06-02-2010, 12:17 PM
A 71-year-old West Texas farmer of Irish ancestry has a nonhealing,
indolent, punched out, clean-looking 2-cm ulcer over the left temple. The
ulcer has been slowly growing over the past 3 years. There are no enlarged lymph nodes in the head and neck. Which of the following would best
dictate proper management?
A. Full thickness biopsy of the center of the lesion
B. Full thickness biopsy of the edge of the lesion
C. Pathologic studies after the entire lesion is resected with a margin
of 1 cm of normal skin all around
D. Response to a trial of radiation therapy
E. Scrapings and culture of the ulcer base
indolent, punched out, clean-looking 2-cm ulcer over the left temple. The
ulcer has been slowly growing over the past 3 years. There are no enlarged lymph nodes in the head and neck. Which of the following would best
dictate proper management?
A. Full thickness biopsy of the center of the lesion
B. Full thickness biopsy of the edge of the lesion
C. Pathologic studies after the entire lesion is resected with a margin
of 1 cm of normal skin all around
D. Response to a trial of radiation therapy
E. Scrapings and culture of the ulcer base