Bone tumours: malignant: 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: malignant

Sample item

A teenager has a sunburst pattern with a Codman triangle at the distal femoral metaphysis, and biopsy confirms osteosarcoma with no metastases on CT chest. What is the standard treatment sequence?

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

The answer and the reasoning

D. Neoadjuvant chemotherapy, limb salvage resection, then adjuvant chemotherapy

Osteosarcoma is treated with chemotherapy before and after surgery, which shrinks the tumour and treats micrometastases. Limb salvage is possible in most cases with wide resection.

Option by option

  • A. Primary amputation without chemotherapy

    Amputation without chemotherapy leaves micrometastases untreated.

  • B. Radiotherapy alone

    Osteosarcoma is relatively radio-resistant, so radiotherapy alone is ineffective.

  • C. Wide excision alone

    Surgery alone gives poor survival because micrometastases are present at diagnosis.

  • D. Neoadjuvant chemotherapy, limb salvage resection, then adjuvant chemotherapy (correct)

    Correct. Chemotherapy before and after wide resection is the standard.

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, Neoadjuvant chemotherapy, limb salvage resection, then adjuvant chemotherapy. Osteosarcoma is treated with chemotherapy before and after surgery, which shrinks the tumour and treats micrometastases.

Why is "Primary amputation without chemotherapy" not the answer?

Amputation without chemotherapy leaves micrometastases untreated.

Why is "Radiotherapy alone" not the answer?

Osteosarcoma is relatively radio-resistant, so radiotherapy alone is ineffective.

Why is "Wide excision alone" not the answer?

Surgery alone gives poor survival because micrometastases are present at diagnosis.

What concept does this question test?

It tests Bone tumours: malignant in Orthopaedics. Limb salvage is possible in most cases with wide resection.

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: malignant?

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.