. Treatment options depend on the size, depth and location of the cancer, and may include surgical excision, electrodesiccation, cryotherapy, topical medications, or Mohs surgery for cancers on the face. With early detection and treatment, basal cell carcinoma has an excellent prognosis.
This document discusses three types of eyelid cancers: basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and sebaceous gland carcinoma (SGC). BCC is the most common eyelid tumor, arising from the basal layer of the epidermis. Though locally invasive, it does not metastasize. SCC arises from the squamous layer and can spread regionally to lymph nodes. SGC arises from sebaceous or meibomian glands and is highly malignant, able to spread to lymph nodes and perineurally to the brain. The document provides details on the epidemiology, classification, histology, and identification of each cancer type.
Melanoma
Cutaneous Melanoma
also known as malignant melanoma, is a type of cancer that develops from the pigment-containing cells known as melanocytes.
Classification Of Melanoma
I : De novo melanoma
A. Melanoma in situ (MIS)
B. Lentigo maligna melanoma (LMM)
C. Superficial spreading melanoma (SSM)
D. Nodular melanoma (NM)
E. Acral-lentiginous melanoma (ALM)
F. Melanoma of the mucous membranes
G. Desmoplastic melanoma
II Melanoma arising from precursors
Melanoma arising in dysplastic nevomelanocytic nevi
B. Melanoma arising in congenital nevomelanocytic nevi
C. Melanoma arising in common NMN
Etiology And Pathogenesis
The etiology and pathogenesis of cutaneous melanoma are unknown.
Epidemiologic studies demonstrate a role for genetic predisposition and sun exposure in melanoma development.
The major genes involved in melanoma development reside on chromosome 9p21.
Etiology
UVR, mostly of the UVB spectrum (290–320 nm) that induces mutations in suppressor genes. The propensity for multiple BCC may be inherited. Associated with mutations in the PTCH gene in many cases.
Predisposing Factors
Genetic markers (CDKN2a mutation)
Skin type I/II
Family history of dysplastic nevi or melanoma
Personal history of melanoma
Ultraviolet irradiation, particularly sunburns during childhood and intermittent burning exposures
Number (>50) and size (>5 mm) of melanocytic nevi
Congenital nevi
Number of dysplastic nevi (>5)
Dysplastic melanocytic nevus syndrome
Immune suppression (debatable)
Number (>50) and size (>5 mm) of melanocytic nevi
Congenital nevi
Number of dysplastic nevi (>5)
Dysplastic melanocytic nevus syndrome
Immune suppression (debatable)
Six Signs of Malignant Melanoma (ABCDE Rule):
A- Asymmetry in shape—one-half unlike the other half.
B- Border is irregular—edges irregularly scalloped, notched, sharply defined.
C- Color is not uniform; mottled—haphazard display of colors; all shades of brown, black, gray, red, and white.
D- Diameter is usually large.
E- Elevation is almost always present and is irregular—surface distortion is assessed by side-lighting. others use E for Enlargement— a history of an increase in the size of lesion is one of the most important signs of malignant melanoma.
Lentigo Maligna Melanoma (LMM)
Invasive Squamous Cell Carcinoma (SCC)
SCC of the skin is a malignant tumor of keratinocytes, arising in the epidermis.
SCC usually arises in epidermal precancerous lesions and, depending on etiology and level of differentiation, varies in its aggressiveness.
The lesion is a plaque or a nodule with varying degrees of keratinization in the nodule and/or on the surface.
Thumb rule:
Undifferentiated SCC: is soft and has no hyperkeratosis;
Differentiated SCC: is hard on palpation and has hyperkeratosis.
Exposure:
Sunlight. Phototherapy, PUVA (oral psoralen + UVA). Excessive photochemotherapy can lead to promotion of SCC, particularly in patients with skin phototypes I and II or in patients with history of previous exposure to ionizing radiation or methotrexate treatment for psoriasis.
Lesions :
Indurated papule, plaque, or nodule ; adherent thick keratotic scale or hyperkeratosis ; when eroded or ulcerated, the lesion may have a crust in the center and a firm, hyperkeratotic, elevated margin
Clark levels
level I, intra-epidermal;
level II, invades papillary dermis;
level III fills papillary dermis;
level IV, invades reticular dermis;
level V, invades subcutaneous fat.
This document discusses squamous cell carcinoma (SCC), a malignant skin tumor. It defines SCC as a cancer originating from keratinizing cells of the epidermis. The document then covers the epidemiology, pathology, spread/complications, clinical presentation, differential diagnosis, investigation, treatment, and prognosis of SCC. Key points include that SCC is the second most common skin cancer, affects sun-exposed skin of elderly males, and has varying malignancy depending on factors like depth of invasion and histological grade.
A detailed presentation on the clinical features, predisposing factors and treatment of skin cancers especially Squamous Cell Carcinoma. Pre - malignant conditions like Actinic keratosis, Bowen disease, Porokeratosis are also discussed. Also the presentation provides a detail of the various differential diagnoses of the skin cancers. Useful for medical students, post graduate trainees and nursing staff. Role of sunlight is also discussed.
Basal cell carcinoma is the most common type of skin cancer. It typically appears as a slow-growing bump or lesion on areas frequently exposed to sunlight, such as the face and scalp. While basal cell carcinoma rarely spreads to other parts of the body, it can cause significant tissue damage if left untreated. Treatment options depend on the size, depth and location of the cancer, and may include surgical excision, electrodesiccation, cryotherapy, topical medications, or Mohs surgery for cancers on the face. With early detection and treatment, basal cell carcinoma has an excellent prognosis.
This document discusses three types of eyelid cancers: basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and sebaceous gland carcinoma (SGC). BCC is the most common eyelid tumor, arising from the basal layer of the epidermis. Though locally invasive, it does not metastasize. SCC arises from the squamous layer and can spread regionally to lymph nodes. SGC arises from sebaceous or meibomian glands and is highly malignant, able to spread to lymph nodes and perineurally to the brain. The document provides details on the epidemiology, classification, histology, and identification of each cancer type.
