In the Enneking staging system for primary bone sarcomas, a Stage IIB tumour is defined as:

• A Low grade, intra-compartmental, no metastasis
• B High grade, intra-compartmental, no metastasis
• C Any grade, with regional or distant metastasis
• D High grade, extra-compartmental, no metastasis ✓

Explanation

Enneking/Musculoskeletal Tumor Society (MSTS) staging: Stage IA — low grade (G1), intra-compartmental (T1); Stage IB — low grade (G1), extra-compartmental (T2); Stage IIA — high grade (G2), intra-compartmental (T1); Stage IIB — high grade (G2), extra-compartmental (T2); Stage III — any grade with regional or distant metastasis. Compartmental status (T) determines whether limb salvage is feasible. High-grade extra-compartmental (IIB) tumors such as osteosarcoma require wide surgical resection + neoadjuvant chemotherapy.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

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