Ewing sarcoma of the diaphysis of the femur in a 12-year-old child is best managed with:

• A Wide surgical resection alone
• B Radiation therapy alone to avoid growth disturbance
• C Intralesional curettage with bone grafting
• D Multiagent chemotherapy (VDC-IE protocol) followed by local control with surgery or radiotherapy ✓

Explanation

Ewing sarcoma is a systemic disease at diagnosis (micrometastases presumed); therefore multiagent chemotherapy using alternating VDC (vincristine, doxorubicin, cyclophosphamide) and IE (ifosfamide, etoposide) is the backbone. Local control is achieved by surgery, radiation, or combined modality. Surgery is preferred when resection achieves clear margins without unacceptable morbidity; radiation is reserved for unresectable sites. Intralesional resection risks local recurrence.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.