A 40-year-old female presented with low back pain, generalized weakness and fractured femoral shaft with no significant history of trauma.

On CT and x-ray correlation, there is a soft tissue swelling with ring-and-arc chondroid matrix noted within it. Moth-eaten appearance of the head of femur and pelvic bones are suggestive of a high-grade tumor. Multiple aggressive lytic lesions are noted in the axial skeleton with soft tissue involvement. Thus the femoral shaft fracture is likely pathological.

On MRI correlation this lesion appears iso-intense on TIWI and predominantly hyperintense on T2WI and STIR. On the postcontrast study, it shows heterogeneous moderate enhancement. Multiple areas of altered signal intensity lesions are noted in the entire spine, largest at the level of T4-5 vertebrae causing compression over the thecal sac and leading to canal stenosis at that level likely suggestive of vertebral metastasis.

In view of the above imaging findings, the above described lesion is suggestive of a chondrosarcoma with multiple bony metastases predominantly involving the spine.