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Orthopaedic

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Bone Tumor

Question
66 out of 104
 

Active benign tumor (Enneking) all are true except



A Intracapsular

B Well defined margins

C Wide area of activity (> 5cm)

D Treated by extended curettage

Ans. C

Wide area of activity (> 5cm)

Enneking System for Staging Benign and Malignant Musculoskeletal Tumors

BENIGN

1. Latent

2. Active

3. Aggressive

MALIGNANT

Stage

Grade

Site

Metastases

IA

Low

Intracompartmental

None

IB

Low

Extracompartmental

None

IIA

High

Intracompartmental

None

IIB

High

Extracompartmental

None

III

Any

Any

Regional or distant metastases


Benign tumors are staged as follows: stage 1, latent; stage 2, active; and stage 3, aggressive.

a. Stage 1lesions are intracapsular, usually asymptomatic, and frequently incidental findings. Radiographic features include a well-defined margin with a thick rim of reactive bone.

b. There is no cortical destruction or expansion. These lesions do not require treatment because they do not compromise the strength of the bone and usually resolve spontaneously.

c. An example is a small asymptomatic nonossifying fibroma discovered incidentally on radiographs taken to evaluate an unrelated injury.

d. Stage 2 lesions also are intracapsular, but are actively growing and can cause symptoms or lead to pathological fracture. They have well-defined margins on radiographs but may expand and thin the cortex. Usually they have only a thin rim of reactive bone. Treatment usually consists of extended curettage.

e. Stage 3 lesions are extracapsular. Their aggressive nature is apparent clinically and radiographically. They usually have broken through the reactive bone and possibly the cortex. MRI may show a soft-tissue mass, and metastases may be present in 5% of patients with these lesions. Treatment consists of extended curettage and marginal or even wide resection, and local recurrences are common.

Bone Tumor Flashcard List

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