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At least 199 records · Page 11Linked to original sources
PubMed2002

[A case of calvarial aneurysmal bone cyst: transcranial contrast sonographic examination with pulse inversion harmonic imaging method].

A 31-year-old female came to our hospital complaining of left frontal bulging with pain on 10 August 2000. The head x-p showed a radiolucent lesion and bulging at the same calvarial site. CT scan and MRI showed fluid-fluid levels, diploic cyst, deformity and hypertrophic calvarial change. There was a partial hypervascular part of cyst adjacent to the left frontal base by selective left external carotid angiography. Harmonic image is a contrast specific imaging modality that uses the nonlinear properties of contrast agents by transmitting at the fundamental frequency and receiving at multiples of these frequencies. Pulse inversion harmonic image(PIHI) using pulse inversion to eliminate and strengthen the harmonic frequency is more effective than conventional harmonic imaging. Transcranial sonographic examination showed hyper- and hypoechoic appearances in the cyst around abnormal hyperechoic appearances of the calvarial site. The transcranial contrast sonographic images with PIHI (hereinafter TCIpi) demonstrated an enhanced intracystic lower stratum and nearby the diploic part. That modality facilitates better visualization than the harmonic imaging method, enabling differentiation of vascular from avascular areas. As contrast agents are microbubbles, those are restricted in the vascular canal space. So TCIpi findings proved to be a blood circulation of the tumor, cyst and neighboring tissue. Enhanced areas changed by every minute and disappeared gradually. The findings were probably based on the vascular component of the tumor. We obtained images similar to those with CT and MRI. The patient underwent on 21 August. The tumor was removed along with the surrounding skull component. Fresh and old blood were mixed in the cyst. The clinical and pathological diagnosis was aneurysmal bone cyst. The postoperative course was uneventful and she was discharged on 29 August. Aneurysmal bone cyst is a rare calvarial tumor. An diagnostic finding is fluid-fluid levels that appear in approximately 30% of aneurysmal bone cysts. However, this is not a specific finding and has also been reported to occur in osteosarcoma, malignant fibrous histiocytoma, fibrous dysplasia, synovial sarcoma, hemangioma and simple bone cyst. Therefore, diagnosis of aneurysmal bone cyst is based on a combination of the various imaging applications, clinical and pathological findings. Gometz reported that sonographic examination was superior to any diagnostic imaging studies for aneurysmal bone cyst. Furthermore, the perfusion examination like TCIpi can directly observe blood circulation channels in tissue, so the specific enhancement changes of aneurysmal bone cyst could be observed. TCIpi is a useful method for diagnosis of aneurysmal bone cyst.

Adult↗
PubMed2000

Increased concentrations of nitrate and nitrite in the cyst fluid suggesting increased nitric oxide synthesis in solitary bone cysts.

The etiology and treatment of a solitary bone cyst have remained undefined. Surgical treatments have not been encouraging, because a less invasive corticosteroid-injection treatment has afforded good results. However, there has been little scientific rationale supporting corticosteroid treatment. In recent reports, bone-resorbing factors, including matrix metalloproteinases, prostaglandins, interleukin-1, and oxygen free radicals, have been demonstrated in the cyst fluid. To better elucidate the pathophysiology of the solitary bone cyst, we examined the activities of nitric oxide and cytokines in the cyst fluid as well as in the cyst membrane. The levels of nitrate and nitrite were significantly higher in the cyst fluid than in serum. Immunostaining of cells in the stroma and lining cells of the cyst wall was strongly positive for inducible nitric synthase. The levels of interleukin-6 and interleukin-1beta in the cyst fluid were elevated, and cells in the cyst membrane were positive for tumor necrosis factor-alpha, interleukin-6, and interleukin-1beta. Cultured cells from the cyst membrane were induced in the production of nitrate and nitrite in response to cytokine treatment. These findings suggest that the solitary bone cyst was in a state favorable for the production of nitric oxide.

Adolescent↗
PubMed1998

Solitary bone cyst: controversies and treatment.

The solitary bone cyst (SBC) has not yet revealed all its secrets. The pathogeny of the SBC is thus considered and also its evolutivity. Conservative treatment has been used in attempts to heal this tumor-like bone. In the case of surgery, an original technique is described. The SBC still remains mysterious in many of its aspects. At the time of this writing, nobody can predict the occurrence modalities of this benign bone tumor. In a similar way, the reality of this tumor-like lesion cannot be precisely described. This emphasizes the first controversial point about this lesion. Indeed, must we consider differently the bone cysts that remain close to the growth plate and those which located in the diaphysis? Must we regard the true unicameral bone cysts (UBCs) differently and those that are multilocular? Moreover, are the cysts located in the long bones identical to the those of the short cancellous bones? Alas, SBC was supposed to be a lesion in children that disappeared after growth ended. Is it still true since some cases have been reported more recently in adults? This study represents a long follow-up. It includes the different aspects of the SBC and emphasizes an original technique in case surgery becomes indicated.

