Oncosurgery

Papillary Thyroid carcinoma

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Q) A 30-year-old female is diagnosed with papillary thyroid carcinoma (PTC) following a fine-needle aspiration biopsy. Ultrasound shows a 1.8 cm solid nodule in the left thyroid lobe, and the ultrasound reveals no evidence of cervical lymphadenopathy. The patient's medical history is unremarkable, and she has no family history of thyroid cancer. According to the NCCN guidelines, which of the following management strategies is MOST appropriate for this patient?

A. Total thyroidectomy, as the tumor size exceeds 1 cm and there is a risk of contralateral disease.

B. Lobectomy with careful monitoring, as there is no extrathyroidal extension or lymph node involvement, and the tumor size is less than 2 cm.

C. Active surveillance with regular follow-up and ultrasound monitoring, given the tumor size and absence of aggressive features.

D. Lobectomy followed by radioactive iodine ablation to reduce the risk of recurrence.

 

Bone tumors

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Q) A 16 year old boy presents with severe groin pain after kicking a football. Imaging confirms a pelvic fracture. A previous pelvic x-ray performed 2 weeks ago shows a lytic lesion with 'onion type' periosteal reaction. What is the lesion?

a) Giant cell tumor

b) Ewing's 

c) Osteosarcoma

d) Osteomalacia

Question  from theme of test 14 

 

Pancoast tumor

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Q) 50 year old male with NSCL carcinoma of upper Rt lung which infiltrates the brachial plexus. WHat will be the managament? 

Lung and Thorax MCQS

a) Surgical resection

b) CCRT and resection

c) CCRT and access for response

d) Neoadjuvant and resection

Giant cell tumor femur

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Q) A 22-year-old woman presents with a giant cell tumor (GCT) of the distal
femur. Appropriate treatment would be: ( theme from test 13 on 31/3/24) 

A. Curettage and debridement.
B. Amputation.
C. Radiation.
D. Preoperative chemotherapy, resection, and adjuvant chemotherapy.

Staging in Adenocarcinoma lung

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Q) Patient with 2cm lung nodule , biopsy proven adenocarcinoma. CT shows hilar lymph node 1.5cm and left pleural effusion. Pleural fluid cytology is positive for malignant cells. What is the stage?

a. T1N1M0
b. T1N2M1
c. T4N1M0
d. T1N1M1

 

Hereditary pancreatic cancers

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Hereditary pancreatic cancers questions is asked many times in NEET SS and GI and onco Surgery CET 

Please understand the difference between x% lifetime risk of pancreatic cancer and x fold increase in risk as compared to normal population

  1. PRSS & SPINK 1 - Familial pancreatitis 40% lifetime increase . 50 fold increase as compared to Normal
  2. STK 11 - Peutz Jeghers - 100 fold increase in Pancreatic cancer . Also associated with lung, ovarian, breast, uterine, and testicular cancers
  3.  CFTR - cystic fibrosis - 30 fold increase
  4. Familial atypical mole and multiple melanoma syndrome (CDKN2A gene mutation). CDKN2A - 20 fold increase
  5.  BRCA 2 - 10 fold increase
  6. Lynch Syndrome  ( MLH) ( MSH) - 8 fold increase
  7. FAP APC gene - 4 fold

Adenoid Cystic carcinoma of Parotid

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Q) 52 year old male undergoes excision of mucoepidermoid carcinoma of parotid. Resection margins are positive?

Next step

a) Re resection

b) Radiotherapy

c) Wait and watch - slow growing tumor

d) Chemotherapy

All questions on head and neck onco are here 

 

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