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Cytogenetic-morphologic correlations in aneurysmal bone cyst, giant cell tumor of bone and combined lesions. A report from the CHAMP study group.

Aneurysmal bone cyst and giant cell tumor of bone are relatively rare bone tumors that sometimes coexist. We examined the karyotypes of 3 aneurysmal bone cysts, 12 giant cell tumors, and 3 combined lesions. All aneurysmal bone cysts showed involvement of chromosome segments 17p11-13 and/or 16q22. In addition, in 1 of the 3 giant cell tumors with secondary aneurysmal bone cyst, both chromosome bands were rearranged as well, albeit not in a balanced translocation. Seven out of 12 giant cell tumors were characterized by telomeric associations. One giant cell tumor showed a dup(16)(q13q22), suggesting the presence of a (minor) secondary aneurysmal bone cyst component, despite the absence of histological proof. Our results, combined with literature data further substantiate that segments 16q22 and 17p11-13 are nonrandomly involved in at least some aneurysmal bone cysts, irrespective of subtype (primary, secondary, intra/extraosseous, solid or classic). These findings strongly suggest that some aneurysmal bone cysts are true neoplasms. In addition, telomeric associations are the most frequent chromosomal aberrations in giant cell tumor of bone, the significance of which remains elusive. In combined giant cell tumor/aneurysmal bone cyst each component seems to retain its own karyotypic abnormality.

Adolescent↗

[Echography for the diagnosis of aneurysmal bone cysts].

Aneurysmal bone cysts are benign tumors which are likely to recur. While growing, they cause severe osteolysis, able to balloon the bone and to thin the cortex. The latter is reduced to a thin bone shell, and sometimes completely interrupted. Tumor mass can spread into the surrounding soft tissues as in other bone tumors, especially malignant ones, which are often misdiagnosed. Whether the cortex is interrupted or only thinned, an acoustic window is obtained which allows an easy study of tumor mass with US. Seven patients were examined, who presented lytic lesions of different bones, produced by aneurysmal cysts. US allowed the expansile lesion to be detected, and its size to be estimated. Moreover, US pattern of the lesion could be determined, which appeared both solid and liquid. A few minutes after beginning the examination, fluid levels could be observed to appear, which are typical of this condition, as both CT and MR imaging demonstrate both in vivo and in vitro. Thus US, thanks to its short execution time, low cost and non-invasiveness, can be considered as the second-step exam, after plain film, in the diagnosis of aneurysmal bone cyst.

Adult↗

Aneurysmal bone cyst of the temporal bone.

Aneurysmal bone cysts are uncommon lesions of the bone, which are benign and non-neoplastic in nature. They are commonly seen in the long bones. Their occurrence in the calvarium is rare. We report the occurrence of an aneurysmal bone cyst in the temporal bone of a young boy, which eroded the posterior part of the orbit to cause proptosis.

Bone Cysts, Aneurysmal↗

[The use of homologous spongiosa chips in the treatment of juvenile bone cysts].

Juvenile bone cysts are characterized by trials of hypothetic interpretations in case of aetiology and general disagreement in relation to indicated therapy. The therapeutic spectrum is ranging from primary conservative treatment till subtotal e.g. total cyst resections. Because in juveniles a quantitative limitation for gathering of autogenous material exists the use of allogenous cancellous bone chips has a definitive place in treatment strategy.

Bone Cysts↗

Treatment of solitary bone cysts by diaphysectomy and bone grafting.

Total diaphysectomy and grafting for solitary bone cysts would appear to produce considerably less recurrence than is found after simple curettage of the lesion and grafting. Three patients with solitary bone cysts, one a primary lesion of the upper humerus and two recurrent lesions involving the intertrochanteric regions, were successfully treated by radical excision of the cyst-bearing region and bone grafting. The operative technique is described as well as the measures taken to prevent discrepancy in limb length or angular deformity ensuing in lesions involving weight-bearing bones such as the femur.

Bone Cysts↗

The role of lysosomes in the pathogenesis of unicameral bone cysts.

Unicameral bone cyst fluid possesses N-acetyl-beta-D-glucosaminidase, beta-glucuronidase, PZ-peptidase, cathepsin D, acid phosphatase, N-acetyl-beta-D galactosaminidase, and beta-galactosidase activities. The activities of lysosomal enzymes in the cyst fluid are, as a rule, higher than in the serum, whereas the total protein content is lower. The content of collagen degradation products in the cyst fluid is higher compared to the serum. In bone cavity wall tissues, the collagen content is decreased. Adenosine 3':5'-cyclic phosphate and cyclic guanosine 3,5'-monophosphate accumulate in the cyst cavity. However, in some cases, there is no correlation among the activities of lysosomal enzymes in the cyst fluid, blood serum, and cyst wall tissues. The ratios of lysosomal enzyme activities in the cyst fluid differ from those in the cyst wall tissues, cultured skin fibroblasts, and blood polymorphonuclear leucocytes. The lack of coincidence of enzymatic spectra of the cyst fluid, wall tissues, and serum is suggestive of the diversity of ways of lysosomal enzyme enter the cyst cavity, i.e., blood, cyst fluid cells, and cyst cavity walls. The cysts with different locations (i.e., active and latent cysts) have similar lysosomal lytic potentials. The presence in the cyst cavity of extracellular lysosomal enzymes and collagen degradation products testifies to the permanent corrosion of the cyst cavity walls from the inside as well as to the increase in the osmotic pressure of the cyst fluid. Lysosome destruction should be regarded as an important pathogenetic factor that requires surgical or pharmacologic correction or both in the course of bone cyst management.

