A 16-year-old boy presents with a 10-week history of knee pain and swelling. MRI shows a metaphyseal lesion of the distal femur with cortical destruction, soft tissue extension, and skip lesions in the mid-femoral diaphysis. Which staging system best evaluates the surgical margin requirements?

• A Enneking/MSTS staging system ✓
• B TNM staging (AJCC)
• C Campanacci radiological grading
• D WHO histological grading

Explanation

The Enneking (MSTS) staging system specifically guides surgical margins in musculoskeletal tumors. It classifies tumors as Stage I (low grade), Stage II (high grade), and Stage III (distant metastasis), with subdivisions A (intracompartmental) and B (extracompartmental). Skip lesions place this tumor in Stage IIB or higher. Enneking's surgical margins (intralesional, marginal, wide, radical) are directly tied to this staging. The AJCC TNM system is used for bone tumors in oncology databases but does not define surgical margins as precisely.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.