A 26-month-old girl was admitted to the Khoula Hospital, Oman, in June 1990 with pseudoparalysis of the left upper limb of 2 days' duration. There was no history or evidence of trauma to the limb. The parents reported no other constitutional symptoms. Clinically, the child appeared to be a healthy girl with a small, bony swelling around the left proximal humerus. There were no signs or symptoms of inflammation. The regional lymph nodes were not palpable. No other lesions were seen in the body. Radiographs showed an expansile osteolytic lesion in the metaphyseal area of the proximal humerus (Fig. 1). We detected no other hematologic or radiologic abnormalities. An ultrasound revealed no fluid around the bony swelling. An open biopsy was performed, and the histopathologic features and electron microscopic and immunohistochemical studies clearly showed the lesion to be an osteosarcoma. Chemotherapy and disarticulation of the shoulder was performed at another institution. The child was alive with no detectable secondary lesions at the follow-up period of 1 year, 4 months.

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