Chondroblastoma with associated aneurysmal bone cyst of the cuboid

The authors describe a young adult patient with a chondroblastoma and associated aneurysmal bone cyst of the cuboid. Although chondroblastoma has been reported to occur in tarsal bones, the cuboid is a very rare location. The association of chondroblastoma with an aneurysmal bone cyst in long bones has been well documented. However, this association in the cuboid has not been reported in the English literature. A 20-year-old man with a 4-month history of foot pain localized to the lateral border of the foot and ankle presented with an expansile lesion in the cuboid bone with a nondisplaced pathologic fracture. A computed tomography scan showed an expansile lesion with discontinuity of the cortex, and magnetic resonance imaging showed marrow replacement within the cuboid with surrounding periosteal edema. An open biopsy was performed, followed by curettage and cementation of the lesion. The histology showed a chondroblastoma with an associated aneurysmal bone cyst of the cuboid.     

Aneurysmal bone cyst of the patella. A case report and literature review

We report a case of an aneurysmal cyst localized in the patella of a 37-year-old man. The lesion was secondary to a chondroblastoma at six years follow-up after initial curettage and bone graft. It were no recurrence. Treatment of aneurysmal cysts depends on the degree of articular involvement. We made a detailed study of 11 cases of this rare localization of aneurysmal cysts reported in the literature.     

Clear cell chondrosarcoma of the proximal femur with intrapelvic extension

Clear cell chondrosarcoma is a rare tumor that can be easily confused with benign tumors. The aim of this report is to present a case that is rare, initially diagnosed as aneurysmal bone cyst and then chondroblastoma, and has an interesting extension pattern. A 41-year-old male patient was treated for an apparently benign cystic lesion of the right proximal femur by intralesional excision and bone grafting. The pathological diagnosis was aneurysmal bone cyst. Two years later, the patient presented with a pathological fracture at the same site and a total hip arthroplasty was performed. The pathological specimen was diagnosed as chondroblastoma. Three years later, clinical and radiological examination of the patient revealed a large mass located on the intrapelvic side of the acetabulum. There was no evidence of distant metastases. Both tumors were resected with a wide margin on the femoral side and a marginal margin on the intrapelvic side. The extremity was reconstructed with a resection-type total hip prosthesis. Again, the pathological diagnosis was chondroblastoma. The patient developed a deep infection that was treated by antibiotic therapy and surgical debridement. One year later, there was recurrence of the femoral and intrapelvic masses and right hemipelvectomy was performed; the specimen was reported as clear cell chondrosarcoma. Since then, the patient has been leading an active life, and there is no evidence of local recurrence or distant metastasis. Clinically and pathologically, clear cell chondrosarcoma may be confused with benign bone tumors. This caused a delay in the final diagnosis of this patient and he received inadequate surgical treatment, leading to a hemipelvectomy. We also found that the intrapelvic mass seemed to have developed independently on the intrapelvic side of the acetabulum. We were unable to find an exact explanation for this finding and postulated that tumor cells might have been seeded into the inner wall of the acetabulum during acetabular preparation of the total hip prosthesis.     

Total Calcanectomy and Bilateral Iliac Bone Autograft Reconstruction for the Treatment of Calcaneal Chondroblastoma Involving a Secondary Aneurysmal Bone Cyst: A Case Report and Literature Review

Chondroblastoma is a rare, benign, cartilaginous-derived tumor accounting for ∼1% to 2% of all primary bone tumors and almost 9% of all benign bone tumors. In this case report, we describe a patient with chondroblastoma and a secondary aneurysmal bone cyst, with the adjacent talus being mildly affected. The initial diagnosis was giant cell tumor and was then confirmed after computed tomography–assisted biopsy. We performed a total calcanectomy via bilateral structural iliac bone autografting to relieve pain and reconstruct the loadbearing function because of the presence of extensive lesions. The patient was pain free and expressed satisfaction with postsurgical dorsiflexion and plantarflexion function at the 60-month follow-up visit. Radiographic images showed that the autografted iliac bone was completely healed, with no evidence of local recurrence.     

