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Objective: The aim of this study was to investigate the expression of bone resorption (RANK/RANKL), bone resorption inhibitor (osteoprotererin [OPG]), and bone formation marker (osteocalcin [OC]) in neoplastic and bone-related lesions (BRL)., Study Design: Using immunohistochemistry, their expression was evaluated in ossifying fibroma (OF), fibrous dysplasia (FD), simple bone cysts (SBC), central giant cell lesions (CGCL), and osteosarcoma (OS)., Results: Quantitative analyses of the expression of bone markers between all lesions, considering fibroblast-like cells and bone matrix, showed that RANK-RANKL presented higher expression in OF and CGCL, whereas OPG and OC presented higher expression in FD and SBC. There was higher expression of all proteins investigated when OS was the BRL. Moreover, the RANKL expression was greater than OPG in this neoplasm., Conclusion: Our data indicate that the bone resorption markers are more highly expressed in OF, CGCL, and OS than in FD and SBC, indicating a significant association between these proteins and the clinical behavior of these lesions., (Copyright © 2010 Mosby, Inc. All rights reserved.)

Two cases of malignant eccrine spiradenoma of the hand are reported. This malignancy is potentially fatal and is believed to arise from preexisting, long-standing benign spiradenomas. These rare tumors should be considered in the hand surgeon's evaluation and management of any long-standing undiagnosed tumor of the hand. Benign spiradenomas should be excised completely and the patient followed carefully. Location and grade of established malignant tumors should dictate therapy.

Derived from postmortem dissections, early descriptions of a muscle belly in the palm that served the index finger in the manner of the flexor digitorum superficialis were published by MacAlister (1868), Graper (1917), and Mainland (1927). In the English literature, we have found reports on only 15 clinical cases that involved the palm. Based on available information regarding sex, 12 patients were female and one was male. The anomaly involved the right hand in all cases and was bilateral in four of the female patients. We report two additional cases, of which one is considered the first bilateral case in a man with symptoms on the left side.