Melanoma
Cutaneous Melanoma
also known as malignant melanoma, is a type of cancer that develops from the pigment-containing cells known as melanocytes.
Classification Of Melanoma
I : De novo melanoma
A. Melanoma in situ (MIS)
B. Lentigo maligna melanoma (LMM)
C. Superficial spreading melanoma (SSM)
D. Nodular melanoma (NM)
E. Acral-lentiginous melanoma (ALM)
F. Melanoma of the mucous membranes
G. Desmoplastic melanoma
II Melanoma arising from precursors
Melanoma arising in dysplastic nevomelanocytic nevi
B. Melanoma arising in congenital nevomelanocytic nevi
C. Melanoma arising in common NMN
Etiology And Pathogenesis
The etiology and pathogenesis of cutaneous melanoma are unknown.
Epidemiologic studies demonstrate a role for genetic predisposition and sun exposure in melanoma development.
The major genes involved in melanoma development reside on chromosome 9p21.
Etiology
UVR, mostly of the UVB spectrum (290–320 nm) that induces mutations in suppressor genes. The propensity for multiple BCC may be inherited. Associated with mutations in the PTCH gene in many cases.
Predisposing Factors
Genetic markers (CDKN2a mutation)
Skin type I/II
Family history of dysplastic nevi or melanoma
Personal history of melanoma
Ultraviolet irradiation, particularly sunburns during childhood and intermittent burning exposures
Number (>50) and size (>5 mm) of melanocytic nevi
Congenital nevi
Number of dysplastic nevi (>5)
Dysplastic melanocytic nevus syndrome
Immune suppression (debatable)
Number (>50) and size (>5 mm) of melanocytic nevi
Congenital nevi
Number of dysplastic nevi (>5)
Dysplastic melanocytic nevus syndrome
Immune suppression (debatable)
Six Signs of Malignant Melanoma (ABCDE Rule):
A- Asymmetry in shape—one-half unlike the other half.
B- Border is irregular—edges irregularly scalloped, notched, sharply defined.
C- Color is not uniform; mottled—haphazard display of colors; all shades of brown, black, gray, red, and white.
D- Diameter is usually large.
E- Elevation is almost always present and is irregular—surface distortion is assessed by side-lighting. others use E for Enlargement— a history of an increase in the size of lesion is one of the most important signs of malignant melanoma.
Lentigo Maligna Melanoma (LMM)
Basal Cell Carcinoma (BCC)
BCC is the most common cancer in humans.
Caused by UVR; PTCH gene mutation in most cases.
Clinically different types: nodular, ulcerating, pigmented, sclerosing , and superficial.
BCC is locally invasive, aggressive, and destructive but slow growing, and there is very limited (literally no) tendency to metastasize.
Skin Lesions: There are five clinical types:
1- Nodular
2- Ulcerating
3- Sclerosing (Cicatricial),
4- Superficial,
5- Pigmented.
histologic variants of oral squmous cell carcinoma /certified fixed orthodont...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
This document discusses cutaneous malignancies including benign and malignant skin tumors. It provides classifications of skin tumors and describes various types of non-melanoma skin cancers like basal cell carcinoma, squamous cell carcinoma, and malignant adnexal tumors. It discusses the pathophysiology of skin cancer in relation to ultraviolet and ionizing radiation damage. Risk factors, presentations, investigations and treatments are summarized for different non-melanoma skin cancers and malignant melanoma.
This document summarizes a case presentation of an 81-year-old patient with an extensive ulcerative lesion on the right side of their nose diagnosed as infiltrative basal cell carcinoma. It provides background information on basal cell carcinoma, including that it is the most common skin cancer, rarely metastasizes but can cause significant local tissue destruction. Treatment options are discussed, favoring surgical excision for this patient given their age and desire to preserve their eye.
Squamous cell carcinoma is the second-most common
cancer of the skin (after basal cell carcinoma but more
common than melanoma). It usually occurs in areas exposed to the sun. Sunlight exposure and immunosuppression are risk factors for SCC of the skin, with chronic sun exposure being the strongest environmental risk factor
Non-melanoma skin cancer is the most common cancer in the US. The two main types are basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). Risk factors include ultraviolet radiation exposure and fair skin. BCC typically occurs on sun exposed areas and is locally destructive but rarely spreads. SCC also occurs on sun exposed skin and has a greater risk of spreading. Treatment options depend on the type and location of the cancer, and may include surgery, Mohs surgery, radiation, or topical medications.
This document describes basal cell carcinoma (BCC), the most common type of skin cancer. It develops from stem cells in the basal layer of the epidermis or hair follicles. The main cause is ultraviolet radiation from sun exposure. BCC usually appears as a raised bump on sun-exposed skin and grows slowly, rarely spreading to other areas. If left untreated, it can cause significant tissue damage. The document outlines the clinical features and subtypes of BCC, including nodular, pigmented, cystic, superficial, micronodular, and infiltrating types. Histopathological analysis is used to diagnose and characterize BCC subtypes based on tissue appearance. Surgical excision or radiation therapy can effectively treat
This document summarizes information about three common skin cancers: basal cell carcinoma, squamous cell carcinoma, and malignant melanoma. It discusses the definition, risk factors, clinical presentation, types, diagnosis, and treatment of each cancer. Basal cell carcinoma is the most common type and arises from the basal layer of the epidermis. Squamous cell carcinoma arises from keratinocytes in the epidermis and can develop from preexisting lesions. Malignant melanoma results from the malignant transformation of melanocytes and occurs mainly in the skin.
