12 year old boy, previously healthy noticed swelling above his left ankle ankle. Initially he was not disturbed with this as it was not painful and did not limit his play and activities. Later he had minimal pain on brisk walking and he observed it was increasing in size. He came to us three months after the onset. He did not have fever. No similar swelling anywhere else. He did not have other symptoms like fatigue ,syncope bleeding manifestations.
No family history of similar swelling on the body. On examination Diffuse swelling on the medial aspect of lower limb, 4 X 4 cm. Surface normal no discoloration. No other swelling anywhere. No pallor No lymph nodes. see figure 1 As the swelling was growing over the last three months we considered the possibility of malignancy. We did a Plain X Ray lower leg and foot AP and Lateral See figure 2 &3 Differential diagnosis of lytic lesions of…
