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An 87-year-old asymptomatic woman was incidentally found to have an elevated alkaline phosphatase level (216 IU per liter; upper limit of the normal range, 136). The remainder of the liver-function studies, metabolic profile, lactate dehydrogenase levels, and blood-cell counts were normal. The serum calcium level was normal (8.5 mg per deciliter [2.1 mmol per liter]), as was the serum albumin level. There were no palpable skull defects or masses. Bone scanning revealed marked uptake in the calvaria (Panel A). Skull radiographs demonstrated a large, round, lucent area in the left parietal bone (Panel B). Computed tomography of the skull confirmed . . . [Full Text of this Article] |
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