Osteoblastic Osteosarcoma
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A 43-year-old woman from presented to a local medical facility with a 2-year history of a left-sided distal forearm mass. The patient denied any history of pain, trauma or constitutional symptoms. Forearm radiographs and subsequent contrast enhanced MRI were performed in Puerto Rico, which raised concern for a bone tumor. An open biopsy was obtained. Histopathology demonstrated irregular lamellar bone with hypocellular fibrous stroma, but no obvious atypia, mitotic activity or necrosis mimicking fibrous dysplasia. Thus, a benign fibro-osseous lesion was diagnosed and follow-up was recommended. Three months later, follow-up radiographs demonstrated changes consistent with a more aggressive neoplasm. At this point, the patient presented to our institution reporting recent growth and new intermittent dull, burning pain exacerbated by maximal supination. On examination, a firm, nontender mass was appreciated on the dorso-medial aspect of the distal ulna with terminal supination defect compared with the contralateral forearm.

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