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A 56-year-old patient presents with a 1-year history of worsening lower back pain and the development of pain radiating down the left leg over the past 2 months. The patient finds it difficult to sleep due to the pain but denies any weakness. The examination reveals normal motor strength and sensory function of lower extremities. Figures A is the patient's MRI. The surgeon determines that an L5 en bloc corpectomy is the most appropriate treatment for this patient. This treatment plan would be most appropraite for which of the following histologic specimens (Figures B-E) obtained on biopsy:
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A 58-year-old male is referred to your clinic for a sacral mass found on a lumbar spine MRI. He brought a pathology report from a biopsy that was performed at an outside hospital that states “primary malignant bone tumor of notochordal remnant cells.” Staging work-up showed no distant disease. Which of the following describes the best treatment strategy for this patient?
Neo-adjuvant chemotherapy, surgical excision, maintenance chemotherapy
Wide surgical excision
Tumor debulking, chemotherapy
Observation with serial imaging
A 47-year-old man presents with 6 months of progressive back pain, especially while sitting in his recliner at home. He's also noted some recent bowel incontinence. Diagnostic tests are performed and shown in Figures A and B. All of the following are true with respect to this diagnosis EXCEPT?
The primitive pathological cells are similar to those that derive the nucleus pulposis
Metastatic disease is common at the time of presentation
MRI studies are in most cases sufficient for diagnosis without the need for formal biopsy
The primary location of these lesions generally does not lead to lower extremity motor deficits
Treatment consists of surgical resection with or without radiation
A 55-year-old man complaining of increasing problems with constipation undergoes a biopsy of a mass after a digital rectal exams reveals a fullness. The radiograph and micrograph of the biopsy specimen are shown in Figures A and B, respectively. Immunohistochemistry is positive for keratin and S-100. Following wide surgical resection, oncologic surveillance is necessary due to the high rate of which of the following?
Regional lymph node metastasis