Aneurysmal bone cyst of the proximal phalanx

A case of aneurysmal bone cyst of the proximal phalanx in a young boy with unfused epiphysial plates is reported. Curettage failed, so diaphysectomy and cortical bone grafting were performed, sparing the epiphysial plate. This resulted in normal length and function, and the graft remodelled completely to a normal appearance of tubular bone.     

Aneurysmal bone cyst of the distal thumb phalanx. A case report and review of the literature

Although aneurysmal bone cysts are a well-known, well described clinical entity, their presence in small bones of the hand are not a common occurrence. Only 13 previous cases involving the bones of the hand have been reported in the English literature. Of these 13, only seven involved the phalanges and no previous case has been described involving the distal phalanx of the thumb. Because these lesions may demonstrate aggressive local biologic behavior, when the diagnosis of aneurysmal bone cyst of the small bones of the hand is considered, prompt diagnostic and therapeutic intervention should be performed. Early recognition and management of this lesion is essential to prevent amputation.     

Aneurysmal bone cyst in the metacarpal of a child: A case report

An unusual case of aneurysmal bone cyst in the metacarpal of a five-year-old girl is described. The lesion was initially diagnosed and treated as a simple bone cyst. Subsequently the affected metacarpal was excised and replaced by an autogenous fibular graft, with good results. A discussion of the pathogenesis of the lesion is given, with a review of the literature.     

Aneurysmal bone cyst

Summary A typical case of aneurysmal bone cyst of thoracic vertebrae responding well to surgical extirpation has been reported. Relevant literature on the subject has been reviewed.

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Zusammenfassung Bericht über einen typischen Fall einer aneurysmatischen Knochenzyste eines Brustwirbelkörpers. Die Veränderung konnte chirurgisch entfernt werden. Die einschlägige Literatur wird dargestellt.

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Resumen Se presenta un caso típico de quiste oseo aneurismático de vértebras torácicas y que cursó bien después de la extirpación quirúrgica. La literatura más importante sobre este tema ha sido revisada.

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Résumé Un cas typique de kyste osseux anévrismal d'une vertèbre thoracique qui répond bien au traitement chirurgical a été rapporté. La littérature, qui est importante, a été revue.

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Riassunto Viene riportato un caso tipico di cisti ossea aneurismatica delle vertebre toraciche estirpata chirurgicamente con successo. La letteratura sull'argomento viene riportata e discussa.

     

Aneurysmal bone cyst

Aneurysmal bone cysts are rare skeletal tumors that most commonly occur in the first two decades of life. They primarily develop about the knee but may arise in any portion of the axial or appendicular skeleton. Pathogenesis of these tumors remains controversial and may be vascular, traumatic, or genetic. Radiographic features include a dilated, radiolucent lesion typically located within the metaphyseal portion of the bone, with fluid-fluid levels visible on MRI. Histologic features include blood-filled lakes interposed between fibrous stromata. Differential diagnosis includes conditions such as telangiectatic osteosarcoma and giant cell tumor. The mainstay of treatment is curettage and bone graft, with or without adjuvant treatment. Other management options include cryotherapy, sclerotherapy, radionuclide ablation, and en bloc resection. The recurrence rate is low after appropriate treatment; however, more than one procedure may be required to completely eradicate the lesion.     

Aneurysmal bone cyst

Summary Twenty cases of aneurysmal bone cyst were reviewed, with an average follow-up of 10.3 years. Twelve patients still had open growth plates at diagnosis, but all of them were fully grown at follow-up. The treatments performed were: resection of the cyst or of the whole affected bone, curettage, and curettage and bone grafting. Radiation therapy was a complementary treatment in three cases. Two patients relapsed, one that had been treated by curettage alone and one by curettage and bone grafting. Five patients showed skeletal deformities at follow-up. Two had lesions of the growth plate, most likely caused by radiation therapy, whereas in the other three growth had probably been impaired by surgical trauma.     

