Benign

Question 1

Imaging features to distinguish desmoids from sarcoma

Answer 1

none

Question 2

Association of desmoids with which condition

Answer 2

FAP

Tend to occur in prior surgical sites intra-abdominally

Question 3

Courvoisier’s sign

Answer 3

palpable gallbladder with painless jaundice (pancreatic malignancy)

Question 4

Recommended BED for keloid

Answer 4

BED2 of at least 60 Gy (can be obtained with 4x5)

Question 5

Brooker class I heterotopic ossification

Answer 5

islands of bone within soft tissues

Question 6

Brooker class II heterotopic ossification

Answer 6

bone spurs from pelvis or proximal femur with >1cm between opposing surfaces

Question 7

Brooker class III heterotopic ossification

Answer 7

Bone spurs from pelvis or proximal femur reducing space between the opposing bone surfaces to <1 cm

Question 8

Brooker class IV heterotopic ossification

Answer 8

Bone ankylosis of the hip

Question 9

Ideal time for RT for heterotopic ossification

Answer 9

4 hours pre surgery to 72h post surgery

Question 10

Best strategy to reduce gynecomastia and breast pain on bicalutamide

Answer 10

Tamoxifen but RT also an acceptable option

Question 11

Dose of tamoxifen used for gynecomastia prevention

Answer 11

10 mg

Question 12

Doses of RT used for gynecomastia prevention

Answer 12

1. 12 Gy x 1
2. 10 Gy x 1
3. 4 Gy x 3

Question 13

Control rates of desmoid tumors with RT alone

Answer 13

80% (sig better than surgery alone)

Question 14

What drug can be used to prevent heterotopic ossification

Answer 14

indomethacin (25 mg TID x 5-6 weeks)

Question 15

Dose of RT used for heterotopic ossification

Answer 15

7-8 Gy x 1

Question 16

Ideal treatment for desmoid tumors

Answer 16

surgical resection

Question 17

Share of paragangliomas in head and neck which produce catecholamines

Answer 17

5% (similar to pheos - most common presentation is HTN)

Question 18

Glomus tumor

Answer 18

aka paraganglioma, benign, slow growing of the carotid artery, middle ear

Question 19

Outcomes of RT for glomus tumors

Answer 19

Good local control (90%)

Relatively modest reduction (30%)

Question 20

When should postop RT begin for keloid

Answer 20

24-48 hours post surgery

Question 21

Setup for gynecomastia prevention

Answer 21

En face electrons using 10 cm circular block around nipple. No bolus.

Question 22

Rule of thumb for 80% IDL for electrons

Answer 22

E/3

Question 23

Recommended RT dose for desmoids

Answer 23

50-56Gy

Question 24

Location for best outcomes in desmoids

Answer 24

abdominal wall

Question 25

Factors associated with greater risk of recurrence for desmoid

Answer 25

1. extremity location
2. young age
3. large tumor size

Question 26

RT dose for Grave’s ophthalmopathy

Answer 26

20 Gy in 10

Give in first year of symptoms

Question 27

Dose options for Kaposi sarcoma

Answer 27

1. 24/12
2. 6-8/1
3. 30/10-15

Question 28

SRS dose for paragangliomas

Answer 28

15 Gy

Question 29

Control rate of keloid after surgery + RT

Answer 29

70%

Question 30

1L for grave’s ophthalmopathy

Answer 30

steroids (pred 30 mg/day)

Question 31

Recurrence rate of keloids after surgery with no RT

Answer 31

50-80%

Question 32

Typical field size for heterotopic ossification

Answer 32

14 x 14 cm

Question 33

Fractionated dose for glomus tumors

Answer 33

45-54 Gy

Question 34

Imaging appearance of glomus tumors

Answer 34

“salt and pepper”- T2 with serpentine flow void pattern

Question 35

Classification for heterotopic ossification

Answer 35

Brooker classification

Question 36

Most common location for paragangliomas

Answer 36

Abdominal (75%) usually at confluence of left renal vein and vena cava or inferior mesenteric artery

Question 37

Type of biopsy which should be used for suspected desmoid

Answer 37

incisional biopsy or Core, not EXCISIONAL