BACKGROUND Angioleiomyoma is a rare and benign stromal tumor typically found in subcutaneous tissue.It rarely occurs in the gastrointestinal tract.Among the reported cases,the most common complication was gastrointest...BACKGROUND Angioleiomyoma is a rare and benign stromal tumor typically found in subcutaneous tissue.It rarely occurs in the gastrointestinal tract.Among the reported cases,the most common complication was gastrointestinal bleeding.Perforation has only been reported as a complication in the last few decades.CASE SUMMARY This case report detailed the discovery of intestinal angioleiomyoma in a 47-yearold male presenting with abdominal pain that had persisted for 3 d.After suspecting hollow organ perforation,surgical intervention involving intestinal resection and anastomosis was performed.CONCLUSION The report underscores the significance of early surgical intervention in effectively treating angioleiomyoma while emphasizing the pivotal role of timely and appropriate measures for favorable outcomes.展开更多
Angioleiomyoma represents a benign stromal tumor, which usually occurs in the subcutaneous tissue of the extremities, although its occurrence in the gastrointestinal tract is very rare. A case of rectal angioleiomyoma...Angioleiomyoma represents a benign stromal tumor, which usually occurs in the subcutaneous tissue of the extremities, although its occurrence in the gastrointestinal tract is very rare. A case of rectal angioleiomyoma in a 40 year-old female patient is described here. Six months earlier, the patient suffered from periodical prolapse of an oval tumor from the anus, along with difficulties in bowel movement. A transanal extirpation of the tumor was performed. This is the first reported case in the English literature of a patient presenting with prolapsed angioleiomyoma of the rectum. During the immediate postoperative period, as well as 6 mo later, the patient had an unremarkable postoperative recovery.展开更多
Introduction: Laryngeal angioleiomyoma is a rare benign tumor of larynx with vascular origin. We report a case of laryngeal angioleiomyoma in a 52-year-old female. Case presentation: A 52- year-old Caucasian female wa...Introduction: Laryngeal angioleiomyoma is a rare benign tumor of larynx with vascular origin. We report a case of laryngeal angioleiomyoma in a 52-year-old female. Case presentation: A 52- year-old Caucasian female was referred to our institute with a chief compliant of severe midnight snoring. Her symptoms were progressive and began from two years ago. There was no history of hoarseness and laryngeal pain. The patient underwent a laryngoscopic examination and a large mass was seen on the left aryepiglotic fold. Surface of lesion was smooth and covered by laryngeal mucosa with no ulcer. There was a rapid enhancing mass on left aryepiglotic fold with bulging into the left piriformis sinus in contrast-enhanced computed tomography. The tumor was complicated by profuse bleeding after biopsy which was not controlled by conventional approaches. The patient was then administered a general anesthesia and the tumor was completely removed via laryngosurgery accompanied by left superior thyroid artery ligation. The specimen was histopathologically compatible with laryngeal angioleiomyoma. Conclusion: Angioleiomyoma of larynx is of benign nature and rarely recurs. However, it can be complicated by profuse bleeding on biopsy and contrast-medium imaging should be considered before surgical intervention to diagnose the tumor properly and prevent life-threatening complications.展开更多
Chordomas are dysembryogenic tumors originating from the notochordal process [1] [2]. They are aggressive tumours with unique diagnostic and management challenges. Primary therapy is complete surgical removal of the t...Chordomas are dysembryogenic tumors originating from the notochordal process [1] [2]. They are aggressive tumours with unique diagnostic and management challenges. Primary therapy is complete surgical removal of the tumour as much as possible. The likelihood of recurrence is high in spite of complete surgical resection. A 52-year-old female patient presented with complaints of decreased vision in right eye, nasal bleeding, nasal blockage and difficulties in swallowing. CT scan and nasal biopsy were performed which confirmed the diagnosis of clivus chordoma. The CT scan showed extension into nasopharynx, nasal cavity and oropharynx pushing onto the soft palate. Surgical excision of the mass was performed with coblator by both intraoral and intra nasal approach [3]. On follow-up, nasal endoscopy and CT were done;the patient was relieved of the symptoms and was clinically better.展开更多
