A 10-YEAR-OLD Malaysian girl was seen for a 7-month history of multiple swellings over the left thigh, upper arm, and anterior chest. Traditional healers had been consulted; however, the swellings continued to increase in size and to ulcerate. There was loss of weight and loss of appetite. On examination, 3 masses were noted measuring 7 × 4 cm over the left thigh, 4 × 5 cm on the left arm (Figure 1), and 5 × 3 cm over the chest wall. There were shotty cervical and inguinal lymph nodes palpable. Findings from general examination were otherwise unremarkable. Computed tomographic (CT) scans of the chest and abdomen were normal. The CT scan of the upper limbs is shown in Figure 2. The complete blood cell count showed a hemoglobin level of 127 g/L; white blood cell count, 30.9 × 109/L; and platelets, 563 × 109/L. There was a predominant neutrophilia. Results of renal and liver function tests were normal. The chest and thigh masses were debulked at surgery and the specimens sent for histopathological examination (Figure 3 and Figure 4).
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