What are the NCCN guidelines on the diagnosis of bone sarcoma?

Updated: Jul 01, 2020
  • Author: Mrinal M Gounder, MD; Chief Editor: Edwin Choy, MD, PhD  more...
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National Comprehensive Cancer Network (NCCN) guidelines recommend that all patients younger than 40 years of age with abnormal radiographs be referred to an orthopedic oncologist for further workup that includes biopsy, which if indicated should be performed at the treating institution. Patients 40 years old or older should undergo a workup for a potential bone metastasis. Recommended studies include the following:

  • Chest radiograph
  • Computed tomography (CT) of the chest, abdomen, and pelvis with contrast
  • Serum protein electrophoresis
  • Laboratory studies, including complete blood cell count (CBC) and comprehensive metabolic panel with calcium to assess for hypercalcemia
  • Bone scan
  • Prostate-specfic antigen assay or mammogram

Findings of other lesions indicates a non-bone primary tumor. If no other lesions are found, the patient should be referred to an orthopedic oncologist for a biopsy. [1]

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