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Metastases to the neck lymph node were observed 3.5 years after recurrence. LESSONS Our results indicated genetic evolution in a microscopically benign condition and highlighted the importance of molecular characterization of fibro-inflammatory lesions of uncertain malignant potential.RATIONALE Tension band wiring is the most widely accepted technique for the treatment of patellar fractures but the technique is associated with common complications like wire migration, prominence, and breakage. To reduce these complications, we developed a