LWBK1006-21 LWW-Govindan-Review December 12, 2011 19:6
Chapter 21•Genitourinary Cancer 281Question 21.7. Which of the following statements about the VHL gene is INCORRECT?
A. It is mutated or altered in>60% of spontaneous clear cell carcinomas
of the kidney.
B. It is critical for the normal oxygen sensing and response system in all
cells.
C. It is part of a ubiquitin ligase complex.
D. Expression is regulated by vascular endothelial growth factor.Question 21.8. Inactivation or alteration in which of the following tumor suppressor
genes is implicated in the pathogenesis of invasive bladder cancer?
A. TP53
B. RB1
C. PTEN
D. All of the aboveQuestion 21.9. The patient is taken to the operating room, where an examination under
general anesthesia reveals a mobile bladder. Resection of the papillary
lesion reveals grade III urothelial papillary carcinoma, and multiple biop-
sies of the erythematous areas of the bladder all reveal diffuse carcinoma
in situ. Muscle is present in the pathologic specimens, and there is no
evidence for invasive tumor. The appropriate therapy is:
A. Intravesical Bacillus Calmette–Guerin (BCG) vaccine ́
B. Intravesical cyclophosphamide
C. Radiation
D. CystectomyQuestion 21.10. The patient receives definitive treatment, as well as with a follow-up main-
tenance program; however, 4 months after initiating the maintenance
BCG program, the urologist notes multiple recurrent papillary lesions.
Repeat biopsy reveals urothelial cancer invasive into muscle. CT scans of
the chest, abdomen, and pelvis are unremarkable, creatinine remains nor-
mal at 1.2 mg/dL, and his performance status is excellent. Appropriate
therapy at this point is:
A. Reinduction with intravesical BCG
B. Intravesical chemotherapy with mitomycin-C
C. Partial cystectomy
D. Cisplatin-based multiagent chemotherapyQuestion 21.11. Which of the following is the most common molecular abnormality seen
in patients with prostate cancer?
A. KRAS mutation
B. BRAF mutation
C. p53 mutation
D. Chromosomal translocations involving TMPRSS2