A 31-year-old tailor in Kerala, India, spent eight months with a swelling in his right upper thigh that would not go away. Painkillers helped briefly. Walking became difficult. Then a tender swelling appeared on the back of his lower right chest wall.
Imaging found holes in his bones. An X-ray showed a lytic lesion in his right proximal femur. MRI added a lesion in his right pubic bone, with a collection of fluid in the thigh tracking into the femur. A CT scan of his chest revealed an expansile lytic lesion destroying his right ninth rib, with a soft tissue collection over it, plus a cavitary nodule under the pleura of his left lower lung.