Rosacea is a chronic skin condition causing flushing and pimple-like lesions on the face. Risk factors include light skin, age 30-50, and stress. Symptoms include redness, pimples, and thickened skin on the nose. Treatment focuses on avoiding triggers and using oral antibiotics or topical metronidazole.
Squamous cell carcinoma is a type of skin cancer arising from sun-exposed skin. Risk is highest in older, fair-skinned males with outdoor jobs. Lesions appear scaly or raised and can ulcerate if untreated. Treatment may include surgery, radiation, or chemotherapy depending on the size and location of the lesion.
Both conditions require protecting skin from
This document provides an outline for a presentation on skin malignancies including basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and malignant melanoma (MM). It covers the epidemiology, etiology, risk factors, pathology, classification, diagnosis, treatment and prevention of these three skin cancers. Diagnosis involves history, examination, and investigations. Treatment involves surgical options like excision and Mohs surgery as well as non-surgical options. Prevention focuses on sun protection and early detection through follow up visits.
This document discusses the histopathology of malignant melanoma. It describes several types of melanoma including superficial spreading melanoma, nodular melanoma, lentigo maligna melanoma, and acral lentiginous melanoma. Key points include that melanoma most commonly affects sites like the scalp, orbit and face in individuals between 20-60 years old. Histopathological examination reveals expansile nodules of atypical melanocytes with mitotic figures. Important prognostic factors mentioned are tumor thickness, ulceration, mitotic rate, lymphocytic infiltration, vascular invasion and presence of satellite lesions. Differential diagnoses and features useful to distinguish melanoma from benign lesions are also provided.
Automated cell counter & its quality controlSaikat Mandal
This document discusses various premalignant lesions of the skin, including actinic keratosis, oral leukoplakia, Bowen's disease, erythroplasia of Queyrat, and bowenoid papulosis. It describes the clinical presentation, histological features, causative factors, and risk of progression to squamous cell carcinoma for each condition. The document focuses on describing the characteristic layers and cell types found in normal skin and how these features are altered in the various premalignant lesions.
This document summarizes information about sebaceous carcinoma, including details about a 76-year-old female patient who presented with an ulceroproliferative growth on her left maxillary region. Microscopic examination of the excised biopsy shows tumor involvement of the lateral surgical margin. The document provides information on the clinical features, gross features, histopathology, grading, variants, differential diagnoses, and immunoprofile of sebaceous carcinoma. IHC stains for Adipophilin, AR, EMA, and P63 are advised.
This document summarizes various types of skin malignancies:
- It classifies skin tumors into keratinocytic (basal cell carcinoma, squamous cell carcinoma), melanocytic (malignant melanoma), and appendageal tumors.
- It describes the histological features and pathogenesis of common tumors like basal cell carcinoma, squamous cell carcinoma, and malignant melanoma. It notes their association with mutations in signaling pathways like Hedgehog and TP53.
- It also summarizes less common tumors like pilomatric carcinoma, sebaceous carcinoma, mycosis fungoides, and dermatofibrosarcoma protuberans, noting their clinical features, histology, and prognosis
Skin tumors can be benign or malignant. Seborrhoeic keratosis is a common benign epidermal tumor unrelated to sebaceous glands that usually arises after age 50 as multiple 'stuck-on' lesions on the face and trunk. Malignant skin tumors include basal cell carcinoma, the most common type of skin cancer, squamous cell carcinoma, and malignant melanoma. Risk factors for these cancers include sun exposure. Accurate diagnosis and treatment is important given the risk of local invasion and metastasis for malignant skin tumors.
This document summarizes a case of basal cell carcinoma in a 65-year-old male patient who has a history of smoking for 30 years and works outdoors on a farm. The patient presents with a non-painful lesion on his nose for 4 months. Based on the clinical features of an erythematous, indurated papule with telangiectatic vessels, a diagnosis of basal cell carcinoma is made. Basal cell carcinoma is the most common type of skin cancer and is caused by prolonged sun exposure, especially in areas like the face that are frequently exposed. Treatment options include surgical excision, Mohs micrographic surgery, photodynamic therapy, and curettage and desiccation.
This document discusses the treatment of common skin cancers. It describes benign and premalignant skin lesions as well as the three main types of malignant skin cancer - basal cell carcinoma, squamous cell carcinoma, and melanoma. It provides details on risk factors, clinical presentation, diagnosis, staging, and treatment options for each type of skin cancer.
This document summarizes the characteristics of the main types of lung cancer. Squamous cell carcinoma is the most common in men and related to smoking, often appearing as a central tumor. Adenocarcinoma is more common in women and non-smokers, arising in peripheral areas such as terminal bronchioles. Bronchoalveolar carcinoma is a distinct histological subtype of adenocarcinoma originating in the bronchoalveolar region. Small cell carcinoma is the most aggressive type and strongly associated with smoking.
Skin cancer is the most commonly diagnosed cancer. The three main types are basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and malignant melanoma. BCC is the most common type and usually appears as a waxy nodule, while SCC can metastasize if not treated early. Malignant melanoma is the most lethal type and risk factors include ultraviolet light exposure and family history. Early detection of skin lesions is important, and treatment may involve surgical excision, Mohs surgery, radiation, or chemotherapy depending on the cancer type and stage. Education about skin cancer signs and protecting skin from the sun are also important.
This document discusses malignant skin tumors including basal cell carcinoma, squamous cell carcinoma, and malignant melanoma. It provides details on the pathogenesis, histology, staging, and management of each tumor type. Basal cell carcinoma is the most common skin cancer, usually appearing as a slow-growing nodular lesion. Squamous cell carcinoma is associated with sun exposure and pre-existing skin conditions. Malignant melanoma subtypes include superficial spreading, nodular, lentigo maligna, and acral lentiginous melanoma, which have varying presentations and prognoses. Staging and surgical excision are important for prognosis and management of these malignant skin tumors.
