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Surgical Management of Bone Tumors - Podiatric Medicine and Surgery

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

Geographic Motheaten permeative Margins

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

Indicates a distinct separation between tumor and normal bone

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

To confirm pathology if malignancy is suspected

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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