Bone Tumors — MCQs

Bone Tumors Indian Medical PG Practice Questions and MCQs

Question 291: What is the most appropriate treatment for a soap bubble appearance at the lower end of the radius?

A. Local excision
B. Excision and bone grafting (Correct Answer)
C. Amputation
D. Radiotherapy

Explanation: ***Excision and bone grafting*** - A **soap bubble appearance** at the lower end of the radius is highly suggestive of a **giant cell tumor (GCT)**, which is locally aggressive and has a high recurrence rate after simple curettage. - **Excision of the tumor and filling the defect with bone graft** is the preferred treatment to reduce recurrence and maintain skeletal integrity. *Local excision* - While local excision might remove the visible tumor, **GCTs are known to recur frequently** (up to 50%) after intralesional treatments like simple curettage. - It does not adequately address microscopic extensions or the risk of **local aggressive behavior**. *Amputation* - **Amputation is an overly aggressive and unnecessary treatment** for a GCT, as it is a benign but locally aggressive tumor. - It would be considered only in rare cases of extensive soft tissue invasion or intractable recurrence, which is not implied by a "soap bubble appearance." *Radiotherapy* - **Radiotherapy is generally not the first-line treatment for GCTs** due to concerns about **malignant transformation** (osteosarcoma) in a small percentage of cases, especially with high doses. - It may be considered for unresectable tumors or recurrent lesions in difficult anatomical locations, or as an adjuvant.

Question 292: Most common site of Ewing's sarcoma?

A. Pelvis
B. Shaft of femur (Correct Answer)
C. Shaft of tibia
D. Ribs

Explanation: ***Shaft of femur*** - The **diaphysis (shaft)** of long bones, particularly the **femur**, is a classic site for Ewing's sarcoma. - This tumor typically arises in the **medullary cavity** of these long bones. *Pelvis* - While the **pelvis** is a common site for Ewing's sarcoma, it is considered the second most common, after the long bones. - Tumors in the pelvis are often associated with a **worse prognosis** due to late presentation and larger tumor volume. *Shaft of tibia* - The **tibia** can be affected by Ewing's sarcoma, but less frequently than the **femur**. - Like the femur, it typically involves the **diaphysis** of the bone. *Ribs* - **Ribs** are also a possible site for Ewing's sarcoma, especially in older children or adolescents. - However, they are less commonly affected than the major long bones or the pelvis.

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Classification of Bone Tumors

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Benign Bone Tumors

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Malignant Primary Bone Tumors

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Metastatic Bone Disease

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Tumor-Like Lesions of Bone

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Soft Tissue Tumors

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Evaluation and Staging of Bone Tumors

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Biopsy Principles

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Limb Salvage Surgery

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Amputation for Bone Tumors

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Adjuvant Therapies

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Surveillance and Follow-up

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Bone Tumors — MCQs

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