Adolescent↗
PubMed2001

Bilateral symmetrical cysts in the upper tibiae in a skeletally mature patient: might they be simple bone cysts?

A 55-year-old Japanese woman presented with right knee pain of 1-month duration. Radiological studies revealed bilateral mild osteoarthritic changes in the medial knee joint compartment and symmetrical cysts in the upper tibial metaphyses, extending to the epiphyses. Intraosseous ganglion was considered the most probable diagnosis. However, intraoperatively, serous fluid-filled cavities were recognized; these were curetted and filled with hydroxyapatite granules. Histopathological examination of the cyst wall revealed thin fibrous tissue formed of collagen fibers without a lining cell layer, with scattered lymphocytes, histiocytes, irregular masses of fibrin-like material, and periosteal osteocartilagenous callus formation; a picture compatible with simple bone cysts. Bilateral symmetrical cysts of the upper tibial metaphyses extending to the epiphyses are extremely rare. A literature review revealed that the age incidence, and bony locations of multiple and epiphyseal simple bone cysts are atypical in relation to the classic metaphyseal simple bone cysts. Also, multiple and epiphyseal simple bone cysts have a better prognosis than the classic metaphyseal ones. Four clinicoanatomic varieties of simple bone cysts are recognized; classic metaphyseal, nontubular, epiphyseal, and multiple.

Bone Cysts↗
PubMed1993

Aneurysmal bone cyst of the mandible.

The aneurysmal bone cyst is a nonmalignant lesion that by expanding disrupts the architecture of the affected bone and destroys surrounding tissue. Developing rarely in the craniofacial region, and more commonly affecting the long bones and the spine, the lesion has characteristic radiographic features but is definitively diagnosed only by pathologic characteristics. Complete surgical excision is used to treat aneurysmal bone cyst, with either curettage or composite resection. Recurrence is common in incompletely excised lesions. Adjunctive cryotherapy reduces the risk of recurrence, and radiotherapy is reserved for nonresectable lesions. The case we report of a young man seen for a large mandibular aneurysmal bone cyst demonstrates the complexity of diagnosing and treating this condition.

Adult↗
PubMed2001

Benign calcaneal bone cyst and pathologic fracture--surgical treatment with injectable calcium-phosphate bone cement (Norian): a case report.

Solitary calcaneal bone cysts are uncommon. Usually they measure 1/3 to 1/2 of the calcaneal length. Symptomatic calcaneal bone cysts are generally treated with open debridement and autologous bone grafting. We report a case of a patient with a displaced intra-articular calcaneal fracture who presents with a large benign calcaneal bone cyst. This patient was treated with debridement and filling of defect with injectable calcium-phosphate bone cement (Norian) and open reduction and internal fixation of the calcaneal fracture.

Adult↗
PubMedDate not supplied

Recurrence of aneurysmal bone cyst of the fourth metatarsal.

Aneurysmal bone cyst is a benign solitary lesion of unknown etiology. Its radiographic and histologic appearance can overlap with those tumors of malignant origin. It is imperative that clinical data, radiographs, and operative and pathological findings be correlated to ensure an accurate diagnosis. Aneurysmal bone cysts occur only 7% of the time in the foot. Recurrence rates are reported to be less than 12%. A case report of recurrence of aneurysmal bone cyst in the foot is reviewed, in addition to the etiology, differential diagnosis, and treatment alternatives.

Adolescent↗
PubMed2003

Surgical management of aneurysmal bone cysts of the spine.

OBJECT: Aneurysmal bone cysts of the spine are benign, highly vascular osseous lesions of unknown origin that may present difficult diagnostic and therapeutic challenges. They are expansile lesions containing thin-walled, blood-filled cystic cavities that cause bone destruction and sometimes spinal deformity and neurological compromise. The treatment of aneurysmal bone cysts of the spine remains controversial according to the literature. In this review, the authors discuss the clinical manifestations, pathophysiological features, neuroimaging characteristics, and treatment strategies for these lesions. METHODS: Treatment options include simple curettage with bone grafting, complete excision, embolization, and radiation therapy. Reconstruction and stabilization of the spine may be warranted if deformity and instability are present. Special factors need to be considered in the management of these lesions. CONCLUSIONS: Complete excision of aneurysmal bone cysts offers the best chance of cure and spinal decompression if neurological deficits are present.

Adolescent↗
PubMed1987

Unicameral bone cyst of the talus.

Unicameral bone cysts are rarely observed in the foot. A histologically proven unicameral bone cyst occurred in the talus of a three-year-old boy. Six additional cases in the world literature are cited to illustrate the therapeutic and diagnostic problems encountered with this lesion.

