Approach to a suspected bone tumor (pediatrics) Quiz: Ace Your Exams
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A 12-year-old girl is brought to the pediatric clinic by her parents due to left leg pain. During the past four months, she has been experiencing left thigh pain that is worse at night and aggravated by movement. She did not have an associated injury or trauma to the area prior to symptom onset. She has also had intermittent night sweats and an unintentional weight loss of 8 lbs. (3.6 kg). Temperature is 37.7ºC (99.9ºF), heart rate is 96/min, respiratory rate is 12/min, and blood pressure is 103/61 mmHg. Physical examination reveals swelling and tenderness to palpation of the left proximal thigh with overlying erythema and a palpable tender mass. Plain radiographs of the left femur show a large lytic lesion with a poorly defined border and a periosteal reaction with an “onion peel” appearance. Which of the following is the best next step in management?
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