Baleful Gem
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The Baleful Gem is a quest item acquired after defeating Fidelitas in The Chamber of Sins Level 3 during the quest, "Intruders in Black".
In conjunction with 
Maligaro's SpikeMaligaro's SpikeMaligaro loved his tools, and took great
pains to keep them excruciatingly sharp.
, it is required to gain access to The Vaal Ruins Level 1 during the quest, "The Root of the Problem".