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Review Question - QID 6354

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QID 6354 (Type "6354" in App Search)
A 12-year-old girl has had increasing left knee pain for the past 3 months. A radiograph is shown in Figure 75a, and low- and high-power photomicrographs are shown in Figures 75b and 75c. What is the most appropriate treatment?
  • A
  • B
  • C

Chemotherapy alone

1%

4/291

Surgery alone

10%

28/291

Radiation therapy alone

1%

4/291

Chemotherapy and surgery

76%

221/291

Radiation therapy and surgery

11%

32/291

  • A
  • B
  • C

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The radiograph reveals an aggressive purely lytic lesion of the distal femoral metaphysis. There is no apparent matrix mineralization or periosteal reaction. The photomicrographs show a malignant spindle cell neoplasm in a storiform pattern. Based on these findings, the diagnosis is malignant fibrous histiocytoma of bone. At most institutions, patients with this tumor are treated similar to patients with osteosarcoma with multi-agent chemotherapy and surgery with wide margins (resection or amputation).

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