Primary aneurysmal bone cyst of the patella: a case report

Aneurysmal bone cysts account for less than 1% of primary bone tumours and have a predilection for the metaphyses of the long bones of the leg. Only 1% of all aneurysmal bone cysts occur in the patella. We report on a 30-year-old man with a primary aneurysmal bone cyst in the right patella treated with curettage. The defect was filled with demineralised bone matrix and allogeneic cancellous bone graft. At the 1.5-year follow-up, the bone graft was well incorporated, the patient experienced no pain or tenderness and had a full range of knee movement.     

A giant cranial aneurysmal bone cyst associated with fibrous dysplasia

An aneurysmal bone cyst (ABC) is a rare, benign fibro-osseous lesion, considered a vascular phenomenon secondary to fibrous dysplasia or a giant-cell tumour, and occurs mainly in long bones and vertebrae. In this case report a 16-year-old male presented with massive epistaxis. He was admitted with a 3-year history of chronic rhinitis, headaches, right ocular pain and recurrent epistaxis. CT scans showed a predominantly cystic, expansive mass obstructing both nasal cavities, extending to all paranasal sinuses and both orbits, with evidence of anterior cranial fossa skull base destruction. The patient underwent a craniofacial resection of the tumour performed with an external approach and an immediate reconstruction of the dural defect. Histology confirmed the lesion was an ABC associated with fibrous dysplasia. The patient's recovery was complete. A large facial aneurysmal bone cyst can damage the facial skeleton and skull base, and requires excision by a combined external approach.     

Successful treatment of aggressive aneurysmal bone cyst of the pelvis with serial embolization

Intralesional surgery is most commonly used for aneurysmal bone cysts. Rarely is en bloc resection used for active, aggressive, recurrent lesions and those located in expendable bones. However, persistence or recurrence of aneurysmal bone cysts is common. The clinical behavior of aneurysmal bone cysts is more aggressive in younger patients. Selective embolization is used as the primary treatment for aneurysmal bone cysts in surgically difficult anatomical locations and as an adjuvant to surgical treatment to reduce intraoperative blood loss and facilitate curettage.This article describes a 3-year-old boy with an aggressive aneurysmal bone cyst of the pelvis involving the right ischiopubic rami that achieved curative treatment with 3 embolizations with N-2-butyl-cyanoacrylate. Biopsy was diagnostic; however, the clinical course was misleading. Twenty days after the first embolization, despite complete occlusion of the feeding vessels, the patient experienced severe pain, increased size of the lesion, and lateral subluxation of the right hip. Based on the imaging and histological diagnosis, intralesional hemorrhage was assumed, and repeat embolization was performed. After the second embolization, the patient experienced perineal skin necrosis from normal vessel embolization; it was treated with wound dressing changes and healed uneventfully. A third embolization was performed because of a persistent lesion. Six years after treatment, the patient was symptom free, and imaging showed complete ossification of the cyst.Selective catheterization and occlusion of the feeding arteries with the appropriate embolic agent provide tumor devascularization, size reduction, pain relief, and induction of new bone formation. Multiple procedures are often necessary, and complications may occur.     

Combined Autograft and Bone Cement for Painful Chondroblastoma: A Case Report

Chondroblastomas of the talus can lead to joint collapse and are often treated using curettage and bone grafting. In the present report, we describe the case of a 19-year-old female with a large chondroblastoma of the talus associated with a secondary aneurysmal cyst. We treated the large cartilage lesion, which involved most of the talus, with an iliac bone graft combined with bone cement to fill the large bone defect and preserve the subchondral bone of the articular surface of the dome of the talus.     

Benign osteoblastoma of the odontoid process of the axis with secondary aneurysmal bone cyst component: a case report

The authors report their experience on one patient with osteoblatoma of the odontoid process of the axis with secondary aneurysmal bone cyst. According to their knowledge, this is the first case, reported in the literature, of this kind of lesion in that particular anatomical region. Because of the rarity of this lesion, it was difficult to have a certain preoperative diagnosis. Therefore, the patient underwent a biopsy via a transoral route. The biopsy was performed over the noncalcified component of the lesion. The intraoperative histological examination showed the benign nature of the lesion. Thereafter, the lesion was totally removed, succeeding in preserving the remaining part of the odontoid process and the anterior arch of C1. In the follow-up, there was no evidence of cranio-vertebral instability. The histological examination revealed an osteoblastoma of the odontoid process of the axis with a secondary aneurysmal bone cyst. To the best of our knowledge, this is the first case reported in the literature.     

