A ski instructor who tripped on a "snow snake"

Case Identification

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

Clinical case information

Case presentation

A 42 year old man who works as a ski instructor at a ski area near Boston presents to the emergency room after suffering an injury to the right hip. He states that he was skiing through a thin layer of new snow on top of the base snow pack when his right ski caught on something, twisting his leg, at which point he felt something very painful happen to his right hip. He fell down and was unable to stand. He said he though he might have caught a "snow snake."

Radiological findings:
A fracture is seen through the neck of the right femur, where a lesion can be noted in the femoral head. No other bone lesions are present.
Differential Diagnosis
What is the differential here?
Further Work Up Needed:
Should this patient have surgery for the fracture combined with biopsy, or some other treatment plan?
Pathology results:
Biopsy material is shown. What is the diagnosis?
Case Answer
Clinical Case Answer