 | The original impression by her doctors was simple bone cyst with pathological fracture. However; the pain continued, which is usually not true for patients with simple bone cysts, whose fractures usually heal uneventfully.
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 | The radiographs are not of good quality, and the metaphyseal destruction was not appreciated. |
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 | Core needle biopsy of the enlarging tumor mass reveals cellular pleomorphic cells forming small amounts of osteoid, and with many bizarre giant cells; the diagnosis of osteosarcoma IIB was made. |
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 | By this time, the tumor has grown enormously, with areas of necrosis revealing the high grade nature of this conventional osteogenic sarcoma. |
 | MRI reveals the multiple areas of tumor bone formation in the soft tissues. |
 | Low power photomicrograph demonstrates the marked pleomorphism and areas of necrosis, all reenforcing the diagnosis of a high grade sarcoma. |
 | Bone scan revealed the extensive local nature of this lesion. |
 | Despite chemotherapy and forequarter amputation (done one month after biopsy), the patient succumbed with wide spread metastases four months after biopsy, indicating its high grade malignant nature. |
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