Clinical presentation:
Adult patient, no clinical detail. Often presents with bone pain or abdominal pain, bowel disorder or renal calculi.

There is a well defined lytic lesion of the middle metacarpal with some expansion. There is a more subtle, expanded lytic lesion at the base of the fifth metacarpal and a small multiloculate lesion in the head of the metacarpalof the ring finger. These lytic areas have a well-defined endosteal margin with a narrow zone of transition between normal and abnormal bone. The phalanges are asymmetrical with bone loss on the radial side. There is acro-osteolysis with some absorption of terminal phalangeal tufts. Sub-periosteal bone resorption is visible on the radial side of the middle phalanges of middle and ring fingers. A small sub-periosteal cyst is on the radial side of the proximal phalanx of the middle finger.