This document provides guidelines for evaluating and managing benign breast diseases. It discusses conducting a thorough history and physical exam. Imaging studies like mammography and ultrasound may be used. Biopsies should be performed when a mass is solid or abnormalities are found. Specific disorders are addressed, such as evaluating nipple discharge, breast pain, cysts, fibroadenomas, and infections. Management depends on factors like patient age and physical exam findings. The goal is to determine if the abnormality is benign or malignant.
Basal Cell Carcinoma (BCC)
BCC is the most common cancer in humans.
Caused by UVR; PTCH gene mutation in most cases.
Clinically different types: nodular, ulcerating, pigmented, sclerosing , and superficial.
BCC is locally invasive, aggressive, and destructive but slow growing, and there is very limited (literally no) tendency to metastasize.
Skin Lesions: There are five clinical types:
1- Nodular
2- Ulcerating
3- Sclerosing (Cicatricial),
4- Superficial,
5- Pigmented.
histologic variants of oral squmous cell carcinoma /certified fixed orthodont...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
This document discusses cutaneous malignancies including benign and malignant skin tumors. It provides classifications of skin tumors and describes various types of non-melanoma skin cancers like basal cell carcinoma, squamous cell carcinoma, and malignant adnexal tumors. It discusses the pathophysiology of skin cancer in relation to ultraviolet and ionizing radiation damage. Risk factors, presentations, investigations and treatments are summarized for different non-melanoma skin cancers and malignant melanoma.
This document summarizes a case presentation of an 81-year-old patient with an extensive ulcerative lesion on the right side of their nose diagnosed as infiltrative basal cell carcinoma. It provides background information on basal cell carcinoma, including that it is the most common skin cancer, rarely metastasizes but can cause significant local tissue destruction. Treatment options are discussed, favoring surgical excision for this patient given their age and desire to preserve their eye.
Squamous cell carcinoma is the second-most common
cancer of the skin (after basal cell carcinoma but more
common than melanoma). It usually occurs in areas exposed to the sun. Sunlight exposure and immunosuppression are risk factors for SCC of the skin, with chronic sun exposure being the strongest environmental risk factor
Non-melanoma skin cancer is the most common cancer in the US. The two main types are basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). Risk factors include ultraviolet radiation exposure and fair skin. BCC typically occurs on sun exposed areas and is locally destructive but rarely spreads. SCC also occurs on sun exposed skin and has a greater risk of spreading. Treatment options depend on the type and location of the cancer, and may include surgery, Mohs surgery, radiation, or topical medications.
This document describes basal cell carcinoma (BCC), the most common type of skin cancer. It develops from stem cells in the basal layer of the epidermis or hair follicles. The main cause is ultraviolet radiation from sun exposure. BCC usually appears as a raised bump on sun-exposed skin and grows slowly, rarely spreading to other areas. If left untreated, it can cause significant tissue damage. The document outlines the clinical features and subtypes of BCC, including nodular, pigmented, cystic, superficial, micronodular, and infiltrating types. Histopathological analysis is used to diagnose and characterize BCC subtypes based on tissue appearance. Surgical excision or radiation therapy can effectively treat
This document summarizes information about three common skin cancers: basal cell carcinoma, squamous cell carcinoma, and malignant melanoma. It discusses the definition, risk factors, clinical presentation, types, diagnosis, and treatment of each cancer. Basal cell carcinoma is the most common type and arises from the basal layer of the epidermis. Squamous cell carcinoma arises from keratinocytes in the epidermis and can develop from preexisting lesions. Malignant melanoma results from the malignant transformation of melanocytes and occurs mainly in the skin.
Rosacea is a chronic skin condition causing flushing and pimple-like lesions on the face. Risk factors include light skin, age 30-50, and stress. Symptoms include redness, pimples, and thickened skin on the nose. Treatment focuses on avoiding triggers and using oral antibiotics or topical metronidazole.
Squamous cell carcinoma is a type of skin cancer arising from sun-exposed skin. Risk is highest in older, fair-skinned males with outdoor jobs. Lesions appear scaly or raised and can ulcerate if untreated. Treatment may include surgery, radiation, or chemotherapy depending on the size and location of the lesion.
Both conditions require protecting skin from
This document provides an outline for a presentation on skin malignancies including basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and malignant melanoma (MM). It covers the epidemiology, etiology, risk factors, pathology, classification, diagnosis, treatment and prevention of these three skin cancers. Diagnosis involves history, examination, and investigations. Treatment involves surgical options like excision and Mohs surgery as well as non-surgical options. Prevention focuses on sun protection and early detection through follow up visits.
This document discusses the histopathology of malignant melanoma. It describes several types of melanoma including superficial spreading melanoma, nodular melanoma, lentigo maligna melanoma, and acral lentiginous melanoma. Key points include that melanoma most commonly affects sites like the scalp, orbit and face in individuals between 20-60 years old. Histopathological examination reveals expansile nodules of atypical melanocytes with mitotic figures. Important prognostic factors mentioned are tumor thickness, ulceration, mitotic rate, lymphocytic infiltration, vascular invasion and presence of satellite lesions. Differential diagnoses and features useful to distinguish melanoma from benign lesions are also provided.
Automated cell counter & its quality controlSaikat Mandal
This document discusses various premalignant lesions of the skin, including actinic keratosis, oral leukoplakia, Bowen's disease, erythroplasia of Queyrat, and bowenoid papulosis. It describes the clinical presentation, histological features, causative factors, and risk of progression to squamous cell carcinoma for each condition. The document focuses on describing the characteristic layers and cell types found in normal skin and how these features are altered in the various premalignant lesions.
