malignant tumors of the skin

8/7/2019 Malignant Tumors of the Skin

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Skiny 3 layers

y Epidermis

y Basement membraney dermis



Etiologic Factorsy Ultraviolet radiation

y Fair complexion

y Chemical carcinogensy Hx of radiation therapy for skin lesions

y Chronic irritation

y Immunosuppression



Basal Cell Carcinomay Most common

y several subtypes:

y nodular, micronodular,y superficial spreading,

y infiltrative,

y Pigmented

y morpheaform



Types1. Nodulocystic or noduloulcerative BCC a waxy,

cream-colored lesion with rolled, pearly borders



2. Pigmented BCC tan to black in color

3. Superficial BCC occur more commonly on thetrunk and form a red, scaling lesion



4. Morpheaform BCC waxy white sclerotic plaqueswith a conspicuous absence of a rolled edge



Superficial BCC

Infiltrating BCC



Treatment Optionsy Curettage and Electrodessication

y Excision



Squamous Cell Carcinoma



Squamous Cell Carcinomay A rise from keratinocytes of the epidermis

y More aggressive and less common then BCC

y Tumor thickness and location correlates well with itsbiologic behavior.



Primary Tumor (T)

TX Primary tumor cannot be assessed

T0 No evidence of primary tumor

Tis Carcinoma in situ

T1 Tumor �2 cm in greatest dimension

T2 Tumor >2 cm, but not >5 cm, in greatest dimension

T3 Tumor >5 cm in greatest dimension

T4 Tumor invades deep extradermal structures (i.e., cartilage, skeletal

muscle, or bone)

Regional Lymph Nodes (N)

NX Regional lymph nodes cannot be assessed

N0 No regional lymph node metastasis

N1 Regional lymph node metastasis

Distant Metastasis (M)

MX Distant metastasis cannot be assessed

M0 No distant metastasis

M1 Distant metastasis

American Joint Committee on Cancer System for Classification and Staging of Carcinomas of the Skin



Stage Grouping

Stage 0 Tis N0 M0

Stage I T1 N0 M0

Stage II T2 N0 M0

T3 N0 M0

Stage III T4 N0 M0

Any T N1 M0

Stage IV Any T Any N M1



FACTOR LOW RISK HIGH RISK

Location

r n an e tre ities < �

Forehea an nec <1 �1

Central part of the face <6 �6

Bor ers Well efine Poorly efine

Inci ence Pri ary Rec rrent

I nos ppression Negative Positive

Previo s ra iation therapy/chronic

infla ation

Negative Positive

Rapi growth rate Negative Positive

Ne rologic sy pto s Negative Positive

Differentiation Well Mo erate or poorly

Perine ral/vasc lar invasion Negative Positive

Nonmelanoma Skin Cancer: Risk Factors for Local Recurrence Based on Characteristics of the

Primary Tumor

Modified from National Comprehensive Cancer Network Practice Guidelines in Oncology



Treatmenty Mohs' Surgery

y curettage and electrodesiccation

y

excision



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malignant tumors of the skin

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