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A 16 year old boy presented with massive bilateral tumorous swellings over both buttocks (fig 1). He had a strong family history of premature coronary artery disease, with one of his first degree relative dying at the age of 18 years. On examination, his weight was 52 kg, height 168 cm, body mass index (BMI) 18.43 kg/m2, and blood pressure 110/76 mmHg. He had evidence of bilateral xanthelasmas, premature arcus cornea, tuberous xanthomas over both …
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