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Review Question - QID 3187

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QID 3187 (Type "3187" in App Search)
A 60-year-old female complains of progressive right hip pain. A pelvis radiograph is shown in Figure A and a biopsy specimen is shown in Figure B. What is the most appropriate treatment?
  • A
  • B

Neoadjuvant radiation followed by surgical resection

6%

224/3700

Neoadjuvant chemotherapy followed by surgery followed by adjuvant chemotherapy

13%

470/3700

Wide surgical resection

75%

2757/3700

Chemotherapy followed by radiation therapy

4%

144/3700

Radiation therapy

2%

89/3700

  • A
  • B

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The history, radiographs, and biopsy specimen are consistent with the diagnosis of a chondrosarcoma. The oblique pelvis view shows a periacetabular lytic lesion with cortical destruction and reactive thickening of the surrounding cortex. The biopsy specimen shows enlarged chondrocytes with plump multinucleated lacunae and hyperchromic nuclear pleomorphism. Chondrosarcoma is primarily treated with wide surgical resection. There is a very limited role for chemotherapy or radiation.

Donati et al reviewed 124 patients with pelvic chondrosarcoma and found that the most significant prognostic factor for distant metastases was the histologic grade of the tumor. They report that limb-sparing resection or hemipelvectomy are acceptable techniques of resection and that central, high-grade tumors need aggressive surgical treatment in order to achieve adequate surgical margins.

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