Score: 0%
Orthopedics Online MCQs
Phalanges of the hand
CORRECT ANSWER:3
Giant cell tumors are common around the knee, distal radius, sacrum and hands. They are not typically found in the diaphysis of bone.
Giant cell tumors are one of the more common tumors in young adults 22-40 years of age. There is much argument as to whether giant cell tumors arise in the metaphysis or the epiphysis, but most authors agree that giant cell tumors are very uncommon in the diaphysis. The most common sites of giant cell tumors in bone, which are the distal radius, sacrum, distal femur, proximal tibia and proximal humerus. Treatment typically involves intralesional curettage with adjuvant treatment (e.g., phenol, hydrogen peroxide, argon beam, etc).
Williams et al undertook a prospective study to evaulate the recurrence rate of giant cell tumors of the hand and they found that soft tissue extension of the tumor significantly increased the rate of local recurrence. This finding is significant because multiple previous studies have demonstrated similar higher recurrence rates for giant cell tumors with soft tissue extension in other areas like around the knee and the distal radius.
Illustration A are radiographs classic for a giant cell tumor showing a large lytic metaphseal-epiphyseal lesion in the distal femur. Illustration B is an axial CT of the distal femur showing the lytic giant cell tumor, abutting and fracturing the subchondral bone. Illustration C is histology classic for a giant cell tumor where the nuclei of the multi-nucleated giant cells look identical to the nuclei of the stromal cells.
Incorrect Answers:
Answers 1,2,4,5: Giant cell tumors are common around the knee, distal radius, sacrum and hands.
What is the most appropriate treatment for a 65-year-old female with a 100-pack-year tobacco history who presents with a new painful lytic lesion in her femoral diaphysis?
CORRECT ANSWER:3
Giant cell tumors are common around the knee, distal radius, sacrum and hands. They are not typically found in the diaphysis of bone.
Giant cell tumors are one of the more common tumors in young adults 22-40 years of age. There is much argument as to whether giant cell tumors arise in the metaphysis or the epiphysis, but most authors agree that giant cell tumors are very uncommon in the diaphysis. The most common sites of giant cell tumors in bone, which are the distal radius, sacrum, distal femur, proximal tibia and proximal humerus. Treatment typically involves intralesional curettage with adjuvant treatment (e.g., phenol, hydrogen peroxide, argon beam, etc).
Williams et al undertook a prospective study to evaulate the recurrence rate of giant cell tumors of the hand and they found that soft tissue extension of the tumor significantly increased the rate of local recurrence. This finding is significant because multiple previous studies have demonstrated similar higher recurrence rates for giant cell tumors with soft tissue extension in other areas like around the knee and the distal radius.
Illustration A are radiographs classic for a giant cell tumor showing a large lytic metaphseal-epiphyseal lesion in the distal femur. Illustration B is an axial CT of the distal femur showing the lytic giant cell tumor, abutting and fracturing the subchondral bone. Illustration C is histology classic for a giant cell tumor where the nuclei of the multi-nucleated giant cells look identical to the nuclei of the stromal cells.
Incorrect Answers:
Answers 1,2,4,5: Giant cell tumors are common around the knee, distal radius, sacrum and hands.
What is the most appropriate treatment for a 65-year-old female with a 100-pack-year tobacco history who presents with a new painful lytic lesion in her femoral diaphysis?
Keywords