7/27/2019 43.Spesen Tumor

1/71

SPECIAL SENSE TUMOR

7/27/2019 43.Spesen Tumor

2/71

Ear tumor

Cholesteatoma

Chondrosarcoma

Basal cell carcinoma Squamous cell carcinoma

Ceruminous carcinoma

Adenoid cystic carcinoma

7/27/2019 43.Spesen Tumor

3/71

Cholesteatoma

7/27/2019 43.Spesen Tumor

4/71

Ceruminous carcinoma

7/27/2019 43.Spesen Tumor

5/71

7/27/2019 43.Spesen Tumor

6/71

NASAL TUMORS

Polyps---really NOT a tumor

Angiofibroma

Papilloma

Plasmacytoma

Neuroblastoma

Nasopharyngeal Carcinoma

7/27/2019 43.Spesen Tumor

7/71

INFLAMMATORY POLYPS OF NASAL CAVITY

7/27/2019 43.Spesen Tumor

8/71

7/27/2019 43.Spesen Tumor

9/71

NECROTIZING Upper Airway Lesions

WEGENER Granulomatosis

Lethal Midline Granuloma

7/27/2019 43.Spesen Tumor

10/71

PAPILLOMA INVERTED PAPILLOMA

7/27/2019 43.Spesen Tumor

11/71

ANGIOFIBROMA

7/27/2019 43.Spesen Tumor

12/71

PLASMACYTOMA

7/27/2019 43.Spesen Tumor

13/71

NEUROBLASTOMA (OLFACTORY)

ESTHESIONEUROBLASTOMA

ROSETTE

7/27/2019 43.Spesen Tumor

14/71

NASOPHARYNGEAL CARCINOMA

7/27/2019 43.Spesen Tumor

15/71

NEVI Junctional (more pigmented, more

closely associated with melanoma)

Intradermal Compound (both)

7/27/2019 43.Spesen Tumor

16/71

7/27/2019 43.Spesen Tumor

17/71

7/27/2019 43.Spesen Tumor

18/71

7/27/2019 43.Spesen Tumor

19/71

7/27/2019 43.Spesen Tumor

20/71

MALIGNANT MELANOMA Incidence rising

Related to SUN like ALL skin cancers are

The only primary skin cancer that can kill you(except for the RARE Merkel cell tumor)

QUICKLY METASTASIZES Has both VERTICAL and HORIZONTAL growth phase

but prognosis is 100% related to the VERTICAL,

(BRESLOW staging, TNM) DIFFICULT to differentiate from NEVUS clinically

and often microscopically

7/27/2019 43.Spesen Tumor

21/71

7/27/2019 43.Spesen Tumor

22/71

7/27/2019 43.Spesen Tumor

23/71

7/27/2019 43.Spesen Tumor

24/71

BENIGN Epidermal Tumors

Seborrheic Keratosis

Acanthosis Nigricans

Fibroepithelial Polyp (skin tag)

Epidermal (inclusion) Cyst

Adnexal tumors : Eccrine, Apocrine

Keratoacanthoma

7/27/2019 43.Spesen Tumor

25/71

7/27/2019 43.Spesen Tumor

26/71

7/27/2019 43.Spesen Tumor

27/71

7/27/2019 43.Spesen Tumor

28/71

7/27/2019 43.Spesen Tumor

29/71

7/27/2019 43.Spesen Tumor

30/71

7/27/2019 43.Spesen Tumor

31/71

7/27/2019 43.Spesen Tumor

32/71

7/27/2019 43.Spesen Tumor

33/71

7/27/2019 43.Spesen Tumor

34/71

ADNEXAL TUMORS

HAIR FOLLICLES

SEBACEOUS GLANDS

SWEAT GLANDS

ECCRINEAPOCRINE

7/27/2019 43.Spesen Tumor

35/71

7/27/2019 43.Spesen Tumor

36/71

7/27/2019 43.Spesen Tumor

37/71

7/27/2019 43.Spesen Tumor

38/71

PREMALIGNANT/MALIGNANT

ACTINIC (Solar) KERATOSIS, i.e. precursor to SCC SQUAMOUS CELL CARCINOMA, squamous

pearls, intercellular bridges

BASAL CELL CARCINOMA, by far, MOST

COMMON, BLUE palisading nests

MERKEL CELL CARCINOMA (TUMOR), VERYMALIGNANT AND LETHAL, LOOK LIKE SMALL CELL

CA. OF LUNG

7/27/2019 43.Spesen Tumor

39/71

GENERAL COMMENTS

BOTH SCC and BCC related to SUN (i.e., radiation)

exposure. (as is MM also)

SCC also related to As, carcinogens, chaw, betel

nut, HPV, familial, etc.

