Surgical Management of Bone Tumors - Podiatric Medicine and Surgery
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Questions and Answers

What are the Common characteristics that can help differentiate benign and malignant bone tumors?

  • Geographic Motheaten permeative Margins (correct)
  • Periosteal Reaction
  • Initial evaluation criteria
  • Conservative and surgical treatment options

    • In bone tumor cases, what is the significance of Wide margins in radiographs?

  • Indicates a distinct separation between tumor and normal bone (correct)
  • Shows an indistinct area with possible bone damage
  • Implies a measurable margin between tumor and normal bone
  • Denotes an area where tumor and normal bone touch closely

    • What is the purpose of a biopsy in bone tumor cases?

  • To determine the patient's age and lifestyle
  • To confirm pathology if malignancy is suspected (correct)
  • To evaluate the extent of the tumor
  • To decide on conservative vs. surgical treatment

    • How are Periosteal Reactions significant in bone lesions?

    <p>They indicate the biologic activity of the bone lesion</p> Signup and view all the answers

    What does a Permeative Margin on a radiograph indicate about a bone tumor?

    <p>The tumor has invaded adjacent structures</p> Signup and view all the answers

    When should a referral to an Oncologist be considered in the management of bone tumors?

    <p>If biopsy results suggest malignancy</p> Signup and view all the answers

    What is the radiographic appearance observed in bone tumors when growth is very rapid and the periosteum has no time to lay down bone?

    <p>Hair-on-end appearance</p> Signup and view all the answers

    What is the most common bone tumor found in the study mentioned?

    <p>Chondrosarcoma</p> Signup and view all the answers

    What is the histological characteristic of benign lesions in stage 2 and 3?

    <p>Immature ossification</p> Signup and view all the answers

    Which treatment modality is recommended for benign stage 1 & 2 lesions involving intralesional curretage followed by cancellous bone grafting?

    <p>Methyl methacrylate augmentation</p> Signup and view all the answers

    Which biopsy technique involves removing the entire lesion for analysis?

    <p>Excisional biopsy</p> Signup and view all the answers

    What type of lesions are classified as malignant stage 1?

    <p>Low grade lesions</p> Signup and view all the answers

    What type of biopsy is performed without forming tissue planes and emphasizes hemostasis?

    <p>Incisional biopsy</p> Signup and view all the answers

    In the study, how many patients had full weightbearing with unlimited activity post-treatment?

    <p>18/33</p> Signup and view all the answers

    What is the appropriate surgical approach for malignant stage 1 lesions?

    <p>Marginal excision</p> Signup and view all the answers

    Which term describes the ossification pattern in bone tumors where only the edges of the raised periosteum ossify, forming a small angle with the bone surface?

    <p>Codman's triangle</p> Signup and view all the answers

    What is the recommended incision placement for a bone tumor biopsy?

    <p>Longitudinal incision</p> Signup and view all the answers

    What should be done sharply during a bone tumor biopsy dissection?

    <p>Remain within one fascial compartment</p> Signup and view all the answers

    What is the recommended treatment for benign stage 2 and 3 lesions?

    <p>Wide marginal excision with partial or complete amputation</p> Signup and view all the answers

    Which of the following describes the radiographic appearance in bone tumors when growth is very rapid and periosteum fails to lay down bone?

    <p>Sun-burst appearance</p> Signup and view all the answers

    For malignant stage 1 lesions, what is the recommended surgical approach?

    <p>Wide marginal excision</p> Signup and view all the answers

    What is the histological characteristic of malignant stage 2 lesions?

    <p>High grade lesions</p> Signup and view all the answers

    Which adjunct treatment modality is NOT recommended for benign stage 1 and 2 lesions?

    <p>Phenol polymethacrylate</p> Signup and view all the answers

    In bone tumor cases, what type of lesions are classified as locally aggressive according to the staging system mentioned?

    <p>Stage 2 and 3 lesions</p> Signup and view all the answers

    What is the most common treatment for bone tumors mentioned in the text?

    <p>Wide resection</p> Signup and view all the answers

    Which type of biopsy involves removing a small piece of tissue from the tumor for analysis?

    <p>Fine needle biopsy</p> Signup and view all the answers

    What percentage of patients in the study had good to excellent functional results post-treatment?

    <p>55%</p> Signup and view all the answers

    What is the significance of a cortical window in bone tumor cases?

    <p>To access the tumor site</p> Signup and view all the answers

    Which type of biopsy is performed with the aim of removing the entire lesion for analysis?

    <p>Excisional biopsy</p> Signup and view all the answers

    What is the recommended surgical approach for malignant stage 1B and 2 lesions?

    <p>BKA</p> Signup and view all the answers

    What is the significance of 'Wide' margins in radiographs of bone tumors?

