Osteosarcoma, Ewing’s sarcoma MCQs

By: Prof. Dr. Fazal Rehman | Last updated: September 28, 2024

What is the most common primary malignant bone tumor in children and adolescents? Osteosarcoma Ewing’s sarcoma Chondrosarcoma Giant cell tumor Answer: Osteosarcoma Which part of the bone is most commonly affected by osteosarcoma? Diaphysis Epiphysis Metaphysis Cortical bone Answer: Metaphysis What is the typical age group for Ewing’s sarcoma? 0-5 years 5-10 years 10-20 years 20-30 years Answer: 10-20 years What is the hallmark histological feature of Ewing’s sarcoma? Osteoid production Small, round, blue cells Giant multinucleated cells Spindle-shaped cells Answer: Small, round, blue cells Which bone tumor is associated with a “sunburst” appearance on radiographs? Osteosarcoma Ewing’s sarcoma Chondrosarcoma Fibrous dysplasia Answer: Osteosarcoma What is the most common site of metastasis for osteosarcoma? Brain Liver Lungs Kidneys Answer: Lungs Which of the following is a common location for Ewing’s sarcoma? Distal femur Pelvis Humerus Skull Answer: Pelvis What is the typical radiographic appearance of Ewing’s sarcoma? Ground glass appearance Sunburst pattern Onion skin periosteal reaction Lytic lesions with sclerotic margins Answer: Onion skin periosteal reaction Which genetic translocation is commonly associated with Ewing’s sarcoma? t(9;22) t(11;22) t(8;14) t(15;17) Answer: t(11;22) Which type of bone is most often affected by osteosarcoma? Flat bones Irregular bones Long bones Short bones Answer: Long bones What is the first-line treatment for osteosarcoma? Radiation therapy Chemotherapy Surgical resection Immunotherapy Answer: Surgical resection Which chemotherapy agent is commonly used in the treatment of osteosarcoma? Methotrexate Cyclophosphamide Vincristine Doxorubicin Answer: Doxorubicin Ewing’s sarcoma is most commonly found in which of the following populations? African-American Caucasian Asian Native American Answer: Caucasian Which bone tumor is more sensitive to radiation therapy? Osteosarcoma Ewing’s sarcoma Chondrosarcoma Giant cell tumor Answer: Ewing’s sarcoma What is the 5-year survival rate for localized osteosarcoma with treatment? Less than 10% 20-30% 50-70% Greater than 80% Answer: 50-70% Which of the following bone tumors is most likely to occur in the diaphysis of long bones? Osteosarcoma Ewing’s sarcoma Giant cell tumor Chondrosarcoma Answer: Ewing’s sarcoma Which tumor is associated with pain that worsens at night and is unrelieved by rest? Ewing’s sarcoma Chondrosarcoma Osteosarcoma Osteochondroma Answer: Osteosarcoma What is the primary mode of metastasis for Ewing’s sarcoma? Lymphatic system Hematogenous spread Direct invasion Seeding along surgical tracts Answer: Hematogenous spread Which of the following is a risk factor for the development of osteosarcoma? Paget’s disease Diabetes mellitus Ankylosing spondylitis Rheumatoid arthritis Answer: Paget’s disease Which imaging modality is most commonly used to evaluate bone tumors? X-ray CT scan MRI Ultrasound Answer: MRI What is the typical treatment protocol for Ewing’s sarcoma? Surgery only Chemotherapy and radiation Radiation only Immunotherapy Answer: Chemotherapy and radiation Which of the following is a characteristic of high-grade osteosarcoma? Slow-growing Well-circumscribed borders Aggressive with a high metastatic potential Involvement limited to the bone cortex Answer: Aggressive with a high metastatic potential Which of the following is a common presenting symptom of Ewing’s sarcoma? Night sweats Localized pain and swelling Jaundice Vision changes Answer: Localized pain and swelling Osteosarcoma primarily arises from which type of bone tissue? Cartilage Fibrous tissue Osteoid Muscle Answer: Osteoid What is a poor prognostic factor in osteosarcoma? Involvement of the distal femur Tumor size less than 8 cm Lung metastasis at presentation Response to chemotherapy Answer: Lung metastasis at presentation Which bone tumor typically presents with systemic symptoms like fever and weight loss? Osteosarcoma Chondrosarcoma Ewing’s sarcoma Osteoid osteoma Answer: Ewing’s sarcoma Which of the following is a known complication of osteosarcoma? Spontaneous fracture Pulmonary embolism Pathologic fracture Bone infarction Answer: Pathologic fracture What is the most common location for osteosarcoma in the long bones? Diaphysis Metaphysis Epiphysis Cortical bone Answer: Metaphysis Which genetic mutation is most often associated with osteosarcoma? TP53 BRCA1 APC RB1 Answer: RB1 Which clinical feature distinguishes Ewing’s sarcoma from osteosarcoma? Occurrence in the diaphysis Production of osteoid Onion-skinning on X-ray Metaphyseal location Answer: Onion-skinning on X-ray Which imaging modality is essential for staging osteosarcoma? Bone scan MRI PET scan CT of the chest Answer: CT of the chest Which bone tumor is more likely to occur after radiation exposure? Osteosarcoma Ewing’s sarcoma Chondrosarcoma Osteoid osteoma Answer: Osteosarcoma What is a common feature of both osteosarcoma and Ewing’s sarcoma? Occurrence in elderly individuals Highly metastatic potential Poor response to chemotherapy Arises from bone marrow cells Answer: Highly metastatic potential Which of the following is a less common site for metastasis in Ewing’s sarcoma? Lungs Liver Bone Lymph nodes Answer: Lymph nodes What is the typical treatment for localized Ewing’s sarcoma? Surgical resection only Chemotherapy and surgery Radiation therapy only Targeted therapy Answer: Chemotherapy and surgery Which condition is often mistaken for Ewing’s sarcoma due to similar radiologic findings? Osteomyelitis Chondrosarcoma Giant cell tumor Fibrous dysplasia Answer: Osteomyelitis What is the most significant factor in determining the prognosis of osteosarcoma? Tumor size Age at diagnosis Location of the tumor Response to chemotherapy Answer: Response to chemotherapy What is a key difference in the treatment of osteosarcoma compared to Ewing’s sarcoma? Osteosarcoma is treated with radiation Ewing’s sarcoma requires surgical resection only Ewing’s sarcoma responds better to chemotherapy Osteosarcoma requires less intensive treatment Answer: Ewing’s sarcoma responds better to chemotherapy Which of the following is a characteristic feature of Ewing’s sarcoma on histopathology? Osteoid production Large pleomorphic cells Rosettes of small, round cells Spindle-shaped cells Answer: Rosettes of small, round cells Which tumor marker is often elevated in osteosarcoma? AFP PSA ALK ALP Answer: ALP What is the 5-year survival rate for Ewing’s sarcoma with localized disease? Less than 10% 20-30% 50-70% Greater than 80% Answer: 50-70% What is the role of limb-sparing surgery in osteosarcoma treatment? To avoid amputation To improve survival rate To ensure complete tumor removal To reduce the need for chemotherapy Answer: To avoid amputation Which of the following is considered an unfavorable site for osteosarcoma? Proximal femur Distal tibia Distal femur Proximal humerus Answer: Proximal femur What is a common post-treatment complication of Ewing’s sarcoma? Lung metastasis Secondary malignancies Osteonecrosis Kidney failure Answer: Secondary malignancies  

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