A 13-year-old presents with pain at night, cough, and dyspnea and is diagnosed with a metasta-sizing malignant bone tumor. The most likely type of tumor is:

a. nonossifying fibroma.
b. chondrosarcoma.
c. Ewing sarcoma.
d. osteosarcoma.


ANS: D
With osteosarcoma, the most common presenting complaint is pain. Night pain, awakening a child from sleep, is a particularly foreboding sign. There may be swelling, warmth, and redness caused by the vascularity of the tumor. Symptoms may also include cough, dyspnea, and chest pain if lung metastasis is present. This symptomatology is not associated with the other options.

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