[Diagnosis and therapy of solitary bone cysts].
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Report on a girl, who died at the age of 6 1/2 years having exhibited different dysplasias which are characteristic features of several phakomatoses: congenital cutaneous pigmentations, fibrolipoma of the scalp, hypertrophy of the right leg, multiple cysts of the long bones (fibrous dysplasia), and an aneurysma racemosum of the retina and mid-brain (syndrome of Bonnet-Blanc-Dechaume).
The case report of a large aneurysmal bone cyst of the ankle is presented, as it occurred in a 10-year-old male. Radiographic and histologic characteristics are illustrated. Treatment was by surgical curettment and autogenous bone grafting.
A 1-year-old child with an aneurysmal bone cyst in the scapula is presented. The sonographic examination showed a cystic formation with intraosseal fluid levels that shifted after repositioning of the child. Similar findings have been reported on CT scans and it is suggested that shifting fluid levels are an indicative feature of aneurysmal bone cyst.
The author presents results of treatment 10 children with calcaneal bone cyst. The mean age in the time of diagnosis was 13.5 years (10-18 years). The mean follow-up was 23.7 months (12-48 months). 4 children complained of heel pain; the rest were asymptomatic. In one child the cyst was large, filled nearly all bone. The rest were typically localized in the antero-middle part of the calcaneus. Steroid injection in one patient failed. All the patient were treated with curettage and bone grafting. The results were good--all the cysts healed. Curretage and bone grafting is indicated in the cases when cyst is large (more than half of the bone), when is localized in the posterior weight-bearing part of the calcaneus, when is painful or the radiograph is not typical.
A 31-year-old woman with an aneurysmal bone cyst of the L1 vertebral body proved by biopsy and studied by plain lumbar spine roentgenography, radionuclide studies, myelography, and CT is presented. The unusual location of involvement of the vertebral body alone and the difficulty in differential diagnosis between aneurysmal bone cyst and benign giant cell tumor are discussed.
A simple bone cyst of the proximal humeral metaphysis was found to cause growth disturbance with shortening and deformity in four patients. All had one pathological fracture. Three of them were treated with cortisone injections; the fourth patient, who presented an erosion of the physis, was treated with saline solution irrigation. Four hypotheses about the aetiology of growth arrest in the evolution of this benign lesion, are discussed: iatrogenic lesion of the physis, growth plate involvement by fracture, cortisone injection, and increased cyst pressure leading to erosion and even perforation of the growth plate.
Two patients with aneurysmal bone cysts of the spine demonstrate striking similarities when examined with magnetic resonance imaging (MRI), while the plain radiographs and images on computed tomography (CT) are quite different. Gadolinium DTPA enhanced T1W images were especially helpful in the definition of the lesion by showing enhancement of the septations of the aneurysmal bone cysts. The septations represent the fibrous walls inherent to these lesions.
A 9-year-old boy presented with a painful left heel. A plain radiograph showed a lytic lesion with a benign appearance, with a simple bone cyst or an intraosseous lipoma as the most likely differential diagnostic possibilities. MRI demonstrated a simple bone cyst.
Computerized tomography can depict most of the characteristic features of aneurysmal bone cyst of the spine even when the plain film findings are not diagnostic. The computed tomographic appearance is that of a benign expansile soft tissue mass surrounded by a shell of bone, an appearance which is analogous to the typical changes of aneurysmal bone cyst in the extremities. Extension into adjacent bones and soft tissues can be demonstrated and thereby facilitate both preoperative planning and later follow-up for recurrence.
OBJECTIVE: The purpose of this study was to evaluate whether gas is present in the cavities of simple bone cysts. STUDY DESIGN: Computed tomographic images of 52 simple bone cyst cases were reviewed and compared with the findings at surgery. RESULTS: Whereas gas was confirmed at the time of surgery in 28 cases, no computed tomographic images indicated the presence of gas in the cavity. Bone expansion was noted in 13 of these 28 cases. CONCLUSIONS: From these findings, we concluded that the presence of gas in the simple bone cyst cavity at surgery has been erroneously interpreted.
A patient suffering from Van Buchem's disease combined with an aneurysmal bone cyst in the para-acetabular region is described. The extreme rarity of both the primary disease and its combination with an aneurysmal bone cyst is discussed with respect to the clinical, radiological, and laboratory features.
A retrospective study of 23 simple bone cysts including analysis of clinical, radiographical, histopathological features and follow-up information was made. The age of the patients varied from 8 to 59 years (mean 21.4 years). All lesions were found in the mandible, and 2 of them were radiologically multilocular. A loose connective tissue lining was found histologically in 8 out of 17 cysts with the biopsy specimens available. At follow-up, 2 failures of the primary surgical treatment were noted. The results emphasize that a proper follow-up is required after the treatment of simple bone cyst.
Florid cemento-osseous dysplasia (FCOD) with concomitant simple bone cysts is not common. We report a case of FCOD involving three quadrants of the jaws and associated with two large cystic lesions of the mandible in a 40-year-old Japanese woman. Microscopic examination revealed unencapsulated fibroblastic proliferation with formation of bone and cementum, showing different developmental stages, and cystic lesions resembling a simple bone cyst.
The effects of percutaneous Ethibloc (Ethicon/Johnson & Johnson, St-Stevens-Woluwe, Belgium) injection into primary aneurysmal bone cysts were analysed. Two patients with a venous drainage after injection of a medium contrast were excluded. Twelve patients underwent at least one percutaneous injection of Ethibloc. The average follow-up period was 5.1 years. At final follow-up, six patients had complete healing of the cyst, three had partial healing and three, who had no response, were treated by curettage and bone grafting. Complete healing was observed for all the aggressive lesions. No major complications were noted. Ethibloc injection may be performed as a primary treatment of aneurysmal bone cysts if the technique is followed with precision.