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PubMed1986

Aneurysmal bone cyst: a review of 26 cases.

Twenty-six cases of aneurysmal bone cyst are reviewed to determine the frequency, preferred treatment and prognosis. Some observations are made as to the existence of aneurysmal bone cyst as a primary entity or a secondary manifestation of a more serious underlying condition. The difficulty of differentiating an aneurysmal bone cyst from a giant cell tumor of bone is acknowledged and certain similarities to unicameral bone cyst are noted, with reference to some intriguing hypotheses put forward in the literature.

Adolescent↗
PubMed1995

[Essential bone cysts in children. Value of systematic cystography. Apropos of a series of 42 cysts].

INTRODUCTION: The treatment of children's essential bone cysts, is controversial. Intra focal injection of a corticoid, the Methylprednisolone, described by Scaglietti in 1974, given in most of the case serials, a rate of healing of more than 30 per cent. MATERIAL AND METHODS: The case serial we present include 42 essential bone cysts treated between 1975 and 1992 in the orthopaedic department of Necker Enfants Malades hospital. These children have been reviewed with a mean follow up of 4 years. A healing rate over 35 per cent has been noticed. However, some failures stayed completely an understanding even if nothing at the beginning let suppose a slower evolution. RESULTS: Attempting to explain those phenomenes, the authors realised in 70 per cent cases, an opaque cystography, before the Methylprednisolone injection. This simple radiological technique permitted to reveal abnormal aspect in 75 per cent cases. Most of the time, it shows massive-veinous licks in an abnormal veinous system or one or plurial separations of the cystic area. This type of picture could perfectly explain the defect of the corticoids action by a lick of the solution or by a partial unefficacity of the solution because of the separation in the cyst area. The hypothetic idea has been completed by the calcul of the duration of the evolution. Effectively, the cysts showing an abnormal cystography had a longer healing delay compared to the cyst whose cystography was normal. CONCLUSION: The opaque cystography is for us a necessary element in the treatment of essential bones cysts, once the diagnostic is certain and the indication of intra focal corticoid injection has been retained. The radiographic study of the cyst area permits to precise the treatment; for example multiplying the injections in the areas of the cysts when there is separations and overseing the evolution.

Adolescent↗
PubMed1983

The aetiology and treatment of simple bone cysts.

The internal pressure of simple bone cysts was found to be slightly higher than the normal pressure of the bone marrow in the contralateral limb. The pressure within the cyst was measured during drilling with a Kirschner wire; it gradually decreased as the number of drill-holes increased. The PO2 of the cyst fluid was markedly lower than that of either venous or arterial blood measured synchronously. It is suggested that venous obstruction in the bone is the likely cause of these cysts. Seven patients with simple bone cysts were treated by the multiple drill-hole method, and the clinical outcome was excellent. Multiple drilling may prove to be the treatment of choice for simple bone cysts in the younger patient, as it presents fewer hazards than other procedures.

Adolescent↗
PubMed1984

[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)

Adult↗
PubMed1997

Cementation of primary aneurysmal bone cysts.

The effects of polymethylmethacrylate (bone cement) on the local control of primary aneurysmal bone cysts excluding spinal lesions were analyzed. After intensive curettage of the lesions, 30 patients underwent a bone graft, and 35 patients had the defect packed with bone cement. After cementation (median time lapse, 4.5 months), 30 of 35 patients underwent a cancellous bone graft after removal of the packed bone cement. The followup period ranged between 24 and 161 months (median, 59.5 months). The local recurrence rate after curettage and cementation was 17% and after curettage and bone graft was 37%. The difference of the cumulative 10-year relapse free survival between patients of both groups was significant. The median time between surgery and local recurrence was 17 months (range, 2-90 months).

Adolescent↗
PubMedDate not supplied

Significance of opening the medullar canal in surgical treatment of simple bone cyst.

