WBR0169: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
No edit summary
No edit summary
Line 1: Line 1:
{{WBRQuestion
{{WBRQuestion
|QuestionAuthor={{Rim}}, {{AJL}} {{Alison}}
|QuestionAuthor={{YD}}{{Alison}} (Reviewed by Serge Korjian)
|ExamType=USMLE Step 1
|MainCategory=Pathology
|SubCategory=Oncology
|SubCategory=Oncology
|MainCategory=Pathology
|MainCategory=Pathology
Line 6: Line 8:
|MainCategory=Pathology
|MainCategory=Pathology
|SubCategory=Oncology
|SubCategory=Oncology
|MainCategory=Pathology
|MainCategory=Pathology
|MainCategory=Pathology
|MainCategory=Pathology
|MainCategory=Pathology
Line 18: Line 21:
|MainCategory=Pathology
|MainCategory=Pathology
|SubCategory=Oncology
|SubCategory=Oncology
|Prompt=A 54-year-old woman presents to the physician's office with complaints of abdominal distention. Following appropriate work-up, the patient is found to have a metastatic bilateral ovarian tumor obstructing the lymphatic drainage, with subsequent ascites. Upon athological analysis of the ovarian tumor you observe signet ring cell adenocarcinoma consistent with the diagnosis. Which of the following is the most appropriate next step in management?
|Prompt=A 54-year-old woman presents to the physician's office with complaints of abdominal distention. Following appropriate work-up, the patient is found to have a bilateral metastatic ovarian tumor obstructing the lymphatic drainage, with subsequent ascites. Upon pathological analysis of the ovarian tumor you observe signet ring cell adenocarcinoma consistent with the diagnosis. Which of the following is the most appropriate next step in management?
|Explanation=The patient in this scenario is most likely diagnosed with a [[Krukenberg tumor]]. A [[Krukenberg tumor]] is characterized by the presence of an epithelial and stromal mass, with an epithelial component containing mucin-laden signet ring cells, which have hyperchromatic nuclei and eosinophilic granular cytoplasm. A [[Krukenberg tumor]] usually appears as bilateral with signs of lymphatic obstruction. [[Krukenberg tumors]] are often diagnosed in patients who are in their 50s. The most common primary site of malignancy is the stomach, warranting radiographic and endoscopic evaluation of the digestive system following diagnosis.
|Explanation=The patient in this scenario is most likely diagnosed with a [[Krukenberg tumor]]. A [[Krukenberg tumor]] is characterized by the presence of an epithelial and stromal mass, with an epithelial component containing mucin-laden signet ring cells, which have hyperchromatic nuclei and eosinophilic granular cytoplasm. A [[Krukenberg tumor]] usually appears as bilateral with signs of lymphatic obstruction. [[Krukenberg tumors]] are often diagnosed in patients who are in their 50s. The most common primary site of malignancy is the stomach, warranting radiographic and endoscopic evaluation of the digestive system following diagnosis.
|EducationalObjectives= The stomach is the most common primary site of [[Krukenberg tumor]]s. Work-up to rule out GI involvement is indicated upon diagnosis.
|References= Al-Agha OM, Nicastri AD. An in-depth look at krukenberg tumor - an overview. Arch Pathol Lab Med. 2006;130:1725-30
|AnswerA=Gastroscopy
|AnswerA=Gastroscopy
|AnswerAExp=Most [[Krukenberg tumors]] originate in the stomach, thus necessitating radiographic and endoscopic work-up of the digestive system.
|AnswerAExp=Most [[Krukenberg tumors]] originate in the stomach, thus necessitating radiographic and endoscopic work-up of the digestive system.
Line 34: Line 33:
|AnswerE=Bronchoscopy
|AnswerE=Bronchoscopy
|AnswerEExp=A bronchoscopy is not necessary upon diagnosis of a [[Krukenberg tumor]], which often originate in the stomach.
|AnswerEExp=A bronchoscopy is not necessary upon diagnosis of a [[Krukenberg tumor]], which often originate in the stomach.
|EducationalObjectives=The stomach is the most common primary site of [[Krukenberg tumor]]s. Work-up to rule out GI involvement is indicated upon diagnosis.
|References=Al-Agha OM, Nicastri AD. An in-depth look at krukenberg tumor - an overview. Arch Pathol Lab Med. 2006;130:1725-30
|RightAnswer=A
|RightAnswer=A
|WBRKeyword=krukenberg, tumor, ovarian, mass, malignant, malignancy, cancer, stomach, gastroscopy, work, up, endoscopy, management, next, step, ascites, abdominal, distention
|WBRKeyword=krukenberg, tumor, ovarian, mass, malignant, cancer, stomach, gastroscopy, endoscopy, management, abdominal
|Approved=Yes
|Approved=Yes
}}
}}

