Tumor Triage 101
This triad of symptoms—bone pain, anemia, and hypercalcemia—is classically associated with this primary bone malignancy.
What is multiple myeloma?
This is the most common benign bone tumor overall.
What is osteochondroma?
This is the most common primary sarcoma of bone, seen most often in adolescents.
What is osteosarcoma?
This “triangular” periosteal reaction on radiograph is classic for aggressive bone lesions like osteosarcoma.
What is Codman’s triangle?
First-line treatment for osteoid osteoma, especially in non-spinal locations.
What is NSAIDs or observation?
These four common presentations should prompt evaluation for a bone or soft tissue tumor.
What are pain, mass, incidental finding, and pathologic fracture?
This benign tumor in kids shows a “bubbly” metaphyseal lesion with a sclerotic rim on X-ray.
What is non-ossifying fibroma?
The most common site for osteosarcoma is this location in the lower extremity.
What is the distal femur?
This translocation is seen in 95% of Ewing’s sarcoma cases.
What is t(11;22)?
This is the definitive treatment for high-grade osteosarcoma after neoadjuvant chemotherapy.
What is wide surgical resection or limb salvage?
A well-defined lesion with a narrow zone of transition and no cortical destruction on X-ray suggests this type of lesion.
What is a benign lesion?
This benign tumor causes pain relieved by NSAIDs and has a central nidus.
What is osteoid osteoma?
This tumor affects the diaphysis of long bones in young patients and shows “onion skin” periosteal reaction.
What is Ewing’s sarcoma?
Name the genetic condition with multiple osteochondromas and increased malignant risk.
What is Multiple Hereditary Exostosis (MHE)?
This tumor is typically managed non-operatively unless there's a symptomatic lesion or risk of fracture.
What is enchondroma?
Name two red flag symptoms from the review of systems that raise concern for malignancy.
What are night pain and unintentional weight loss? (Other acceptable: decreased appetite, fever, chills, night sweats)
This cartilage tumor presents as a well-defined, medullary lesion with popcorn-like calcification, often found in the hands.
What is enchondroma?
Name one poor prognostic factor in osteosarcoma.
What is large tumor size, advanced stage, high ALP/LDH, skip lesions, pelvic location, or poor chemo response?
“Popcorn” mineralization in a lesion is most often associated with tumors of this tissue origin.
What is cartilage?
This benign but locally destructive lesion is treated with curettage and bone grafting and has up to a 25% recurrence rate.
What is aneurysmal bone cyst?
This imaging modality is best for evaluating soft tissue detail and neurovascular involvement.
What is MRI?
This tumor has a “fallen leaf sign” on X-ray and may resolve with fracture healing.
What is a unicameral bone cyst?
This tumor presents in older adults, shows intralesional calcifications, and is generally resistant to chemo/radiation.
What is chondrosarcoma?
This lab test detects abnormal immunoglobulin production in multiple myeloma and reveals an “M spike.”
What is serum protein electrophoresis (SPEP)?
Surgical stabilization is indicated in metastatic bone disease if the patient has this life expectancy.
What is more than 3 months?