American Board of Internal Medicine (ABIM) Certification Practice Exam

Which tumor types can be treated urgently with radiation therapy for metastatic spinal cord compression?

1. Breast and lung cancer

2. Leukemia, lymphoma, myeloma, germ cell tumors

3. Prostate cancer and melanoma

4. All types of tumors

The correct answer is: Leukemia, lymphoma, myeloma, germ cell tumors

The urgency in treating metastatic spinal cord compression is particularly associated with hematologic malignancies like leukemia and lymphoma, as well as multiple myeloma and germ cell tumors. These conditions can progress rapidly, leading to decreased neurological function and necessitating immediate intervention to alleviate pressure on the spinal cord. Radiation therapy is a well-established treatment for these malignancies, as it can quickly reduce the size of tumors compressing the spinal cord. In contrast, while tumors from breast and lung cancer may also cause similar symptoms, they often have different patterns of spread and may not require the same urgent approach in all cases. Similarly, prostate cancer and melanoma can cause spinal cord compression, but these malignancies generally present less frequently with acute emergencies compared to the tumor types identified in the correct response. Thus, the need for prompt and effective treatment through radiation therapy aligns closely with the urgency presented by hematologic cancers and germ cell tumors.