Angioleiomyoma (ALM) is a benign tumor that occurs most frequently in the subcutaneous tissue of the upper and lower extremities. ALM arising in the sinonasal tract is rare, with fewer than 1% of cases presenting in t...Angioleiomyoma (ALM) is a benign tumor that occurs most frequently in the subcutaneous tissue of the upper and lower extremities. ALM arising in the sinonasal tract is rare, with fewer than 1% of cases presenting in this region. Only two cases localized to the sinuses have been reported to date in the literature. We report a case of a 30-year-old man complaining of a headache noted to have a concomitant lesion in the maxillary sinus. Histopathological examination following surgical resection confirmed a diagnosis of ALM. This report is the first known report of ALM limited to the maxillary sinus, and the first report to present the imaging data in the ALM in the sinus.展开更多
BACKGROUND Immunoglobulin G4 related disease(Ig G4-RD)is a fibroinflammatory disease with markedly elevated serum Ig G4 levels and fibrous tissue proliferation,accompanied by numerous plasma cells.Ig G4 related hypert...BACKGROUND Immunoglobulin G4 related disease(Ig G4-RD)is a fibroinflammatory disease with markedly elevated serum Ig G4 levels and fibrous tissue proliferation,accompanied by numerous plasma cells.Ig G4 related hypertrophic pachymeningitis(Ig G4-RHP)is relatively rare and indistinguishable from other phymatoid diseases before the operation.The risk of long-term immunosuppression needs to be balanced with disease activity.CASE SUMMARY A 40-year-old man presented with headache and bilateral abducent paralysis.He was also diagnosed with pulmonary tuberculosis 10 years ago and was on regular treatment for the same.Before the operation and steroid therapy,the patient was suspected of having tubercular meningitis at a local hospital.A clivus lesion was found via brain magnetic resonance imaging(MRI)at this presentation.He was preliminarily diagnosed with meningioma and underwent Gamma Knife Surgery.Transnasal endoscopic resection was performed to treat deterioration of nerve function.Postoperative pathologic examination suggested Ig G4-RD.Moreover,the serum Ig G4 was elevated at 1.90 g/L(reference range:0.035-1.500 g/L).After steroid therapy for 2 mo,the lesion size diminished on MRI,and the function of bilateral abducent nerves recovered.CONCLUSION Ig G4-RHP is relatively rare and indistinguishable before the operation.Elevated serum Ig G4 levels and imaging examination help in the diagnosis of Ig G4-RHP.Surgery is necessary when lesions progress and patients start to develop cranial nerve function deficit.展开更多
Purpose:To report a rare case of angioleiomyoma of the ciliary body Methods:The clinical manifestation, imaging findings, histopathologic characteristics were analyzed in a 32-year-old male patient with angioleiomyoma...Purpose:To report a rare case of angioleiomyoma of the ciliary body Methods:The clinical manifestation, imaging findings, histopathologic characteristics were analyzed in a 32-year-old male patient with angioleiomyoma of the ciliary body.Results:The tumor was removed intact with local resection. Histopathologic examination revealed that the tumor was full of vessels and it was composed of spindle cells with abundant cytoplasm. Immunohistochemical studies showed positive for SMA and Desmin and negative for S100 and HMB-45. Conclusions:Angioleiomyoma of the ciliary body is a rare tumor that can be successfully treated with local surgical resection in this area. It needs to be differentiated from other tumors, especially malignant melanoma. Eye Science 2004;20:19-22.展开更多
目的通过分析儿童正常斜坡的MRI特点,探索儿童斜坡开始黄髓化的年龄界值,以利于更好地识别骨髓病变。材料与方法选取2022年4月至2023年10月在本院放射科行颅脑MRI检查的儿童作为研究对象,通过分析2141例儿童正常斜坡信号特点与年龄分布...目的通过分析儿童正常斜坡的MRI特点,探索儿童斜坡开始黄髓化的年龄界值,以利于更好地识别骨髓病变。材料与方法选取2022年4月至2023年10月在本院放射科行颅脑MRI检查的儿童作为研究对象,通过分析2141例儿童正常斜坡信号特点与年龄分布的关系,探讨儿童斜坡开始黄髓化的年龄界限。在T1WI序列正中矢状面观察斜坡的信号特点,分析未黄髓化及黄髓化年龄分布特点,计算Youden指数及绘制年龄预测斜坡黄髓化的受试者工作特征(receiver-operating chatacteristic,ROC)曲线,探索儿童斜坡开始黄髓化的年龄界值。结果2141例儿童中,男孩1339例,女孩802例。1339例男孩中,未黄髓化者521例(1个月~36个月),黄髓化者818例(4个月~180个月);802例女孩中,未黄髓化者326例(1个月~35个月),黄髓化者476例(5个月~201个月)。男孩年龄为13.5个月时,Youden指数为0.814,ROC曲线下面积(area under the curve,AUC)为0.976,95%置信区间(confidence interval,CI):0.969~0.982;女孩年龄为11.5个月时,Youden指数0.836,AUC为0.980,95%CI:0.973~0.987。结论年龄>13.5个月可作为男孩斜坡开始黄髓化的年龄界值;年龄>11.5个月可作为女孩斜坡开始黄髓化的年龄界值;男孩开始黄髓化的年龄晚于女孩。展开更多
