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Burdiles A, Marín R, Klaber I, Solar A, Calderón M, Jara F, Kara F, Bazáes D. Polyostotic fibrous dysplasia (McCune-Albright) with rare multiple epiphyseal lesions in association with aneurysmal bone cyst and pathologic fracture. Radiol Case Rep 2021; 16:2719-2725. [PMID: 34336077 PMCID: PMC8318835 DOI: 10.1016/j.radcr.2021.06.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 06/05/2021] [Accepted: 06/06/2021] [Indexed: 11/10/2022] Open
Abstract
Fibrous dysplasia, including McCune-Albright syndrome, is a genetic, non-inheritable benign bone disorder that may involve a single or multiple bone, typically occurring in the diaphysis or the metaphysis of long bones. In very rare instances polyostotic fibrous dysplasia present involvement of the epiphysis in long bones. Aneurysmal bone cysts are benign, expansile, lytic bone lesions formed by cystic cavities containing blood, that may occur de novo or secondary to other lesions of bone, including fibrous dysplasia. We report a case of an 18-year-old female with polyostotic fibrous dysplasia (McCune-Albright syndrome) with diaphyseal and unusual multiple foci of epiphyseal involvement of long bones as well as in the patella, and a simultaneous aneurysmal bone cyst of the left femoral neck with pathologic fracture. This is the first report of a simultaneous aneurysmal bone cyst in a patient with polyostotic fibrous dysplasia (McCune-Albright syndrome) with involvement of diaphysis and epiphysis of long bones, highlighting that fibrous dysplasia should be included in the differential diagnosis of polyostotic tumors involving the diaphysis as well as the epiphysis. In patients with polyostotic fibrous dysplasia there should be an active search for lesions in the epiphysis.
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Affiliation(s)
- Alvaro Burdiles
- Department of Radiology, Pontificia Universidad Católica de Chile
| | - Rodrigo Marín
- Pontificia Universidad Católica de Chile, Santiago, RM, Chile 8330024
| | - Ianiv Klaber
- Department of Orthopedics, Pontificia Universidad Católica de Chile, Santiago, RM, Chile 8330024
| | - Antonieta Solar
- Department of Pathology, Pontificia Universidad Católica de Chile, Santiago, RM, Chile 8330024
| | - Miguel Calderón
- Pontificia Universidad Católica de Chile , Santiago, RM, Chile 8330024
| | - Felipe Jara
- Pontificia Universidad Católica de Chile , Santiago, RM, Chile 8330024
| | - Fernanda Kara
- Pontificia Universidad Católica de Chile, Santiago, RM, Chile 8330024
| | - Diego Bazáes
- Pontificia Universidad Católica de Chile, Santiago, RM, Chile 8330024
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Magnetic resonance imaging features of craniofacial fibrous dysplasia. Pol J Radiol 2018; 84:e16-e24. [PMID: 31019590 PMCID: PMC6479141 DOI: 10.5114/pjr.2019.82747] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 11/06/2018] [Indexed: 12/22/2022] Open
Abstract
Purpose To assess the value of magnetic resonance imaging (MRI) in detecting craniofacial fibrous dysplasia (CFD) and diagnosing and differentiating it from intraosseous meningioma. Additionally, the MRI appearance of the typical computed tomography (CT) imaging feature, the ground glass phenomenon, was evaluated. Material and methods MRI datasets of 32 patients with CFD were analysed retrospectively. Detectability in MRI was assessed by analysis of 10 randomly selected patients with CFD and 10 normal controls by two blinded readers. Changes of affected bone, internal lesion structure, T1 and T2 signal intensity, and contrast enhancement of the lesion in general and ground glass areas in particular were assessed. Ten patients with intraosseous meningioma (one in each) served as differential diagnosis for CFD. Results All 10 CFD lesions were reliably detected in MRI. In 32 patients 36 CFD lesions were evaluated. In 66.7% CFD were iso- to hypointense in T1 and hyperintense in T2; this proportion was similar for ground glass areas (65.7%). Ground glass areas were more homogeneously structured than the whole CFD lesion in both T1 (100% vs. 56%, respectively) and T2 (91% vs. 61%, respectively). Contrast enhancement was found in 97% of complete CFD lesions and 93% of ground glass areas. The accuracy for CFD vs. intraosseous meningioma was 100% for 'no soft-tissue component' and 98% for 'bone broadening' in MRI. Conclusions Distinct morphological changes of CFD are reliably detected in MRI and allow differentiation from intraosseous meningioma. Areas with ground glass phenomenon in CT show a predominantly homogenous internal structure in MRI with contrast enhancement.
