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Dermatofibrosarcoma protuberans (DFSP) is an uncommon, low-grade sarcoma of fibroblast origin with an incidence rate of 0.8 cases per million persons per year. It rarely metastasizes. However, initial misdiagnosis, prolonged time to correct diagnosis, and large tumor size at the time of diagnosis are common. NCCN's Non-Melanoma Skin Cancer panel has developed a guideline outlining treatment of DFSP to supplement the squamous cell and basal cell skin cancers guidelines. The NCCN Sarcoma Panel also provided expert input in the development of this DFSP guideline.

For the most recent version of the guidelines, please visit NCCN.org

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Kelly G. Paulson and Shailender Bhatia

toxicity. 65 Conclusions MCC is a highly immunogenic, virus-associated skin cancer with a rapidly increasing incidence and clinical impact. Immunotherapy with PD-1 axis blockade leads to quick-onset, durable responses in metastatic MCC, and thus

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Merkel cell carcinoma (MCC) is an aggressive cutaneous tumor that combines the local recurrence rates of infiltrative non-melanoma skin cancer along with the regional and distant metastatic rates of thick melanoma. MCC has a mortality rate that exceeds that of melanoma. MCC is a rare tumor; therefore, no prospective, statistically significant data are available to verify the validity of any prognostic features or treatment outcomes. The panel relied on trends that are documented in smaller, individual studies and meta-analyses as well as their own collective experiences in developing these guidelines.

For the most recent version of the guidelines, please visit NCCN.org

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Douglas B. Johnson and Jeffrey A. Sosman

Melanoma is an aggressive skin cancer with historically limited treatment options. Approximately 50% of melanomas harbor BRAFV600 mutations. This report describes a 32-year-old man with metastatic BRAFV600-mutant melanoma who presented with cardiac involvement. Recently developed treatment options for patients with BRAF-mutant melanoma include BRAF inhibitors (vemurafenib, dabrafenib), MEK inhibitors (trametinib), and immune-based therapeutics (interleukin-2 or ipilimumab), but the most effective strategy for first-line therapy is heavily debated. Opinions vary for treatment selection, but the general consensus recommends immune-based therapies initially for asymptomatic patients with low-volume disease, and BRAF inhibitors for those with highly symptomatic or rapidly progressing disease. In this case, melanoma with cardiac involvement, although clinically uncommon, presents challenging management decisions.

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MD 05 2007 5 5 5 5 497 497 504 504 0050497 10.6004/jnccn.2007.0044 Basal Cell and Squamous Cell Skin Cancers Guidelines 05 2007 5 5 5 5 506 506 506 506 0050506 10.6004/jnccn.2007.0045 Photodynamic Therapy for Non-Melanoma Skin Cancer

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New Patient Resource From NCCN Clears Up Confusion Around Highly Common Type of Skin Cancer NCCN has published a new book of patient information that explains prevention, diagnosis and treatment for squamous cell skin cancer—the second-most common

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2 2 1 1 Basal Cell and Squamous Cell Skin Cancers Clinical Practice Guidelines in Oncology 1 2004 2 2 1 1 6 6 6 6 10.6004/jnccn.2004.0001 NMSC in Organ Transplant Recipients and Other High-Risk Groups Pennington Brent E. MD Stasko Thomas

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.0061 Basal Cell and Squamous Cell Skin Cancers Miller Stanley J. MD Alam Murad MD Andersen James MD Berg Daniel MD Bichakjian Christopher K. MD Bowen Glen MD Cheney Richard T. MD Glass L. Frank MD Grekin Roy

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Alan C. Geller, Sophie J. Balk and David E. Fisher

skin cancers. 1 , 5 , 6 Fueled by the proliferation of tanning salons in the United States, which now seem to outnumber Starbucks or McDonalds, and a very low per-use cost, nearly 40% of girls aged 16 and 17 years have used tanning beds in the past

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Allan C. Halpern and Sanjay K. Mandal

malignant melanoma by dermatologists of the American Academy of Dermatology. II. Definitive surgery for malignant melanoma . J Am Acad Dermatol 1995 ; 33 : 451 – 461 . 11. Armstrong BK Kricker A . The epidemiology of UV induced skin cancer