Expansile Lytic Proximal Humeral Epiphyseal Lesion - USMLE Forums
USMLE Forums Logo
USMLE Forums         Your Reliable USMLE Online Community     Members     Posts
Home
USMLE Articles
USMLE News
USMLE Polls
USMLE Books
USMLE Apps
Go Back   USMLE Forums > USMLE Step 1 Forum

USMLE Step 1 Forum USMLE Step 1 Discussion Forum: Let's talk about anything related to USMLE Step 1 exam


Reply
 
Thread Tools Search this Thread Display Modes
  #1  
Old 12-17-2013
USMLE Forums Newbie
 
Steps History: Not yet
Posts: 4
Threads: 1
Thanked 1 Time in 1 Post
Reputation: 11
Bones Expansile Lytic Proximal Humeral Epiphyseal Lesion

A 24-year-old baseball player visits his doctor with complaints of right arm pain. On questioning, he states that it has hurt for several weeks but he has been ignoring it, attributing to muscle strain. Radiographic examination demonstrates an expansile, lytic proximal right humeral epiphyseal lesion. Based on the clinical, radiologic, and biopsy findings, the mass and proximal humerus are resected. On gross examination, the mass demonstrates hemorrhagic areas with multiple small spindle-shaped cells. Laboratory tests performed at the same time demonstrate normal serum and calcium levels. Which of the following is the likely diagnosis?


(A) Aneurysmal bone cyst
(B) Brown tumor
(C) Giant cell tumor
(D) Ewing sarcoma
(E) Osteoid osteoma
Reply With Quote Quick reply to this message



  #2  
Old 12-17-2013
USMLE Forums Scout
 
Steps History: Not yet
Posts: 30
Threads: 9
Thanked 4 Times in 4 Posts
Reputation: 14
Default

probably osteoid osteoma or giant cell
Reply With Quote Quick reply to this message
  #3  
Old 12-19-2013
USMLE Forums Newbie
 
Steps History: Not yet
Posts: 1
Threads: 0
Thanked 0 Times in 0 Posts
Reputation: 10
Warning!

(A) Aneurysmal bone cyst

other name is Osteolytic Bone Neoplasm = clue would be lytic lesion, small-spindle shaped cells, but in general logic Ca, Alk.phosph. should be high, I have no idea why the Ca2+ is normal
Reply With Quote Quick reply to this message
 
  #4  
Old 12-21-2013
USMLE Forums Scout
 
Steps History: Not yet
Posts: 18
Threads: 3
Thanked 0 Times in 0 Posts
Reputation: 10
Default

aneurysmal bone cyst..
Reply With Quote Quick reply to this message
  #5  
Old 12-21-2013
singular's Avatar
USMLE Forums Scout
 
Steps History: ---
Posts: 78
Threads: 9
Thanked 41 Times in 31 Posts
Reputation: 51
Default

24 year age, lytic proximal epiphysial lesion & spindle shaped cells point towards giant cell tumor.
Reply With Quote Quick reply to this message
  #6  
Old 12-21-2013
USMLE Forums Scout
 
Steps History: Not yet
Posts: 18
Threads: 3
Thanked 0 Times in 0 Posts
Reputation: 10
Default

giant cell tumor contains multinucleated giant cells and oval mononuclear cells
not spindle shaped cells
Reply With Quote Quick reply to this message
  #7  
Old 12-21-2013
singular's Avatar
USMLE Forums Scout
 
Steps History: ---
Posts: 78
Threads: 9
Thanked 41 Times in 31 Posts
Reputation: 51
Default

There is a mention of spindle shaped cells with multinucleated giant cells in GCT on FA'2013 p.389 with no errata.
Reply With Quote Quick reply to this message
  #8  
Old 12-22-2013
USMLE Forums Newbie
 
Steps History: Not yet
Posts: 4
Threads: 1
Thanked 1 Time in 1 Post
Reputation: 11
Default

(C) CORRECT: The key factor in determining the nature of a bone neoplasm is knowing the patient's age and region of bone involved. Giant cell tumors are epiphyseal lesions that affect the distal femur, proximal tibia, distal radius and as, in this case, the proximal humerus. This lesion expands the bone, thins the cortex, and has a lytic appearance. Often these are associated with an extraosseous soft tissue component. There is low malignant potential, however, local recurrence is frequent.
Reply With Quote Quick reply to this message
The above post was thanked by:
zen228 (04-08-2014)



Reply

Tags
Musculoskeletal-, Pathology-, Step-1-Questions

Quick Reply
Message:
Options

Register Now

In order to be able to post messages on the USMLE Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:
Medical School
Choose "---" if you don't want to tell. AMG for US & Canadian medical schools. IMG for all other medical schools.
USMLE Steps History
What steps finished! Example: 1+CK+CS+3 = Passed Step 1, Step 2 CK, Step 2 CS, and Step 3.

Choose "---" if you don't want to tell.

Favorite USMLE Books
What USMLE books you really think are useful. Leave blank if you don't want to tell.
Location
Where you live. Leave blank if you don't want to tell.

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes


Similar Threads
Thread Thread Starter Forum Replies Last Post
Causes of Proximal Muscle Weakness rasheed USMLE Step 2 CK Bits & Pieces 7 05-17-2016 09:28 AM
Is ape hand caused by both proximal and distal median N lesion? voicesinmyhead USMLE Step 1 Forum 1 10-28-2013 02:21 AM
which collagen type in epiphyseal plate? voicesinmyhead USMLE Step 1 Forum 0 08-01-2013 07:12 PM
Nerve injury in mid shaft humeral fracture plasticsurgeon USMLE Step 1 Forum 5 09-26-2011 01:02 PM
Amilotropic Lateral Sclerosis: Mixed Lesion or Pure Motor Lesion? patelMD USMLE Step 1 Forum 5 08-16-2011 11:29 AM

RSS Feed
Find Us on Facebook
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2017 DragonByte Technologies Ltd.

USMLE® & other trade marks belong to their respective owners, read full disclaimer
USMLE Forums created under Creative Commons 3.0 License. (2009-2014)