<prompt> 76 year old man presents with a lytic lesion in the vertebrae. X-ray skull showed multiple punched out lesions. The diagnosis isMetastasisMultiple myelomaOsteomalaciaHyperparathyroidism  <response>: Punched out lesions of skull are seen both in Eosinophilic granuloma and multiple myeloma. However, beveled edges double contour is characteristic of eosinophilic granuloma due to uneven destruction of the inner and outer table of the skull. Punched out lesions of skull Multiple myeloma Punched out lesions with beveled edges Eosinophilic granuloma 