Bone tumours: telangiectatic osteosarcoma: practice question

A Orthopaedics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Orthopaedics · Bone tumours: telangiectatic osteosarcoma

Sample item

A 15-year-old has a purely lytic, expansile lesion of the distal femur. MRI shows multiple cystic spaces with fluid-fluid levels, and biopsy of the thick septa shows malignant osteoid-producing cells. What is the diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Telangiectatic osteosarcoma

Telangiectatic osteosarcoma is an aggressive variant composed of blood-filled spaces separated by septa containing malignant cells. It resembles an aneurysmal bone cyst on imaging, so the septa must be biopsied adequately. It is treated like conventional osteosarcoma with chemotherapy and surgery.

Option by option

  • A. Aneurysmal bone cyst

    An aneurysmal bone cyst has benign septa without malignant cells.

  • B. Giant cell tumour

    Giant cell tumour is epiphyseal in skeletally mature patients and has multinucleate giant cells.

  • C. Simple bone cyst

    A simple bone cyst does not show fluid-fluid levels or malignant septa.

  • D. Telangiectatic osteosarcoma (correct)

    Correct. Malignant osteoid-producing cells in the septa of a cystic lesion indicate a telangiectatic osteosarcoma.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is D, Telangiectatic osteosarcoma. Telangiectatic osteosarcoma is an aggressive variant composed of blood-filled spaces separated by septa containing malignant cells.

Why is "Aneurysmal bone cyst" not the answer?

An aneurysmal bone cyst has benign septa without malignant cells.

Why is "Giant cell tumour" not the answer?

Giant cell tumour is epiphyseal in skeletally mature patients and has multinucleate giant cells.

Why is "Simple bone cyst" not the answer?

A simple bone cyst does not show fluid-fluid levels or malignant septa.

What concept does this question test?

It tests Bone tumours: telangiectatic osteosarcoma in Orthopaedics. It resembles an aneurysmal bone cyst on imaging, so the septa must be biopsied adequately. It is treated like conventional osteosarcoma with chemotherapy and surgery.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Bone tumours: telangiectatic osteosarcoma?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.