| Summary points: | A 24-year-old with a 13-year history of systemic lupus erythematosus, who had been treated with high dose immunosuppressive agents, presents with pain and haematuria. This case report details the patient's history, clinical presentation, diagnostic investigations, and treatment outcome, and includes various images. The authors discuss the differential diagnosis, potential predisposing factors, the immunohistochemical profile, and the link between SLE and osteosarcoma. |