Bone Tumors MCQs

A 14-year-old boy complains of progressive distal thigh pain that awakens him at night. Radiographs reveal a metaphyseal, poorly defined lytic lesion with a 'sunburst' periosteal reaction and Codman's triangle. What is the most likely diagnosis?

A 9-year-old girl presents with fever, weight loss, and severe mid-shaft thigh pain. Radiographs show a permeative diaphyseal lesion of the femur with an "onion skin" periosteal reaction. What specific chromosomal translocation is diagnostic for this malignancy?

A 70-year-old man presents with generalized fatigue, severe back pain, and hypercalcemia. Radiographs of his skull reveal multiple 'punched-out' lytic lesions. Serum protein electrophoresis shows an M-spike. Which of the following is the most definitive primary treatment for his skeletal disease?

A 16-year-old boy presents with severe night pain in his right tibia that is dramatically relieved by NSAIDs. Radiographs show a 7 mm radiolucent nidus surrounded by dense sclerotic bone. Which of the following is the most appropriate definitive management?

A 60-year-old man presents with back pain, anemia, and elevated creatinine. Radiographs reveal multiple punched-out lytic lesions in the skull and spine. Which laboratory finding is essential to confirm the diagnosis?

A 65-year-old male with a 40-pack-year smoking history presents with bilateral knee and ankle pain. Radiographs reveal symmetric, solid periosteal new bone formation along the diaphyses and metaphyses of the tibiae and fibulae. Which of the following is the most likely underlying diagnosis?

A 15-year-old male is undergoing chemotherapy for conventional osteosarcoma of the proximal tibia. He presents to the emergency department with sudden onset pleuritic chest pain and shortness of breath. Chest radiograph shows a spontaneous pneumothorax. What is the most likely underlying cause?

A 65-year-old man presents with severe mid-back pain. Laboratory tests reveal anemia, hypercalcemia, and elevated serum creatinine. Serum protein electrophoresis shows a monoclonal spike. Which test is most appropriate to evaluate the full extent of skeletal involvement?

A 15-year-old boy presents with progressive distal thigh pain that awakens him at night. Radiographs of the distal femur reveal an ill-defined, destructive, bone-forming lesion in the metaphysis accompanied by a sunburst periosteal reaction and a Codman's triangle. A core needle biopsy confirms a high-grade conventional osteosarcoma. What is the current standard of care sequence for this patient?

An orthopedic researcher wants to investigate the association between a rare primary bone malignancy (e.g., osteosarcoma) and a specific prior environmental exposure. Which epidemiological study design is the most appropriate and efficient for this scenario?

A 65-year-old man presents with a pathologic subtrochanteric femur fracture. Laboratory workup reveals hypercalcemia, renal insufficiency, and anemia. Serum protein electrophoresis shows an M-spike. Which of the following radiographic findings is most characteristic of this patient's underlying disease?

A 65-year-old man with hypercalcemia and an M-spike on protein electrophoresis has multiple "punched-out" skull lesions. Which is the most appropriate initial screening test to evaluate for impending pathologic appendicular fractures?

Aneurysmal bone cyst of the spine is most likely in this age group:

A 15-year-old girl presents with pain and a 17°-scoliosis curve. The film suggests an enlargement and sclerosis of the transverse process of L2. The best study to further evaluate the nature and anatomic extent of the lesion is:

A 12-year-old boy with hemophilia A has a painless mass in his thigh. The femur is eroded anterolaterally and there is a large overlying soft tissue mass. Magnetic resonance imaging shows a 5 cm x 7 cm mass arising from the bone. The most likely diagnosis is:

Which of the following is the most common final attribution of back pain in children and adolescents after all appropriate diagnostic studies are performed:

A 9-year-old girl presents with precocious puberty, irregular hyperpigmented macules, and a limp. Radiographs of her femur reveal a ground-glass appearance and a "shepherd's crook" deformity. Which of the following best describes the underlying genetic defect?

A 7-year-old girl presents with precocious puberty and a large cafe-au-lait macule with an irregular "coast of Maine" border. Radiographs of her proximal femur show a lytic, expansile, "ground-glass" lesion with a shepherd's crook deformity. What is the underlying genetic mechanism of this disease?

A 4-year-old boy presents with a painless, hard mass on the medial aspect of his right knee, causing a progressive asymmetric valgus deformity. Radiographs show an irregular, ossified mass arising from the medial half of the distal femoral epiphysis. What is the most likely diagnosis?

C ongenital pseudarthrosis of the clavicle occurs most commonly on which side: