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Appropriate penicillin therapy often leads to radiologic improvement or resolution ( This case underscores a critical clinical principle: in the presence of serological abnormalities, if imaging and clinical data strongly indicate a neoplastic processsuch as a focal mass causing progressive spinal cord compressionsurgical intervention should not be unduly delayed on the basis of seropositivity alone

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Not all pigmented lesions need biopsy, but those that are new, changing, or clinically suspicious may warrant one