 | Radiographs reveal a huge osteolytic and osteoblastic lesion involving her entire tibial diaphysis, and both the proximal and distal metaphyses. These radiographs suggested osteomyelitis, primary bone tumor, or metastatic neuroblastoma. |
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 | Core needle biopsies yielded tissue with sheets of small round blue cells on H and E stains, which suggested Ewing's Sarcoma. Blood studies were normal, including normal catecholamines which suggested that the diagnosis was not neuroblastoma metastasis. Proper chemotherapy was begun, and because of her age and the extent of the lesion, limb sparing was not considered. Knee disarticulation was carried out, and radiation was also given. |
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 | Radiographs of the knee disarticulation amputation specimen. |
 | This large histosection demonstrates the extensive involvement of the tibial diaphysis and metaphyses. |
 | Radiograph of the entire remaining femur demonstrates the intact femoral condyles and the distal femoral epiphysis, to ensure an end bearing stump and full growth of the distal femur. |
 | The patient at about 5 years of age, 3 years after amputation. She was able to do cartwheels easily while wearing her artificial limb, and was free of disease. |
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 | The patient and her mother. She is now 26 years of age, 24 years after her amputation. Her end bearing stump allows excellent function. She continues to be free of disease, and states that she does not feel as though she is disabled. |