Order Spinal Oncology Assignment Solutions
Order Spinal Oncology Assignment Solutions
1. Which one of the following statements
regarding spinal tumors is most accurate?
a. The commonest extradural tumor is an
b. Intradural tumors in adults are predominantly intramedullary rather than
c. The commonest intramedullary tumor in
adults is ependymoma
d. Intramedullary metastases are more common than extradural metastases
e. The commonest intramedullary tumor in
children is ganglioglioma
2. Which one of the following groups of primary
malignancies represents the most frequent
causes of spinal column metastases?
a. Breast, lung, kidney, melanoma, and
b. Breast, lung, thyroid, melanoma, and
c. Breast, lung, kidney, prostate, and thyroid
d. Breast, lung, prostate, melanoma, and
e. Breast, prostate, lung, kidney, thyroid
3. Which one of the following clinical presentations is most concerning for spinal metastatic
a. A 47-year-old with breast cancer treated
with mastectomy and lymph node dissection, on tamoxifen, presentswithmoderate
lower back pain worse at the end of the
day, relieved by rest, not exacerbated by
b. A 54-year-old with previous Dukes B
colorectal cancer who underwent bowel
resection and end ileostomy, followed by
chemotherapy presents with gait disturbance. On examination he has a stocking
distribution of sensory loss in the lower
c. A 35-year-old with a past medical history
of wide local excision of melanoma
presents with mechanical back pain, stabbing in nature, which she is more aware of
at night. On examination there is nonspecific tenderness in the mid-thoracic
spine, but no focal neurological signs.
d. A 79-year-old with a past medical history of
benign prostatic hyperplasia presents with
mechanical back pain after a fall. On examination there is tenderness in the paraspinal
muscles, but no focal neurological signs.
e. A 57-year-old with a past medical history
of small cell lung cancer presents with
mechanical back pain. On examination
he appears kyphotic there is tenderness
in the mid-thoracic spine. Neurological
examination shows brisk reflexes and
extensor plantars in both lower limbs.
4. Which one of the following statements
regarding the imaging of spinal metastatic
disease is LEAST accurate?
a. Plain radiographs may only show changes
in approximately half of affected vertebrae
b. Nuclear scintigraphy detects areas of
increased metabolic activity in bone but
this is not specific to metastatic lesions.
c. SPECT can be used to differentiate
between malignant and benign lesions
d. PET scans can be used to identify the
e. Angiography is not likely to be of benefit
prior to resection of vertebral metastases
from renal cell carcinoma
5. Which one of the following statements
regarding prognostic scoring for patients
presenting with metastatic disease of the
spine is LEAST accurate?
a. Tokuhashi score considers Karnofsky
performance status, number of extraspinal metastases and neurological status
whereas the Tomita score does not
b. A lower Tomita score favors more aggressive surgical treatment
c. A higher Tokuhashi score predicts a
d. Both Tokuhashi and Tomita scores consider the treatability of visceral metastases
e. Tokuhashi score assesses neurological sta
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