Devita, Hellman, and Rosenberg's Cancer

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

Chapter 29•Cancers of Childhood 401

Question 29.42. All of the following treatment approaches have decreased recurrence rates

in Ewing sarcoma, EXCEPT:

A. The addition of ifosfamide and etoposide in nonmetastatic patients

B. The addition of irradiation to both the primary tumor and whole

lung and/or bone in the case of metastatic disease

C. Preoperative chemotherapy followed by surgical resection

D. Myeloablative chemotherapy and stem cell rescue

Questions

29.43.–29.45.

A 12-month-old boy who had hemihypertrophy at birth presents with

abdominal distension and a right-sided abdominal mass. The mass is

confirmed to be arising from the right lobe of the liver by ultrasound of

the abdomen. No calcification is identified. The serum alpha-fetoprotein

(AFP) level is increased markedly.

Question 29.43. The most likely histologic diagnosis of this mass is:

A. Hepatoblastoma

B. Neuroblastoma

C. Hepatocellular carcinoma (HCC)

D. Choriocarcinoma

Question 29.44. Which of the following hereditary syndromes is associated with predis-

position for developing this tumor?

A. Beckwith-Wiedemann syndrome

B. Von Hippel-Lindau syndrome

C. Neurofibromatosis type 1

D. Peutz-Jeghers syndrome

Question 29.45. Staging workup for this patient should include the following, EXCEPT:

A. Liver and renal function tests

B. Chest radiograph or chest CT

C. MRI of the head

D. CT and/or MRI with magnetic resonance (MR) angiography of the

abdomen

Question 29.46. The most important treatment of hepatoblastoma is:

A. Adjuvant chemotherapy

B. Concomitant radiation

C. Cryoablation or radio frequency ablation of tumor

D. Complete resection of tumor and liver transplantation, if necessary