Bone tumours: solitary plasmacytoma: 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.

Try it

Orthopaedics · Bone tumours: solitary plasmacytoma

Sample item

A 58-year-old man has a single lytic lesion in a vertebral body, with plasma cell infiltration on biopsy, a normal bone marrow and a normal skeletal survey elsewhere. What is the preferred treatment and the main risk?

AChemotherapy alone; no risk of progressionBRadiotherapy; later progression to multiple myelomaCAmputation; high risk of lung metastasisDObservation; the lesion is benign

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

The answer and the reasoning

B. Radiotherapy; later progression to multiple myeloma

Solitary plasmacytoma of bone is a localised plasma cell tumour that is sensitive to radiotherapy. Many patients later develop multiple myeloma, so they need long-term follow-up with paraprotein monitoring. Surgery is reserved for stabilisation or decompression.

Option by option

A. Chemotherapy alone; no risk of progression
Systemic chemotherapy is not the first-line treatment, and progression is common.
B. Radiotherapy; later progression to multiple myeloma (correct)
Correct. Radiotherapy treats the lesion and progression to myeloma is the main risk.
C. Amputation; high risk of lung metastasis
The disease is not treated by amputation and is not typified by lung metastasis.
D. Observation; the lesion is benign
Plasma cell infiltration is malignant, so observation alone is wrong.

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.

Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is B, Radiotherapy; later progression to multiple myeloma. Solitary plasmacytoma of bone is a localised plasma cell tumour that is sensitive to radiotherapy.

Why is "Chemotherapy alone; no risk of progression" not the answer?

Systemic chemotherapy is not the first-line treatment, and progression is common.

Why is "Amputation; high risk of lung metastasis" not the answer?

The disease is not treated by amputation and is not typified by lung metastasis.

Why is "Observation; the lesion is benign" not the answer?

Plasma cell infiltration is malignant, so observation alone is wrong.

What concept does this question test?

It tests Bone tumours: solitary plasmacytoma in Orthopaedics. Many patients later develop multiple myeloma, so they need long-term follow-up with paraprotein monitoring. Surgery is reserved for stabilisation or decompression.

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: solitary plasmacytoma?

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.