A 17-year-old presents with a distal femoral tumor showing a sunburst pattern on X-ray and Codman's triangle. Biopsy reveals high-grade osteosarcoma. According to Enneking staging, a high-grade tumor confined within the cortex without lymph node or distant metastases is classified as:
- A Stage IIA ✓
- B Stage IA
- C Stage IB
- D Stage IIB
Correct answer: A. Stage IIA
Explanation
The Enneking (MSTS) staging uses grade (I=low, II=high), compartment (A=intracompartmental, B=extracompartmental), and metastases (III=any metastasis). Stage IIA is high-grade (G2) intracompartmental (T1), no metastasis. Stage IIB is high-grade extracompartmental. The tumor described is high-grade (sunburst/Codman's) but confined within the cortex (intracompartmental) without metastases — Stage IIA. This distinction is critical for resection margin planning.
Reference: Maheshwari Essential Orthopaedics, 6th ed.
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