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Slouma M, Bouzid S, Tlili K, Yedaes D, Radhwen K, Gharsallah I. Isolated Rosai-Dorfman disease of the spine: A systematic literature review. Clin Neurol Neurosurg 2024; 239:108206. [PMID: 38461672 DOI: 10.1016/j.clineuro.2024.108206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 02/21/2024] [Accepted: 02/24/2024] [Indexed: 03/12/2024]
Abstract
INTRODUCTION Rosai-Dorfman disease (RDD) is a rare non-Langerhans cell histiocytosis involving the central nervous system in 5% of cases. Spinal location occurs in less than 1% of extranodal RDD and can be responsible for neurological manifestations. We present a systematic review of cases of isolated spinal RDD. We also report a new case of isolated spinal RDD revealed by spinal cord compression. MATERIALS AND METHODS The systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline using the MEDLINE and SCOPUS databases and included case reports and case series describing isolated RDD of the spine. RESULTS There were 53 patients with isolated spinal RDD (including our case). The mean age was 35.85±16.48 years. Neurological deficit was the most frequent clinical presentation (89%). RDD lesions were mainly located in the thoracic spine (51%), then the cervical spine (32%). The lesion was reported to be extradural (57%), intradural extramedullary (26%), intramedullary (7%), and in the vertebral body (10%). Histological examination showed emperipolesis in 73%. Histocytes were positive for S-100 protein in 83%. Treatment was based on surgery 96%), radiotherapy, chemotherapy, and adjunctive steroid therapy were indicated in four, one, and eight cases. After a mean follow-up period of 14.84±13.00 months, recurrence of RDD was noted in 15%. CONCLUSION Spinal RDD is a rare condition, requiring meticulous histological examination for accurate diagnosis. Complete surgical resection is the treatment of choice. Adjuvant chemotherapy and radiotherapy can also be indicated in patients demonstrating partial improvement following surgery.
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Affiliation(s)
- Maroua Slouma
- Department of Rheumatology, Military Hospital, Tunis, Tunisia; University of Tunis El Manar, Tunisia.
| | - Sirine Bouzid
- Department of Rheumatology, Military Hospital, Tunis, Tunisia; University of Tunis El Manar, Tunisia
| | - Karima Tlili
- Department of Anatomy and Cell Biology, Military Hospital, Tunis, Tunisia; Department of Neurosurgery, Military Hospital, Tunis, Tunisia
| | - Dahmani Yedaes
- Department of Neurosurgery, Military Hospital, Tunis, Tunisia; University of Tunis El Manar, Tunisia
| | - Khaled Radhwen
- Department of Neurosurgery, Military Hospital, Tunis, Tunisia; University of Tunis El Manar, Tunisia
| | - Imen Gharsallah
- Department of Rheumatology, Military Hospital, Tunis, Tunisia; University of Tunis El Manar, Tunisia
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Rao X, Kang Z, Chen J, Cai C, Wang B, Zhang Q. Cervical spine Rosai-Dorfman disease: A case report and literature review. Medicine (Baltimore) 2023; 102:e35654. [PMID: 37904362 PMCID: PMC10615454 DOI: 10.1097/md.0000000000035654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 09/25/2023] [Indexed: 11/01/2023] Open
Abstract
BACKGROUND Rosai-Dorfman disease is a benign lymphatic tissue proliferative disease with slow growth and is rarely observed in the clinic. Most of these patients present clinically with enlarged lymph nodes. In patients with spinal extranodal Rosai-Dorfman disease, which is even rare than the disease of lymph nodes, patients may experience numbness and weakness in the extremities. CASE PRESENTATION We report a 32-year-old male patient with multi-segmental spinal Rosai-Dorfman disease. On admission, his left fingers had been numb for 2 months. Over a 2-month period, the limb numbness progressed from the left to the right hand. The patient underwent resection of the lesion and internal fixation of the C2-C7 spine. The postoperative outcomes were satisfied and no recurrence was observed at 1-year follow-up. CONCLUSION Spinal Rosai-Dorfman disease is a relatively rare tumor of which the pathogenesis is still unclear, and most patients have no specific clinical manifestations. Characteristic imaging findings can indicate this disease, however, a definitive diagnosis still depends on a pathological examination. Currently, total surgical resection of the tumor is a relatively effective and preferred treatment.
