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PubMed2004

Simple bone cysts of the calcaneus: a report of five cases and a review of the literature.

BACKGROUND: Simple bone cysts of the calcaneus are relatively uncommon. There is no clear consensus on either their etiology or management. Pathological fractures of such cysts are exceptionally rare. MATERIALS AND METHODS: Five simple bone cysts of the calcaneus were present in three males and two females with an average age of 44 years. One patient presented with pain, three cysts were incidental findings on ankle radiographs, and one patient presented with a fracture after a significant fall. RESULTS: All five were managed nonoperatively and had satisfactory outcomes. CONCLUSIONS: A review the literature on the etiology and management of simple bone cysts of the calcaneus and the outcomes of these patients indicate that complications of these cysts are rare and nonoperative management is appropriate.

Adolescent↗
PubMed2004

[Intracystic allograft in management of long bone cyst merging pathologic fracture].

OBJECTIVE: To investigate the efficiency of intracystic allograft fixed with bone plate and steel plate in management of long bone cyst merging pathologic fracture. METHODS: Twelve cases of long bone cysts with pathologic fractures were treated from January 1996 to April 2002. The median dimension of the cyst on the radiograph was 3. 6 cm x 8.1 cm. We regularly revealed the sites of cysts, cut the anterior wall, got cystic membrane away, implanted allo-bone fibula, ulna or radius shafts which were defatted and deproteined. The auto-bone and the allo-bone of all cases were fixed with bone plate and steel plate; external fixation was managed for 3 weeks after operation. RESULTS: All incisions achieved primary healing. All cases were followed up 2. 7 years on average. According to Capanna's standard, 9 cases completely healed, 3 cases basically healed, no cases recurred. The function in shoulder joint was slightly limited in 2 cases that cysts were located on the upper humerus, while that of the other 10 cases were recovered completely. CONCLUSION: Intracystic allograft fixed with bone plate and steel plate is safe and effective in management of long bone cyst merging pathologic fracture.

Adolescent↗
PubMedDate not supplied

Aneurysmal bone cyst of the rib: a case report.

An aneurysmal bone cyst involving the rib is very rare. Forty-four cases have been reported in the literature. Primary neoplasms of the ribs are uncommon and malignant tumours are significantly more common than benign tumours in this location. The condition is a rare benign, progressive bone tumour. The aetiology and natural history are unknown. The Authors report the case of a 38-year-old man with an aneurysmal bone cyst of the right 6th rib, treated by en-bloc resection. The patient has been followed up now for ten years with no signs of recurrence.

Adult↗
PubMedDate not supplied

Considerations in the corticosteroid treatment of bone cysts.

To be effective in treating bone cysts, intracavital injections of corticosteroids must be able to run freely over their lining membrane. Free movement may be prevented by complete or partial osseous or fibrous septa or by the cyst contents. This report illustrates such situations. To solve the problem, the interior anatomy of the cyst should be evaluated by a contrast study and then, when necessary, several corticosteroid injections should be made in different cyst compartments. The volume of corticosteroid should be modified according to the size of the cyst.

Bone Cysts↗
PubMed2002

Cannulation of simple bone cysts.

We describe a consecutive series of 26 patients with simple bone cysts who were treated by curettage, multiple drilling and continuous decompression by the insertion of either a cannulated screw or a pin. In the first 15 patients we used titanium cannulated screws (group 1) and in the next 11 a cannulated hydroxyapatite pin (group 2). Satisfactory healing was achieved in 12 patients in group 1 (80%) and in all in group 2. This technique seems to be a promising option for the treatment of simple bone cysts. The cannulated hydroxyapatite pin is recommended because of its higher success rate and the fact that it does not need to be removed.

Adolescent↗
PubMed1997

Traumatic bone cyst resembling apical periodontitis.

Among the pseudocysts of the jaws, the traumatic bone cyst is known as an asymptomatic lesion often noted unintentionally during routine radiographic examinations. The lesion neither devitalizes the teeth within its borders, nor does it cause resorption of their roots. The well-demarcated traumatic bone cyst often projects into the intraradicular septa and hence has been described as having scalloped borders. The following presentation is of a traumatic bone cyst that resembled periodontal pathology in its appearance.

Alveolar Bone Loss↗
PubMedDate not supplied

[Diagnostic and therapeutic considerations in aneurysmatic bone cysts of the jaws].

A case of aneurysmatic bone cyst of the mandible is described. Following curettage the condition recurred twice and was then successfully treated with cross-section and primary reconstruction of the mandible. The pathogenesis of aneurysmatic bone cysts and the indications for radical surgical treatment are discussed.

