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An 18 month old boy presented with reluctance to move his left arm after a fall. He had received bacille Calmette-Guérin (BCG) vaccination six months prior to presentation. Radiological examination of the humerus showed a proximal pathological fracture and a number of lytic lesions. Magnetic resonance imaging showed an aggressive lesion within the proximal metaphysis with cortical disruption.
A bone biopsy showed …