Workup/Staging Flashcards
What are the 3 imaging tests commonly ordered for the workup of a possible chondrosarcoma?
Plain radiographs, MRI, and CT are commonly ordered for the workup of a possible chondrosarcoma. CT is best for examining tumor matrix mineralization, while MRI is best for assessing marrow and soft tissue involvement. In addition, CT C/A/P may be indicated to evaluate for metastatic Dz, particularly for high-grade histologies. If ≥40 y/o then rule out potential bone mets.
What is the characteristic plain film appearance of chondrosarcoma?
Although chondrosarcoma has a variable plain radiograph appearance, mineralization of chondroid matrix may produce a punctate or ring-and-arc pattern of calcification.
What 2 subspecialty referrals/workups should be performed prior to Tx of skull base chondrosarcoma?
Baseline neuro-ophthalmology and endocrinology workup is indicated for skull base chondrosarcoma.
What are the AJCC 8th edition (2017) TNM stage categories for bone tumors? (Note: Lymphoma and multiple myeloma have separate staging systems.)
Appendicular Skeleton, Trunk, Skull, and Facial Bones
T1: ≤8 cm
T2: >8 cm
T3: Discontinuous tumors in primary bone site
Spine
T1: 1 or 2 adjacent vertebra
T2: 3 adjacent vertebra
T3: ≥4 vertebra, or nonadjacent vertebra
T4a: Extension into spinal canal
T4b: Gross vascular invasion or tumor thrombus in great vessels
Pelvis
T1a: ≤8 cm confined to 1 pelvic segment
T1b: >8 cm confined to 1 pelvic segment
T2a: ≤8 cm confined to 1 pelvic segment with extraosseous extension or 2 segments without extraosseous extension
T2b: >8 cm confined to 1 pelvic segment with extraosseous extension or 2 segments without extraosseous extension
T3a: ≤8 cm in 2 pelvic segments with extraosseous extension
T3b: >8 cm in 2 pelvic segments with extraosseous extension
T4a: SI joint/sacral neuroforamen
T4b: Encasement of external iliac vessels or tumor thrombus in major pelvic vessels
N1: Regional LN mets
M1a: Lung
M1b: Bone or other
What is the AJCC stage grouping for bone tumors?
Appendicular Skeleton, Trunk, Skull, and Facial Bones
Stage IA: T1, N0, Grade 1–X
Stage IB: T2–3, N0, Grade 1–X
Stage IIA: T1, N0, Grade 2–3
Stage IIB: T2, N0, Grade 2–3
Stage III: T3, N0, Grade 2–3
Stage IVA: M1a
Stage IVB: N1 or M1b
No AJCC group staging for spine and pelvis.
What are the preferred techniques to confirm primary bone cancer?
Core needle or open Bx is recommended to confirm Dx. FNA is not suitable due to lower diagnostic accuracy.
