Devita, Hellman, and Rosenberg's Cancer

LWBK1006-25 LWW-Govindan-Review December 12, 2011 19:21

Chapter 25•Cancer of the Endocrine System 353

Question 25.16. The most commonly used chemotherapeutic agent(s) in metastatic thyroid

carcinoma is (are):

A. Methotrexate

B. Cisplatin

C. 5-Fluorouracil

D. Doxorubicin (Adriamycin)

Question 25.17. Parathyroid carcinoma is suspected in a 48-year-old man. He pre-

sented with symptoms of hypercalcemia and was treated with standard

approach. Parathyroid hormone (PTH) level is markedly elevated; cal-

cium level is 16 mg/dL on presentation. PTH sestamibi scan showed an

intense uptake in the left superior parathyroid gland. CT of the neck

showed a 3-cm mass corresponding to the PTH scan findings. What is

the most appropriate management?

A. Total or subtotal parathyroidectomy

B. Single gland resection followed by external beam irradiation to the

neck

C. External beam irradiation alone

D. Radioactive iodine ablation

Question 25.18. Which of the following can be used to treat malignant hypercalcemia

related to metastatic parathyroid carcinoma?

A. Cinacalcet (Sensipar)

B. Mithramycin

C. IV hydration

D. IV bisphosphonates

E. All of the above

Question 25.19. Which of the following genetic defects is most likely associated with

parathyroid carcinoma?

A. Mutations of the HRPT2 gene (1q25-31)

B. Allelic loss in several chromosomes

C. RET proto-oncogene mutation

D. All of the above

Question 25.20. Which of the following is a TRUE statement regarding parathyroid car-

cinoma?

A. If a neck mass is palpated, parathyroid carcinoma should be sus-

pected.

B. Reported overall 5-year survival rate is approximately 30%.

C. TNM staging corresponds to prognosis.