A 15-year old white male presents with atraumatic right thigh pain and swelling that been getting worse over the last few months. He also notes increasing fatigue and weight loss as well. His X-ray is shown below that shows an "Onion skin" periosteal reaction of his distal femur. A biopsy demonstrates a translocation of chromosome 11 to 22. What is the most likely diagnosis?

Given the atraumatic right thigh pain and swelling, weight loss, fatigue, 'onion skin' periosteal reaction, and translocation of chromosome 11 to 22, the most likely diagnosis for this 15-year-old male is Ewing's Sarcoma.

Explanation:

The patient's symptoms of atraumatic right thigh pain and swelling, weight loss, and fatigue, along with the 'onion skin' periosteal reaction seen in the X-ray image and the translocation of chromosome 11 to 22 identified in the biopsy, suggest a diagnosis of Ewing's Sarcoma. Ewing's Sarcoma is a rare type of cancer that affects bones or the tissue surrounding the bones (soft tissue) predominantly seen in children and young adults. Early diagnosis and treatment are pivotal for a favorable prognosis.

Learn more about Ewing's Sarcoma here:

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