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64419 Surgery

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?

AOriginates from cells in the stratum basalis
BNegative staining for I IMB45
CPrognosis typically determined by amount of horizontal spread
DSignet ring cells are commonly seen on histology
Surgery
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