This document summarizes information about sebaceous carcinoma, including details about a 76-year-old female patient who presented with an ulceroproliferative growth on her left maxillary region. Microscopic examination of the excised biopsy shows tumor involvement of the lateral surgical margin. The document provides information on the clinical features, gross features, histopathology, grading, variants, differential diagnoses, and immunoprofile of sebaceous carcinoma. IHC stains for Adipophilin, AR, EMA, and P63 are advised.
This document summarizes various types of skin malignancies:
- It classifies skin tumors into keratinocytic (basal cell carcinoma, squamous cell carcinoma), melanocytic (malignant melanoma), and appendageal tumors.
- It describes the histological features and pathogenesis of common tumors like basal cell carcinoma, squamous cell carcinoma, and malignant melanoma. It notes their association with mutations in signaling pathways like Hedgehog and TP53.
- It also summarizes less common tumors like pilomatric carcinoma, sebaceous carcinoma, mycosis fungoides, and dermatofibrosarcoma protuberans, noting their clinical features, histology, and prognosis
Skin tumors can be benign or malignant. Seborrhoeic keratosis is a common benign epidermal tumor unrelated to sebaceous glands that usually arises after age 50 as multiple 'stuck-on' lesions on the face and trunk. Malignant skin tumors include basal cell carcinoma, the most common type of skin cancer, squamous cell carcinoma, and malignant melanoma. Risk factors for these cancers include sun exposure. Accurate diagnosis and treatment is important given the risk of local invasion and metastasis for malignant skin tumors.
This document summarizes a case of basal cell carcinoma in a 65-year-old male patient who has a history of smoking for 30 years and works outdoors on a farm. The patient presents with a non-painful lesion on his nose for 4 months. Based on the clinical features of an erythematous, indurated papule with telangiectatic vessels, a diagnosis of basal cell carcinoma is made. Basal cell carcinoma is the most common type of skin cancer and is caused by prolonged sun exposure, especially in areas like the face that are frequently exposed. Treatment options include surgical excision, Mohs micrographic surgery, photodynamic therapy, and curettage and desiccation.
This document discusses the treatment of common skin cancers. It describes benign and premalignant skin lesions as well as the three main types of malignant skin cancer - basal cell carcinoma, squamous cell carcinoma, and melanoma. It provides details on risk factors, clinical presentation, diagnosis, staging, and treatment options for each type of skin cancer.
This document summarizes the characteristics of the main types of lung cancer. Squamous cell carcinoma is the most common in men and related to smoking, often appearing as a central tumor. Adenocarcinoma is more common in women and non-smokers, arising in peripheral areas such as terminal bronchioles. Bronchoalveolar carcinoma is a distinct histological subtype of adenocarcinoma originating in the bronchoalveolar region. Small cell carcinoma is the most aggressive type and strongly associated with smoking.
Skin cancer is the most commonly diagnosed cancer. The three main types are basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and malignant melanoma. BCC is the most common type and usually appears as a waxy nodule, while SCC can metastasize if not treated early. Malignant melanoma is the most lethal type and risk factors include ultraviolet light exposure and family history. Early detection of skin lesions is important, and treatment may involve surgical excision, Mohs surgery, radiation, or chemotherapy depending on the cancer type and stage. Education about skin cancer signs and protecting skin from the sun are also important.
This document discusses malignant skin tumors including basal cell carcinoma, squamous cell carcinoma, and malignant melanoma. It provides details on the pathogenesis, histology, staging, and management of each tumor type. Basal cell carcinoma is the most common skin cancer, usually appearing as a slow-growing nodular lesion. Squamous cell carcinoma is associated with sun exposure and pre-existing skin conditions. Malignant melanoma subtypes include superficial spreading, nodular, lentigo maligna, and acral lentiginous melanoma, which have varying presentations and prognoses. Staging and surgical excision are important for prognosis and management of these malignant skin tumors.
This document provides guidelines for evaluating and managing benign breast diseases. It discusses conducting a thorough history and physical exam. Imaging studies like mammography and ultrasound may be used. Biopsies should be performed when a mass is solid or abnormalities are found. Specific disorders are addressed, such as evaluating nipple discharge, breast pain, cysts, fibroadenomas, and infections. Management depends on factors like patient age and physical exam findings. The goal is to determine if the abnormality is benign or malignant.
Basal cell carcinoma and squamous cell carcinoma are the two most common types of skin cancer. Basal cell carcinoma is the most common human cancer, making up 25% of all cancers. It rarely metastasizes but can cause extensive damage locally. Risk factors include sun exposure, lighter skin, older age, immunosuppression, and genetic conditions. Treatment options include curettage and electrodesiccation, surgical excision with margin assessment, Mohs surgery, radiation therapy, and topical therapies like imiquimod for superficial lesions. Mohs surgery achieves the highest cure rates of over 99% for basal cell carcinoma.
This document summarizes information about benign skin lesions. It discusses several common epidermal lesions including seborrheic keratosis, keratoacanthoma, verrucous nevus, and verruca vulgaris. It also covers various pigmented lesions such as nevus, congenital melanocytic nevus, blue nevus, and dysplastic nevi. Congenital melanocytic nevi are present at birth and can range in size from small to giant. Treatment options for congenital melanocytic nevi include serial excision, tissue expansion, skin grafts, and lasers depending on the size and location of the lesion. Blue nevi appear bluish due
Il trattamento chirurgico dei tumori del labbroMerqurio
The document summarizes the surgical management of lip cancer. It discusses that lip cancer is most commonly squamous cell carcinoma, usually originating in the lower lip. The management of lip cancer involves controlling the primary tumor with appropriate margins while allowing for oral competence, as well as potential neck metastases. Reconstruction is challenging, especially for advanced lesions, requiring preoperative planning and various surgical techniques. Early stage tumors have better prognostic and functional outcomes after surgery compared to advanced lesions. The authors report their experience treating lip tumors and managing neck metastases.