Background: Until recently, tumors of the clivus and the anterior region of the posterior cranial fossa were considered extremely difficult to access and often inoperable using standard transcranial approaches. With t...Background: Until recently, tumors of the clivus and the anterior region of the posterior cranial fossa were considered extremely difficult to access and often inoperable using standard transcranial approaches. With the introduction into the neurosurgical practice of minimally invasive methods utilizing endoscopic techniques, it became possible to effectively remove hard-to-reach tumors, including central tumors of the anterior region of the posterior cranial fossa. Methods: From 2008 to the present time, the inpatient institution has operated on 140 patients with various tumors of the base of the skull, localized to the clivus and anterior region of the posterior cranial fossa (65 men and 75 women). The age of patients ranged from 3 to 74 years. Tumor distribution according to the histopathological features was as follows: chordomas, 103 (73.57%);meningiomas, 12 (8.57%);pituitary adenomas, 9 (6.43%);fibrous dysplasia, 4 (2.86%);cholesteatoma, 3 (2.14%);craniopharyngiomas, 2 (1.43%);plasmacytomas, 2 (1.43%);and other tumors (giant cell tumor, neurohypophyseal glioma, osteoma, carcinoid, chondroma), 5 (3.57%). The tumors had the following size distribution: giant (more than 60 mm), 35 (25%);large (35–59 mm), 83 (59.3%);medium (21–35 mm), 21 (15%);and small (less than 20 mm), 1 (0.7%). In 11 cases, intraoperative monitoring of the cranial nerves was performed (21 cranial nerves were identified). Results: Upper, middle, and lower transclival approaches provide access to the anterior surface of the upper, middle, and lower neurovascular complexes of the posterior cranial fossa. The chordoma cases were distributed as follows according to extent of removal: total removal, 68 (66.02%);subtotal removal, 25 (24.27%);and partial removal, 10 (9.71%). The adenomas of the pituitary gland were removed totally in 6 cases, subtotally in 1 case and partially in 2 cases. The meningiomas were removed totally in 1 case, subtotally in 5 cases, and partially in 5 cases, with less than 50% of the tumor removed in 1 case. Other tumors (cholesteatoma, craniopharyngioma, fibrous dysplasia, giant cell tumor, glioma of the neurohypophysis, osteoma, plasmacytoma, carcinoid, and chondroma) were removed totally in 9 cases and subtotally in 7 cases. Postoperative CSF leaks occurred in 9 cases (6.43%) and meningitis in 13 cases (9.29%). Oculomotor disorders developed in 19 patients (13.57%), 12 of which regressed during the period from 4 to 38 days after surgery, and 7 of which were permanent. In 2 cases, surgical treatment had a lethal outcome (1.43%). (Continued on next page) (Continued from previous page) Conclusion: The endoscopic endonasal transclival approach can be used to obtain access to the centrally located tumors of the posterior cranial fossa. It is an alternative to transcranial approaches in the surgical treatment of tumors of the clivus. The results of using this approach are comparable with the results of transcranial and transfacial approaches and, in some cases, surpass them in effectiveness. The extended endoscopic endonasal posterior (transclival) approach, considering its minimally invasive nature, allows fora radical and low-risk (in terms of postoperative complications and lethality) removal of various skull base tumors of central localization with the involvement and without the involvement of the clivus, which, until recently, were considered to be almost inoperable.展开更多