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Affiliation(s)
- Xianfeng Rao
- Department of Neurosurgery, Shenzhen Second People’s Hospital, Shenzhen University First Affiliated Hospital, Clinical College of Shantou University Medical College, Shenzhen, China
| | - Zhengwen Kang
- Department of Neurosurgery, Shenzhen Second People’s Hospital, Shenzhen University First Affiliated Hospital, Clinical College of Shantou University Medical College, Shenzhen, China
| | - Jianwei Chen
- Department of Neurosurgery, Shenzhen Second People’s Hospital, Shenzhen University First Affiliated Hospital, Clinical College of Shantou University Medical College, Shenzhen, China
| | - Chang Cai
- Department of Pathology, Shenzhen Second People’s Hospital, Shenzhen University First Affiliated Hospital, Shenzhen, China
| | - Bo Wang
- Department of Neurosurgery, Shenzhen Second People’s Hospital, Shenzhen University First Affiliated Hospital, Clinical College of Shantou University Medical College, Shenzhen, China
| | - Qiusheng Zhang
- Department of Neurosurgery, Shenzhen Second People’s Hospital, Shenzhen University First Affiliated Hospital, Clinical College of Shantou University Medical College, Shenzhen, China
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Nóbrega PR, Rodrigues PGB, de Sousa Pereira I, de Figueiredo Santos C, Gerson G, de Arruda JAM, Júnior JWLT, de Araújo Coimbra PP, Braga-Neto P. Steroid responsive cavernous sinus syndrome due to Rosai-Dorfman disease: beyond Tolosa-Hunt syndrome - a case report. BMC Neurol 2021; 21:264. [PMID: 34225703 PMCID: PMC8256567 DOI: 10.1186/s12883-021-02255-z] [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: 01/27/2021] [Accepted: 05/26/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The term "Tolosa-Hunt syndrome" (THS) has been used to refer to painful ophthalmoplegia associated with nonspecific inflammation of the cavernous sinus and many processes can result in a similar clinical picture, including infectious, inflammatory and neoplastic diseases. Rosai-Dorfman disease (RDD) is a lymphoproliferative disorder that rarely affects the central nervous system. We report a case of isolated CNS Rosai-Dorfman disease involving the cavernous sinus and presenting as "Tolosa-Hunt syndrome". CASE PRESENTATION Our patient presented with horizontal diplopia due to impairment of cranial nerves III, IV and VI and a stabbing/throbbing headache predominantly in the left temporal and periorbitary regions. There was a nonspecific enlargement of the left cavernous sinus on MRI and the patient had a dramatic response to steroids. Biopsy of a frontal meningeal lesion was compatible with RDD. CONCLUSIONS We highlight the importance of including Rosai-Dorfman disease as a differential diagnosis in cavernous sinus syndrome and demonstrate a satisfactory long-term response to steroid treatment in this disease.
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Affiliation(s)
- Paulo Ribeiro Nóbrega
- Division of Neurology, Department of Clinical Medicine, Universidade Federal do Ceará, Rua Capitão Francisco Pedro, 1290, 60430-370, Fortaleza, Brazil.
| | - Pedro Gustavo Barros Rodrigues
- Division of Neurology, Department of Clinical Medicine, Universidade Federal do Ceará, Rua Capitão Francisco Pedro, 1290, 60430-370, Fortaleza, Brazil
| | - Isabelle de Sousa Pereira
- Division of Neurology, Department of Clinical Medicine, Universidade Federal do Ceará, Rua Capitão Francisco Pedro, 1290, 60430-370, Fortaleza, Brazil
| | | | - Gunter Gerson
- Department of Pathology, Universidade Federal do Ceará, Fortaleza, Brazil
| | | | - José Wagner Leonel Tavares Júnior
- Division of Neurology, Department of Clinical Medicine, Universidade Federal do Ceará, Rua Capitão Francisco Pedro, 1290, 60430-370, Fortaleza, Brazil
| | | | - Pedro Braga-Neto
- Division of Neurology, Department of Clinical Medicine, Universidade Federal do Ceará, Rua Capitão Francisco Pedro, 1290, 60430-370, Fortaleza, Brazil.,Center of Health Sciences, Universidade Estadual do Ceará, Fortaleza, Brazil
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Tatit RT, Raffa PEAZ, de Almeida Motta GC, Bocchi AA, Guimaraes JL, Franceschini PR, de Aguiar PHP. Rosai-Dorfman disease mimicking images of meningiomas: Two case reports and literature review. Surg Neurol Int 2021; 12:292. [PMID: 34221623 PMCID: PMC8247728 DOI: 10.25259/sni_918_2020] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 05/11/2021] [Indexed: 11/05/2022] Open
