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A 10-year-old male presents with ongoing complaints of left thigh pain after falling during a soccer game. A clinical photo is seen in Figure A. He has tenderness and general warmth over the lateral aspect of his left thigh. His ESR is 82 and his WBC is 15. A radiograph and histology slide are shown in Figures B and C. What is the most likely translocation and fusion protein associated with this condition?
t (x:18), EWS-FL1
t (2:13), PAK3-FKHR
t (11: 22), EWS-FL1
t (11: 22), EWS-CHN
t (9: 22), EWS-CHN
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A 15-year-old cross country runner complains of vague shin pain. A radiograph of the tibia is seen in Figure A. A biopsy is performed and is shown in Figure B. Which of the following chromosomal translocations is most likely associated with this condition?
Each of the following neoplasms demonstrate round cells when examined histologically EXCEPT
Primitive neuroectodermal tumors (PNET)
For which of the following patients would a bone marrow biopsy be indicated during tumor staging?
15-year-old girl with bone forming distal femoral lesion on radiographs
7-year-old boy with lipomatous lesion in his proximal thigh
3-year-old boy with pituitary intracranial mass
5-year-old girl with lytic diaphyseal femur lesion positive for the EWS-FLI1 transgene
12-year-old boy with shepard's crook deformity of his proximal femur and deactivating mutation in the G-beta subunit of the G-protein coupled receptor.
An 8-year-old girl comes to the office with increasing thigh pain mostly at night. Radiograph and biopsy specimen are shown in Figures A and B. The patients WBC and ESR are both elevated. What is the most likely diagnosis?
Giant cell tumor
A 13-year old female complains of constant, dull right knee pain for the past several months. The pain is worse at night and with walking. She denies weight loss or fatigue. An AP and lateral radiograph are shown in Figures A and B, respectively. She was found to have a bony lesion in the distal femur which was biopsied at an outside institution which is shown in Figure C. What is the genetic translocation with this type of condition?
t (9; 22)
After tumor staging, what is the most appropriate treatment for a 17-year-old male with stage IIb Ewing's sarcoma in his proximal tibia?
Neoadjuvant radiotherapy, marginal surgical resection, adjuvant chemotherapy
Neoadjuvant chemotherapy, marginal surgical resection, adjuvant radiotherapy
Neoadjuvant chemotherapy, wide surgical resection, adjuvant chemotherapy
Wide surgical excision and reconstruction
Radiotherapy and chemotherapy without surgery
Which of the following tests is required for a standard work-up of Ewing's sarcoma that is not routinely obtained for staging of osteosarcoma?
Bone marrow biopsy
What is the appropriate treatment for a 10-year-old boy with Ewing's sarcoma isolated to the proximal femur?
Neoadjuvant chemotherapy and surgical excision
Neoadjuvant chemotherapy, surgical excision, and radiation therapy
Neoadjuvant chemotherapy, surgical excision, and adjuvant chemotherapy
Neoadjuvant radiation therapy and surgical excision
Surgical excision and hormonal therapy