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Lee HS, Koh YC, Roh HG, Park HK, Kim SY. Secondary Aneurysmal Bone Cyst in a Craniofacial Fibrous Dysplasia: Case Report. Brain Tumor Res Treat 2018; 6:86-91. [PMID: 30381923 PMCID: PMC6212691 DOI: 10.14791/btrt.2018.6.e15] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 09/22/2018] [Accepted: 09/28/2018] [Indexed: 12/13/2022] Open
Abstract
Aneurysmal bone cyst (ABC) is a rare non-neoplastic bone lesion that involves mostly the long bones and vertebrae and may occur very rarely in the craniofacial bones. ABCs may occur as secondary bony pathologies in association with various benign and malignant bone tumors and with fibrous dysplasia (FD). FD is a common non-neoplastic bony pathology mostly affecting craniofacial bones. Secondary ABC occurring in craniofacial FD is extremely rare, with only approximately 20 cases reported in the literature to date. Here, we report on a case of secondary ABC in a 25-year-old woman who has had a craniofacial deformity for over 10 years and who presented to us with a rapidly growing painful pulsatile mass in the right frontal region that began over 2 months prior to admission. On thorough examination of computed tomography and magnetic resonance imaging brain scans taken at two-month interval, an aggressive, rapidly enlarging ABC, arising from the right frontal FD, was diagnosed. The patient underwent preoperative embolization followed by gross total resection of the ABC and cranioplasty. The 6-month follow up showed no recurrence of the ABC, nor was any progression of the FD noticed.
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Affiliation(s)
- Hyun Seok Lee
- Department of Neurosurgery, Konkuk University Medical Center, Seoul, Korea
| | - Young Cho Koh
- Department of Neurosurgery, Konkuk University Medical Center, Seoul, Korea.
| | - Hong Gee Roh
- Department of Radiology, Konkuk University Medical Center, Seoul, Korea
| | - Hyung Kyu Park
- Department of Pathology, Konkuk University Medical Center, Seoul, Korea
| | - Soo Yeon Kim
- Department of Neurosurgery, Konkuk University Medical Center, Seoul, Korea.
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Cheng Y, Xu H, Kvit AA, Yu Z. Diagnosis of an aneurysmal bone cyst of the cricoid cartilage: A case report. Exp Ther Med 2015; 10:531-534. [PMID: 26622349 DOI: 10.3892/etm.2015.2513] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 04/28/2015] [Indexed: 11/05/2022] Open
Abstract
An aneurysmal bone cyst (ABC) is a type of reactive reparative bone neoplasm that rarely occurs in the head and neck. To date, only a small number of cases have been previously reported. The present study reports the case of a 58-year-old male who presented with a tumor in the laryngeal cricoid cartilage, a rare position for a tumor, who subsequently underwent treatment by surgical resection. Based on the observations of the present study and a literature review, it was concluded that an ABC of the larynx can be identified based on a combination of radiology and postoperative histopathology examinations. However, following a tracheotomy and excision, the difficulty of performing tracheal cannula removal is inevitable. The present study described in detail a rare disease, ABC, occurring in the larynx. More cases are required for follow-up studies.