Abstract
Background: Rosai-Dorfman disease (RDD) is a rare non-Langerhans cell histiocytic proliferative disorder classically as a massive cervical lymphadenopathy. However, over the years, extranodal locations were confirmed with the central nervous system involvement in less than 5% of cases, which is marked as a significant differential diagnosis of meningiomas, with which they are widely confused due to the similarity of their radiological images. Case Description: We report a 37-year-old man and 45-year-old man who were diagnosed with intracranial RDD but whose radiological images mimic meningiomas, requiring anatomopathological and tumor’s immunohistochemistry for definitive diagnosis. Moreover, a review of 184 publications with 285 cases of intracranial involvement of this disease was also performed, comparing these findings with those brought in the previous studies. Conclusion: Intracranial Rosai-Dorfman tumors should always be remembered as differential diagnosis of meningiomas since they are similar radiologically and macroscopically. Once remembered and diagnosed, the lesion must be treated following the same pattern of resection done in meningiomas and, treatment’s differences will not occur in the surgical excision technique, but in complementary chemotherapy implementation, radiotherapy, and even with radiosurgery aid, depending on the case. Thus, it is possible to obtain better results than with just the isolated surgical procedure.
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Affiliation(s)
- Rafael Trindade Tatit
- Department of Medicine, Albert Einstein Israeli Faculty of Health Sciences, São Paulo, Brazil
| | | | | | | | - Júlia Loripe Guimaraes
- Department of Medicine, Albert Einstein Israeli Faculty of Health Sciences, São Paulo, Brazil
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Hu PP, Wei F, Liu XG, Liu ZJ. Diagnosis and treatment of Rosai-Dorfman disease of the spine: a systematic literature review. Syst Rev 2021; 10:31. [PMID: 33461611 PMCID: PMC7814441 DOI: 10.1186/s13643-021-01581-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 01/02/2021] [Indexed: 02/08/2023] Open
Abstract
PURPOSE To review and summarize the clinical features, diagnosis, treatment strategies, and prognosis of spinal Rosai-Dorfman disease (RDD). METHODS RDD is also termed as sinus histiocytosis with massive lymphadenopathy. We searched the databases of PubMed, Elsevier ScienceDirect, SpringerLink, and OVID. The keywords were Rosai-Dorfman disease and spine/central nervous system. Research articles and case reports with accessibility to full texts regarding spinal RDD were eligible for the inclusion. A total of 62 articles were included, and they contained 69 cases. We extracted the information of interest and analyzed them using SPSS statistics package. RESULTS The average age was 33.1 ± 18.3 years. The ratio of males to females was 1.9/1. Overall, 63 cases presented with spine-related symptoms. A total of 27 cases (39.1%) had multi-organ lesions, and 12 cases had records of massive lymphadenopathy. Among 47 cases who first manifested spine-related symptoms, 93.6% were preoperatively misdiagnosed. The disease had a predilection for cervical spine (38.8%) and thoracic spine (40.3%). 62.9% of lesions were dura-based. Surgery remained the mainstream treatment option (78.8%), with or without adjuvant therapies. Total lesion resection was achieved in 34.8% of cases. The rate of lesion recurrence/progression was 19.5%, which was marginally lower for total resection than for non-total resection. CONCLUSION Spinal RDD has no pathognomonic clinical and imaging features. Most cases first present with spine-relevant symptoms. Massive lymphadenopathy is not common, but a tendency for multi-organ involvement should be considered. Spinal RDD has a high recurrence rate; thus, total resection is the treatment of choice. Adjuvant therapies are indicated for multi-organ lesions and residual lesions. A wait and watch strategy is recommended for asymptomatic patients. Herein, a workflow of diagnosis and treatment of the spinal RDD is established.