Fifty patients up to 15 years of age with simple bone cysts were treated at the Department of Pediatric Surgery at the Children's Hospital Zagreb. There were 35 boys and 15 girls with 26 humeral cysts, 15 femoral cysts, 8 tibial cysts, and 1 radial cyst. There was one case of multilocularity of a simple bone cyst (in the humerus and femur). Among those cysts, 19 were multicameral (in the femur and humerus). The size of cysts was determined with regard to the length of the affected bone. Cysts involving up to one tenth of the bone length were defined as small, those up to one fifth as medium, and those exceeding one fifth of the bone length as large. Small cysts were followed up, medium ones were treated surgically in case they did not heal after pathologic fracture, and large cysts were treated surgically without delay. The surgery included opening the cyst wall, curetting the wall epithelium, rinsing with peroxide, opening the medullar canal, and filling the cavity with lyophilized bone. If necessary, a thin "old" Küntscher nail was inserted to achieve stability of fragments and to keep the medullar canal free. The medullar canal was opened in 38 surgically treated patients, and there were 36 good results. In the patients who had the medullar canal opened during surgery, there were fewer recurrences. Healing time was shorter than reported in the literature, even more so if the thin Küntscher nail was used.

Adolescent↗
PubMed2002

Unicameral bone cyst in the spinous process of a thoracic vertebra.

Unicameral bone cysts affecting the spine are extremely rare and tend to be misdiagnosed. We report on a 17-year-old female patient who presented with a 2-year history of persistent low back pain. The radiographic evaluation and bone scan failed to reveal a pathologic process. Magnetic resonance of the painful area and subsequent computed tomography scan showed a well-circumscribed osteolytic lesion originating from the spinous process and extending into both laminae of T9 vertebra. Aneurysmal bone cyst or osteoblastoma was considered to be the most probable diagnosis. The patient underwent excisional biopsy of the tumor. The intraoperative findings were suggestive of solitary bone cyst, a diagnosis that was confirmed histologically. Because the tumor had not invaded the articular facets, no posterolateral spine fusion was required. The patient had an unremarkable postoperative clinical course. Her symptoms resolved and she returned to her previous level of physical activities. Unicameral bone cysts, although uncommon, should be included in the differential diagnosis of an osteolytic lesion involving the spine.

Adolescent↗
PubMed1978

Primary and secondary aneurysmal bone cyst: a radiological study of 75 cases.

Radiological findings in 75 cases of aneurysmal bone cyst were analyzed. Sixty-five per cent were primary or simple and 35% were secondary, the aneurysmal bone cyst being combined with other osseous lesions. A primary aneurysmal bone cyst can be diagnosed with a high degree of certainty, but only 20% of secondary forms had the radiological appearance of aneurysmal bone cyst; in the other 80% the associated lesion dominated the radiological picture, particularly when it was malignant. In the secondary form a small biopsy specimen may show the features of aneurysmal bone cyst only; without radiological assistance a concomitant malignant lesion may be missed. Therefore, there must be close collaboration between the radiologist and and the pathologist.

Adolescent↗
PubMed2006

[Distraction osteogenesis for adjusting humeral length difference due to premature closure of the proximal growth plate in a simple bone cyst].

Complications after pathological fractures of simple bone cysts of the humerus are refracture, cyst recurrence, and in rare cases premature closure of the physeal plate with resulting shortening of the arm. Length discrepancies of the lower limbs beyond physiological limits need early compensation in children as well as adults to avoid interference with the pelvis and spine. However, surgical treatment of length differences of the humerus is usually cosmetic, because even considerable discrepancies do not lead to functional deficits. We report the long-term course of a complicated bone cyst of the proximal humerus and resolving a severe length difference of 7 cm by distraction osteogenesis in a young adult. The cause of the premature physeal closure and the primary therapeutical concept are discussed.

Adolescent↗
PubMed2003

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.

Adolescent↗
PubMed1996

[Solitary bone cysts. Morphologic variation, site, incidence and differential diagnosis].

Analysis of 402 solitary bone cysts demonstrates the wide morphological variation of this cystic lesion with regard to histology and radiology. Aside from metaphyseal location in femur (33%) and humerus (23%), solitary bone cysts are also often located in calcaneus (11%), tibia (11%) and pelvis (10%). Most patients are in the second decade of life. Differentiation between this benign lesion and malignant bone tumors is very important in daily clinical routine. The diagnosis cannot be based solely on radiological findings because of the variation of solitary bone cysts and the special forms, such as calcifying solitary bone cyst. Therefore, exact histological diagnosis is of particular importance.

Adolescent↗
PubMed2005

Unicameral bone cysts of the pelvis: a study of 16 cases.