Aneurysmal bone cyst

Summary Authors report on the results of treatment of 52 primary and 16 secondary aneurysmal bone cysts (ABC). ABC grow rapidly; 84% of them have already destroyed more than the half of the bone width at recognition. En bloc resection is preferred when the ABC is growing superficially and eccentrically and more than half of the bone width is intact. Careful curettage and bone grafting still remains the surgical method of choice in the majority of cases, when the ABC is more destructive and affects the subchondral bone of the joints. Segmental resection is only indicated when removal of the affected bone does not influence the function of the extremity. Superselective embolization of the cyst was performed in seven cases with excellent results. This method is suggested for ABC in certain locations inaccessible to surgical intervention, e.g., the pelvis, or to avoid excessive bleeding in hypervascularized tumors. In one case, however, an incomplete rebuilding of the ABC could only be achieved by the administration of calcitonin. The 16 cases of secondary ABC were observed mostly in association with osteoblastomas, giant-cell tumors, and osteosarcomas. The incidence of the secondary ABC was 23% in the whole ABC group but not more than 2–4% among the osteosarcomas and giant-cell tumors. Secondary ABC may confuse the histological and clinical diagnoses and that, especially in cases of osteosarcoma, may have fatal consequences.     

Aneurysmal bone cyst of the occipital bone

A 13 years boy presented with a painless hard and fixed swelling in occipital region for the last three months. Plain X-ray, CT scan and MRI showed an expansile multi loculated cystic lesion in occipital bone. Histopathological examination revealed it to be an aneurysmal bone cyst. Treatment of choice is surgery. However, radiotherapy may be helpful in incompletely excised lesions.     

Aneurysmal bone cyst in 2006

The etiology of aneurysmal bone cyst is probably multifactorial. Recent progress in genetics and immunohistochemistry tends to prove that aneurysmal bone cyst is tumor and not a pseudo-tumor. Involvement of chromosomes 17p11-13 or 16q22 has been described. MRI is indispensable. Signs highly suggestive of aneurysmal bone cyst are: well-limited expansive bone lesion, low intensity T1 signal associated with high intensity T2 signal (liquid component), a low intensity peripheral line with enhancement after contrast injection, septal partitioning and fluid levels. Gadolinium injection is informative since it demonstrates the thick regular septal partitioning and the amorphous contents (lack of contrast uptake), a structure which is not seen in any other tumors, particularly malignant tumors. Plain x-ray and MRI contribute well to diagnosis but histological confirmation is always required. The debate on Ethibloc(R) remains open. For certain authors, this technique is an effective safe treatment which can be proposed as a first-line option. Ethibloc(R) should however be reserved for specialized teams because of the serious complications reported in the literature. A new treatment has also been reported to be promising, but further results will be required for confirmation. With this technique demineralized allogenic bone particles associated with autologous bone marrow are implanted in the cyst to achieve an osteogenic effect. This induces the cyst to pass from the destructive resorption phase to the repairing osteogenic phase. Curettage is not necessary. This method, which avoids extensive surgery and blood loss, is well adapted to difficult localizations such as the pelvis.     

Aneurysmal bone cyst in the hamate

Aneurysmal bone cysts (ABCs) show a predilection for the metaphysis of the long bones and the vertebrae and seldom involve the carpal bones. We present a case of an ABC in the left hamate of an 18-year-old man. Curettage and bone grafting were performed, and, because destruction of the cortex was extensive, the hamate was excised. At 3-year follow-up, the wrist was stable.     

Aneurysmal bone cyst of the frontal bone

Aneurysmal bone cyst rarely affects the skull. We report two cases of aneurysmal bone cyst of the frontal bone. One of the cases is associated with pregnancy. The association of pregnancy with aneurysmal bone cyst and enlargement of the aneurysmal bone cyst during the pregnancy have been discussed.     

Aneurysmal bone cyst of the cuboid

Aneurysmal bone cyst was considered a variety of giant cell tumour up until 1942, when Jaffe and Lichtenstein isolated it and suggested it was an independent pathology in itself. Aneurysmal bone cyst of cuboid represents about 1% of all tumours and benign pseudotumoral lesions. Foot location of this type of condition is quite rare; its location in the cuboid bone is an exceptional occurrence. A review of the literature confirms its extreme rarity: we found only two cases.