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Case 2. (A) Computed tomography revealed a tumor in the anterior mediastinum. (B) X-ray of the right distal femur showing an aggressive lytic bony lesion in the distal femoral metaphysis. (C) Pathological examination confirmed osteoblastic osteosarcoma (hematoxylin and eosin staining; magnification, ×200). (D) Primary cancer: Germ cell tumor in the anterior mediastinum (hematoxylin and eosin staining; magnification, ×200).