Angioleiomyoma of the hand is a rare differential diagnosis of painful soft tissue nodule in the extremity.It arises from smooth muscle of the blood vessels and the most common symptom is pain.Imaging with magnetic re...Angioleiomyoma of the hand is a rare differential diagnosis of painful soft tissue nodule in the extremity.It arises from smooth muscle of the blood vessels and the most common symptom is pain.Imaging with magnetic resonance imaging shows characteristic features like a hypodense peripheral capsule with linear or branching internal hyperdensities on T2-weighted images,and post-contrast diffuse homogenous enhancement with a vessel leading up to the lesion.Histopathological examination shows well circumscribed fascicles of mature smooth muscle cells surrounding vascular lumina,lined by normal appearing endothelium without elastic lamina present.These cells stain positive for smooth muscle actin,desmin,vimentin,type IV collagen and S100,but stain negative for HMB-45 and ER.Angioleiomyoma is amenable for surgical resection.We report a case of painful subcutaneous nodule of hand,with radiological and histopathological findings suggestive of angioleiomyoma.We outline the clinical,radiological and histopathological features of this rare diagnosis for painful nodule of extremity.展开更多
文摘BACKGROUND Angioleiomyoma is a rare and benign stromal tumor typically found in subcutaneous tissue.It rarely occurs in the gastrointestinal tract.Among the reported cases,the most common complication was gastrointestinal bleeding.Perforation has only been reported as a complication in the last few decades.CASE SUMMARY This case report detailed the discovery of intestinal angioleiomyoma in a 47-yearold male presenting with abdominal pain that had persisted for 3 d.After suspecting hollow organ perforation,surgical intervention involving intestinal resection and anastomosis was performed.CONCLUSION The report underscores the significance of early surgical intervention in effectively treating angioleiomyoma while emphasizing the pivotal role of timely and appropriate measures for favorable outcomes.
文摘Angioleiomyoma represents a benign stromal tumor, which usually occurs in the subcutaneous tissue of the extremities, although its occurrence in the gastrointestinal tract is very rare. A case of rectal angioleiomyoma in a 40 year-old female patient is described here. Six months earlier, the patient suffered from periodical prolapse of an oval tumor from the anus, along with difficulties in bowel movement. A transanal extirpation of the tumor was performed. This is the first reported case in the English literature of a patient presenting with prolapsed angioleiomyoma of the rectum. During the immediate postoperative period, as well as 6 mo later, the patient had an unremarkable postoperative recovery.
文摘Introduction: Laryngeal angioleiomyoma is a rare benign tumor of larynx with vascular origin. We report a case of laryngeal angioleiomyoma in a 52-year-old female. Case presentation: A 52- year-old Caucasian female was referred to our institute with a chief compliant of severe midnight snoring. Her symptoms were progressive and began from two years ago. There was no history of hoarseness and laryngeal pain. The patient underwent a laryngoscopic examination and a large mass was seen on the left aryepiglotic fold. Surface of lesion was smooth and covered by laryngeal mucosa with no ulcer. There was a rapid enhancing mass on left aryepiglotic fold with bulging into the left piriformis sinus in contrast-enhanced computed tomography. The tumor was complicated by profuse bleeding after biopsy which was not controlled by conventional approaches. The patient was then administered a general anesthesia and the tumor was completely removed via laryngosurgery accompanied by left superior thyroid artery ligation. The specimen was histopathologically compatible with laryngeal angioleiomyoma. Conclusion: Angioleiomyoma of larynx is of benign nature and rarely recurs. However, it can be complicated by profuse bleeding on biopsy and contrast-medium imaging should be considered before surgical intervention to diagnose the tumor properly and prevent life-threatening complications.
文摘Chordomas are dysembryogenic tumors originating from the notochordal process [1] [2]. They are aggressive tumours with unique diagnostic and management challenges. Primary therapy is complete surgical removal of the tumour as much as possible. The likelihood of recurrence is high in spite of complete surgical resection. A 52-year-old female patient presented with complaints of decreased vision in right eye, nasal bleeding, nasal blockage and difficulties in swallowing. CT scan and nasal biopsy were performed which confirmed the diagnosis of clivus chordoma. The CT scan showed extension into nasopharynx, nasal cavity and oropharynx pushing onto the soft palate. Surgical excision of the mass was performed with coblator by both intraoral and intra nasal approach [3]. On follow-up, nasal endoscopy and CT were done;the patient was relieved of the symptoms and was clinically better.
