Right thigh pain in a 37 year old man

Case Identification

Case ID Number
Position within the bone
Periosteal reaction
Benign or Malignant

Clinical case information

Case presentation

This 37 year old IT manager has 6 months of mild thigh pain, which gradually has gotten worse and is now bothering him at night.

Radiological findings:
There is a permeative lesion in the meta-diaphysis of the right femur. Bone scan shows increased uptake, and MRI shows a mass in the surrounding soft tissues.

The imaging studies show an aggressive lesion. Complete work up showed multiple nodules in the lungs. Aggressive lesions include malignant bone tumors and some benign lesions.
Differential Diagnosis
The differential should include osteosarcoma, Ewing's sarcoma, primary lymphoma, osteoblastoma, infection, and eosinophilic granuloma.
Special Features of this Case:
What is the most likely diagnosis?
Case Answer
Clinical Case Answer