Il trattamento chirurgico dei tumori del labbroMerqurio
This document summarizes a study on the surgical management of lip cancer. The most common type of lip cancer is squamous cell carcinoma, usually occurring on the lower lip. Treatment involves complete excision of the primary tumor with oncologically appropriate margins while preserving lip structure and function during reconstruction. For early-stage tumors, surgery results in good aesthetic and functional outcomes. More advanced tumors require complex reconstruction techniques using local or regional flaps to restore lip shape, texture, and mobility. Management of possible neck metastases is also important, as lymph node involvement significantly reduces survival rates. The authors report their experience treating 32 cases of lip cancer with surgical excision and various reconstructive procedures.
Il trattamento chirurgico dei tumori del labbroMerqurio
This document summarizes a study on the surgical management of lip cancer. The study examined 32 patients treated for lip cancer over 5 years. Most cases involved squamous cell carcinoma of the lower lip. Surgical excision of the tumor was performed with oncologically appropriate margins. Reconstruction after surgery posed challenges, especially for advanced or extensive lesions. Local flaps from the lip or surrounding tissues were often used for reconstruction. Neck dissection was also performed in some cases to control lymph node metastases. While early stage tumors had good postoperative outcomes, advanced lesions resulted in greater functional impairments like drooling or chewing difficulties after surgery. The document discusses the surgical and reconstructive techniques used to treat lip cancers while aiming to preserve lip appearance and
Lipoma is one of the most common soft tissue tumor arising from the mesenchyme. It is slow growing, encapsulated, and usually benign in nature. Tumors over the back, shoulder, and neck region have a high propensity to assume large size thereby getting redefined as a giant lipoma when they exceed 10 cm in width or weigh more than 1000 grams. MRI is the investigation of choice for evaluating giant lipomas. Fine needle aspiration cytology (FNAC) or frozen section may be pertinent in suspected cases of liposarcoma. Complete surgical incision is the treatment of choice. A case of a giant lipoma on the back of a 64-year-old lady is presented with a view to revisit conceptual understanding of the clinical evaluation, investigation, and management of giant lipomas.
This document provides information about soft tissue tumors. It discusses the epidemiology, classification, etiology, diagnosis and treatment of both benign and malignant soft tissue tumors. Some key points include:
- Benign soft tissue tumors are more common than sarcomas. Common benign tumors include lipomas, schwannomas and giant cell tumors of the tendon sheath.
- Risk factors for soft tissue sarcoma include exposure to herbicides/pesticides, radiation exposure, genetic conditions and viral infections.
- MRI is usually the best imaging modality for evaluating soft tissue tumors. Biopsy is needed for diagnosis.
- Treatment depends on whether the tumor is benign or malignant. Benign tumors may
More than 1 million skin cancer cases are diagnosed in the United States each year, with basal cell carcinoma making up about 80% of cases, squamous cell carcinoma making up about 16% of cases, and malignant melanoma making up about 4% of cases. Risk factors for skin cancer include sun exposure, older age, fair skin, and genetic factors. Common signs of skin cancer include changes to moles and lesions including asymmetry, irregular borders, varied color, diameter larger than 6mm, and evolving size or appearance. Diagnosis involves examination, biopsy, and sometimes imaging, while treatment involves surgical excision and may include lymph node assessment and other procedures depending on cancer type and stage. Prognosis depends on cancer type, thickness or
Squamous cell carcinoma and basal cell carcinoma are the two most common types of non-melanoma skin cancer. Squamous cell carcinoma occurs more often in sun-exposed areas and affects men more than women. Larger lesions, deeper invasion and higher grades are associated with greater recurrence risk. Treatment options include excision, cryotherapy and radiation therapy. Basal cell carcinoma is more common and occurs predominantly in light-skinned individuals on sun-exposed areas. The nodular type is most common. Treatment involves wide local excision, Mohs surgery, or radiation therapy depending on size and location.
Skin cancer is the most common form of cancer in the United States and arises from DNA mutations in skin cells. The three main types are basal cell carcinoma, squamous cell carcinoma, and melanoma. Basal and squamous cell carcinomas are common, locally destructive cancers but rarely spread, while melanoma is less common but more dangerous as it can spread. Diagnosis involves examination of suspicious skin lesions and biopsy of concerning areas. Treatment options depend on cancer type and severity but may include topical medications, surgery, radiation, or chemotherapy. Prevention through sun protection and skin self-exams is important given skin cancer risks like sun exposure and suppressed immunity.
This document discusses squamous cell carcinoma (SCC), a type of non-melanoma skin cancer. It notes that SCC comprises about 20% of non-melanoma skin cancers. Risk factors for SCC include cumulative sun exposure, fair skin, genetic conditions, immunosuppression, arsenic exposure, and other skin damage or diseases. Actinic keratosis is a precancerous lesion that can progress to SCC. Diagnosis involves biopsy and imaging if needed to assess spread. Treatment depends on risk factors and location but commonly includes surgery, Mohs surgery, radiation, or a combination for more advanced cases.
This document discusses neck dissection procedures for treating cervical lymph node metastases. It begins by outlining factors that influence the incidence of neck metastases from various head and neck cancers. These include the size and characteristics of the primary tumor. It then discusses staging of neck cancer and limitations of current staging systems. The indications for neck dissection are described as either therapeutic for palpable disease or elective for occult metastases. Comprehensive neck dissections remove lymph nodes from levels I-VI, while selective dissections remove only nodes at specific levels predicted to contain metastases from the primary site.
Dr Patrick Treacy on Diagnosis and Treatment of Malignant Melanoma Dr. Patrick J. Treacy
A 23-year-old Siberian female patient presented with a changing lesion on her abdomen. The patient stated the lesion was present for about two years and it started
off from within a freckle, which started to grow larger and somewhat darken in appearance. It had the clinical appearance of a melanoma and the dermoscopy three-point checklist (designed to allow non-experts not to miss detection of melanomas) was used to determine whether this had a high likelihood of malignancy. It included:
Asymmetry: asymmetry of colour and structure in one or
two perpendicular axes
Atypical network: pigment network with irregular holes
and thick lines
Blue-white structures: there was some evidence of blue-
white veil and regression structures
Dr Patrick Treacy shares some of his most challenging cases.
