10. Pathology and Oncology MCQs

A 60-year-old male is diagnosed with a grade 1 chondrosarcoma of the proximal femur. MRI confirms the tumor is contained completely within the medullary canal. There are no distant metastases. What is the Enneking stage of this tumor?

A surgeon plans a below-knee amputation for a patient with a high-grade osteosarcoma confined to the distal tibia. The transection plane is through the proximal third of the tibia, which is grossly and microscopically free of tumor. What surgical margin does this amputation achieve?

A patient with an Enneking Stage IIB sarcoma of the distal thigh undergoes a limb-salvage resection. The pathology report notes that tumor cells are present at the inked surgical edge. This margin is best classified as:

Which of the following factors is NOT considered a primary criterion in the Enneking surgical staging system for malignant musculoskeletal tumors?

A 22-year-old has a biopsy-proven non-ossifying fibroma of the distal femur that was discovered incidentally on a radiograph for a knee sprain. The lesion has a thick sclerotic rim and no cortical breach. Which Enneking stage applies, and what is the typical treatment?

A 35-year-old male presents with an Enneking Stage 2 (active) benign bone tumor. If a marginal excision is performed without any adjuvant treatments, what is the primary risk associated with the residual pseudocapsule?

Which of the following scenarios describes a "Radical" surgical margin for a primary bone sarcoma of the femoral diaphysis?

A biopsy tract for a suspected sarcoma was placed outside the planned surgical resection field and is left behind during the definitive limb-salvage surgery. According to oncologic surgical principles, what margin has been achieved for the patient as a whole?

A 55-year-old female undergoes resection for a high-grade classical osteosarcoma. The pathology report demonstrates that the tumor was resected completely through normal tissue, but the margin was less than 1 mm in an area where the tumor abutted the periosteum of an adjacent bone. No pseudocapsule was breached. What Enneking margin is this?

When staging a primary bone tumor, which of the following imaging modalities is considered the gold standard for defining the local compartmental extent (T stage) in the Enneking system?

A 40-year-old male presents with an Enneking Stage IB parosteal osteosarcoma of the distal femur. What is the most appropriate surgical management to achieve the lowest local recurrence rate while preserving function?

A surgeon plans a resection for a primary bone sarcoma. The planned surgical margin involves removing the tumor, its pseudocapsule, the reactive zone, and a continuous cuff of normal, unaffected tissue surrounding the lesion. Which of the following defines this surgical margin?

According to the Enneking staging system, certain anatomical regions are considered entirely extracompartmental due to their lack of restricting fascial boundaries. Which of the following spaces is classified as naturally extracompartmental?

A 24-year-old woman presents with severe knee pain. Radiographs reveal an expansile, eccentric lytic lesion in the distal femur. MRI demonstrates cortical destruction with a soft tissue mass. Biopsy confirms a Giant Cell Tumor of bone without metastasis. Which Enneking stage best describes this benign lesion?

During the resection of a soft tissue sarcoma, the surgeon dissects along the pseudocapsule and through the reactive zone, removing the tumor intact but leaving the reactive zone behind. Which Enneking surgical margin was achieved?