Rotations 2.0 Episode 70 Basal Cell Carcinoma

Episode 70 Basal Cell Carcinoma

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 Intro Music: KI Instrumental (Rock Celtic) by Lyrium-2025

Outro Music: Rock Got That Heat This Action by Alex Grohl

Courtesy of Pixabay under Creative Commons non-commercial use.

Produced by: Todd Fredricks DO MSS 

Edited by: Todd Fredricks DO MSS

EADO Staging reference: https://www.ejcancer.com/article/S0959-8049%2823%2900356-8/fulltext

Answers for Episode 69 Melanoma 

Question 1: Pathology and Prognosis

A 56‑year‑old man presents with a changing pigmented lesion on his upper back. An excisional biopsy is performed. Pathology reveals a superficial spreading melanoma with a Breslow thickness of 0.7 mm, no ulceration, and no dermal mitoses. There is pagetoid spread of atypical melanocytes within the epidermis.

Which pathologic feature is considered the single most important prognostic factor and is used directly to determine the tumor (T) category in melanoma staging?

C. Breslow thickness

Question 2: Surgical Staging and Management

A 63‑year‑old woman is diagnosed with a cutaneous melanoma on her lower leg. Pathology shows a Breslow thickness of 1.4 mm with no clinical evidence of lymphadenopathy. Imaging studies are unremarkable.

Which of the following is the most appropriate next step in management for accurate pathological staging?

D. Sentinel lymph node biopsy

Question 3: Systemic Therapy and Emerging Treatments

A 48‑year‑old man with resected stage IIC melanoma is being evaluated for adjuvant therapy. His tumor is BRAF wild‑type. He has no contraindications to immunotherapy.

Based on recent clinical trial evidence discussed in the article, which class of medications has been shown to reduce recurrence risk in patients with high‑risk stage II melanoma?

D. PD‑1 immune checkpoint inhibitors

Anderson, Ronald, Nomzamo M. Mkhize, Mahlatse M. C. Kgokolo, Helen C. Steel, Theresa M. Rossouw, Lindsay Anderson, and Bernardo L. Rapoport. 2025. “Current and Emerging Insights into the Causes, Immunopathogenesis, and Treatment of Cutaneous Squamous Cell Carcinoma.” Cancers 17 (10): 1702. https://doi.org/10.3390/cancers17101702.  

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