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Affiliation(s)
- Yusheng Cheng
- Department of Otolaryngology, Head and Neck Surgery, Shanghai Jiao Tong University Affiliated First People's Hospital, Shanghai 200080, P.R. China
| | - Hongming Xu
- Department of Otolaryngology, Head and Neck Surgery, Shanghai Jiao Tong University Affiliated First People's Hospital, Shanghai 200080, P.R. China
| | - Anton A Kvit
- Department of Surgery, University of Wisconsin, Madison, WI 53562, USA
| | - Ziwei Yu
- Department of Otolaryngology, Head and Neck Surgery, Shanghai Jiao Tong University Affiliated First People's Hospital, Shanghai 200080, P.R. China
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Anderson N, DiBella C, Pianta M, Slavin J, Choong P. Aggressive aneurysmal bone cyst in association with polyostotic fibrous dysplasia: A case report. Int J Surg Case Rep 2015; 12:52-6. [PMID: 26011801 PMCID: PMC4486103 DOI: 10.1016/j.ijscr.2015.05.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2015] [Revised: 05/10/2015] [Accepted: 05/11/2015] [Indexed: 11/26/2022] Open
Abstract
Aneurysmal bone cyst occurring in the setting of previously diagnosed fibrous dysplasia is a rare occurrence. Repeat investigation with imaging and biopsy was required to obtain accurate diagnosis and exclude malignancy. Due to the aggressive nature of the disease and the patient’s medical comorbidities, an above knee amputation was required for disease control.
Introduction Aneurysmal bone cyst occurring in the setting of previously diagnosed fibrous dysplasia is rare. While both are benign processes, pain, compression of nearby structures and risk of fracture can require treatment. Presentation of case In this report, we describe a 56 year old male who developed an aggressive aneurysmal bone cyst secondary to fibrous dysplasia in the proximal tibia over a period of 8 months. He required an above knee amputation for disease and symptom control due to the aggressive nature of disease and medical comorbidities. Discussion The diagnosis of a secondary lesion can prove difficult. It is important to exclude a malignant disease process, particularly when imaging demonstrates an aggressive appearance. In this case, repeat imaging, CT guided biopsies and an open biopsy were performed to exclude malignancy prior to definitive surgical management. Conclusion In order to exclude secondary lesions, we suggest further investigation for new onset pain in the setting of a benign lesion.
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Affiliation(s)
- Nathan Anderson
- Department of Orthopaedics, St Vincent's Hospital Melbourne, 41 Victoria Parade, Fitzroy, Victoria 3065 Australia; Bone and Soft Tissue Sarcoma Service, Peter MacCallum Cancer Institute, Melbourne, Victoria 3002, Australia.
| | - Claudia DiBella
- Department of Orthopaedics, St Vincent's Hospital Melbourne, 41 Victoria Parade, Fitzroy, Victoria 3065 Australia; Bone and Soft Tissue Sarcoma Service, Peter MacCallum Cancer Institute, Melbourne, Victoria 3002, Australia; Department of Surgery, The University of Melbourne, Parkville, Victoria 3002, Australia.
| | - Marcus Pianta
- Department of Radiology, St Vincent's Hospital Melbourne, 41 Victoria Parade, Fitzroy, Victoria 3065, Australia.
| | - John Slavin
- Department of Pathology, St Vincent's Hospital Melbourne, 41 Victoria Parade, Fitzroy, Victoria 3065, Australia.
| | - Peter Choong
- Department of Orthopaedics, St Vincent's Hospital Melbourne, 41 Victoria Parade, Fitzroy, Victoria 3065 Australia; Bone and Soft Tissue Sarcoma Service, Peter MacCallum Cancer Institute, Melbourne, Victoria 3002, Australia; Department of Surgery, The University of Melbourne, Parkville, Victoria 3002, Australia.
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Manjila S, Zender CA, Weaver J, Rodgers M, Cohen AR. Aneurysmal bone cyst within fibrous dysplasia of the anterior skull base: continued intracranial extension after endoscopic resections requiring craniofacial approach with free tissue transfer reconstruction. Childs Nerv Syst 2013; 29:1183-92. [PMID: 23435492 DOI: 10.1007/s00381-013-2034-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2012] [Accepted: 01/14/2013] [Indexed: 12/18/2022]
Affiliation(s)
- Sunil Manjila
- Division of Pediatric Neurosurgery & Minimally Invasive Neurosurgical Laboratory, University Hospitals Case Medical Center, Cleveland, OH, USA
| | - Chad A Zender
- Division of Otolaryngology & Minimally Invasive Otolaryngological, Laboratory, University Hospitals Case Medical Center, Cleveland, OH, USA
| | - John Weaver
- Division of Pediatric Neurosurgery & Minimally Invasive Neurosurgical Laboratory, University Hospitals Case Medical Center, Cleveland, OH, USA
| | - Mark Rodgers
- Department of Pathology, University Hospitals Case Medical Center, Cleveland, OH, USA
| | - Alan R Cohen
- Department of Neurosurgery, Children's Hospital Boston, Harvard Medical School, 300 Longwood Avenue, Boston, MA, 02115, USA.
