Chapter 083. Cancer of the Skin (Part 10)

Other Nonmelanoma Cutaneous MalignanciesNeoplasms 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 Kaposis 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 MalignanciesTumor TypeMost Common LocationRecurrenc e Rate,a...
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Chapter 083. Cancer of the Skin (Part 10) 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 canportend 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 a5-year survival rate of 30–40%. Others, such as the human herpes virus 8-induced,HIV-related Kaposis sarcoma, exhibit a more indolent course. The markeddecrease in incidence of this tumor parallels the institution of the highly activeantiretroviral therapy. Table 83-6 Other Nonmelanoma Cutaneous Malignancies Tumor Type Most Recurrenc Metastati Common e Rate,a % c Rate, % Location Atypical Head and 21 4fibroxanthoma neck Merkel cell Head and 40 75carcinoma neck Dermatofibrosarcom Trunk 50 1a protuberans Sebaceous Eyelid 12 30carcinoma Microcystic adnexal Face 50 1 casecarcinoma 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 towidespread use of Mohs micrographic surgery. Acknowledgment Katarina G. Chiller, MD, and Howard K. Koh, MD, contributed to thischapter 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 cutaneousmelanoma. J Clin Oncol 19:3635, 2001 [PMID: 11504745] Drake LA et al: Guidelines of care of basal cell carcinoma. J Am AcadDermatol 26:117, 1992 [PMID: 1732317] ——— et al: Guidelines of care for cutaneous squamous cell carcinoma. JAm Acad Dermatol 28:628, 1993 Geisse JK et al: Imiquimod 5% cream for the treatment of superficial basalcell carcinoma: A double-blind, randomized, vehicle-controlled study. J Am AcadDermatol 47:390, 2002 [PMID: 12196749] Johnson TM et al: Staging workup, sentinel node biopsy, and follow-uptests 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 metastaticmelanoma: 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 ofmelanoma. 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. JAm Acad Dermatol 7:69, 1990 Armstrong BK: Epidemiology of malignant melanoma: Intermittent or totalaccumulated exposure to the sun. J Dermatol Surg Oncol 14:835, 1988 [PMID:3397443] Atkins MB et al: High-dose recombinant interleukin 2 therapy for patientswith metastatic melanoma: Analysis of 270 patients treated between 1985 and1993. J Clin Oncol 17:2105, 1999 [PMID: 10561265] Balch CM et al (eds): Cutaneous Melanoma 4th ed. St. Louis, QualityMedical Publishing, 2003 Clark WH Jr et al: The histogenesis and biologic behavior of primaryhuman malignant melanoma of the skin. Cancer Res 29:705, 1969 [PMID:5773814] Friedman RI et al (eds): Cancer of the Skin. Philadelphia, Saunders, 1991 ——— et al: Malignant melanoma in the 1990s: The continued importanceof early detection and the role of physician examination and self-examination ofthe skin. CA Cancer J Clin 1:201, 1991 Kirkwood JM et al: High-dose interferon alfa 2b significantly prolongsrel ...