Question 25

Question:

A 60-year-old woman comes to a primary care physician for the first time in 30 years. She has experienced significant weight-loss recently and is thought to have developed cancer. Which of the following conditions is a precursor to cancer and could have been detected on routine clinical examination?

Correct Answer: A.  Actinic keratosis

Actinic keratosis is a premalignant condition to squamous cell carcinoma of exposed areas of skin. It results from progressive dysplastic changes that begin in the basal layer of the epidermis. The most important risk factor is chronic exposure to UV light. If removed early, SCC can safely be prevented. Fibrocystic breast changes are benign and occur in a cyclical pattern with menstruation. Uterine leiomyomas, also known as “fibroids”, may cause bleeding but are benign. Transitional cell carcinoma, or cancer of the bladder wall, is rare and not routinely screened for. Adrenal adenomas are also not routinely screened for, and are often discovered incidentally by CT for other reasons.