Tumor II Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Question 2) Figure A is the biopsy specimen of a 30-year-old man with a 4-month history of a painless, slow-growing mass in his medial thigh. Local imaging (orthogonal radiographs and MR images with intravenous gadolinium) reveals a 6- x 5- x 7-cm heterogeneous mass in the adductor magnus muscle. Additional analysis confirms the presence of translocation t(x;18). What are the appropriate staging steps to establish a diagnosis?Tumor Question 2) Figure A Select the Correct AnswerChest CT scan and whole-body bone scanChest radiographs and chest CT scanChest radiographs, chest CT scan, and whole-body bone scanChest radiographs, chest CT scan, and examination of locoregional lymph nodesChest radiographs, chest CT scan, whole-body bone scan, and examination of locoregional lymph nodesCorrect Answer: Chest radiographs, chest CT scan, and examination of locoregional lymph nodes Explanation: The MR imaging and pathologic description are consistent with a high-grade soft-tissue sarcoma, with subclassification of synovial sarcoma through identification of the translocation t(X; 18). Like all high-grade sarcomas, synovial sarcoma has a propensity to metastasize to the lungs, so chest radiography and chest CT are critical components of staging. Examination of locoregional lymph nodes also is indicated in soft-tissue sarcoma staging, with additional imaging and biopsy indicated for suspicious nodes. Whole-body bone scan is not a routine component of the staging of soft-tissue sarcomas, except in the case of myxoid liposarcomas, which can metastasize to bone. References: Source: AAOS SAE Gilbert NF, Cannon CP, Lin PP, Lewis VO. Soft-tissue sarcoma. J Am Acad Orthop Surg. 2009 Jan;17(1):40-7. doi: 10.5435/00124635-200901000-00006. PMID: 19136426. Weber KL. Evaluation of the adult patient (aged >40 years) with a destructive bone lesion. J Am Acad Orthop Surg. 2010 Mar;18(3):169-79. doi: 10.5C435/00124635-201003000-00006. PMID: 20190107. Wrong Answer: Please try again! Submit Post navigation Previous QuestionIntroductionNext QuestionTumor III
