An American housewife, aged 51, was seen because of bilateral fibrosarcoma of the lower extremities. The patient's father and mother, four sisters and two brothers were living and well. One brother was killed in an accident. The patient had had three normal deliveries. The diseases of childhood included measles, chickenpox and pertussis. She had frequent sore throats. At 31 years of age, six weeks after the birth of her second child, she had rheumatic fever. At the age of 34, a large ovarian cyst was removed. At 40, a tonsillectomy was done, but only after joint changes were quite marked. At the age of 45, she noticed a swelling beginning on the dorsum of each foot just behind the toe clefts, the right slightly larger than the left, and both accompanied by occasional sharp, cutting pain. No history of trauma or ulcer was obtained. The patient consulted a physician, who