PubMed · 5270772
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C A Silva. [Traumatic cysts].. https://pubmed.ncbi.nlm.nih.gov/5270772/
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The surgical treatment of spinal tumors depends on a host of factors that include: the type of tumor and its location within the spine, the presence or absence of neural compression, the portion of the vertebrae involved, the anticipated mode of spinal failure, the biology of the tumor, the anticipated life expectancy of the patient, and the type of prior or subsequent adjuvant treatment. Two thirds of all spinal tumors arise from the vertebral body and only 1/3 originate from the posterior elements. Malignant tumors more commonly involve the vertebral body and benign lesions usually are located posteriorly. Malignant tumors, because of their aggressive nature and their propensity for anterior vertebral body involvement, are associated with a higher incidence of neurologic deficit than are benign lesions. The surgical treatment of spinal tumors is dictated largely by the location of the tumor within the spine; anterior vertebral body tumors generally should be approached anteriorly, whereas posterior lesions should be approached posteriorly. Because most malignant tumors, whether primary or secondary (metastatic), are located anteriorly within the vertebral body, most surgery for malignant tumors should be approached anteriorly. Anterior decompression should be accompanied by reconstruction with biologic materials such as autogenous bone graft unless life expectancy is certain to be very limited (<6 months).
We discuss four cases of bone cyst in the proximal humerus, in two boys aged 8 and 9, and two girls aged 2 and 5. Differentiation between a solitary and an aneurysmatic bone cyst can be difficult. The bone cyst in the proximal humerus is mostly benign. In one case (the 2-year-old girl) a malignancy, a telangiectatic osteosarcoma, was observed after 2-5 years follow-up. Humerus resection was performed.
Problems in diagnosis of bone tumors in routine laboratories concern very rare tumors, differentiation between chondroma and low grade chondrosarcoma, the recognition of lesions containing multinucleated giant cells, lesions with secondary cysts simulating iuvenile or aneurysmal bone cyst and sometimes the discrimination of callus from osteosarcoma. Real misdiagnoses are done in ossifying pseudotumors interpreted as osteosarcoma, metaphyseal fibrous defect confound with giant cell tumor and chondroblastoma misdiagnosed as giant cell tumor or osteosarcoma. All these mistakes are avoidable if the clinical and radiological features, especially age and exact site in bone studied on the x-rays, are taken into consideration.