Devita, Hellman, and Rosenberg's Cancer

LWBK1006-29 LWW-Govindan-Review December 9, 2011 15:36

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

Question 29.18. Therapeutic interventions targeted at known molecular abnormalities and

pathways are being tested using the following intervention strategies:

A. Agents blocking growth hormone IGF-1 pathways

B. Agents targeting mutant transcription factors

C. Agents targeting tyrosine kinase enzymes that transduce growth fac-

tor signals

D. All agents listed

Question 29.19. A 2-year-old girl is brought to the doctor after her mother feels a hard

lump near the umbilicus that is not painful. On physical examination,

she is noted to be a large child with hemihypertrophy. A large (6×6-cm)

hard mass is palpable in the left flank. The remainder of his examina-

tion is normal. Laboratory evaluation of blood counts, urinalysis, serum

electrolytes, and liver and renal function test results are normal. An ultra-

sound confirms the presence of a mass involving the superior pole of the

left kidney. Which of the following anatomic areas are unlikely to be

involved by this tumor?

A. Lung

B. Muscle

C. Lymph nodes

D. Renal vein

Question 29.20. Which of the tests listed below is necessary to correctly stage this tumor?

A. Head computed tomography (CT)

B. Bone scan

C. Plain chest radiograph

D. Skeletal survey

Question 29.21. The patient is taken to surgery. Which of the following is the ideal surgical

approach for accurate diagnosis and staging?

A. Start preoperative chemotherapy followed by resection at a later date

because of the size of mass.

B. Biopsy the mass and sample draining lymph nodes.

C. Resect the mass and renal vein if involved.

D. Resect the mass with renal vein if involved, explore the opposite

kidney, and sample draining lymph nodes.

Question 29.22. After surgical resection and staging, the tumor is confirmed to be consis-

tent with stage III favorable histology Wilms’ tumor. Treatment should

include which of the following:

A. Surgical resection only

B. Surgery and radiation therapy to kidney

C. Radiation and chemotherapy

D. Surgery, radiation, and chemotherapy