Devita, Hellman, and Rosenberg's Cancer

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

354 DeVita, Hellman, and Rosenberg’s CANCER: Principles and Practice of Oncology Review

Question 25.21. A 36-year-old man presents to his primary physician reporting reduced

libido for the past 9 months. He also reports periodic epigastric pain

associated with occasional heartburn. His medical history includes two

episodes of kidney stones in the past 10 years. Family history includes kid-

ney stone formation in his father. Physical examination results are unre-

markable. Laboratory evaluation showed prolactin level of 180 ng/mL,

testosterone level of 90 ng/dL, serum calcium of 10.9, and PTH level of

110 pg/mL. Magnetic resonance imaging of the brain revealed a 1.5-cm

mass in the sella without evidence of damage of the surrounding struc-

tures. CT scan of the abdomen did not reveal any abnormality. What is

the appropriate management of this patient?

A. Subtotal parathyroidectomy

B. Dopamine agonists (bromocriptine) with subtotal parathyroidec-

tomy

C. Transsphenoidal pituitary resection with subtotal parathyroidec-

tomy

Question 25.22. All of the following are considered to be part of MEN1, EXCEPT:

A. Pituitary adenoma

B. Carcinoids

C. MTC

D. Benign adrenal tumors

Question 25.23. The following are considered to be part of MEN2A syndrome,

EXCEPT:

A. MTC

B. Pheochromocytoma

C. Parathyroid adenoma

D. Diffuse neuronal hypertrophy

Question 25.24. What is the best approach to individuals with kindreds with MEN2A who

are interested in screening and prevention?

A. Screen for RET mutation

B. Periodic imaging

C. Periodic laboratory tests

D. Clinical surveillance

Question 25.25. What is the genetic defect that is likely to be associated with MEN1?

A. RET proto-oncogene

B. MENIN gene

C. APC gene

D. HRPT2 gene