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Affiliation(s)
- Pan-Pan Hu
- Department of Orthopaedics and Beijing Key Laboratory of Spinal Disease Research, Peking University Third Hospital, No. 49 North Garden Rd, Haidian District, Beijing, 100191, China
| | - Feng Wei
- Department of Orthopaedics and Beijing Key Laboratory of Spinal Disease Research, Peking University Third Hospital, No. 49 North Garden Rd, Haidian District, Beijing, 100191, China.
| | - Xiao-Guang Liu
- Department of Orthopaedics and Beijing Key Laboratory of Spinal Disease Research, Peking University Third Hospital, No. 49 North Garden Rd, Haidian District, Beijing, 100191, China
| | - Zhong-Jun Liu
- Department of Orthopaedics and Beijing Key Laboratory of Spinal Disease Research, Peking University Third Hospital, No. 49 North Garden Rd, Haidian District, Beijing, 100191, China
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Petraglia AF, Davick JJ, Mandell JW, Lapides DA. Rosai-Dorfman Disease: A Less Common Cause of Leptomeningeal and Nerve Root Enhancement. Neurohospitalist 2020; 10:309-313. [PMID: 32983353 DOI: 10.1177/1941874420929187] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
A 46-year-old male experienced progressive neurocognitive decline, weight loss, intermittent headaches, and weakness over 6 months. Magnetic resonance imaging of the brain revealed hydrocephalus and the spinal cord imaging showed diffuse leptomeningeal enhancement with prominent nerve root involvement. Intradural biopsy of lumbar arachnoid tissue found mixed inflammatory infiltrate consisting predominantly of histiocytes, S100 and CD68 positivity, and lymphocytophagocytosis (emperipolesis) consistent with extranodal Rosai-Dorfman disease. Rosai-Dorfman disease, a non-Langerhans cell histocytic disorder, can mimic the appearance of neurosarcoidosis and leptomeningeal carcinomatosis and should remain on the differential of a patient presenting with diffuse leptomeningeal enhancement, a common occurrence on a neurohospitalist service.
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Affiliation(s)
| | - Jonathan J Davick
- Department of Pathology, University of Virginia Health System, VA, USA
| | - James W Mandell
- Department of Pathology, University of Virginia Health System, VA, USA
| | - David A Lapides
- Department of Neurology, University of Virginia Health System, VA, USA
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Abla O, Jacobsen E, Picarsic J, Krenova Z, Jaffe R, Emile JF, Durham BH, Braier J, Charlotte F, Donadieu J, Cohen-Aubart F, Rodriguez-Galindo C, Allen C, Whitlock JA, Weitzman S, McClain KL, Haroche J, Diamond EL. Consensus recommendations for the diagnosis and clinical management of Rosai-Dorfman-Destombes disease. Blood 2018; 131:2877-2890. [PMID: 29720485 PMCID: PMC6024636 DOI: 10.1182/blood-2018-03-839753] [Citation(s) in RCA: 303] [Impact Index Per Article: 50.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 04/27/2018] [Indexed: 12/21/2022] Open
Abstract
Rosai-Dorfman-Destombes disease (RDD) is a rare non-Langerhans cell histiocytosis characterized by accumulation of activated histiocytes within affected tissues. RDD, which now belongs to the R group of the 2016 revised histiocytosis classification, is a widely heterogeneous entity with a range of clinical phenotypes occurring in isolation or in association with autoimmune or malignant diseases. Recent studies have found NRAS, KRAS, MAP2K1, and ARAF mutations in lesional tissues, raising the possibility of a clonal origin in some forms of RDD. More than 1000 reports have been published in the English literature; however, there is a lack of consensus regarding approach for the clinical management of RDD. Although in most cases RDD can be observed or treated with local therapies, some patients with refractory or multifocal disease experience morbidity and mortality. Here we provide the first consensus multidisciplinary recommendations for the diagnosis and management of RDD. These recommendations were discussed at the 32nd Histiocyte Society Meeting by an international group of academic clinicians and pathologists with expertise in RDD. We include guidelines for clinical, laboratory, pathologic, and radiographic evaluation of patients with RDD together with treatment recommendations based on clinical experience and review of the literature.
