As knowledge and technology advance, the practice of medicine gets more and more specialized. This is especially true of practices based in large academic tertiarily referral centers, and physicians who care for patients with rare diseases. Furthermore, within orthopedic surgery, general practice is rare, and we are even seeing specialization within subspecialty disciplines. However, the practice of orthopedic oncology offers a unique dichotomy. While we provide highly specialized care for patients with a rare cancer, our scope of practice is quite diverse; not only with regard to anatomic location of tumors, but also with a relevant understanding of radiology and pathology that allows us to provide safe and efficient care to our patients.

We interpret our own musculoskeletal imaging with regard to differential diagnosis, and need for biopsy. We are often required to interpret chest imaging of patients seen in clinic for sarcoma surveillance prior to availability of an official radiology report. We participate in the interpretation of intraoperative biopsies that affect surgical decision making, which may be done with a non-musculoskeletal pathologist. Furthermore, even at locations where a multidisciplinary sarcoma team exists, the orthopedic oncologist has the unique perspective of the patient’s clinical presentation in its entirety. Thus, it is important to be able to interpret all of the data in order to make the most appropriate clinical decisions. Here I present a few challenging cases that highlight the importance of this comprehensive base of knowledge, and how it directly impacted the care and outcome of these patients.