Adolescent↗
PubMedDate not supplied

Treatment of simple bone cysts in children with curettage and cryosurgery.

A retrospective study in children with simple or unicameral bone cysts treated with curettage, cryosurgery, and bone grafting was conducted. The purpose of this study was to evaluate local tumor control and bony healing after this method of treatment. Five (12%) of 42 treated patients had a local recurrence with a mean clinical follow-up of 24.5 months. Surgical complications consisted of two superficial wound infections, one radial nerve palsy, and two fractures, which all resolved completely. A review of the literature was performed to compare our results with historic controls using steroid-injection therapy and curettage with bone grafting alone. We believe that the use of cryosurgery as adjuvant therapy in the surgical treatment of simple bone cysts is of value in controlling local recurrences and achieving bony consolidation.

Adolescent↗
PubMedDate not supplied

Epiphyseal involvement of simple bone cysts.

Epiphyseal involvement of a simple bone cyst (SBC) is uncommon. Eight patients are reported in whom an SBC was found to cross the growth plate, involving the epiphysis in seven patients and the apophysis in one. All patients had more than two pathologic fractures. In seven patients growth disturbance was found. Functional impairment did not develop in any patient. Radiographically, all lesions presented a characteristic involvement of the epiphysis and metaphysis in various proportions. Only one of four cysts treated with methylprednisolone acetate injections showed incomplete healing; the others failed to respond. After percutaneous grafting of autologous bone marrow, three of seven cysts healed and the others attained incomplete healing. Epiphyseal involvement of SBC should be considered a more aggressive form of an active lesion.

Adolescent↗
PubMed2001

Aneurysmal bone cyst of the larynx presenting with hypoglottic obstruction.

We report a new case of aneurysmal bone cyst of the larynx occurring in a 22-year-old man. The lesion manifested with progressive breathing discomfort and appeared as a polypoid pedunculated mass attached to the subglottic mucosa. Microscopically, it featured numerous mononuclear and multinucleated giant cells surrounding cavernous spaces filled with blood. Foci of proliferating spindle cells and mature osteoid tissue could be recognized. There was no apparent relationship with the cricoid perichondrium. Clinical follow-up was negative for local recurrence. Based on this report and a review of the literature, we conclude that aneurysmal bone cyst of the larynx is phenotypically comparable to its bone homologue; however, its microscopic recognition may be difficult, especially on small biopsy fragments. Since it can be confused with several lesions, including telangiectatic osteosarcoma, awareness of this rare appearance of aneurysmal bone cyst is important to avoid unnecessary radical surgery.

Adult↗
PubMed1982

[Evaluation of the treatment of the unicameral bone cyst in children (author's transl)].

Solitary bone cyst is characterized by its tenacity and the risk of recurrence. This fact led the authors to use a surgical procedure very different of the classic ways of treatment as they excluded any bone graft to the benefit of a muscle graft with wide resection. 35 cases have been operated on at several steps of childhood. The recurrence's rate decreased plainly and is no more than 9%. They concern only the wide humeral cysts which were active and close to the fertile plate of the humeral head. These recurrences have been very well tolerated and have not predisposed the child to some pathological fractures. Residual pseudo-cysts were seen in 20% of the cases; they related for us, to some gaps of rehabilitation. This procedure ay be considered as the complement of cortisone's local infection when this one is not able to heal the solitary bone cyst.

Bone Cysts↗
PubMed2005

Aneurysmal bone cyst: a review of 150 patients.

PURPOSE: We have reviewed a series of 150 aneurysmal bone cysts treated over the last 20 years. PATIENTS AND METHODS: The lesions were principally located in the tibia, femur, pelvis, humerus, and spine and, in most cases, presented the imaging appearance originally described by Jaffe and Lichtenstein as a blowout with thin cortices. RESULTS: Only one of the patients was believed to have an osteoblastoma of the spine with secondary development of an aneurysmal bone cyst, and none of the patients developed additional lesions. The patients were treated primarily with curettage and implantation of allograft chips or polymethylmethacrylate, but some patients were treated with insertion of autografts or allografts. The local recurrence rate was 20%, which is consistent with that reported by other centers. CONCLUSION: Aneurysmal bone cysts are enigmatic lesions of unknown cause and presentation and are difficult to distinguish from other lesions. Overall, the treatment is satisfactory, but it is possible that newer approaches, such as improved magnetic resonance imaging studies, may help diagnose the lesions and allow the physicians to plan for more effective treatment protocols.

