Primary Bone Tumors
A 16-year-old male presents with 3 months of progressive knee pain and swelling. He initially attributed it to sports but the pain has worsened and now awakens him at night. Examination reveals a firm, tender mass in the distal thigh with limited knee motion. X-rays show a destructive lesion in the distal femoral metaphysis with mixed lytic and sclerotic changes, periosteal reaction with Codman triangle, and soft tissue mass. MRI confirms intramedullary and extraosseous tumor extent. Staging CT chest shows no metastases. Biopsy confirms high-grade osteosarcoma. The oncology team discusses neoadjuvant chemotherapy and limb-salvage options. Regarding osteosarcoma:
Mark each as TRUE or FALSE
Osteosarcoma is the most common PRIMARY MALIGNANT bone tumor in children/adolescents (excluding myel...
X-RAY findings: MIXED lytic-sclerotic destructive lesion with MALIGNANT OSTEOID (cloudlike); periost...
Osteosarcoma is most common in elderly over 80; it primarily affects the DIAPHYSIS; it has a purely ...
Treatment is MULTIMODAL: NEOADJUVANT chemotherapy (MAP: methotrexate, doxorubicin/Adriamycin, cispla...
LIMB SALVAGE now standard (90% of cases) vs amputation; requires adequate surgical margins, expendab...
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