Please confirm topic selection

Are you sure you want to trigger topic in your Anconeus AI algorithm?

Please confirm action

You are done for today with this topic.

Would you like to start learning session with this topic items scheduled for future?

Review Question - QID 1271

In scope icon L 2 A
QID 1271 (Type "1271" in App Search)
A 79-year-old healthy male has 1 year of progressively worse left hip pain. He denies any significant weight loss but does complain of night pain. Radiograph and MRI are shown in Figures A & B. Bone scan and histology is shown in Figures C-E. What is the definitive treatment of this?
  • A
  • B
  • C
  • D
  • E

observation

2%

33/1655

radiation therapy alone

3%

53/1655

wide resection and reconstruction

57%

946/1655

wide resection, reconstruction and chemotherapy

21%

348/1655

wide resection, reconstruction and local radiation therapy.

16%

263/1655

  • A
  • B
  • C
  • D
  • E

Select Answer to see Preferred Response

bookmode logo Review TC In New Tab

The history, imaging and pathology points to chondrosarcoma as the diagnosis, and therefore wide resection and reconstruction is the most appropriate treatment.

Chondrosarcoma tends to occur in an older individuals and the most common sites of origin are the femur, tibia, humerus, ribs, scapula then pelvis. Chondrosarcomas grow slowly and patients present with dull aching pain.

X-rays typically have a subtle, radiolucent, permeative lesion or may have hazy or speckled calcifications with either a diffuse "salt & pepper" pattern or a more discrete "popcorn" pattern. The MRI defines the amount of marrow and soft-tissue involvment, and typically has high T2 signal intensity. Bone scintigraphy will be positive.

In pathological sections, low-power imaging demonstrates lobulated clusters of chondrocytes, and high-power imaging demonstrates a bland cellular appearance, extensive basophilic cytoplasm, and no mitotic figures (low grade chondrosarcoma).

In terms of treatment, low-grade tumors usually respond well to wide resection and reconstruction of limb. Chemotherapy is usually not used except in rare cases of certain chondrosarcoma subtypes (mesenchymal chondrosarcoma). Radiation therapy is not very effective against chondrosarcoma.

Authors
Rating
Please Rate Question Quality

3.4

  • star icon star icon star icon
  • star icon star icon star icon
  • star icon star icon star icon
  • star icon star icon star icon
  • star icon star icon star icon

(31)

Attach Treatment Poll
Treatment poll is required to gain more useful feedback from members.
Please enter Question Text
Please enter at least 2 unique options
Please enter at least 2 unique options
Please enter at least 2 unique options