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A longer follow-up period and regular imaging evaluation are needed to confirm whether the identical twin of these patients will suffer OS in the future. The occurrence of OS in one of identical twins is a relatively rare event but may present the best opportunity to understand the genetic mechanisms underlying the tumorigenesis and progression of this disease in humans. A longer follow-up period and regular imaging evaluation are needed to confirm whether the identical twin of these patients will suffer OS in the future. In vivo muscle