Devita, Hellman, and Rosenberg's Cancer

LWBK1006-19 LWW-Govindan-Review December 7, 2011 21:24

CHAPTER 19 NEOPLASMS OF

THE MEDIASTINUM

GREGORY P. KALEMKERIAN

DIRECTIONS Each of the numbered items below is followed by lettered answers. Select the

ONE lettered answer that is BEST in each case unless instructed otherwise.

QUESTIONS

Question 19.1. A 51-year-old woman presents with dull anterior chest pain. She is a

lifelong nonsmoker. Her medical history is significant for Hashimoto’s

thyroiditis, for which she has been taking levothyroxine for 1 year. Exam-

ination is unremarkable. Laboratory studies show normal blood counts,

lactate dehydrogenase (LDH),-fetoprotein, and beta-human chorionic

gonadotropin (-hCG). Chest radiograph reveals clear lung fields with

a retrosternal density. Computed tomography (CT) scan shows a 4-cm,

smooth, anterior mediastinal mass. What is the most likely diagnosis?

A. Small cell lung cancer

B. Pericardial cyst

C. Nonseminomatous germ cell tumor (NSGCT)

D. Thymoma

Question 19.2. A 5-year-old boy has been experiencing left upper back pain that radiates

around his left chest wall for 2 months. Examination reveals a healthy-

appearing boy with no spinal or chest wall deformity, tenderness or

masses. He is neurologically intact. A chest radiograph suggests a left

paravertebral mass adjacent to T5. A magnetic resonance imaging (MRI)

scan shows a 2-cm, smooth, fusiform mass abutting the left T5–6 neural

foramen without bony erosion. What is the most likely diagnosis?

A. Non-Hodgkin’s lymphoma

B. Neurogenic tumor

C. Thymoma

D. Mediastinal germ cell tumor

Corresponding Chapter inCancer: Principles & Practice of Oncology,Ninth Edition: 77 (Neoplasms of the Medi-

astinum).

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