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Review Question - QID 6280

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QID 6280 (Type "6280" in App Search)
A 12-year-old girl has had pain in her right knee for 1 month that started as activity-related and progressed to night pain. Radiographs are shown in Figures 16a and 16b, and a biopsy specimen is shown in Figure 16c. What is the recommended treatment?
  • A
  • B
  • C

Resection of the distal femur and postoperative chemotherapy

8%

23/296

Preoperative chemotherapy followed by radiation therapy, then resection of the distal femur

3%

8/296

Preoperative chemotherapy followed by surgical resection of the lesion and postoperative chemotherapy

79%

233/296

Preoperative chemotherapy followed by radiation therapy, resection of the distal femur, then postoperative chemotherapy

8%

24/296

Resection of the distal femur followed by radiation therapy

2%

7/296

  • A
  • B
  • C

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This is a classic appearance for an osteosarcoma. The radiographs reveal a mixed osteolytic and osteoblastic lesion in a skeletally immature patient in the distal right femoral metaphysis. The pain pattern with progressive symptoms leading to the presence of night pain is also typical for this condition. The biopsy specimen reveals pleomorphic cells and the presence of osteoid. The current standard of care in the treatment of osteosarcoma is neoadjuvant chemotherapy followed by surgical resection or amputation followed by additional postoperative chemotherapy. Osteosarcoma is not radiosensitive.

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