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43 Cards in this Set
- Front
- Back
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predominant type of collagen
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type 1
70% wt of dermis gives tensile strength |
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blood supply mechanism to skin graft for days 0-3
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imbibition then neovascularization
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MCC of flap necrosis
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venous thrombosis
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most 911 determinant of TRAM flap viability
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periumbilical perforators
rely on superior epigastrics |
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type 4 pressure ulcers
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need myocutaneous flaps (type 3 probably too)
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single best factor for protecting skin from UV radiation
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melanin
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responsible for chronic sun damage
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UV-B
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melanoma % of skin CA and %deaths
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3-5%, 65%
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RF for melanoma
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nevi (large, dysplastic, atypical)
familial BK mole syndrome xeroderma pigmentosum 10% familial |
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MC location of melanoma
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back in men
legs in women |
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most ominous
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blue color
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MC mets location of melanoma
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lungs
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management of <2 or >2 cm lesions
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excisional vs incisonal biopsy
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5 types of melanoma (most/least aggressive)
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lentigo maligna (radial growth first)
nodular (vertical, mets) need CXR, LFTs |
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Indications for SLNB in melanoma
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1mm deep
stage III tumors |
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anterior head and neck melanomas need what?
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superficial parotidectomy
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axillary node melanoma with no primary
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formal ALND
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margins needed in melanoma
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<1mm - 1cm
1-4mm - 2cm >4 - 2-3 cm |
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MC CA in US
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Basal cell CA (80% on head and neck)
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description/pathology/margins needed/most agg type of basal cell CA
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pearly
rolled borders peripheral palisading nuclei and stromal retraction no mets slow growth, ulcerative regional adenectomy for clinically + nodes morpheaform most agg - has collagenase 0.3-0.5cm margins |
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SCCa
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overlying erythema
papulonodular with crust/ulceration mets more freq then BCC occur in post XRT or old burn scars |
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MC soft tissue sarcoma
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#1 malignant fibrous histiosarcoma
#2 liposarcoma |
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Characteristics of sarcomas
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large
asymptomatic grow rapidly painless |
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excisional vs incisional biopsy
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<4 cm excisional
>4cm longitudinal incision biopsy (do not enucleate) |
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how do sarcomas spread
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hematogenous
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MCC site of mets
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lungs
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staging of sarcomas is based on?
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grade only
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Principles of resecting sarcomas
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3cm margins
1 uninvolved fascial plane limb sparing |
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indications for postop XRT
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high grade
close margins tumors>5cm |
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chemo for sarcomas
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doxorubicin
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preop chemoXRT?
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>10cm
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5YSR with complete resection?
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40%
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visceral/retroperitoneal sarcomas are usually what type
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liposarcomas and leiomyosarcomas
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RF for sarcoma?
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asbestos
PVC/arsenic XRT, pesticides chronic lymphedema |
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Kaposi's sarcoma treatment
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skin, GI tract
XRT or intralesional vinblastine systemic chemo for disseminated disease surgery for intestinal hemorrhage |
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#1 soft tissue sarcoma in kids
MC subtype? worst prognosis? |
childhood rhabdomyosarcoma
embryonal alveolar tx: surgery; doxorubicin based chemo |
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osteosarcoma
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increased around knee
from metaphyseal cells usually in children |
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actinic vs seborrheic keratosis
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former is premalignant
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Merkel cell CA
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neuroendocrine
neuron specific enolase red-purple papulonodule/indurated plaque |
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glomus cell tumor
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painful tumor (blood vessels, nerves)
benign MC in terminal aspect of digit tx: tumor excision |
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MC location of desmoid tumors
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anterior abdominal wall
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intraabdominal desmoids are associated with
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gardner's syndrome
retroperitoneal fibrosis |
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keratoacanthoma
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rapid growth
rolled edges keratin filled center always biopsy; excise if small |
