Chapter 142 - Principles of Treatment of Musculoskeletal Tumors

Question 1

treatment of eosinophilic granuloma

Answer 1

curretage, injection of methylprednisolone

Question 2

treatment of unicameral bone cysts

Answer 2

curretage, injection of methylprednisolone

Question 3

benign tumors frequently treated with intralesional curretage

Answer 3

giant cell tumor (often have to add thermal or burring or something to keep it from coming back - also methylmethacrylate cement back fill
chondroblastoma
chondromyxoid fibroma
osteoblastoma
ABC (with doxycycline foam)

Question 4

what malignant tumors get treated with wide resection ONLY (no chemo or radiation)

Answer 4

chondrosarcoma
adamantinoma
parosteal osteosarcoma
low grade intramedullary osteosarcoma

Question 5

what malignant tumors get chemo?

Answer 5

osteosarcoma
ewings sarcoma
undifferentiated pleomorphic sarcoma

** chemo reduced the risk of pulmonary mets

Question 6

which malignant tumors get radiation?

Answer 6

ewing sarcoma
primary lymphoma of bone
hemangioendothelioma
solitary plasmacytoma of bone
chordoma

** radiation increases the rte of local control

Question 7

pre-operative radiation for soft tissue sarcoma

Answer 7

• lower dose of radiation (5000cgy)
• lower rate of fibrosis
  higher rate of wound complications (2x)

Question 8

post-operative radiation for soft tissue sarcoma

Answer 8

• higher dose of radiation (6200-6600cGy)
• higher rate of fibrosis
• lower risk of wound healing complications