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Aneurysmal bone cyst of the mandible.

Aneurysmal bone cyst is an uncommon benign lesion that rarely presents in the craniofacial region. No prior reports of this entity involving the mandible could be found in the otolaryngologic literature, and it has been reported only infrequently in the maxilla. Two previously unreported cases originating in the mandible are presented with a review of the literature, pathology, and diagnosis of this lesion. Treatment of this lesion consists of complete surgical removal and immediate bone grafting for reconstruction.

Adolescent↗

Aneurysmal bone cyst of the calcaneus.

Aneurysmal bone cyst of the calcaneus is an uncommon entity. Radiographs showed a large lytic expanding lesion arising in the calcaneus with cortical disruption inferiorly. CT of the patient with this condition showed fluid-fluid levels that were the result of blood layering. These findings may suggest the specific diagnosis.

Adolescent↗

Aneurysmal bone cysts of the jaws.

Aneurysmal bone cysts of the jaws are histologically the same as those found in the more usual appendicular sites for this lesion. They may be primary or secondary (associated with another definable osseous lesion) and have a 2:1 or 3:1 predilection for the mandible over the maxilla. Curettage is associated with relatively high recurrence rates, while surgical excision, with negative margins, of primary lesions markedly reduces this incidence.

Adolescent↗

Aneurysmal bone cyst of the skull.

Aneurysmal bone cysts rarely affect the skull. Thirty-six cases including four reported in this paper are reviewed. The condition usually affects children and young adults and progresses rapidly. It may result in raised intracranial or intraorbital pressure. Complete excision of the mass is the treatment of choice, but if not feasible curettage followed by low dose radiotherapy is effective. As the prognosis in this condition is good, prompt diagnosis and early treatment are of utmost importance.

Adolescent↗

Aneurysmal bone cysts of the spine.

Aneurysmal bone cysts are uncommon bony lesions of the spine. Two such patients are reported in the study. The first patient had involvement of first and second thoracic vertebrae, and a preoperative diagnosis was made possible due to the typical magnetic resonance imaging appearances. A total removal was achieved in two stages. In the second patient the C2 spinous process was involved, and this patient presented as atantoaxial dislocation. Removal of the abnormal tissue and posterior fusion was done. Both the patients showed neurologic improvement. The relevant literature is reviewed.

Adult↗

Aneurysmal bone cysts of the spine.

Aneurysmal bone cysts of the spine are uncommon. In the English language literature, there have been less than one hundred reported cases. We present five examples, all of which arose in a vertebral body. One case is the first reported arising from the coccyx; one presented at the sixth thoracic vertebral body with complete paraplegia and two with extremely large abdominal masses and catastrophic bleeding during attempted open biopsy. All were resected by a one-stage anterior or combined anterior-posterior approach. Two cases were treated with preoperative irradiation because of profuse, life-threatening bleeding during biopsy, and 4 weeks later complete anterior excision was carried out without difficulty.

Adolescent↗

The traumatic bone cyst: review of literature and report of two cases.

The traumatic bone cyst, seen by clinicians both physician and dentist alike, is a well recognized yet poorly understood entity whose pathogenesis remains obscure. Generally asymptomatic, this lesion is most often found as an incidental finding on routine radiographic survey. Its diagnosis, however, is important to rule out more significant pathology. A brief review of pertinent literature and two new cases of traumatic bone cyst have been presented, including an infrequently reported case of traumatic bone cysts occurring bilaterally in the mandible.

Adolescent↗

[Minimally invasive technique treatment of postoperative recurrent bone cysts in juvenile patients].

