LWBK1006-29 LWW-Govindan-Review December 9, 2011 15:36
Chapter 29•Cancers of Childhood 399Question 29.31. The potential side effects of therapy for this patient include all of the
following, EXCEPT:
A. Second cancers
B. Orbital hypoplasia
C. Cataract formation in the contralateral eye
D. Recurrent diseaseQuestion 29.32. Which of the following inherited cancer syndromes is/are associated with
increased risk of developing RMS?
A. Li-Fraumeni syndrome
B. Beckwith-Wiedemann syndrome
C. Costello syndrome
D. All of the aboveQuestion 29.33. Survival is excellent (>70%) with current therapy in all of the following
groups of patients, EXCEPT:
A. Embryonal extremity Group III tumors
B. Group III orbital tumors
C. Embryonal Group III nonorbital tumors
D. Embryonal tumors in children between 1 and 10 years of ageQuestion 29.34. Staging studies for RMS should include all of the following, EXCEPT:
A. CT or MRI of the primary site
B. MIBG scan
C. Bone scan and bilateral bone marrow sampling
D. Lymph node samplingQuestion 29.35. A 6-year-old boy presents with a soft tissue mass involving the right cheek,
noticed by his mother to cause facial asymmetry and proptosis, worsening
over 3 to 4 weeks. He has no other systemic symptoms. Physical exami-
nation reveals a large, hard, right, lower orbital mass. An upper cervical
lymph node is also palpable on the right side of his neck, measuring 2
cm in diameter. CT scan of the face and neck confirms the presence of a
large tumor involving the right orbit and maxillary sinus. An incisional
biopsy confirms the presence of embryonal RMS, and the lymph node is
positive for tumor. Which of the following would NOT be appropriate
therapy for this child?
A. Gross total resection of tumor with facial reconstruction at initial
diagnosis
B. Chemotherapy: vincristine, dactinomycin, and cyclophosphamide
C. Radiation therapy to the site of tumor and lymph node metastasis
D. Second-look surgery to assess chemotherapy responsiveness to
chemotherapy