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Affiliation(s)
- Oussama Abla
- Division of Haematology/Oncology, Department of Paediatrics, The Hospital for Sick Children, Toronto, ON, Canada
| | | | - Jennifer Picarsic
- Department of Pathology, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Zdenka Krenova
- Pediatric Oncology Clinic, Faculty of Medicine, Masaryk University, Brno, Czech Republic
- Department of Pathology, University Hospital, Brno, Czech Republic
| | - Ronald Jaffe
- Department of Pathology, Magee Women's Hospital of UPMC, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Jean-Francois Emile
- Pathology Department, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Boulogne, France
- Research Unit EA4340, Versailles SQY University, Paris-Saclay University, Boulogne, France
| | - Benjamin H Durham
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Jorge Braier
- Department of Hematology, Oncology, Hospital de Pediatría JP Garrahan, Buenos Aires, Argentina
| | - Frédéric Charlotte
- Department of Pathology, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
- Department of Internal Medicine, Paris VI University, Université Pierre et Marie Curie, Sorbonne Universités, Paris, France
| | - Jean Donadieu
- Department of Haematology, AP-HP, Trousseau Hospital, Paris, France
| | - Fleur Cohen-Aubart
- Department of Internal Medicine, Paris VI University, Université Pierre et Marie Curie, Sorbonne Universités, Paris, France
- Department of Internal Medicine 2, French National Centre for Rare Systemic Diseases, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | | | - Carl Allen
- Section of Hematology-Oncology, Department of Pediatrics, Baylor College of Medicine, Houston, TX
- Texas Children's Cancer Center, Texas Children's Hospital, Houston, TX
- Program in Translational Biology and Molecular Medicine, Baylor College of Medicine, Houston, TX
| | - James A Whitlock
- Division of Haematology/Oncology, Department of Paediatrics, The Hospital for Sick Children, Toronto, ON, Canada
| | - Sheila Weitzman
- Division of Haematology/Oncology, Department of Paediatrics, The Hospital for Sick Children, Toronto, ON, Canada
| | - Kenneth L McClain
- Section of Hematology-Oncology, Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - Julien Haroche
- Department of Internal Medicine, Paris VI University, Université Pierre et Marie Curie, Sorbonne Universités, Paris, France
- Department of Internal Medicine 2, French National Centre for Rare Systemic Diseases, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - Eli L Diamond
- Department of Neurology, Memorial Sloan Kettering Cancer Center, New York, NY; and
- Department of Neurology, Weill Cornell Medical College, New York, NY
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Xu H, Zhang F, Lu F, Jiang J. Spinal Rosai-Dorfman disease: case report and literature review. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2017; 26:117-127. [PMID: 28168342 DOI: 10.1007/s00586-017-4975-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Accepted: 12/01/2016] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Sinus histiocytosis with massive lymphadenopathy or Rosai-Dorfman disease (RDD) is a rare benign disease of dubious etiology that arises predominantly in lymph nodes with generalized fever and malaise. Isolated intraspinal involvement has its unique characteristics. The purpose of this study is to present the largest series of cases in the spinal Rosai-Dorfman disease literature to increase familiarity with its clinicopathologic features, diagnosis, and treatment of RDD from spine. METHODS We present the case of a 34-year-old man who presented with paraplegia secondary to an isolated thoracic vertebral lesion. On physical exam, the patient displayed progressive weakness and tendon hyperreflexia of the lower limbs. After a totally section, symptoms of the patient were obviously relieved and the patient remained asymptomatic and no signs of recurrences were observed after follow-up for 5 months. We also retrospectively analyzed 60 cases of patients with spinal RDD published in English since 1969. Clinical date, histopathology, and radiological feature were retrospectively analyzed. RESULTS Spinal RDD should no longer be considered rare and it may occupy an increasingly prominent place in the list of differential diagnoses for intraspinal lesions. Only elaborate histopathology was diagnostic for RDD. Most of the patients were surgically treated and marked improvements were observed in their clinical conditions. CONCLUSIONS RDD with spinal involvement is uncommon and it is challengeable in making a certain diagnosis. Histopathologic characteristics and immunohistochemical findings are considered as the key points for the diagnosis of this disease. The optimal treatment remains controversial, and more efforts should be focused on the investigation of etiology and adjuvant therapy for relapsing cases or subresected lesions.
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Affiliation(s)
- Haocheng Xu
- Department of Orthopedics, Huashan Hospital, Fudan University, No. 12 Wulumuqi Middle Road, Shanghai, China
| | - Fan Zhang
- Department of Orthopedics, Huashan Hospital, Fudan University, No. 12 Wulumuqi Middle Road, Shanghai, China
| | - Feizhou Lu
- Department of Orthopedics, Huashan Hospital, Fudan University, No. 12 Wulumuqi Middle Road, Shanghai, China. .,The Fifth People's Hospital of Shanghai, Fudan University, Shanghai, China.
| | - Jianyuan Jiang
- Department of Orthopedics, Huashan Hospital, Fudan University, No. 12 Wulumuqi Middle Road, Shanghai, China
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