OBJECTIVE: To study the effect of minimally invasive treatment of postoperative recurrent bone cysts in juvenile patients. METHODS: From December 1984 to December 2003, 36 cases of postoperative recurrent bone cysts after focal curettage and bone graft included 19 males and 17 females, aging 9-21 years with an average of 15 years. The size of bone cyst ranged from 2.5 cm x 6.0 cm to 3.5 cm x 13.0 cm with an average of 3.0 cm x 8.0 cm. The locations were proximal humerus in 18 cases, humeral shaft in 10 and femoral trochanteric region in 8. The focal curette and bone graft were given once in 23 cases, twice in 10 cases and 3 times in 3 cases. The interval between recurrence and minimally invasive treatment was 5-13 months (6.5 months on average). The posteroanterior and lateral X-ray films were taken to determine the location, range and feature of the focus. Under local anesthesia, 2 canulated needles were used; one was used to aspirate the contents of the cyst, the other was used to inject hydrocortisone acetate. The dose was determined according to the range of the focus. The treatment was repeated every 3. 5-4 months until the focus healed. RESULTS: All patients were followed up from 3 to 18 years with an average of 5 years. The minimally invasive treatment was repeated 3-11 times with an average of 6 times. Twenty-six cases healed completely, 6 cases healed significantly, and 4 cases healed partially. No local or general complications occurred during the treatment. CONCLUSION: This minimally invasive method for the treatment of postoperative recurrent bone cyst in juvenile patients has following advantages : less pain, easy manipulation, no hospitalization, low cost and definite effect.

Adolescent↗

Simple bone cyst. Evaluation of contents with conventional radiography and computed tomography.

To evaluate whether gas is present in the cavity of simple bone cysts, the clinical and histologic findings of 53 patients with simple bone cysts were examined and compared with an experimental model. The model consisted of a dry mandible with the medullary bone removed and the resulting cavity injected with water. Although an air-liquid level was observed on all radiographs for the experimental model, none was observed in the clinical cases of simple bone cysts. When the experimental cavity was completely filled with water, the density in the cavity was similar to that of the surrounding water on computed tomography, but when it was filled with air, the density was lower than that of the surrounding water. In contrast, in simple bone cysts said to contain air at surgery, the cavity contents were not consistent with the density for gas on computed tomography. These results indicate that the operative finding of air in the cavity of simple bone cysts may have been in error at least in some cases.

Adolescent↗

The cause of subchondral bone cysts in osteoarthrosis: a finite element analysis.

BACKGROUND: The etiology of subchondral bone cysts in arthrotic joints is unclear. MATERIALS AND METHODS: We used two-dimensional finite element analysis to evaluate the hypothesis that subchondral bone cysts in the osteoarthrotic hip joint may be the result of microfractures caused by localized cartilage defects or a thinned layer of cartilage. We evaluated the equivalent bone stress (von Mises (VM) stress) in the cancellous bone as an indicator of potential microfractures and further development of cystic lesions. RESULTS: Cartilage defects induced stress peaks in the subchondral bone. This peak stress distribution corresponded to the clinical observation of development of acetabular and femoral subchondral cysts in a "kissing" position. A femoral subchondral bone cyst induced a stress peak at the corresponding acetabular site, whereas subchondral acetabular cysts did not increase stress in the femoral head. Acetabular cysts showed an increased level of stress at the lateral and medial border of the lesion which was much higher than the stress levels in the femoral head, indicating a tendency to faster growth. INTERPRETATION: Our study supports the theory that stress-induced bone resorption may cause development of subchondral bone cysts in osteoarthrosis.

Acetabulum↗

Unicameral bone cyst in the scapula of an adolescent.

Unicameral bone cysts of the scapula have been reported mainly in adult patients. The atypical location of the unicameral bone cyst in a 12-year-old girl presented a diagnostic dilemma. Curettage proved to be an effective method for both diagnosis and treatment of this benign lesion.

Bone Cysts↗

[Comparison of treatment of juvenile bone cysts using local administration of corticoids and surgical therapy].

The authors describe the results of the juvenile bone cyst in the group of 41 patients by the method of the application of corticoids and compare them with the results of the therapy by means of excochleation and filling the cavity of the cyst with bone grafts. In the therapy by corticoids restitutio ad integrum was achieved in 37.8 per cent and in 43.2 per cent of patients the healing was incomplete. In 5.5 per cent of cases there occurred recurrence after the cyst was healed, in 13.5 per cent there was no response to the application of corticoids. In the groups of surgically treated patients the cyst was healed in 68.8 per cent, out of which 48 per cent was restitutio ad integrum. The number of recurrence was relatively high--31.2 per cent. Both methods have their place in the therapy of bone cysts. The surgical approach makes it possible to achieve more quickly restitutio ad integrum in extensive bone cysts located at lower extremities. For the cysts affecting the humerus the method of choice is the local application of corticoids. In the therapy by steroids the authors the necessity of regular control and in case of the survival of the cyst the necessity of repeating the instillation of the steroid.