Revision as of 15:20, 29 August 2014
Author [[PageAuthor::Yazan Daaboul, M.D.(Reviewed by Alison Leibowitz) (Reviewed by Serge Korjian)]]
Exam Type ExamType::USMLE Step 1
Main Category MainCategory::Pathology
Sub Category SubCategory::Oncology
Prompt [[Prompt::A 54-year-old woman presents to the physician's office with complaints of abdominal distention. Following appropriate work-up, the patient is found to have a bilateral metastatic ovarian tumor obstructing the lymphatic drainage, with subsequent ascites. Upon pathological analysis of the ovarian tumor you observe signet ring cell adenocarcinoma consistent with the diagnosis. Which of the following is the most appropriate next step in management?]]
Answer A AnswerA::Gastroscopy
Answer A Explanation [[AnswerAExp::Most Krukenberg tumors originate in the stomach, thus necessitating radiographic and endoscopic work-up of the digestive system.]]
Answer B AnswerB::Observation with annual check-up
Answer B Explanation [[AnswerBExp::Evaluation of the primary site of malignancy is indicated in Krukenberg tumors, which often originate in the stomach.]]
Answer C AnswerC::Brain MRI
Answer C Explanation [[AnswerCExp::A brain MRI is not necessary upon diagnosis of a Krukenberg tumor if no clinical suspicion of brain involvement is found.]]
Answer D AnswerD::Lumbar puncture
Answer D Explanation [[AnswerDExp::Lumbar punctures usually are not necessary, because Krukenberg tumors often originate in the stomach.]]
Answer E AnswerE::Bronchoscopy
Answer E Explanation [[AnswerEExp::A bronchoscopy is not necessary upon diagnosis of a Krukenberg tumor, which often originate in the stomach.]]
Right Answer RightAnswer::A
Explanation [[Explanation::The patient in this scenario is most likely diagnosed with a Krukenberg tumor. A Krukenberg tumor is characterized by the presence of an epithelial and stromal mass, with an epithelial component containing mucin-laden signet ring cells, which have hyperchromatic nuclei and eosinophilic granular cytoplasm. A Krukenberg tumor usually appears as bilateral with signs of lymphatic obstruction. Krukenberg tumors are often diagnosed in patients who are in their 50s. The most common primary site of malignancy is the stomach, warranting radiographic and endoscopic evaluation of the digestive system following diagnosis.

Educational Objective: The stomach is the most common primary site of Krukenberg tumors. Work-up to rule out GI involvement is indicated upon diagnosis.
References: Al-Agha OM, Nicastri AD. An in-depth look at krukenberg tumor - an overview. Arch Pathol Lab Med. 2006;130:1725-30]]

Approved Approved::Yes
Keyword WBRKeyword::krukenberg, WBRKeyword::tumor, WBRKeyword::ovarian, WBRKeyword::mass, WBRKeyword::malignant, WBRKeyword::cancer, WBRKeyword::stomach, WBRKeyword::gastroscopy, WBRKeyword::endoscopy, WBRKeyword::management, WBRKeyword::abdominal
Linked Question Linked::
Order in Linked Questions LinkedOrder::
Retrieved from "https://www.wikidoc.org/index.php?title=WBR0169&oldid=1014713"