Osteogenic Sarcoma Recurrence

13-year-old female with history of osteogenic sarcoma of the left humerus, status post tumor resection and implant reconstruction. Routine follow-up MRI with metal reduction technique demonstrates a T1 isointense-to-muscle, T2/STIR hyperintense, enhancing mass in the medial arm with abnormal signal extending along the posterior muscle fascia and along the humeral implant. Post-contrast imaging further shows an enhancing nodule in the right lung that demonstrated calcification on CT. Findings are compatible with local sarcoma recurrence and pulmonary metastatic disease.