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Spindle cell hemangioma (SCH) an uncommon vascular tumor typically appears as solitary or multiple cutaneous and subcutaneous nodules in middle-aged adults. Its occurrence in bone is extremely rare. We report a case of SCH arising at an uncommon site, the distal femur with radiological local invasion, but without histological pleomorphism and mitosis. It is important to avoid misdiagnosis as these lesions are considered to be benign, non-neoplastic reactive vascular proliferations, with high incidence of recurrence.
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