Chapter 083. Cancer of the Skin (Part 10)

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Other Nonmelanoma Cutaneous Malignancies Neoplasms of cutaneous adnexa and sarcomas of fibrous, mesenchymal, fatty, and vascular tissues make up 1–2% of NMSC (Table 83-6). Some can portend a poor prognosis such as Merkel cell carcinoma, which is a neural crestderived, highly aggressive malignancy that exhibits a metastatic rate of 75% and a 5-year survival rate of 30–40%. Others, such as the human herpes virus 8-induced, HIV-related Kaposi's sarcoma, exhibit a more indolent course. The marked decrease in incidence of this tumor parallels the institution of the highly active antiretroviral therapy. Table 83-6 Other Nonmelanoma Cutaneous Malignancies Tumor Type Most Common Location Recurrenc e Rate,a...

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Chapter 083. Cancer of the Skin (Part 10) Other Nonmelanoma Cutaneous Malignancies Neoplasms of cutaneous adnexa and sarcomas of fibrous, mesenchymal, fatty, and vascular tissues make up 1–2% of NMSC (Table 83-6). Some can portend a poor prognosis such as Merkel cell carcinoma, which is a neural crest- derived, highly aggressive malignancy that exhibits a metastatic rate of 75% and a 5-year survival rate of 30–40%. Others, such as the human herpes virus 8-induced, HIV-related Kaposi's sarcoma, exhibit a more indolent course. The marked decrease in incidence of this tumor parallels the institution of the highly active antiretroviral therapy. Table 83-6 Other Nonmelanoma Cutaneous Malignancies
Tumor Type Most Recurrenc Metastati Common e Rate,a % c Rate, % Location Atypical Head and 21 4 fibroxanthoma neck Merkel cell Head and 40 75 carcinoma neck Dermatofibrosarcom Trunk 50 1 a protuberans Sebaceous Eyelid 12 30 carcinoma Microcystic adnexal Face 50 1 case carcinoma Porocarcinoma Extremit 20 10
y Eccrine carcinoma Head and 36 11 neck Angiosarcoma Head and 75 75 neck a Recurrence rates are the highest reported and were established prior to widespread use of Mohs micrographic surgery. Acknowledgment Katarina G. Chiller, MD, and Howard K. Koh, MD, contributed to this chapter in the 16th edition and material from that chapter is included here Further Readings American Cancer Society: Website at www.cancer.org Balch CM et al: Prognostic factors analysis of 17,600 melanoma patients: Validation of the American Joint Committee on Cancer melanoma staging system.
J Clin Oncol 19:3622, 2001 [PMID: 11504744] Balch CM et al: Final version of the AJCC staging system for cutaneous melanoma. J Clin Oncol 19:3635, 2001 [PMID: 11504745] Drake LA et al: Guidelines of care of basal cell carcinoma. J Am Acad Dermatol 26:117, 1992 [PMID: 1732317] ——— et al: Guidelines of care for cutaneous squamous cell carcinoma. J Am Acad Dermatol 28:628, 1993 Geisse JK et al: Imiquimod 5% cream for the treatment of superficial basal cell carcinoma: A double-blind, randomized, vehicle-controlled study. J Am Acad Dermatol 47:390, 2002 [PMID: 12196749] Johnson TM et al: Staging workup, sentinel node biopsy, and follow-up tests for melanoma: Update of current concepts, Arch Dermatol 140:107, 2004 [PMID: 14732667] Morton DL et al: Sentinel-node biopsy on nodal observation in melanoma. N Engl J Med 355:1307, 2006 [PMID: 17005948]
Petrella T et al: Single agent interleukin-2 in the treatment of metastatic melanoma: A systematic review. Cancer Treat Rev 2007 [epub ahead of print] [PMID: 17562357] Rigel DS et al: ABCDE: An evolving concept in the early diagnosis of melanoma. Arch Dermatol 141:1032, 2005 [PMID: 16103334] Tsao H et al: Management of cutaneous melanoma. N Engl J Med 351:998, 2004 [PMID: 15342808] Bibliography Albert L et al: Dysplastic melanocytic nevi and cutaneous melanoma: Markers of increased melanoma risk for affected individuals and blood relatives. J Am Acad Dermatol 7:69, 1990 Armstrong BK: Epidemiology of malignant melanoma: Intermittent or total accumulated exposure to the sun. J Dermatol Surg Oncol 14:835, 1988 [PMID: 3397443] Atkins MB et al: High-dose recombinant interleukin 2 therapy for patients
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Langley RGB et al: Neoplasms: Cutaneous melanoma, in Dermatology in General Medicine, 6th ed, IM Freedberg et al (eds). New York, McGraw Hill 2003, pp 917–947 Lippman SM et al: l3-cis-retinoic acid and interferon-a2a: Effective combination therapy for advanced squamous cell carcinoma of the skin. J Natl Cancer Inst 84:235, 1992 [PMID: 1734084] Marks R: An overview of skin cancers. Incidence and causation. Cancer 75(Suppl):607, 1995 Preston DS et al: Nonmelanoma cancer of the skin. N Engl J Med 327:1649, 1992 [PMID: 1435901] Rhodes AR: Neoplasms: Benign neoplasias, hyperplasias, and dysplasias of melanocytes, in Dermatology in General Medicine, 4th ed, TB Fitzpatrick et al (eds). New York, McGraw-Hill, 1993, pp 996–1097 Rhodes AR et al: Risk factors for cutaneous melanoma. JAMA 258:3146, 1987 [PMID: 3312689]
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