Chondroblastoma with secondary aneurysmal bone cyst of the hamate: case report

Chondroblastoma of the carpals is rare, can mimic other benign bone tumors, and presents a diagnostic challenge. There have been few cases of benign tumors involving the hamate, with only one reported case of chondroblastoma, which was treated with complete hamate excision. We present a case of chondroblastoma with secondary aneurysmal bone cyst of the hamate treated with curettage, high-speed burring, phenol, and autogenous iliac crest bone grafting. At the time of the most recent radiographic follow-up, there was full graft incorporation, preserved hamate morphology, and no evidence of recurrence.     

Calcaneal Chondroblastoma with Secondary Aneurysmal Bone Cyst: A Case Report

We present a case of destructive chondroblastoma associated with secondary aneurysmal bone cyst involving the left calcaneus. Because of the extensive destruction of the calcaneus, total calcanectomy was the treatment of choice.     

Treatment of an aneurysmal bone cyst of the second metatarsal using an endoscopic approach.

An aneurysmal bone cyst is a benign solitary lesion of unknown etiology. A case report is presented of recurrence of an aneurysmal bone cyst in the foot that was treated with endoscopic curettage without bone grafting. Bone remodeling and bone formation were completed in the early stages postsurgically. At 2-year follow-up, the patient is asymptomatic with no radiographic evidence of recurrence.     

Case of aneurysmal bone cyst of the skull

A case of aneurysmal bone cyst of the right temporal bone was reported. The patient was a 36-year-old male who was admitted to our hospital with complaints of decreased right hearing and transient impairment of the right vision. A large tumor was palpated on the right temporal bone. Neurological examinations revealed right auditory loss, along with right facial weakness of peripheral type, and minimal pyramidal signs on the right side. The results of the laboratory examination proved to be normal. Neuroradiological examinations tended to be quite impressive. Plain x-ray films of the skull showed a blow out appearance of the right temporal bone and a bone decay in the right middle fossa, the right anterior clinoid process, and the posterior half of the right zygomatic arch. Angiograms revealed a right temporal extradural mass lesion without vascularity. CT scans showed a moderately enhanced mass lesion of soap bubble appearance in the right middle fossa. Surgical treatment was done under the diagnosis of extradural bone tumor. The operative findings disclosed many cysts containing bloody fluid and xanthochromic fluid. Numerous multinucleated giant cells, spindle cells, and foam cells were found in the microscopic examination. On the basis of macroscopic and microscopic findings, the patient was diagnosed as having an aneurysmal bone cyst. The aneurysmal bone cyst of the skull is very rare and sixteen cases have been reported in detail. This case had two interesting points, one was the transient impairment of visual acuity and the other was the CT findings.(ABSTRACT TRUNCATED AT 250 WORDS)     

Giant cell tumor along with secondary aneurysmal bone cyst of scapula: A rare presentation

Giant cell tumor (GCT) is a distinctive lesion characterized by the proliferation of multinucleate giant cells in a stroma of mononuclear cells; it is generally seen in skeletally mature individuals. GCT of bone is usually found in the long bones around the knee or in the distal radius of young adults and is unusual in the flat bones. We report a case of GCT of the acromion of the scapula, with a secondary aneurysmal bone cyst, in a 30-year-old female. Based on our review of the English language medical literature, it appears that the occurrence of a GCT along with a secondary aneurysmal bone cyst in flat bones (e.g.. the scapula) is very rare.     

