Review Question - QID 7491

The next most appropriate step in management is to proceed with a biopsy of the most accessible site. This can be done by the surgeon or by an interventional radiologist trained in core biopsy techniques. It is imperative to make a pathologic diagnosis prior to proceeding with any further medical, surgical, or radiation treatments. A histologic diagnosis at this point is the only way a medical oncologist can have a meaningful discussion with the patient about their disease, its natural history, and ultimately discuss treatment options and prognosis. Further imaging at this point only delays the time to histologic evaluation. Consideration of surgical stabilization can be delayed until a diagnosis is established and a multidisciplinary approach is initiated. This fracture can be treated at least temporarily with nonsurgical protected weight bearing with a walker or crutches. Hospice may soon serve a useful role but a diagnosis must first be rendered and a limited life expectancy anticipated.