Q1)) Most important prognostic marker in malignant melanoma?
a) Size
b) Thickness
c) Mitosis
d) Irregular margins
b) Thickness
Malignant melanoma spread in radial and vertical manner. As long as it is above the dermis, spread is contained. As soon as tumor cells breach the dermis, chances of lymphatic spread increase.
Breslow thickness index is more important for depth assessment
Bailey 26th - 596
Q2. What is not true about dermatofibroma Protuberans
a) It arises from the fibroblasts
b) Highly malignant
c) Characterstic is translocation of 17:22
d) Imatinab is useful'
ans is b
• Dermatofibrosarcoma protuberans is a low-grade sarcoma of fibroblast origin. It has low rates of metastases and recurrence and is characterized by a t(17:22) translocation Imatinib is used as it has over expression of PDGFR.
Q3) True about merkel cell carcinoma A) Radio resistant B) Adjuvant RT decreases local recurrence and improves survival c)RT used only for palliation d.RT is the main modality of treatment
Ans 3 b
It is radio sensitive
If the SLN is positive, adjuvant radiation to the nodal basin after CLND may decrease the rate of regional recurrence and improve overall survival.(sabiston page 750)
Adjuvant radiation therapy to the primary tumor site may be beneficial and should be considered in specific cases; it may be appropriate for low-risk patients with a small primary tumor (less than 1 cm) and no other adverse risk factors (such as immunosuppression or lymphovascular invasion).