    <p>There is a clear area between the tumor and normal bone</p> Signup and view all the answers

    What does a 'Permeative Margin' on a radiograph indicate about a bone tumor?

    <p>There is no clear separation between tumor and normal bone</p> Signup and view all the answers

    How are 'Periosteal Reactions' significant in bone lesions?

    <p>They indicate increased activity of the bone lesion</p> Signup and view all the answers

    What is the purpose of a biopsy in bone tumor cases?

    <p>To confirm if the lesion is malignant or benign</p> Signup and view all the answers

    When evaluating 'Narrow' margins in radiographs of bone tumors, what does it indicate?

    <p>Complete separation between tumor and normal bone</p> Signup and view all the answers

    What should be done if pathology from a biopsy of a bone lesion suggests malignancy?

    <p>Evaluate for metastasis with a CT scan of lungs and bone scan</p> Signup and view all the answers

    What is the significance of Narrow margins in radiographs of bone tumors?

    <p>Show that tumor and surrounding normal bone are touching with a very small distance between them</p> Signup and view all the answers

    Which characteristic is associated with Permeative Margins on radiographs of bone tumors?

    <p>Irregular and indistinct borders of the tumor within the bone</p> Signup and view all the answers

    What is the significance of Poorly defined margins in radiographs of bone tumors?

    <p>Imprecise lesion boundaries with difficulty identifying the extent of the tumor</p> Signup and view all the answers

    What does a Periosteal Reaction indicate in bone lesions?

    <p>High suspicion for malignancy</p> Signup and view all the answers

    Which type of margin in radiographs indicates an area representing tumor with clear distinction from normal bone?

    <p>Narrow margin</p> Signup and view all the answers

    What is the purpose of incisional biopsy in bone tumor cases?

    <p>To remove a small piece of tissue from the tumor for examination</p> Signup and view all the answers

    What radiographic appearance is observed when the periosteum fails to lay down bone due to rapid growth in bone tumors?

    <p>Hair-on-end appearance</p> Signup and view all the answers

    What is the term used to describe the ossification pattern in bone tumors where only the edges of the raised periosteum ossify?

    <p>Codman’s triangle</p> Signup and view all the answers

    What is indicated by the presence of metastasis in malignant bone tumors according to the staging system mentioned?

    <p>Stage 2 lesions</p> Signup and view all the answers

    In bone tumor cases, what is the recommended surgical approach for malignant stage 1 lesions?

    <p>Partial amputation</p> Signup and view all the answers

    Which treatment modality is NOT recommended for benign stage 1 & 2 lesions following intralesional curettage and cancellous bone grafting?

    <p>Marginal excision</p> Signup and view all the answers

    Which adjunct treatment is recommended for benign stage 2 & 3 lesions besides intralesional curettage and cancellous bone grafting?

    <p>Methyl methacrylate augmentation</p> Signup and view all the answers

    What is the recommended biopsy technique for bone tumors as mentioned in the text?

    <p>Fine needle biopsy</p> Signup and view all the answers

    Which age group had the highest average in the study mentioned in the text?

    <p>21 to 30 years</p> Signup and view all the answers

    What kind of patients present with a chief complaint of right heel pain according to the cases mentioned?

    <p>Teenagers with ankle issues</p> Signup and view all the answers

    What was the most common type of bone tumors found in the foot and ankle study?

    <p>Aneurysmal bone cyst</p> Signup and view all the answers

    What percentage of patients in the foot and ankle tumor study had full weightbearing with unlimited activity post-treatment?

    <p>55%</p> Signup and view all the answers

    What was the average duration of follow-up for patients in the foot and ankle tumor study?

    <p>7.2 years</p> Signup and view all the answers

    What is the appropriate initial treatment for a 12-year-old male with an increase in level of activity?

    <p>Packing of the defect (tri-cortical graft) illiac crest</p> Signup and view all the answers

    What is the treatment recommended for a 37-year-old male with pain in the right hallux associated with ambulation?

    <p>Curretage of tumor and adjacent bone</p> Signup and view all the answers

    What is the pathology finding in a 14-year-old male with heel pain unresponsive to conservative treatment?

    <p>Aneurysmal bone cyst</p> Signup and view all the answers

    What is the diagnosis for a 27-year-old female presenting with stiffness and periodic pain in the ankle joint?

    <p>Intra-osseous ganglion</p> Signup and view all the answers

    What is the presentation in a 35-year-old female with a mass over the lateral right foot centered on the 5th metatarsophalangeal joint?

    <p>Chondroma</p> Signup and view all the answers

    What symptom does a 57-year-old female present with?

    <p>Recent onset of severe pain to the hallux</p> Signup and view all the answers

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