Adolescent↗
PubMedDate not supplied

Aneurysmal bone cyst: a preliminary report on a new surgical approach.

Aneurysmal bone cyst is a relatively uncommon bone tumor. Six children treated between February 1985 and May 1987 with an operative approach involving insertion of several Kirschner pins across the tumor area are reviewed. Postoperatively, pain relief and varied healing of the lesion was noted radiologically. We conclude that it is worthwhile to consider insertion of Kirschner pins as a first step in treatment.

Adolescent↗
PubMed2004

[Exploration of diagnosis and treatment of maxillary aneurysmal bone cyst (report of 4 cases and review of literature)].

OBJECTIVE: To explore the diagnosis and treatment of maxillary aneurysmal bone cyst. METHOD: For 4 cases with maxillary aneurysmal bone cyst, 1 case underwent radical maxillary sinusotomy in local anaesthesia and 3 cases underwent lateral rhinotomy in general anaestesia. RESULT: The 4 cases were followed up for 13 months to 2 years after operation and no patient was found recurrence. CONCLUSION: The main treatment of aneurysmal bone cyst was radical operation, to strive for thorough treatment. Confirming and embolizing the feed artery by DSA preoperatively can reduce bleeding during operation and shorten the time of operation and general anesthesia obviously.

Adolescent↗
PubMed2003

Simple bone cyst with pathologic lumbar pedicle fracture: a case report.

STUDY DESIGN: A case report and review of the literature are presented. OBJECTIVE: To describe an unusual simple bone cyst involving the pedicle of lumbar spine. SUMMARY OF BACKGROUND DATA: To the authors' knowledge, only nine cases of a simple bone cyst involving the spine have been reported. Most of these reports have described mild back or neck pain because the presenting symptoms or cysts were found incidentally. In the reported case, acute severe back pain with radiating pain developed. Therefore, the study focus was on the unusual location, the presenting symptoms, and its spinal involvement. METHODS: A cystic lesion involving the left pedicle of the first lumber vertebra was identified in a 53-year-old woman with sudden-onset severe back pain with pain radiating to the left leg. Surgical resection was undertaken along with review of the patient's medical record, imaging studies, microscopic findings of the lesion, and the related literature. RESULTS: Microscopic examination of the cystic lesion corresponded with the findings of a simple bone cyst. A thin fibrous membrane with reactive bone formation was identified without evidence of hemorrhage. A favorable result was achieved by surgical resection. CONCLUSIONS: This case study suggests that a simple bone cyst may be found in any portion of the spine, including the pedicle. Severe resting pain would be elicited by a pathologic fracture of the pedicle. Direct nerve compression by the fractured fragment and chemical irritation by cystic fluid would be compatible with the observed clinical manifestations.

Back Pain↗
PubMed1999

Quantitative analysis of the plain radiographic appearance of unicameral bone cysts.

RATIONALE AND OBJECTIVES: The authors determine the features that distinguish the radiographic appearance of unicameral bone cysts (UBC) from other solitary lesions of bone and to develop an ordered differential of similar-appearing lesions. MATERIALS AND METHODS: Seven hundred nine cases of solitary bone lesions, including 40 UBCs, were analyzed according to demographic, anatomic, and plain radiographic features. Vector analysis of both classic and new groups of features was performed to determine the sensitivity and specificity of radiographs for UBC and an ordered differential based on radiographic features. RESULTS: The features of the UBCs in this study compared favorably with those in the literature. The male:female ratio was 3.3:1, with an average age of 15 +/- 13 years. Age ranges and lesion diameters were similar for both sexes. Thirty-three of the 40 (83%) UBCs were in long bones, and seven were in the pelvis or calcaneus. All 40 UBCs were geographic, medullary, and lytic. None had an associated soft-tissue mass. Fifty-five percent had pathologic fractures, and 10% had fallen fragment signs. Ninety-eight percent had no cortical break, and 88% had well-defined margins. CONCLUSION: Classic descriptions of UBCs can be refined to improve sensitivity without sacrificing specificity. The best vector in this study had a sensitivity of 80% and a specificity of 93% and included these radiographic features: metaphyseal, diaphyseal, or flat bone location, geographic, lytic, medullary-based, no matrix, no satellite lesions, no subarticular extension, no soft-tissue mass, no cortical break, and central location in long bones. An ordered differential diagnosis, starting with the most likely lesion, includes enchondroma, aneurysmal bone cyst, fibrous dysplasia, nonossifying fibroma, Brodie abscess, and chondrosarcoma.

Adolescent↗