This month he talks about treating Cutaneous Malignant Melanoma. Melanoma, also known as malignant melanoma, is a type of cancer that develops from the pigment-containing cells known as melanocytes. They typically occur in the skin but may rarely occur in the mouth, intestines, or eye. In women they most commonly occur on the legs, while in men they are most common on the back. Sometimes they develop from a mole with concerning changes including an increase in size, irregular edges, change in color, itchiness, or skin breakdown
Introduction .
Statics.
Risk factors.
survival rate.
Staging , Grading.
Special investigations.
WHO Classification .
Most common Benign and Malignant salivary gland Tumors
Clinical presentation and prognosis.
Surgical Treatment .
Summary.
Salivary gland tumors account for 2% to 6.5% of all head and neck neoplasms, are more common in female with a peak incidence in their 60s and 70s, but can occur in all age groups.
The majority of neoplasms occur in the parotid, and pleomorphic adenoma is the most common benign tumor and mucoepidermoid carcinoma the most common malignant tumor.
Irregular margins, bony invasions, the presence of metastatic lymph nodes and perineural spread can all be signs of malignancy.
Necrosis can also characterize malignancy.
Benign tumors were more common than malignant ones.
The prevalent benign tumor was PA, and the prevalent malignant tumors were ACC and MEC.
The smaller the gland more likely that a mass is malignant.
Primary mucinous adenocarcinoma of scalp is a rare malignant neoplasm with predilection to head and neck area. This tumor mostly occurs in sixth or seventh decade with tendency of local recurrence. The distant metastasis is rarely seen. It is essential to differentiate the primary neoplasms from metastatic neoplasm arising from breast, gastrointestinal tract and other organs because the prognosis and management differs drastically. We present a case report of a 43-year-old female with swelling in scalp diagnosed as primary mucinous carcinoma, without any systemic dissemination. We review the literature about primary and metastatic mucinous neoplasms in order to better understand, identify and manage this entity.
Similar to Acs0304 Surgical Management Of Melanoma And Other Skin Cancers (20)
Acs0522 procedures for benign and malignant biliary tract disease-2005medbookonline
This document discusses procedures for benign and malignant biliary tract diseases. It provides guidance on preoperative evaluation and management of biliary obstruction. Specific considerations are given to infection, renal dysfunction, impaired immunity, malnutrition, and coagulation issues. The document outlines operative planning details such as patient positioning, exposure techniques, and guidelines for biliary anastomoses including suture placement and techniques for difficult access situations.
This document discusses the anatomy and surgical procedure of splenectomy. It describes:
- The spleen's highly variable arterial blood supply, which can take bundled or distributed patterns. This variability impacts the difficulty of surgery.
- The splenic artery typically branches off the celiac axis but can originate from other nearby arteries in rare cases.
- Additional branches of the splenic artery before it enters the spleen, including short gastric and pancreatic arteries.
- A history of splenectomy beginning in the 16th century and its increasing use through the 20th century for trauma and hematologic disorders.
- The development of laparoscopic splenectomy in the early 1990s and ongoing refinement of minim
Gastrostomy is commonly used as a temporary procedure to avoid discomfort from prolonged nasogastric suction after major abdominal surgery. It can also be used permanently when the esophagus is obstructed to nonresectable cancer. The Stamm gastrostomy is most common temporary procedure where a catheter is placed through the stomach wall and anchored to the skin. The Janeway gastrostomy is a permanent alternative where a flap of stomach is brought through the abdominal wall and attached to form a mucosal lined tube to prevent regurgitation. Postoperative care involves gradual advancement to oral intake as the stomach heals and functions return to normal.
This document describes the Billroth I gastric resection procedure, which involves removing part of the stomach and reattaching it to the duodenum. Key steps include transecting the stomach, attaching it to the duodenum using a circular stapler, and closing the gastrotomy site. The procedure aims to control peptic ulcers by combining hemigastrectomy with vagotomy while restoring normal gastrointestinal continuity. Postoperative care focuses on gradual advancement of oral intake and monitoring for complications.
This document describes the Billroth I procedure for gastroduodenostomy. It involves extensive mobilization of the stomach and duodenum to allow for an end-to-end anastomosis between the stomach and duodenum, restoring normal continuity of the gastrointestinal tract. The stomach is divided and sutured closed, then sutured to the duodenum in layers to create the gastroduodenal connection. Postoperative care focuses on gradual advancement of diet and monitoring for gastric retention to support healing and prevent complications.
Gastrostomy is commonly used as a temporary procedure to avoid discomfort from prolonged nasogastric suction after major abdominal surgery. It can also be used permanently when the esophagus is obstructed to nonresectable cancer. The Stamm gastrostomy is most common temporary procedure where a catheter is placed through the stomach wall and anchored to prevent leakage. The Janeway gastrostomy is a permanent alternative where a flap of stomach is brought through the abdominal wall and lined with mucosa to form a permanent opening, preventing regurgitation. Postoperative care involves gradual advancement to oral intake as the stomach and bowel recover function.
Gastrojejunostomy is a surgical procedure that connects the stomach directly to the jejunum. It is indicated for patients with duodenal ulcers complicated by pyloric obstruction or nonresectable stomach or pancreatic cancers causing obstruction. The procedure involves opening the stomach and jejunum, suturing them together to form a stoma, then closing in multiple layers. Postoperatively, gastric emptying is monitored and diet advanced gradually to ensure proper healing.