Unicameral bone cysts of the pelvis are extremely rare. This study summarizes the clinical, radiologic and pathologic features of 16 cases. Patients ranged in age from nine to 69. Most lesions were in the anterior portion of the iliac wing; many appeared to be related to an open iliac crest apophysis. This suggests that the pathogenesis of unicameral bone cysts in this portion of the ilium is similar to that seen in the proximal humerus and the proximal femur. The correct diagnosis was made preoperatively in only five cases. This indicates that, although they are well documented, unicameral bone cysts of the pelvis remain a diagnostic problem. Patients received a spectrum of treatments from curettage to observation. There appeared to be no difference in the outcome after any form of treatment. Therefore, unicameral bone cysts of the pelvis can be managed conservatively. The choice to manage patients conservatively depends on making the correct diagnosis based on clinical history and imaging. The most effective imaging is a combination of plain radiographs, computed tomography (CT) and magnetic resonance imaging (MRI).

Adolescent↗
PubMedDate not supplied

Aneurysmal bone cyst of the ethmoid.

Although nearly 500 cases of aneurysmal bone cyst have been recorded in the English literature, involvement of the facial bone is uncommon. To our knowledge, this is the first case of extragnathic, facial aneurysmal bone cyst to be reported in the English literature. A left ethmoid aneurysmal bone cyst was found in a 20-year-old pregnant woman who had a 5-month history of progressive left periorbital swelling, left cystic nasal mass, progressive nasal obstruction, blurred vision, and occasional diplopia. The diagnostic evaluation included a sinus series, facial lamiograms, and an EMI scan. Needle aspirates taken frequently from the intranasal cyst consisted of a dark bloody fluid. The surgical procedure, using external rhinotomy approaches, pathologic findings, and a literature review are presented.

Adult↗
PubMedDate not supplied

Distal tibial aneurysmal bone cyst treatment by using a proximal fibular autologous bone graft: a case report.

A case of an aneurysmal bone cyst that involved the distal tibia and medial malleolus with erosion of the medial cortex in a 22-year-old woman is presented. The patient was surgically treated by curettage and bone grafting along with reconstruction of the distal tibia by using ipsilateral proximal fibula. At the 2-year follow-up, the patient had full, painless range of motion and complete incorporation of the fibular graft. The authors discuss the different treatment options for benign tumors of the distal tibia and the advantages of using proximal fibula as an autologous bone graft in the reconstruction of medial malleolus.

Adult↗
PubMed2000

A solitary bone cyst in the spinous process of the cervical spine: a case report.

STUDY DESIGN: A case report. OBJECTIVES: To illustrate a rare case of histologically confirmed solitary bone cyst involving the spinous process of C7. SUMMARY OF BACKGROUND DATA: A solitary bone cyst involving the spine is very unusual. Although four cases of a solitary bone cyst in the spine have been reported in the literature, the current authors have been able to find only one case of solitary bone cyst in the spinous process. All four patients reported in the literature were over 30 years of age. The patient in the current case was a 13-year-old girl with no history of trauma. METHODS: Radiographs and a computed tomography scan of the cervical spine were performed before the operation, as was a histologic examination to make a diagnosis of the lesion. RESULTS: The intraoperative findings from examination of the stagnant fluid within the lesion and the histologic examination indicated the diagnosis of a solitary bone cyst. CONCLUSIONS: A solitary bone cyst in the spine is rare, especially in the young. An osteolytic lesion in the spinous process of the spine tends to be diagnosed as an osteoblastoma or as a giant cell tumor of the bone. A solitary bone cyst of the spine, although rare, must be considered as a differential diagnosis.

Adolescent↗
PubMed1993

[Diagnosis and treatment of secondary bone cysts].

The article reported 17 cases of confirmed or suspected secondary bone cyst originating from cystic degeneration of pre-existed tumor or tumor-like lesions. Twelve cases were diagnosed as solitary bone cysts pathologically after operation, but their clinical or radiological manifestations were not in keeping with the pathological findings. Among them aggressive or malignant tumors appeared in 6 cases during follow-up and no primary lesions could be found in other 6 cases. The macroscopic features of the lesion of other 5 cases were very similar to a solitary bone cyst, nevertheless, primary tumors were found histologically. The authors held that when dealing with a cystic lesion of bone, it was important, but sometimes difficult to differentiate a solitary bone cyst from a secondary one, and suggested that if the latter was suspected, injection therapy should not be used, but more radical procedures should be taken for treatment instead and the patient should be observed closely for a longer period.

Adolescent↗