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1/4. Symptomatic giant (10-cm) bone island of the tibia.

    A bone island represents a focus of mature compact bone within the cancellous bone, and it can be diagnosed based on characteristic clinical and radiologic features. The lesion is typically asymptomatic with a preference for the pelvis, femur, and other long bones. On radiographs, the lesion appears as an ovoid, round or oblong homogeneously dense and sclerotic focus in the cancellous bone. The characteristic features of this lesion are radiating bony streaks, known as thorny radiations or pseudopodia. Most bone islands are small, and the majority of these lesions measure from 0.1 to 2.0 cm. A giant bone island, defined as having a diameter greater than 2 cm, has been rarely reported in the English-language literature. We report here on a case of a giant bone island that measured 10 x 1.7 x 1 cm in the diaphysis of the right tibia in a 31-year-old man who complained of right lower leg pain for 3 weeks.
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keywords = tibia
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2/4. A true aneurysm of the posterior tibial artery: a case report.

    True aneurysm of the posterior tibial artery is very rare. A 69-year-old woman presented with a pulsatile painful mass of the right lower leg.
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ranking = 1
keywords = tibia
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3/4. Schnitzler's syndrome treated successfully with intravenous pulse cyclophosphamide.

    Schnitzler's syndrome is a rare clinical condition characterized by chronic urticaria, intermittent fever, bone pain, arthralgia or arthritis, and monoclonal immunoglobulin m (IgM) gammopathy. Here we describe the case of a 48-year-old Italian female with a long history of arthralgia, leucocytosis, spiking fever, and chronic urticaria with severe pruritus. The IgM-kappa monoclonal component in the serum and bone densification on conventional X-ray with hyperfixation on bone technetium scanning at the distal part of the femurs and at the proximal part of the tibias were detected 4 years after the onset of the symptoms. After many ineffective treatments, the use of pulse cyclophosphamide (CPX) resulted in complete remission of the disease that is still lasting after a 2-year follow-up.
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keywords = tibia
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4/4. Classical and atypical location of adamantinomas--presentation of two cases.

    BACKGROUND: Adamantinomas are rare low-grade primary bone tumors of unknown histological origin. They typically develop in the diaphyses and metaphyses of long bones, prevalently the tibia. case reports: The cases of 2 female patients, one with localized swelling of the lateral metatarsals and one with pain of the tibia are being reported. The diagnostic work-up including biopsy verified an adamantinoma in both cases. In the younger patient, the tumor was located in the metatarsals 4 and 5, in the older patient in the left tibial diaphyses. In both patients, an en-bloc resection of the tumor with wide surgical margins was performed. Further follow-ups 73 and 36 months after surgery showed no local recurrence or metastatic spread. CONCLUSION: Adamantinomas of the short bones are rarely reported. In accordance to the literature, an en-bloc resection with wide surgical margins seems to reduce the risk of local recurrence and metastatic spread.
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ranking = 0.6
keywords = tibia
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