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case_images: Ultrasound examination of the tumor: Spindle-shaped hypoechogenic and subcutaneously placed mass (a) with marked hypervascularity on color flow mapping (b).
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case_images: The ultrasound showed a heterogeneous, but predominantly hypoechoic mass with increased through transmission and increased vascularization (Fig. 1).
case_images: MRI findings of the tumor (arrows): (a) T1 image, coronal view; (b) T2 image, sagittal view; (c) T1 image, axial view revealing presence of a well-defined soft tissue tumor positioned in the subcutaneous fat tissue of the left calf with size of 3 cm and swelling of the surrounding muscles.
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case_images: Magnetic resonance imaging (MRI) was performed, confirming the presence of a soft tissue tumor in the subcutaneous tissue of the left calf (Fig. 2).
case_images: Macroscopic appearance of the specimen.
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case_images: Macroscopy of the specimen showed a whiteish soft fragment measuring 2 x 2 x 0.8 cm, microscopically composed of fibroblastic stroma with myxoid degeneration and immature osteoid embedded in between atypical osteoblasts with inconspicuous mitotic activity (Fig. 3).
case_images: Microscopic appearance of the tumor, He-Eo, x40.
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case_images: The proliferative index, Ki67 was  5%, thereupon a diagnosis of low-grade ESOS was made (Fig. 4).
case_images: Microscopic appearance, from the biopsy of the iliac wing, showing late (sclerotic) phase of Paget disease, He-Eo, x200.
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case_images: The microscopic analysis was consistent with the late (sclerotic) phase of Paget disease of bone (Fig. 5).