This document provides guidance on treating a perforated ulcer or subphrenic abscess. It describes:
1) Preparing patients preoperatively by administering IV fluids/antibiotics and gastric suction.
2) Closing perforations by suturing the ulcer and reinforcing it with omentum, or sealing it if too indurated.
3) Draining subphrenic abscesses extraperitoneally by making incisions below the costal margin or through the 12th rib bed and inserting drains into the abscess cavity.
A C S0103 Perioperative Considerations For Anesthesiamedbookonline
This document discusses perioperative considerations for anesthesia. It notes advancements in modern surgical care and alterations in anesthetic management to maximize patient benefit. A preoperative evaluation is important to assess medical history and current medications. Certain medications may need to be adjusted or discontinued before surgery, such as MAOIs, oral anticoagulants, and some herbal supplements, to reduce risks of adverse reactions or bleeding complications during the procedure. The risks and options for anesthesia should be discussed with the patient.
A C S0105 Postoperative Management Of The Hospitalized Patientmedbookonline
This document discusses postoperative management of surgical patients. It describes the different levels of postoperative care including same-day surgery, the surgical floor, telemetry ward, and intensive care unit. Factors determining a patient's disposition include their preoperative health, procedure performed, and postoperative clinical status. The document also discusses common postoperative orders related to tubes, drains, oxygen therapy, and wound care to guide nursing staff.
Postoperative pain is a complex experience involving sensory, emotional, and mental components. Effective pain management is important for patient comfort and recovery. Guidelines for postoperative pain treatment have been developed for specific procedures. Multimodal analgesic regimens targeting multiple pathways are recommended over reliance on opioids alone to prevent tolerance and hyperalgesia. Nonpharmacological complementary therapies can be combined with drug treatments to enhance pain control.
The document discusses the approach to a patient experiencing ongoing bleeding. It outlines the following key steps:
1. First consider the possibility of a technical cause like an unligated vessel and examine for injuries.
2. If no technical cause is found, check the patient's temperature and perform laboratory tests. Hypothermia can cause coagulopathy.
3. Evaluate test results along with the patient's history for clues to underlying causes like platelet dysfunction, coagulation factor deficiencies, or inherited bleeding disorders. Treat the specific condition while continuing evaluation.
A C S0812 Brain Failure And Brain Deathmedbookonline
This document discusses brain failure and brain death. It defines different levels of impaired consciousness from cloudy consciousness to coma. It describes how brain failure results from cardiac arrest and the challenges of restarting the brain after lack of oxygen. It outlines the criteria for diagnosing brain death, including absence of brain stem reflexes and apnea testing. It also discusses the evolution of determining death as technology has allowed life support to prolong vital signs indefinitely.
This document summarizes key points about surgical treatment of early rectal cancer and care of elderly surgical patients. It discusses that radical resection for early rectal cancer achieves excellent local control but has risks, while local excision may be preferable but has a higher local recurrence rate. Adjuvant therapy after local excision may help address this. It also notes that the elderly population is growing and physiologic changes with aging, like cardiac function decline, must be considered in surgical planning and risk assessment for elderly patients. Functional status is more important than age alone.
This document provides information on parotidectomy surgery and the Fundamentals of Laparoscopic Surgery (FLS) program.
It describes the technique for parotidectomy surgery, including identifying and dissecting around the facial nerve. It notes that most parotid tumors are benign and complications are usually temporary facial nerve paralysis.
It then discusses the development of the FLS program to standardize laparoscopic surgery training. The program includes cognitive training and manual skills assessment. Many residency programs and hospitals now require surgeons to complete the FLS. A large grant will help make the program more accessible to residency programs.
This document summarizes an article about volunteer surgeons providing care to wounded soldiers in Iraq and Afghanistan. It discusses the senior visiting surgeon program established by the American College of Surgeons that allows surgeons to volunteer their time. The volunteer rotation described involved caring for patients at Landstuhl Regional Medical Center in Germany as part of the complex medical evacuation process bringing wounded soldiers from war zones to the United States for further treatment and recovery.
1. The document discusses various sources of data for benchmarking surgical outcomes, including public reporting programs, public use administrative databases, and clinical registries. It notes limitations of using administrative data including problems with accuracy, completeness, and clinical precision of coding.
2. Clinical registries like the National Surgical Quality Improvement Program (NSQIP) and the Society of Thoracic Surgeons database are described as better sources of benchmarking data as they provide risk-adjusted outcomes while protecting individual hospital and surgeon confidentiality.
3. Limitations of all surgical benchmarking sources include small sample sizes, lack of generalizability between databases, and lack of external auditing to ensure accuracy and completeness of submitted data.
This document discusses organ procurement from cadaveric donors. It describes the coordination between donor and recipient activities, including matching organs to recipients based on factors like blood type, medical urgency, and waiting time. The evaluation of donor organs is outlined for different organs. Careful donor management aims to optimize organs while respecting donor dignity.
Hand-assisted laparoscopic surgery (HALS) is a hybrid technique that provides many of the advantages of traditional open surgery and laparoscopic colectomy. HALS employs a special access device that allows the surgeon to place a hand in the abdomen to assist with retraction, dissection, and visualization while maintaining pneumoperitoneum and laparoscopic instrumentation through trocars. Studies have shown HALS results in shorter operative times and lower conversion rates to open surgery compared to traditional laparoscopic colectomy while preserving similar short-term clinical outcomes. HALS may help expand the use of minimally invasive approaches for complex colectomies by providing an easier transition from open surgery than traditional laparoscopic techniques.
The document summarizes the evolution of trauma surgery training and practice in the United States. It discusses how trauma surgery originated in large city hospitals but has since expanded to regional trauma centers. It also notes changes in surgical training away from generalist models towards increased specialization. Trauma surgery is increasingly encompassing broader emergency general surgery duties due to workforce shortages, while training programs emphasize specialized rather than broad skills.