USMLE Forum Archives - USMLE Step 2 CK - Large skin cancer!!!
Large skin cancer!!!
laparotomy - 01-14-08 05:21
A 95 year old lady presents with a 2cm skin lesion on her right cheek. She is booked for an elective removal of the lesion but does not show up. 2 years later she presents to your emergency department with a large skin cancerous lesion covering almost the entire right side of the face (not affecting the eyes). What is your next step in management?
a. Analgesia only because she is too old and the lesion is too advanced for an operation
b. Excision and healing by secondary intention
c. Excision and skin flap
d. Excision and skin graft.
e. Radiation therapy
f. Chemotherapy
g. Other (please specify)
laparotomy - 01-14-08 05:21
A 95 year old lady presents with a 2cm skin lesion on her right cheek. She is booked for an elective removal of the lesion but does not show up. 2 years later she presents to your emergency department with a large skin cancerous lesion covering almost the entire right side of the face (not affecting the eyes). What is your next step in management?
a. Analgesia only because she is too old and the lesion is too advanced for an operation
b. Excision and healing by secondary intention
c. Excision and skin flap
d. Excision and skin graft.
e. Radiation therapy
f. Chemotherapy
g. Other (please specify)
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#1
Re: Large skin cancer!!! radhamesramos - 01-14-08 10:27 d. These cancers should always be excised. And the defect beign filled with a graft
#2
Re: Large skin cancer!!! 8401glacieres - 01-14-08 12:28 E----Radiation theraphy
Considering her presentation woth ulceration and wide disease, she is more likely having SCC. Her age is main limiting factor for surgical theraphy also achiving correct excision of the lesion would not be possible.Therefore I personally feel that she should be given radiation theraphy, however this itself may predispose her to another skin cancer.
Other details about lymphnode status are not mentioned. Just by looking at the lesion Rx can't be discussed with patient.
#6
Re: Large skin cancer!!! babbu5508 - 07-07-10 21:36 d. Excision and skin graft...it looks like a basal cell carcinoma based on the age...but looks advanced...wide excision can be done
#7
Re: Large skin cancer!!! bingousmle - 07-12-10 05:29 basal cell carcinomas are the ones that are locally invasive but do not metastasize and respond well .. surgery and skin flap
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