American Board of Internal Medicine (ABIM) Certification Practice Exam

Which mechanical intervention can be used to reduce hormone production from liver metastasis?

1. Deep brain stimulation

2. Hepatic arterial embolization

3. Chemotherapy alone

4. Radiation therapy

The correct answer is: Hepatic arterial embolization

Hepatic arterial embolization is a targeted treatment approach for liver metastases that can effectively reduce hormone production. This procedure involves selectively blocking the blood supply to the tumor located in the liver by injecting substances into the hepatic artery. By depriving the tumor of its blood supply, this intervention not only helps shrink the tumor but also reduces the production of hormones that may be secreted by the tumor cells. In the case of liver metastases, particularly those arising from several solid tumors, the tumors can produce various hormones or hormone-like substances that contribute to paraneoplastic syndromes. By utilizing hepatic arterial embolization, one can achieve localized control of the tumor growth, thereby mitigating the disruptive hormonal effects. Other interventions listed, such as deep brain stimulation, are not directly related to addressing tumor-induced hormone production. Chemotherapy can treat cancer systemically but does not specifically target hormone suppression from liver metastases and may not reduce hormone levels effectively. Radiation therapy can also be employed to target tumors in the liver, although it primarily serves to reduce tumor size rather than specifically targeting hormone production pathways.