Practice Questions – Oncology SBA

1. A girl, aged 7 years, with no significant past medical history presented with breast enlargement and intermittent periumblical abdominal pain of 4 months duration that was accompanied with nausea but without vomiting. She had no headache or visual complaint. She also complaint of intermittent vaginal bleeding. When she was visited, her weight was 21 kg and her height was 120 cm. Breast enlargement and pubic hair were compatible with Tanner III. No abdominal mass was palpated in the abdomen. Ultrasonography of pelvis showed a 6.2 × 5 × 4.1 cm hypoechoic solid mass in projection of left adnexa which had multiple cystic structures up to 1.2 cm, and left ovary could not be separated from it. Her serum laboratory findings were consistent with peripheral precocious puberty: estradiol: 216 pmol/L. Under general anesthesia, laparotomy was done. An ovarian mass in the left side with diameters of 5 × 7 cm was detected and resected with left ovary. The right ovary was normal. No lymphadenopathy was detected in the pelvic area. The mass was sent for histopathologic study and ovarian was reported as below. What is diagnosis?

2. What is the prevalence of BRCA1 and BRCA2 mutation in woman with fallopian tube cancer and ovarian cancer respectively?

3. In the UK, HPV vaccination of girls started in September, 2008. ACIP recommends all girls and boys get vaccinated 11-12 years. Almost 90% of girls eligible for the vaccine received all three doses in recent studies. What is the predicted impact that HPV vaccination may have, based on the current high uptake?

4. A 27-year-old patient is found to have high-grade squamous dyskaryosis at routine cervical smear at 6 weeks’ gestation. Colposcopic biopsies show CIN-3. Repeat colposcopy done at the end second trimester shows early invasive disease. Cone biopsy done and the specimen has disease free margins. What would be the most appropriate plan of action?

5. A 67-year-old woman is diagnosed with vulval cancer after biopsy. The lesion is 2 cm and lateral. Wide local excision done for biopsy. Lesion on histopathology with sqauamous cell carcinoma with clear margins. The pathologist has phoned and informed you that the frozen section for the sentinel lymph node biopsies is positive.
How will you proceed with the surgery?