A FIT 49 YEAR OLD WOMAN WITH A PAST HISTORY OF RENAL CELL CARCINOMA PRESENTS WITH BACK PAIN AND IS FOUND TO HAVE A SOLITARY LYTIC METASTASIS IN THE SECOND LUMBAR VERTEBRA

A FIT 49 YEAR OLD WOMAN WITH A PAST HISTORY OF RENAL CELL CARCINOMA PRESENTS WITH BACK PAIN AND IS FOUND TO HAVE A SOLITARY LYTIC METASTASIS IN THE SECOND LUMBAR VERTEBRA

A fit 49 year old woman with a past history of renal cell carcinoma presents with back pain and is found to have a solitary lytic metastasis in the second lumbar vertebra (L2).
a) What are the local treatment options for treating this woman’s bone lesion?
(1 mark)
b) What factors need to be taken into account when making your recommendation as to how to
treat her bone disease?
(4 marks)
c) What are the advantages and disadvantages of a stereotactic approach to delivery of
radiation therapy in this setting?
(3 marks)
d) Describe the mechanism of action for one class of molecular-targeted agents used in renal
cell carcinoma and name two (2) drugs in this class.
(2 marks)
Clinical Oncology February 2013 Page 4 of 4
Question 5
A 70 year old man with a history of occupational asbestos exposure presents with a large right pleural
effusion. Pleural fluid cytology shows malignant cells.
a) How would you further evaluate this patient to confirm a diagnosis of mesothelioma?
(2 marks)
A diagnosis of mesothelioma is confirmed.
b) Describe the factors which influence management options in this man.
(2 marks)
c) What are the management options for mesothelioma confined to the right hemithorax?
Discuss the advantages and disadvantages of each option.
(5 marks)
d) What are the medicolegal implications of establishing a diagnosis of mesothelioma?
(1 mark)

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