Aggressive aneurysmal bone cyst in association with polyostotic fibrous dysplasia: A case report

IntroductionAneurysmal bone cyst occurring in the setting of previously diagnosed fibrous dysplasia is rare. While both are benign processes, pain, compression of nearby structures and risk of fracture can require treatment.Presentation of caseIn this report, we describe a 56 year old male who developed an aggressive aneurysmal bone cyst secondary to fibrous dysplasia in the proximal tibia over a period of 8 months. He required an above knee amputation for disease and symptom control due to the aggressive nature of disease and medical comorbidities.DiscussionThe diagnosis of a secondary lesion can prove difficult. It is important to exclude a malignant disease process, particularly when imaging demonstrates an aggressive appearance. In this case, repeat imaging, CT guided biopsies and an open biopsy were performed to exclude malignancy prior to definitive surgical management.ConclusionIn order to exclude secondary lesions, we suggest further investigation for new onset pain in the setting of a benign lesion.     

Combined anterior and posterior resection and spinal stabilization for aneurysmal bone cyst

Summary We report on a 19-year-old man with a 6-month history of pain and stiffness in the upper cervical region who proved to have a lytic lesion affecting the anterior and posterior elements of C2-4, causing a severe gibbous deformity at C3. The tumour was excised through a posterior approach, and spinal fusion with instrumentation was performed. Two weeks later, through a rightsided, anteromedial approach, the remaining tumour was excised, and the spine was reconstructed with tricortical iliac bone as a strut graft. The patient was placed in a Minerva jacket for 3 months, during which time a solid fusion was otained. The histological diagnosis was aneurysmal bone cyst. The patient has remained pain free and suffered no recurrence 2 and a half years after surgery. Involvement of several adjacent cervical vertebrae by an aneurysmal bone cyst is rare, and conventional treatment with curettage and bone grafting is most likely to carry a high rate of recurrence and spinal instability. We recommend complete excision of the tumour in a combined staged procedure and instrumentation to prevent recurrence and avoid instability.     

Aneurysmal bone cyst in the first rib

Aneurysmal bone cyst is a benign tumor of the skeletal system that rarely occurs in ribs. We report two cases of aneurysmal bone cyst in the first rib. The first patient was a 21-year-old woman with an aneurysmal bone cyst in the left first rib that was resected with an L incision. The second patient was a 42-year-old man with an aneurysmal bone cyst in the right first rib that was resected with a posterolateral incision but recurred 1 year later. An en bloc resection was performed, without recurrence to date. We also review this disease with emphasis on the etiology, clinicopathology, and treatment approaches.     

Diagnosing aneurysmal and unicameral bone cysts with magnetic resonance imaging

The differential between aneurysmal bone cysts and unicameral bone cysts usually is clear clinically and radiographically. Occasionally there are cases in which the diagnosis is not clear. Because natural history and treatment are different, the ability to distinguish between these two entities before surgery is important. The authors reviewed, in a blinded fashion, the preoperative magnetic resonance images to investigate criteria that could be used to differentiate between the two lesions. All patients had operative or pathologic confirmation of an aneurysmal bone cyst or unicameral bone cyst. The authors analyzed the preoperative magnetic resonance images of 14 patients with diagnostically difficult bone cysts (eight children with unicameral bone cysts and six children with aneurysmal bone cysts) and correlated these findings with diagnosis after biopsy or cyst aspiration and contrast injection. The presence of a double density fluid level within the lesion strongly indicated that the lesion was an aneurysmal bone cyst, rather than a unicameral bone cyst. Other criteria that suggested the lesion was an aneurysmal bone cyst were the presence of septations within the lesion and signal characteristics of low intensity on T1 images and high intensity on T2 images. The authors identified a way of helping to differentiate between aneurysmal bone cysts and unicameral bone cysts on magnetic resonance images. Double density fluid level, septation, and low signal on T1 images and high signal on T2 images strongly suggest the bone cyst in question is an aneurysmal bone cyst, rather than a unicameral bone cyst. This may be helpful before surgery for the child who has a cystic lesion for which radiographic features do not allow a clear differentiation of unicameral bone cyst from aneurysmal bone cyst.     

Solid variant of aneurysmal bone cyst of the hamate

Solid variant of aneurysmal bone cyst is a variant of aneurysmal bone cyst in which the predominant histology is that of the solid material of a cystic aneurysmal bone cyst. In this article, we present a patient with solid variant of aneurysmal bone cyst of the hamate and discuss the differential diagnosis and current treatment for this lesion.