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 (C)</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 (B)</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 (C)</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 (A)</p> Signup and view all the answers

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

<p>Chondrosarcoma (B)</p> Signup and view all the answers

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

<p>Immature ossification (A)</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 (C)</p> Signup and view all the answers

Which biopsy technique involves removing the entire lesion for analysis?

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

What type of lesions are classified as malignant stage 1?

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

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

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

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

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

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

<p>Marginal excision (A)</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 (C)</p> Signup and view all the answers

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

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

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

<p>Remain within one fascial compartment (B)</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 (A)</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 (D)</p> Signup and view all the answers

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

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

What is the histological characteristic of malignant stage 2 lesions?

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

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

<p>Phenol polymethacrylate (C)</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 (B)</p> Signup and view all the answers

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

<p>Wide resection (B)</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 (A)</p> Signup and view all the answers

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

<p>55% (D)</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 (C)</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 (D)</p> Signup and view all the answers

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

<p>BKA (B)</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 (D)</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 (C)</p> Signup and view all the answers

How are 'Periosteal Reactions' significant in bone lesions?

<p>They indicate increased activity of the bone lesion (C)</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 (A)</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 (B)</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 (A)</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 (B)</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 (B)</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 (A)</p> Signup and view all the answers

What does a Periosteal Reaction indicate in bone lesions?

<p>High suspicion for malignancy (D)</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 (B)</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 (B)</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 (C)</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 (B)</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 (C)</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 (A)</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 (B)</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 (A)</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 (C)</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 (C)</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 (D)</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 (A)</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% (D)</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 (B)</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 (D)</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 (B)</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 (B)</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 (A)</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 (C)</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 (B)</p> Signup and view all the answers

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