Chapter 8. Surgical Oncology
What organ is not prophylactically resected to prevent cancer in patients with specific genetic mutations?
In patients with familial adenomatous polyposis, the colon can be removed in order to prevent the development of colon cancer. Patients with an increased susceptibility to breast cancer, for example, women with the BRCA I or II mutation, can undergo prophylactic mastectomy. The thyroid is removed in patients with MEN II syndrome to prevent the development of medullary thyroid carcinoma.
Which of the following is not associated with gastric cancer?
C. Male preponderance world-wide
D. Associated with Menetrier disease
Virchow node, a palpable enlarged lymph node in the left supraclavicular fossa, is often associated with gastric cancer. It is one of the first places in which gastric cancer metastasizes. Krukenberg tumor is a metastatic lesion to the ovary often arising from a gastrointestinal source, gastric most commonly. Gastric cancer, world-wide, is more common in men than in women.
Which of the following is the most important prognostic factor in patients with soft tissue sarcoma?
C. Expression of tumor markers
Although tumor size, expression of tumor markers, and depth of tumor can be assessed in the prognosis of soft tissue sarcoma, the histologic grade of the tumor is the most important prognostic factor.
In which of the following cases should a sentinel lymph node biopsy be performed?
A. A 0.7-mm melanoma over the right tibia with a clinically negative right groin
B. A 1.0-mm melanoma overlying the left groin
C. A 1.5-mm melanoma of the right upper arm and clinically negative right axilla
D. A 1.7- to 5-mm melanoma of the left thigh with palpable adenopathy of the left groin
A melanoma less than 1.0 mm does not undergo a sentinel lymph node dissection. A melanoma overlying a draining lymph node basin should undergo lymph node dissection. The patient with palpable adenopathy should undergo lymph node dissection.