Bone Cysts↗
PubMed2001

[A new method of bone defect repairing after bone cyst curettage].

OBJECTIVE: To introduce a new method of bone defect repairing after bone cyst curettage. METHODS: Eight cases with bone cyst were treated with this new method. The pieces of autogenous periosteum were implanted into the hematoma within the enveloped bone defect created after the bone cyst curettage. Among these patients, there were 5 males and 3 females, aged from 14 to 36 years old. All the lesions located in the upper of femur except one being located in humerus. The results were evaluated through the postoperative radiological findings with the preoperative ones and analysis of clinical functions. RESULTS: All the patients were followed up for 2 to 11 years. X-ray films showed that osteogenesis developed well and that the enveloped bone defects had been repaired. No recurrence was found and the function of the affected limbs were maintained. CONCLUSION: Autogenous periosteum grafting is effective in the treatment of solitary bone cyst.

Adolescent↗
PubMed1997

Growth disturbances associated with untreated benign bone cysts.

BACKGROUND: The occurrence of benign bone cysts adjacent to an active physis may be associated with a physeal arrest. That arrest may result from physeal penetration of the cysts itself, secondary pathologic fracture or the result of surgical curettage. METHODS: The pre-treatment X-rays of patients attending the Bone Tumor Clinic at the Children's Hospital and Medical Center were reviewed. Those patients presenting with a bone cyst were identified and the affected side was compared to the normal side in order to determine growth discrepancies. RESULTS: Three cases of benign bone cysts are presented that were located adjacent to a growing physis nad produced growth disturbance in the absence of surgical intervention. CONCLUSIONS: The risk of growth disturbance in itself should not be a contraindication to surgical intervention.

Adolescent↗
PubMed1984

Aneurysmal bone cyst of the jaws. (II). Pathogenesis.

The pathogenesis of the aneurysmal bone cyst is the subject of much controversy. This study was undertaken to test the hypothesis that the aneurysmal bone cyst is a secondary phenomenon which occurs in a primary lesion of bone. Histological material from 303 bone lesions was studied for evidence of development of aneurysmal bone cyst. Microcysts and blood-filled spaces, similar to those seen in aneurysmal bone cysts, were observed in 15 of 54 central giant cell granulomas studied (28%). The frequency was lower (10%) in 49 cases of fibrous dysplasia and very low in ossifying and cementifying fibromas. 1 of 7 cases of Paget's disease of bone showed large blood spaces. It is postulated that the initiating process of the aneurysmal bone cyst is the microcyst, which forms as a result of intercellular oedema in a primary lesion with loose, unsupported stroma. Rupture of vessels into the microcysts introduces blood under haemodynamic pressure. With little resistance provided by the stroma, the blood spaces resorb the surrounding bone and lift the periosteum, which produces a thin shell of new bone. Similar histological features were observed in 6 of 42 fibrosarcomas examined (14%) and in 8 of a series of 75 osteosarcomas (11%). While many of these lesions did not present with clinical similarity to the aneurysmal bone cyst, it is postulated that this type of case may account for the so-called malignant aneurysmal bone cyst occasionally reported.

Bone Cysts↗
PubMed1976

[Solitary bone cysts in the foot].

The localisations of bone cysts known under the title of "intraosseous ganglion, synovial cyst of bone and solitary unicameral cyst" are summarised from the literature. Two of the authors' patients are added to the few cases of talar cysts recorded up to the present. In addition, a patient with a calcaneal cyst is described. The cysts can be traumatic or non-traumatic in origin. The various theories concerning their etiology are discussed. The clinical findings, differential diagnosis and therapy of subchondral bone cysts particularly in the region of the foot are considered.

Adult↗
PubMed2001

Treatment of aneurysmal bone cysts of the pelvis and sacrum.

BACKGROUND: Aneurysmal bone cysts are benign, non-neoplastic, highly vascular bone lesions. The purpose of this study was to describe the prevalence, the clinical presentation, and the recurrence rate of aneurysmal bone cysts of the pelvis and sacrum and to examine the diagnostic and therapeutic options and prognosis for patients with this condition. METHODS: Forty consecutive patients with an aneurysmal bone cyst of the pelvis and/or sacrum were treated from 1921 to 1996. Their medical records and radiographic and imaging studies were reviewed, and histological sections from the cysts were examined. Seventeen lesions were iliosacral, sixteen were acetabular, and seven were ischiopubic. Seven involved the hip joint, and two involved the sacroiliac joint. All twelve sacral lesions extended to more than one sacral segment and were associated with neurological signs and symptoms. Destructive acetabular lesions were associated with pathological fracture in five patients and with medial migration of the femoral head, hip subluxation, and hip dislocation in one patient each. The mean duration of follow-up was thirteen years (range, three to fifty-three years). RESULTS: Thirty-five patients who were initially treated for a primary lesion had surgical treatment (twenty-one had excision-curettage and fourteen had intralesional excision); two patients also had adjuvant radiation therapy. Of the thirty-five patients, five (14%) had a local recurrence noted less than eighteen months after the operation. Of five patients initially treated for a recurrent lesion, one had a local recurrence. At the latest follow-up examination, all forty patients were disease-free and twenty-eight (70%) were asymptomatic. There were two deep infections. CONCLUSION: Aneurysmal bone cysts of the pelvis and sacrum are usually aggressive lesions associated with substantial bone destruction, pathological fractures, and local recurrence. Current management recommendations include preoperative selective arterial embolization, excision-curettage, and bone-grafting.

