A 34-year-old woman initially presented with left thigh pain to an orthopedic surgeon. The patient had no history of medical conditions or prior surgery and denied constitutional symptoms such as fever, weight loss, or malaise. She had emigrated from Iraq approximately 10 years before presentation. Findings from the initial basic serum chemical analysis were normal. Results of a complete blood cell count demonstrated mild leukocytosis, with a white blood cell count of 11.2 × 10 9 /L and an elevated neutrophil count of 9.2 × 10 9 /L. Serologic antibody studies were not performed at the time but were done later. Radiography and magnetic resonance (MR) imaging were performed. Results of pathologic examination of the specimen from needle biopsy revealed the diagnosis. The patient initially refused surgical intervention and was treated medically with albendazole. Despite the antiparasitic treatment, the patient experienced persistent pain. Because follow-up clinical and imaging findings indicated disease progression, the patient eventually decided to undergo surgery, requiring radical resection of the left femur and femoral replacement with a custom prosthesis.
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