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A 63-year-old male has been referred to the dermatologist for evaluation of a concerning skin lesion (pictured in Figure A). The man first noticed the lesion years ago, but believes it has changed in the last 2 months. He notes it is changing color and has become itchy. He is very concerned because his mother was diagnosed with basal cell carcinoma in her 60s. As the dermatologist, which of the following factors is most important for prognosis of this lesion?
Depth of invasion of the lesion
Number of dysplastic cells within the lesion
Patient's family history
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A 52-year-old Caucasian male presents to your office with an 8 mm dark lesion on his back. The lesion, as seen below, has irregular borders and marked internal color variation. Upon excisional biopsy, the presence of which of the following would best estimate the risk of metastasis in this patient’s lesion:
Vertical tumor growth
Increased production of melanosomes
A 61-year-old Caucasian male presents to your office complaining of morning headaches of 6 weeks duration. A head MRI reveals a likely metastasis of unknown origin in the supratentorial region of the brain. On biopsy, the neoplastic mass is shown to have a mutation in BRAF, a protein kinase, in which a glutamic acid is substituted for valine at position 600 of the protein. Where did this metastasis most likely originate?