Bone Tumors MCQs

A 72-year-old man with a history of an enlarging skull and bowing of his long bones presents with severe, progressive right hip pain. Radiographs show mixed lytic and sclerotic changes in the hemipelvis with cortical destruction and an expansile soft tissue mass. What is the most likely underlying condition predisposing him to this malignancy?

A 16-year-old boy presents with an enlarging mass on the anterior aspect of his mid-tibia. Radiographs demonstrate a broad-based, surface lesion with a sunburst appearance and no medullary involvement. Histology reveals a predominantly chondroblastic matrix with intermediate-grade atypia. What is the diagnosis?

The standard neoadjuvant chemotherapy regimen for conventional high-grade osteosarcoma typically includes methotrexate, doxorubicin, and cisplatin. What is the primary antineoplastic mechanism of action of cisplatin?

Neoadjuvant chemotherapy has significantly improved survival rates in patients with conventional high-grade osteosarcoma. Which of the following regimens represents the standard first-line combination therapy?

A 70-year-old male with a 20-year history of Paget's disease of bone develops acute, severe pain and rapid swelling in his right proximal femur. Radiographs show a new destructive lytic lesion with cortical breakthrough. What is the most likely etiology?

A 20-year-old female presents with a palpable mass on the anterior midshaft of her tibia. Radiographs show a broad-based surface lesion with a sunburst 'hair-on-end' periosteal reaction. There is no medullary involvement. Biopsy reveals an intermediate-grade chondroblastic matrix. What is the diagnosis?

A 14-year-old boy presents with progressive, non-mechanical knee pain. Radiographs demonstrate a mixed sclerotic and lytic lesion in the distal femoral metaphysis with a Codman's triangle and sunburst periosteal reaction. Which of the following MRI sequences is most critical for surgical planning of the resection?

A 15-year-old boy with conventional high-grade osteosarcoma of the proximal tibia is undergoing neoadjuvant MAP chemotherapy (Methotrexate, Doxorubicin, Cisplatin). He suddenly develops dyspnea and bilateral lower extremity edema. Echocardiography shows a severely reduced ejection fraction. Which chemotherapeutic agent is most likely responsible for this complication?

A 65-year-old male presents with severe back pain. Imaging shows a pathological compression fracture of L4. Laboratory tests reveal hypercalcemia, anemia, and an elevated total serum protein. Which diagnostic test is most essential to confirm the underlying diagnosis and identify the specific protein abnormality?

A 16-year-old male complains of right thigh pain that is worse at night and dramatically relieved by ibuprofen. Imaging shows a cortical thickening with a 7 mm radiolucent nidus in the femoral diaphysis. Radiofrequency ablation (RFA) is planned. What is the most critical anatomical consideration when performing RFA for this lesion?

A 65-year-old male presents with generalized bone pain, severe fatigue, and a large radiolucent lesion in the proximal femur. Laboratory workup shows hypercalcemia, normocytic anemia, and an M-spike on serum protein electrophoresis. Which distinct radiographic characteristic of the bone lesion is classically associated with the underlying pathophysiology of this disease?

A 4-year-old boy presents with a painless, asymmetric, hard mass on the medial aspect of his right ankle. Radiographs show an irregular, lobulated, ossifying mass arising from the medial aspect of the distal tibial epiphysis. What is the most likely diagnosis?

A 4-year-old boy presents with a painless, asymmetric swelling on the medial aspect of his ankle. Radiographs show an irregular, ossified mass arising from the medial epiphysis of the distal tibia. Histologically, the lesion strongly resembles an osteochondroma. What is the most likely diagnosis?

A 48-year-old male presents with severe right thigh pain. Plain radiographs appear largely unremarkable except for a very subtle permeative radiolucency in the diaphysis. MRI demonstrates extensive marrow replacement and a massive soft tissue mass surrounding the bone. Which of the following is the most likely diagnosis?

A 6-year-old girl is noted to have early breast development and vaginal bleeding. She complains of left hip pain, and radiographs reveal a ground-glass, expansile lytic lesion in the proximal femur with a "shepherd's crook" deformity. Physical exam reveals large, irregular hyperpigmented skin macules. A mutation in which of the following genes is responsible for this condition?

Which histologic feature is considered the hallmark of a chondromyxoid fibroma, aiding in differentiating it from chondrosarcoma?

A 45-year-old male completes definitive radiation therapy for primary diffuse large B-cell lymphoma of the femoral diaphysis. Which of the following is the most significant orthopedic complication directly associated with treating appendicular primary bone lymphoma exclusively with local high-dose radiation?