 | This oblique radiograph of her knee (1975) revealed an osteolytic lesion of the distal metaphysis, and into the epiphysis as well.
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 | AP x-rays of both knees. The poorly marginated lesion with loss of cortex suggests a malignant lesion best shown in the oblique study.
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 | Biopsy and frozen section revealed a pattern of vascular spaces and new bone that suggested the diagnosis of aneurysmal bone cyst. |
 | However, final histosections a few days later revealed the true nature of this high grade, pleomorphic lesion, which when combined with the tumor vascular nature was diagnosed as a telangiectatic osteogenic sarcoma IIB; only small amounts of new bone were formed. |
 | The time was 1975 before limb sparing was common and when telangiectatic osteogenic sarcoma was considered to be usually fatal. A high thigh amputation was performed. The gross appearance of the sectioned femur revealed the hemorrhagic nature of the lesion which destroyed local cortex.
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 | The true malignant nature of this neoplasm is demonstrated by this chest x-ray at one year after amputation, revealing a pneumothorax, pleural effusion and a solid pulmonary tumor mass. Aspiration of the pleural effusion yielded sarcoma cells. Chemotherapy was continued and the pulmonary metastases resolved completely.
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