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Periprosthetic Epithelioid Hemangioma of the Proximal Part of the TibiaA Case Report
Aparna Viswanath, MRCS1; John F. Nolan, FRCS(Orth)1
1 Department of Orthopaedics, Norfolk and Norwich University Hospital, Colney Lane, Norwich, Norfolk NR4 7UY, United Kingdom. E-mail address for A. Viswanath: aviswanath@doctors.org.uk. E-mail address for J.F. Nolan: john.nolan@nnuh.nhs.uk
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Investigation performed at Norfolk and Norwich University Hospital, Norwich, Norfolk, United Kingdom

Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. None of the authors, or their institution(s), have had any financial relationship, in the thirty-six months prior to submission of this work, with any entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. Also, no author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

Copyright © 2012 by The Journal of Bone and Joint Surgery, Inc.
JBJS Case Connector, 2012 Nov 28;2(4):e70 1-4. doi: 10.2106/JBJS.CC.K.00158
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Epithelioid hemangioma is an unusual vascular tumor, only recently accepted as an entity in bone1,2. It is generally considered a benign lesion; however, there have been reports describing cortical destruction and local soft-tissue invasion2-4, particularly when affecting small tubular bones. It can affect patients of any age, has no sex preponderance, and usually presents with localized pain. Although the etiology in bone is unknown, allergic reactions, trauma, and autoimmune processes have been implicated in the pathogenesis of the soft-tissue variant of this tumor5,6. We report a case of epithelioid hemangioma in the proximal part of the tibia of a fifty-three-year-old man, which occurred soon after total knee arthroplasty. To our knowledge, this is the first reported case of this type of lesion associated with an implanted prosthesis. The patient was informed that data concerning the case would be submitted for publication, and he provided consent.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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