Clinical imaging
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Clinical and radiological features of 22 Chinese patients with sacral insufficiency fractures were reviewed. Twenty-one were postmenopausal women. Other risk factors were external pelvic radiotherapy (eight) and total hip replacement (two). ⋯ Concomitant parasymphyseal and pubic rami fractures were detected in 17 and 10 patients, respectively. Follow-up assessment by CT and bone scintigraphy in five patients showed various stages of fracture healing. Recognition of the radiological patterns of this entity is emphasized.
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Primary thymic carcinoma is a rare neoplasm that in contradistinction to thymoma, is not supposed to be associated with a paraneoplastic syndrome. A 73-year-old man, with new onset of disorientation, was found to have an elevated serum calcium level as the cause. ⋯ Examination of a biopsy specimen revealed thymic squamous cell carcinoma. Thus, a paraneoplastic syndrome, in this case hypercalcemia, does not exclude primary carcinoma of the thymus.