BOTH SCC and BCC can do local damage but very

rarely metastasize or kill.

MERKEL CELL tumors metastasize early and

extensively, like melanomas.

7/27/2019 43.Spesen Tumor

40/71

7/27/2019 43.Spesen Tumor

41/71

7/27/2019 43.Spesen Tumor

42/71

7/27/2019 43.Spesen Tumor

43/71

7/27/2019 43.Spesen Tumor

44/71

7/27/2019 43.Spesen Tumor

45/71

7/27/2019 43.Spesen Tumor

46/71

7/27/2019 43.Spesen Tumor

47/71

7/27/2019 43.Spesen Tumor

48/71

DERMIS TUMORS DERMATOFIBROMA (BENIGN FIBROUS

HISTIOCYTOMA)

DERMATOFIBROSARCOMA PROTUBERANS

(DFP)

MALIGNANT FIBROUS HISTIOCYTOMA (MFH)

XANTHOMA

VASCULAR TUMORS of various types

7/27/2019 43.Spesen Tumor

49/71

7/27/2019 43.Spesen Tumor

50/71

7/27/2019 43.Spesen Tumor

51/71

7/27/2019 43.Spesen Tumor

52/71

7/27/2019 43.Spesen Tumor

53/71

7/27/2019 43.Spesen Tumor

54/71

7/27/2019 43.Spesen Tumor

55/71

7/27/2019 43.Spesen Tumor

56/71

7/27/2019 43.Spesen Tumor

57/71

C ll l I i t

7/27/2019 43.Spesen Tumor

58/71

Cellular Immigrants

Langerhans cells (Histiocytosis)

Mycosis Fungoides (T-Cell

cutaneous lymphoma)

Mastocytosis (mast cell tumors)

7/27/2019 43.Spesen Tumor

59/71

7/27/2019 43.Spesen Tumor

60/71

7/27/2019 43.Spesen Tumor

61/71

Orbit - Tumors

Wide variety of lacrimal, lymphoid, neural,

vascular, meningeal origin tumors, and

metastatic tumors

Children

rhabdomyosarcoma is the most common primary

malignancy of orbit.

neuroblastoma is most common metastatic tumor

7/27/2019 43.Spesen Tumor

62/71

7/27/2019 43.Spesen Tumor

63/71

LIDS - Tumors

Malignant

Basal cell carcinoma - mostcommon

Squamous

Melanoma

Sebaceous cell carcinoma

Benign

Chalazion vs. Hordeolum Papillomas/Verrucae

Epidermal inclusion cysts

Pleomorphic adenoma

7/27/2019 43.Spesen Tumor

64/71

Basal cell carcinoma

7/27/2019 43.Spesen Tumor

65/71

LIDS - Tumors

Chalazion a cyst of the meibomian gland

Hordeolum an inflammedcyst of the MG

(foreign body granuloma)

7/27/2019 43.Spesen Tumor

66/71

Conjunctiva - tumors

Conjunctival intraepithelial neoplasia (CIN)

Squamous Cell

Melanoma

Lymphoid - arising from mucosa-associated

lymphoid tissue (MALT)

Lymphoma

Conjunctiva

7/27/2019 43.Spesen Tumor

67/71

Conjunctiva

CIN (squamous cell), HPV 16/18

7/27/2019 43.Spesen Tumor

68/71

The Uvea - Tumors

The Choroid is a highly perfused vascular

net feeding the outer retina

It is apotential target site for metastasis for

carcinoma, such as breast and lung.

The Uvea - Tumors

7/27/2019 43.Spesen Tumor

69/71

The Uvea Tumors

The uvea (especially choroid) is also richly pigmented, and

primary melanocytic tumors are common. Nevi and malignant melanomas are both relatively

common, and can be difficult to distinguish, clinically.

Tumors with spindle-B or epithelioid histologic patterns

are malignant

7/27/2019 43.Spesen Tumor

70/71

The Retina - Tumors

Retinoblastoma

Classic pediatric tumor of retina

Hereditary or Sporadic

Requires two gene mutations (Knudsens

two-hit hypothesis)

Classic histologic features of Flexner-

Wintersteiner Rosettes, and fleurettes

7/27/2019 43.Spesen Tumor

71/71