文摘Angioleiomyoma (ALM) is a benign tumor that occurs most frequently in the subcutaneous tissue of the upper and lower extremities. ALM arising in the sinonasal tract is rare, with fewer than 1% of cases presenting in this region. Only two cases localized to the sinuses have been reported to date in the literature. We report a case of a 30-year-old man complaining of a headache noted to have a concomitant lesion in the maxillary sinus. Histopathological examination following surgical resection confirmed a diagnosis of ALM. This report is the first known report of ALM limited to the maxillary sinus, and the first report to present the imaging data in the ALM in the sinus.
基金Supported by 1·3·5 Project for Disciplines of Excellence–Clinical Research Incubation Project,West China Hospital,Sichuan University,No.2019HXFH018。
文摘BACKGROUND Immunoglobulin G4 related disease(Ig G4-RD)is a fibroinflammatory disease with markedly elevated serum Ig G4 levels and fibrous tissue proliferation,accompanied by numerous plasma cells.Ig G4 related hypertrophic pachymeningitis(Ig G4-RHP)is relatively rare and indistinguishable from other phymatoid diseases before the operation.The risk of long-term immunosuppression needs to be balanced with disease activity.CASE SUMMARY A 40-year-old man presented with headache and bilateral abducent paralysis.He was also diagnosed with pulmonary tuberculosis 10 years ago and was on regular treatment for the same.Before the operation and steroid therapy,the patient was suspected of having tubercular meningitis at a local hospital.A clivus lesion was found via brain magnetic resonance imaging(MRI)at this presentation.He was preliminarily diagnosed with meningioma and underwent Gamma Knife Surgery.Transnasal endoscopic resection was performed to treat deterioration of nerve function.Postoperative pathologic examination suggested Ig G4-RD.Moreover,the serum Ig G4 was elevated at 1.90 g/L(reference range:0.035-1.500 g/L).After steroid therapy for 2 mo,the lesion size diminished on MRI,and the function of bilateral abducent nerves recovered.CONCLUSION Ig G4-RHP is relatively rare and indistinguishable before the operation.Elevated serum Ig G4 levels and imaging examination help in the diagnosis of Ig G4-RHP.Surgery is necessary when lesions progress and patients start to develop cranial nerve function deficit.
文摘Purpose:To report a rare case of angioleiomyoma of the ciliary body Methods:The clinical manifestation, imaging findings, histopathologic characteristics were analyzed in a 32-year-old male patient with angioleiomyoma of the ciliary body.Results:The tumor was removed intact with local resection. Histopathologic examination revealed that the tumor was full of vessels and it was composed of spindle cells with abundant cytoplasm. Immunohistochemical studies showed positive for SMA and Desmin and negative for S100 and HMB-45. Conclusions:Angioleiomyoma of the ciliary body is a rare tumor that can be successfully treated with local surgical resection in this area. It needs to be differentiated from other tumors, especially malignant melanoma. Eye Science 2004;20:19-22.
文摘目的通过分析儿童正常斜坡的MRI特点,探索儿童斜坡开始黄髓化的年龄界值,以利于更好地识别骨髓病变。材料与方法选取2022年4月至2023年10月在本院放射科行颅脑MRI检查的儿童作为研究对象,通过分析2141例儿童正常斜坡信号特点与年龄分布的关系,探讨儿童斜坡开始黄髓化的年龄界限。在T1WI序列正中矢状面观察斜坡的信号特点,分析未黄髓化及黄髓化年龄分布特点,计算Youden指数及绘制年龄预测斜坡黄髓化的受试者工作特征(receiver-operating chatacteristic,ROC)曲线,探索儿童斜坡开始黄髓化的年龄界值。结果2141例儿童中,男孩1339例,女孩802例。1339例男孩中,未黄髓化者521例(1个月~36个月),黄髓化者818例(4个月~180个月);802例女孩中,未黄髓化者326例(1个月~35个月),黄髓化者476例(5个月~201个月)。男孩年龄为13.5个月时,Youden指数为0.814,ROC曲线下面积(area under the curve,AUC)为0.976,95%置信区间(confidence interval,CI):0.969~0.982;女孩年龄为11.5个月时,Youden指数0.836,AUC为0.980,95%CI:0.973~0.987。结论年龄>13.5个月可作为男孩斜坡开始黄髓化的年龄界值;年龄>11.5个月可作为女孩斜坡开始黄髓化的年龄界值;男孩开始黄髓化的年龄晚于女孩。