Adolescent↗
PubMed1986

[Aneurysmal bone cyst of a rib].

Aneurysmatic bone cyst is rare in ribs; only 37 cases were found in literature up to 1984. In a group of 21 children suffering from aneurysmatic bone cyst only one 13 year-old girl had the lesion in sternal part of the 2nd rib.

Adolescent↗
PubMed1993

[Successful operation for two cases of an aneurysmal bone cyst of the rib].

An aneurysmal bone cyst involving the rib is very rare. A 43-year-old man and 49-year-old woman complained of pain and swelling on the chest. X-ray and CT revealed a local expansion and honeycomb lesion of the right 9th rib. Surgical excision of the rib were performed to remove the tumor completely. The histopathological examination revealed that the lesion consisted of many cavities filled with blood and trabecullae containing osteoid tissue and giant cells, showing it to be an aneurysmal bone cyst. Because of the potential for the rapid growth and difficulty in differentiation between benign and malignant rib tumor, an excisional biopsy should be considered for the treatment of an aneurysmal bone cyst of the rib.

Adult↗
PubMed1995

Aneurysmal bone cyst: concept, controversy, clinical presentation, and imaging.

The aneurysmal bone cyst is the result of a specific pathophysiologic change, which is probably the result of trauma or a tumor-induced anomalous vascular process. In approximately one third of cases, the preexisting lesion can be clearly identified. The most common of these is the giant cell tumor, which accounts for 19-39% of cases in which the preceding lesion is found. Other common precursor lesions include osteoblastoma, angioma, and chondroblastoma. Less common lesions include fibrous dysplasia, fibroxanthoma (nonossifying fibroma), chondromyxoid fibroma, solitary bone cyst, fibrous histiocytoma, eosinophilic granuloma, and even osteosarcoma. Interestingly, some of the controversy surrounding this lesion may be the result of a change in how the lesion was defined by Lichtenstein in 1953, when intramedullary lesions were added to the previously described juxtacortical (superficial) lesions. Members of the AFIP have suggested that many of the intramedullary lesions in which no previous lesion can be identified may represent giant cell tumors of bone. Their similarity to proved giant cell tumors in skeletally immature patients can be striking and seems more than coincidental. Appropriate treatment of an aneurysmal bone cyst requires the realization that it results from a specific pathophysiologic process, and identification of the preexisting lesion, if possible, is essential. Clearly an osteosarcoma with superimposed secondary aneurysmal bone cyst change must be treated as an osteosarcoma, and giant cell tumor with secondary features of aneurysmal bone cyst would be expected to be more likely to recur locally. The vast majority (approximately 80%) of patients presenting with aneurysmal bone cystlike findings are less than 20 years old. More than half of all such lesions occur in long bones, with approximately 12-30% of cases occurring in the spine. The pelvis accounts for about half of all flat bone lesions. Most patients present with pain and/or swelling, with symptoms usually present for less than 6 months. The imaging appearance of aneurysmal bone cyst reflects the underlying pathophysiologic change. Radiographs show an eccentric, lytic lesion with an expanded, remodeled "blown-out" or "ballooned" bony contour of the host bone, frequently with a delicate trabeculated appearance. Radiographs may rarely show flocculent densities within the lesion, which may mimic chondroid matrix. CT scanning will define the lesion and is especially valuable for those lesions located in areas in which the bony anatomy is complex, and which are not adequately evaluated by plain films. Fluid-fluid levels are common and may be seen on CT scans and MR images.(ABSTRACT TRUNCATED AT 250 WORDS)

Bone Cysts, Aneurysmal↗
PubMed2006

Intra-osseous pseudoaneurysm following curettage of an aneurysmal bone cyst.

BACKGROUND: Pseudoaneurysms secondary to bone tumours are rare and most of the reported cases are related to osteochondromas, either due to direct pressure or following surgery. Aneurysmal bone cysts are relatively common bony lesions usually treated by curettage. DISCUSSION: We describe an unusual case of pseudoaneurysm of the anterior tibial artery complicating curettage of an aneurysmal bone cyst which presented as a rapidly enlarging mass clinically thought to be rapid recurrence of the tumour. This was successfully treated by embolisation.

Aneurysm, False↗