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The role of dual-phase Tc-99m MIBI in the evaluation of potentially operable lesions detected by bone scanning in fibrous dysplasia: a long-term prospective follow-up study. Nucl Med Commun 2011; 33:288-96. [PMID: 22198723 DOI: 10.1097/mnm.0b013e32834eac86] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE The aim of this study was to determine the role of whole-body Tc-99m MDP bone scintigraphy (BSc) with dual-phase Tc-99m MIBI scintigraphy (DPMSc) in the assessment of fibrous dysplasia (FD) and the value of DPMSc in the detection of potentially operable lesions for guiding surgical treatment. METHODS Twelve patients with histopathologically confirmed FD were evaluated with BSc and DPMSc. The patients were clinically followed up for a mean duration of 75 months. BSc images have been used as a guide to identify the site and the extent of the skeletal involvement. The symptomatic lesions were evaluated with DPMSc. RESULTS Forty-three lesions were evaluated in 12 patients. BSc showed increased uptake in all of the lesions, whereas DPMSc findings correlated more accurately with the symptoms. Fifteen symptomatic lesions showed increased Tc-99m MIBI uptake on DPMSc, especially in the early phase of DPMSc. The sensitivity, specificity and accuracy values for the early phase in detecting the symptomatic lesions were 100 and 93%, and for delayed phase were 100 and 98%, respectively. CONCLUSION BSc is useful in determining the site and extent of the skeletal involvement, especially in polyostotic FD. It seems that the potentially operable symptomatic lesions may be evaluated more accurately with DPMSc as compared with BSc. In addition, it seems that DPMSc findings correlate with the symptoms of FD, and this relationship may have a role in improving the preoperative assessment for guiding surgical treatment. DPMSc could be useful in the work-up of symptomatic patients if our results are validated in a larger patient series.
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Monostotic fibrous dysplasia of a lumbar vertebral body with secondary aneurysmal bone cyst formation: a case report. J Med Case Rep 2009; 3:7227. [PMID: 19830140 PMCID: PMC2726553 DOI: 10.4076/1752-1947-3-7227] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2008] [Accepted: 01/22/2009] [Indexed: 12/04/2022] Open
Abstract
We report the case of a 25-year-old Caucasian woman with symptomatic monostotic fibrous dysplasia of the fourth lumbar vertebral body. The patient suffered from a five-week history of progressive low back pain, radiating continuously to the left leg. Her medical history and physical and neurological examination did not demonstrate any significant abnormalities. Radiographs, computed tomography and magnetic resonance imaging revealed an osteolytic expansive lesion with a cystic component of the fourth lumbar vertebral body. Percutaneous transpedicular biopsy showed histological characteristics of fibrous dysplasia superimposed by the formation of aneurysmal bone cyst components. The patient was treated by subtotal vertebrectomy of the L4 vertebral body with anterior reconstruction and her postoperative course was uncomplicated. To our knowledge, this is the first reported case of a monostotic fibrous dysplasia with superimposed secondary aneurysmal bone cysts of a lumbar vertebral body.
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Diah E, Morris DE, Lo LJ, Chen YR. Cyst degeneration in craniofacial fibrous dysplasia: clinical presentation and management. J Neurosurg 2007; 107:504-8. [PMID: 17886547 DOI: 10.3171/jns-07/09/0504] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Object
Fibrous dysplasia (FD) is a common osseous tumor that may affect the craniofacial skeleton. Cyst degeneration may occur within an existing FD lesion, manifesting as acute clinical deterioration. Because existing reports of this entity are limited, the object of this study was to describe the presentation and management of cyst degeneration in a relatively large series of patients.