Adolescent↗

A solitary bone cyst of the mandibular condyle.

A review of the literature concerning solitary bone cysts of the jaws is presented. Our patient is typical except for the location of the cyst. No previous case of a solitary bone cyst confirmed to the mandibular condyle has been reported. No precise etiology for solitary bone cyst is known. The use of routine panoramic radiography has made detection of such cysts more common. Surgical exploration is indicated for diagnosis and treatment.

Child↗

MR evaluation of bone cysts treated with intracavital steroid injection.

The objective of this study was to evaluate the role of MR examination in showing the effects of intralesional steroid injection on bone cysts. Nineteen patients with radiologically suspected (group A, n=15) or already treated (group B, n=4) bone cysts underwent MRI (0.5 T; protocol: T2* gradient recalled echo; short tau inversion recovery or inversion recovery fast spin echo; T1 SE before and after contrast administration, 0.2 mmol/kg). All patients underwent steroid therapy for bone cysts and were followed up for 6-18 months after treatment. Evaluation of bone cyst response to therapy was based mainly on the detection of reparative tissue outlining all cystic portions at first MRI control. In group A, as early as 1 month after the first injection, the presence of a thin reparative tissue lining the cystic wall was observed. Follow-up studies revealed the progressive thickening of this reparative tissue and new bone formation. Similar features were present in the cysts of group B. Residual cystic cavities were depicted in 7 cases, with no evidence of enhancing tissue, requiring further treatment. The formation of a reparative tissue is the first feature of bone cyst recovery after intracavital steroid injection and is appreciable only on MRI. Because of the optimal visualisation of this reparative tissue and of residual cystic cavities, MRI could be proposed as a non-invasive, alternative and effective tool for evaluating the efficacy of steroid injection therapy of bone cysts.

Anti-Inflammatory Agents↗

[Interdisciplinary treatment strategy of aneurysmal bone cyst].

In this report the management of an aneurysmal bone cyst in the cervicothoracic region of an 13-year-old girl is described. Aneurysmal bone cyst is a histologically benign lesion that is often extremely vascular. In the spine, it can cause extensive bone destruction and compress neural structures and this can result in high-grade tetraparesis. In the treatment a three-stage operation with radical total removal of the cyst from two posterior approaches and one anterior approach for osteosynthetic stabilisation gave an excellent result. The value of preoperative embolization to reduce tumor vascularity, allowing total excision without neurological deficits to the patient, is demonstrated.

Adolescent↗

Old fibrin coagula and their ossification in simple bone cysts.

Old calcified fibrin coagula are frequently found in simple bone cysts. They provide a scaffold on which new bone is laid down, in a process analogous to endochondral ossification. It is suggested that these coagula are derived in substantial part from the plasma-like contents of the cyst, after the release of plasma-clotting factors as the result of injury. Major haemorrhage is not involved and in many cases there is no antecedent fracture. The phenomenon is not seen in other common cystic conditions of bone and its recognition is thus helpful in the histological diagnosis of simple bone cyst. Cystic bone infarcts and their possible confusion with simple bone cysts are also briefly discussed.

Blood Coagulation↗

Traumatic bone cyst: report of two cases and review of the literature.

Traumatic bone cysts usually are found in young individuals and most frequently have the radiographic appearance of well-circumscribed radiolucent lesions with a tendency to scallop between the roots of the teeth. Two well-documented cases of traumatic bone cysts are presented in which some differences related to their radiographic features were observed. The possible explanations for these differences are discussed and a brief review of the literature regarding the main characteristics of traumatic bone cyst lesions also is provided.

Adolescent↗