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A 16-year-old female with no significant past medical history presented to an outside physician with complaints of 18 months of left hip pain that was intermittent, primarily located in the upper left leg. She described the pain as sharp and worse with movement. The pain was initially intermittent and it plagued her approximately every 1-2 months. However, about two weeks prior to presentation the pain significantly worsened and became more constant, prompting her to seek medical evaluation. Following evaluation by the outside physician that included imaging that found a concerning lesion in the pelvis, the patient was referred to a Children's Hospital for further workup and evaluation. An MRI of the pelvis was obtained upon arrival at Texas Children's Hospital and found a left ischiopubic tumor with large associated extraosseous soft tissue mass involving the pubic crest, the superior and inferior pubic rami, the ischiotuberosity and the acetabulum on the left. A CT scan of the chest was then obtained that revealed multiple bilateral lung masses, felt to be consistent with metastases. Biopsy obtained of the suspicious mass in the left hemipelvis was positive for Ewing's sarcoma.
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