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Here we present a case of 19-year-old male.

Came to me with following complaint: Pain and huge swelling in pelvis

Past history: Pain in left hip starts from February 2021

Xray and MRI was done

All these investigations was done by General Orthopaedic Surgeon and he concluded it could be tuberculosis and ATT was started, which was continued for 6 weeks.

But patient is not getting any relief, swelling & pain continued to increase. He went to other center and there biopsy was done s/o osteosarcoma (a type of bone cancer).

Then he went to some onco centre, there 1 cycle of chemotherapy was given. Along with 15 sittings of radiotherapy was given to local site after counselling that tumor will shrink and pain will reduce.

Then 4 cycle of chemo given again.

Now patient came to me with above mentioned Complaint and Present picture.

Examination Finding & Clinical Picture

Inspection: Huge swelling over left pelvis

Oedema in left lower limb Distal Pulsation were feeble

Biopsy Reviewed – S/O Osteosarcoma of pelvis.

PET-CT s/o multiple lung metastasis

Plan – Palliative management

Result: The patient passed away after a while.

I/V/O multiple lung metastasis as disease is already metastasized (R0 Resection not possible)

Take Home Message from this case!

• Every bone lesion is not TB (could be something else), Biopsy is must to get correct diagnosis.
• Radiologist should never report the diagnosis, differential should be given.
• Treatment should never be started upon Radiology report, Clinician should know how to see MRI and how to conclude final diagnosis after detailed clinical History and Examination with Radiology.
• Treatment should be started after proper diagnosis.
• Anti tubercular drug should be started after histopathological diagnosis only.
• Bone cancer treatment should be taken from Ortho Onco Specialist.

There is no role of radiation therapy in osteosarcoma (except palliative).