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Multicentric Giant Cell Tumor of Bone and ParagangliomaA Case Report
Shintaro Iwata, MD1; Tsukasa Yonemoto, MD1; Takeshi Ishii, MD1; Akinobu Araki, MD1; Yoko Hagiwara, MD2; Shin-ichiro Tatezaki, MD1
1 Division of Orthopedic Surgery (S.I., T.Y., T.I., S.-i.T.), Division of Surgical Pathology (A.A.), Chiba Cancer Center, Nitona 666-2, Chuoh-ku, Chiba 260-8717, Japan. E-mail address for S. Iwata: siwata@chiba-cc.jp
2 Department of Orthopedic Surgery, Tokyo Women’s Medical University, Kawada 8, Shinjuku-ku, Tokyo 162-8666, Japan.
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Investigation performed at the Chiba Cancer Center, Chiba, Japan

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 © 2013 by The Journal of Bone and Joint Surgery, Inc.
JBJS Case Connector, 2013 Mar 13;3(1):e23 1-5. doi: 10.2106/JBJS.CC.L.00155
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Giant cell tumor (GCT) of bone accounts for 4% to 5% of primary bone tumors1. Distant metastasis occurs most commonly in the lung, reported at a rate of 2% to 5%2,3, although the overall outcome of metastatic GCT is favorable2. Recently, it was reported that the receptor activator of nuclear factor kappa-B ligand (RANKL) might play a pivotal role in osteoclast differentiation in the genesis of GCT4. However, the precise mechanism of GCT development remains obscure.
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