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Surgery Miscellaneous (Neoplasia) 65e30b2a

A 48 -year-old woman presents with new onset of seizures and behavioral changes that started approximately 6 months ago. Advanced imaging reveals multiple round metastatic lesions in her brain. Her past medical history is remarkable for a black lesion on her toe she had excised 20 years prior. A thorough workup and multiple additional imaging studies reveal no primary malignancy. A lesion on the arm is noted and shown. Which of the most likely characterizes this type of malignancy?

A
Originates from cells in the stratum basalis
B
Negative staining for I IMB45
C
Prognosis typically determined by amount of horizontal spread
D
Signet ring cells are commonly seen on histology
High-Yield Explanation
Ans. (a) Originates from cells in the stratum basalis.This patient is most likely suffering from metastatic malignant melanoma. Her description of a black lesion on her toe that was removed many years prior suggests a long latency between metastasis, which is not usually seen with other tumors. Malignant melanoma may often metastasize to areas that other tumors do not typically metastasize to. Malignant melanoma originates from melanocytes in the stratum basalis layer of the epidermis.Image source- style="text-decoration: underline; color: rgba(17, 85, 204, 1); font-family: Times New Roman, Times, serif">t/images/dis107.jpg

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