Methods
For nine patients who were treated for cyst degeneration of craniofacial FD the following data were reviewed: demographic factors, clinical presentation, tumor type, computed tomography (CT) findings, surgical management, intraoperative findings, and histopathological findings.
Results
The mean age at tumor presentation was 14.9 years. Seven patients had received a diagnosis of FD before the acute changes of cyst degeneration occurred; this change occurred between 1 and 7 years after the initial diagnosis. The most common presenting symptoms were sudden mass enlargement (78% of patients) and pain (67%). No predisposing factor for cystic change was identified. Four patients presented with visual disturbance; blindness developed in two despite optic nerve decompression. Cyst degeneration occurred most commonly in the sphenoid and frontal bones. The cysts' appearance ranged from a simple lesion to aneurysmal bone cyst.
Conclusions
Cyst degeneration may occur spontaneously within the FD lesion years after the initial diagnosis. Evaluation with CT scanning remains effective in the diagnosis and monitoring of disease progression, and in treatment planning. Surgical intervention is indicated for patients with symptoms or functional impairment. Optimal management of this entity has been facilitated through careful collaboration between neurosurgeons and plastic surgeons.
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Affiliation(s)
- Enrina Diah
- Craniofacial Center and Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan
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Fitzpatrick KA, Taljanovic MS, Speer DP, Graham AR, Jacobson JA, Barnes GR, Hunter TB. Imaging Findings of Fibrous Dysplasia with Histopathologic and Intraoperative Correlation. AJR Am J Roentgenol 2004; 182:1389-98. [PMID: 15149980 DOI: 10.2214/ajr.182.6.1821389] [Citation(s) in RCA: 170] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Kimberly A Fitzpatrick
- Department of Radiology, University of Arizona College of Medicine, 1501 N Campbell Avenue, PO Box 245067, Tucson, AZ 85724-5067, USA
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Putnam A, Yandow S, Coffin CM. Classic adamantinoma with osteofibrous dysplasia-like foci and secondary aneurysmal bone cyst. Pediatr Dev Pathol 2003; 6:173-8. [PMID: 12574919 DOI: 10.1007/s10024-002-8812-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2002] [Accepted: 10/10/2002] [Indexed: 10/27/2022]
Abstract
Adamantinoma, a rare bone lesion of the tibia and fibula, has two distinct variants, classic adamantinoma and osteofibrous dysplasia-like adamantinoma. Composite lesions have not been described. Aneurysmal bone cyst is a benign cystic lesion which may also occur in the tibia and fibula. We report an unusual case of classic adamantinoma with osteofibrous dysplasia-like areas and foci of secondary aneurysmal bone cyst with prominent giant cells. A lesion was diagnosed in a 17-year-old girl with a 14-year history of a slowly enlarging left tibial mass and increasing deformity. Pathologically, the predominant pattern was classic adamantinoma, with minor foci of osteofibrous dysplasia-like adamantinoma and areas of secondary aneurysmal bone cyst with abundant multinucleated giant cells. We report the clinical, radiologic, and pathologic features of this case, and summarize lesions associated with secondary aneurysmal bone cyst. To our knowledge, the association of adamantinoma with secondary aneurysmal bone cyst has not been previously reported.
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Affiliation(s)
- Angelica Putnam
- Department of Pathology, University of Utah School of Medicine, 50 North Medical Drive, Salt Lake City, UT 84132-2501, USA
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Affiliation(s)
- T A Burd
- Department of Orthopedic Surgery, University of Missouri Hospital & Clinics, Columbia 65212, USA
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Bandiera S, Bacchini P, Bertoni F. Secondary aneurysmal bone cyst simulating malignant transformation in fibrous dysplasia. Orthopedics 2000; 23:1205-7. [PMID: 11103968 DOI: 10.3928/0147-7447-20001101-23] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- S Bandiera
- Divisione di Ortopedica e Traumatologia, Ospedale Maggiore CA Pizzardi, Bologna, Italy
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Letson D, Falcone R, Muro-Cacho CA. Pathologic and Radiologic Features of Primary Bone Tumors. Cancer Control 1999; 6:283-293. [PMID: 10758559 DOI: 10.1177/107327489900600313] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- D Letson
- Department of Surgery, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida 33612, USA
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