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A 32 year old auto mechanic with multiple femur lesions

Case Identification
Case ID Number: 
Clinical case information
Case presentation: 

A 35 year old auto mechanic whose wife had just had their first baby presented with severe pain in the distal femur. Subsequent work up showed multiple ipsilateral lesions. Pathology images from a similar lesion are shown.

Radiological findings:: 
The initial work-up revealed multiple lesions in both lower extremities, including a lesion in the mid-diaphysis of the ipsilateral tibia and two lesions in the contralateral femur. A CT scan of the chest showed pulmonary nodules.
Differential Diagnosis: 
metastatic adenocarcinoma, metastatic sarcoma, multiple myeloma (very rare in this age group)
Pathology results:: 
Images are from a similar tumor