Bone Cysts↗

Recurrent t(16;17)(q22;p13) in aneurysmal bone cysts.

Aneurysmal bone cyst (ABC) is a benign bone lesion for which no previous cytogenetic data exist. We describe the finding of clonal chromosome aberrations in three tumors; two had a t(16;17)(q22;p13) as the sole anomaly, and the third had a del(16)(q22) as the only change. These findings show that somatic mutations contribute to the development of ABC and furthermore indicate that bands 16q22 and 17p13 may harbor genes of importance in this process.

Adolescent↗

Aneurysmal bone cyst in the sphenoid bone: treatment with minimally invasive surgery.

Aneurysmal bone cysts are vascular lesions that destroy and expand bone. We report a recently treated case of an aneurysmal cyst of the sphenoid bone. A 14-year-old girl presented with frontal headaches, bouts of nausea, and vomiting. Computed tomography and magnetic resonance imaging showed typical features of an aneurysmal bone cyst. Arterial embolization was undertaken before surgery. The endoscopic transnasal procedure used allowed the complete removal of the aneurysmal bone cyst. This use of minimally invasive surgery makes this case of interest to surgeons of the skull base and sinuses.

Adolescent↗

Aneurysmal bone cyst of the sphenoid bone.

Aneurysmal bone cyst (ABC) is an uncommon benign lesion that rarely presents in the craniofacial region. Aneurysmal bone cysts represent nearly 1.4% of all bone tumors, and among those, only 3% are located in the cranium. In this study, we report on an ABC located in the sphenoid bone with superior nasal cavity and ethmoid extension. The presenting symptom of our patient was headache, followed by diplopia, loss of visual accuracy, and abduction restriction. We successfully resected the lesion by a combined subcranial-midfacial degloving approach without any complications or recurrence.

Abducens Nerve Diseases↗

Autogenic bone marrow injections as a treatment for simple bone cyst.

Simple bone cyst (SBC) is a benign fluid-filled cavity found primarily at the proximal ends of long bones in children. Treatments proposed for SBC range from observation to intralesional curettage and bone grafting, which are all associated with uncertainty and complications. Because of these factors, a relatively noninvasive protocol with osteoinductive autogenic bone marrow was instituted. Twelve patients were identified with SBCs. Bone marrow was aspirated from the patient's iliac crests and injected into the cyst cavity. Follow-up ranged from 9 to 57 months. Eight (67%) patients demonstrated substantial healing, two (17%) showed partial healing, and two (17%) did not respond to bone marrow therapy. The advantages suggested by bone marrow injection over the currently practiced methods include a higher success rate with a single injection and earlier healing.

Adolescent↗

Aneurysmal bone cyst of the temporal bone presenting as a spontaneous intracerebral hemorrhage: case report.

An aneurysmal bone cyst originating from the squamous portion of the left temporal bone is reported. The lesion presented in a 62-year-old nonhypertensive man as a spontaneous, intraparenchymal left temporal lobe hematoma. No evidence of trauma, hermorrhagic diathesis, or concurrent systemic disease was found. Previous case reports of aneurysmal bone cysts of the skull are reviewed.

Bone Cysts↗

Aneurysmal bone cyst of the temporal bone.

Aneurysmal bone cysts occurring within the calvarium are uncommon. The following case report describes the radiological and pathological findings of a temporal bone aneurysmal bone cyst with intra- and extracranial manifestations. The pertinent literature is reviewed.

Adolescent↗

Case reports: malignant transformation of aneurysmal bone cysts.

An aneurysmal bone cyst is an uncommon benign primary bone tumor. Careful intralesional curettage through a wide cortical window in addition to cauterization with or without adjuvant therapy (phenol or hydrogen peroxide) and bone grafting or cementation is the preferred surgical treatment. Adjuvant or primary radiation of an aneurysmal bone cyst rarely is used because of its association with malignant transformation of the lesion. Several cases of late malignant transformation of primary aneurysmal bone cysts without adjuvant radiation have been reported. We provide additional documentation of two primary aneurysmal bone cysts treated surgically with careful intralesional curettage through a wide cortical window and allograft bone grafting without adjuvant radiation. At 5.5 years and 12 years after treatment, a telangiectatic osteosarcoma and a fibroblastic osteosarcoma, respectively, were identified in the site of the original lesions. Not only should aneurysmal bone cysts be evaluated carefully through histologic examination at presentation, patients also should be counseled regarding possible recurrence and the need for routine followups, especially if symptoms change.

Adolescent↗

Aneurysmal bone cyst of the temporal bone: a case report.

Aneurysmal bone cyst in temporal region is rare. It is a benign condition and may extend intracranially. Total surgical removal is recommended, whenever possible in one stage or in multiple stages. Prognosis is excellent and total removal will effect a cure. An unusual case of aneurysmal bone cyst of temporal region is reported.

Adolescent↗