The patient has had tonsillectomy, and a benign tumor removed from the right breast. She does not smoke. In the family there is high blood pressure in the brother and diabetes and a brother. There is no other contributory history. Examination of the left ankle shows diffuse swelling. The range of motion is preserved. There is diffuse tenderness, but no definite mass is palpable. There is a faint mild lesion in the neck of the talus, that was visible on the original xrays taken months ago. MRI films show a mass in the neck of the talus which appears to have arisen in bone or adjacent to bone. A bone scan shows there are two areas of increased uptake, one in the talus and one in the hip. A CT scan of the abdomen is shown.