文摘Background: Until recently, tumors of the clivus and the anterior region of the posterior cranial fossa were considered extremely difficult to access and often inoperable using standard transcranial approaches. With the introduction into the neurosurgical practice of minimally invasive methods utilizing endoscopic techniques, it became possible to effectively remove hard-to-reach tumors, including central tumors of the anterior region of the posterior cranial fossa. Methods: From 2008 to the present time, the inpatient institution has operated on 140 patients with various tumors of the base of the skull, localized to the clivus and anterior region of the posterior cranial fossa (65 men and 75 women). The age of patients ranged from 3 to 74 years. Tumor distribution according to the histopathological features was as follows: chordomas, 103 (73.57%);meningiomas, 12 (8.57%);pituitary adenomas, 9 (6.43%);fibrous dysplasia, 4 (2.86%);cholesteatoma, 3 (2.14%);craniopharyngiomas, 2 (1.43%);plasmacytomas, 2 (1.43%);and other tumors (giant cell tumor, neurohypophyseal glioma, osteoma, carcinoid, chondroma), 5 (3.57%). The tumors had the following size distribution: giant (more than 60 mm), 35 (25%);large (35–59 mm), 83 (59.3%);medium (21–35 mm), 21 (15%);and small (less than 20 mm), 1 (0.7%). In 11 cases, intraoperative monitoring of the cranial nerves was performed (21 cranial nerves were identified). Results: Upper, middle, and lower transclival approaches provide access to the anterior surface of the upper, middle, and lower neurovascular complexes of the posterior cranial fossa. The chordoma cases were distributed as follows according to extent of removal: total removal, 68 (66.02%);subtotal removal, 25 (24.27%);and partial removal, 10 (9.71%). The adenomas of the pituitary gland were removed totally in 6 cases, subtotally in 1 case and partially in 2 cases. The meningiomas were removed totally in 1 case, subtotally in 5 cases, and partially in 5 cases, with less than 50% of the tumor removed in 1 case. Other tumors (cholesteatoma, craniopharyngioma, fibrous dysplasia, giant cell tumor, glioma of the neurohypophysis, osteoma, plasmacytoma, carcinoid, and chondroma) were removed totally in 9 cases and subtotally in 7 cases. Postoperative CSF leaks occurred in 9 cases (6.43%) and meningitis in 13 cases (9.29%). Oculomotor disorders developed in 19 patients (13.57%), 12 of which regressed during the period from 4 to 38 days after surgery, and 7 of which were permanent. In 2 cases, surgical treatment had a lethal outcome (1.43%). (Continued on next page) (Continued from previous page) Conclusion: The endoscopic endonasal transclival approach can be used to obtain access to the centrally located tumors of the posterior cranial fossa. It is an alternative to transcranial approaches in the surgical treatment of tumors of the clivus. The results of using this approach are comparable with the results of transcranial and transfacial approaches and, in some cases, surpass them in effectiveness. The extended endoscopic endonasal posterior (transclival) approach, considering its minimally invasive nature, allows fora radical and low-risk (in terms of postoperative complications and lethality) removal of various skull base tumors of central localization with the involvement and without the involvement of the clivus, which, until recently, were considered to be almost inoperable.
文摘Angioleiomyoma of the hand is a rare differential diagnosis of painful soft tissue nodule in the extremity.It arises from smooth muscle of the blood vessels and the most common symptom is pain.Imaging with magnetic resonance imaging shows characteristic features like a hypodense peripheral capsule with linear or branching internal hyperdensities on T2-weighted images,and post-contrast diffuse homogenous enhancement with a vessel leading up to the lesion.Histopathological examination shows well circumscribed fascicles of mature smooth muscle cells surrounding vascular lumina,lined by normal appearing endothelium without elastic lamina present.These cells stain positive for smooth muscle actin,desmin,vimentin,type IV collagen and S100,but stain negative for HMB-45 and ER.Angioleiomyoma is amenable for surgical resection.We report a case of painful subcutaneous nodule of hand,with radiological and histopathological findings suggestive of angioleiomyoma.We outline the clinical,radiological and histopathological features of this rare diagnosis for painful nodule of extremity.
