Osteosarcoma, Ewing’s sarcoma MCQs

By: Prof. Dr. Fazal Rehman Shamil | 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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