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The application of the ND-YAG-Laser in juvenile bone cysts prevents recurrencies. That can be put down to the fact that the laser has a deep action which destroys the organells of the cystic tissue up to 2-4 mm irreversibly. By this the whole cystic tissue is being destroyed and recurrencies are being prevented.
A nine months old Japanese domestic cat with a solitary bone cyst, which is a benign tumor-like lesion and is particularly uncommon in feline practice was referred. Radiographic examination revealed an expansive radiolucency in the distal metaphysis of the right ulna and pathologic fracture. The histological examination demonstrated immature osteogenesis consisting of osteoblasts surrounded by connective tissue. We applied drainage and instillation of steroid solution into the cystic cavity. Clinical signs, including lameness and pain, disappeared three weeks after the therapy started. Fourteen months after the therapy, the cystic lesion of bone was remodeling successfully without re-developing. We conclude that our procedure was useful treatment in this case.
The authors emphasize the rarity of aneurysmal bone cysts localised in the hand. They report three cases and describe the radiographic, macroscopic and histological appearances. These three cases were out of a total of 350 tumours of the hand. The surgical treatment is described, also the differential diagnosis and the criteria used to select the type of surgery adopted.
A 63-year-old female presented with an extremely rare solitary bone cyst in the spine involving the C-5 vertebral body. Computed tomography showed an air-density area inside the cyst, without postcontrast enhancement. Magnetic resonance imaging demonstrated a low-intensity lesion on both T1- and T2-weighted images. At surgery, the cyst cavity contained no fluid. Histological examination of the surgical specimen revealed that the cyst wall was lined by a thin fibrous membrane. This rare bone cyst may have originated from a defect in the epiphyseal plate of the vertebral body.
OBJECTIVE: Ethibloc is a fibrogenic and thrombogenic agent recently proposed for the treatment of bone cysts. The purpose of this study is to report the results of direct Ethibloc injection in primary aneurysmal bone cyst (ABC) in children. DESIGN AND PATIENTS: Seventeen patients, aged from 2 to 18 years (mean 8 years), were treated with either a single injection (14 patients) or supplementary injections (3 patients) of Ethibloc. The histological diagnosis was assessed following surgical biopsy and was retrospectively reviewed. The mean follow-up was 5 years (range 18 months to 11 years). RESULTS: At 5 year follow-up, 14 of 17 patients demonstrated complete healing manifest by increased cortical and septal thickening. Surgical excision was required in three patients, in two of whom the ABC increased rapidly in size despite the injection, and in one of whom the healing was incomplete. We observed inflammatory reactions in 16 of 17 patients with local pain and fever. Three patients developed a small cutaneous fistula which resolved spontaneously in a few weeks. No major complications such as deep infection, pulmonary embolism, epiphyseal necrosis or malignant degeneration were observed. CONCLUSION: Percutaneous direct Ethibloc injection is a safe, efficient and noninvasive treatment for ABC. The authors highlight the frequent local reactions.
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Various theoretical hypotheses have been proposed for the nontraumatic etiology of osteochondritis dissecans, subchondral bone cyst formation, and Legg-Calvé-Perthes disease. Although a direct relationship between these distinct clinical entities has sparse referral in the literature, their common theories of etiology and evolution have been extensively documented, although not correlated. The various etiologic theories of osteochondritis dissecans, Legg-Calvé-Perthes disease, and subchondral bone cyst formation have been individually presented. The conclusion drawn upon review of these theories would prove that all of the proposed etiologies for the above syndromes are remarkably similar. Furthermore, as referred to in the contents of this paper, the signs, symptoms, and roentgenographic findings also appear to be common to all three syndromes. Various clinicopathologic studies have demonstrated similar gross pathologic and histologic findings between osteochondritis dissecans, subchondral bone cysts formation, and Legg-Calvé-Perthes disease. The authors, therefore, contend that the most likely nontraumatic etiology of this condition is a common multifactorial causation with an identical pathogenesis. They propose a common etiology resulting in a pathologic process, originating in subchondral cyst formation. Eventually, a communication between the cysts and the joint will occur secondary to either the duration and progression of the cystic process, endogenous, or exogenous stress resulting in collapse of the articular surface. A complete or partially detached osteochondral fragment results from these forces. Osteochondritis dissecans and Legg-Calvé-Perthes disease may represent the same stage in the pathologic process. Degenerative joint disease is the final stage of this pathologic process. Further studies need to be performed to explore this relationship and the proposed pathogenesis.(ABSTRACT TRUNCATED AT 250 WORDS)
Twenty-three cases of pelvic aneurysmal bone cysts treated at the Istituto Ortopedico Rizzoli were reviewed after a mean follow-up of 7 years. Eighteen cysts involved the anterior arch, four extended into the iliac wing and the anterior arch, and one invaded the entire hemipelvis. The acetabulum was involved in 56.5% of the cases. Fourteen patients were treated with surgery (curettage 11; resection 3), and five with radiation therapy; two patients had both modalities; two additional patients refused any treatment after biopsy. The overall recurrence rate was 13% (one case after curettage, one after radiation therapy, and one after combined treatment). Significant complications affected the final functional result in four of seven patients who received radiation therapy, while only one minor complication was seen in the surgical group.
The article describes up-to-date views on epidemiology, diagnosis and treatment simple bone cyst. It presented six cases of simple bone cyst treated in the Maxillofacial Surgery Division of Wojewódzki Szpital Specjalistyczny in Rzeszów.
This is a case of aneurysmal bone cyst arising from a fibrous metaphyseal defect of the proximal tibia in a toddler. A 32-month-old girl presented with physiologic bowing with a small metaphyseal defect at the medial aspect of the left proximal tibia. A large aneurysmal bone cyst, occupying almost the entire metaphysis of the proximal tibia, evolved from this lesion during the following 1 year 3 months. The lesion healed uneventfully after curettage and bone grafting. This case emphasizes the importance of regular followups to observe the clinical course of a fibrous metaphyseal defect during childhood.
This report describes a rare, juxta-articular bone cyst of the posterior glenoid that developed after a fracture of the glenoid in a 38-year-old male. The patient had persistent pain, popping and stiffness of his right shoulder for 3 years, and failed to improve after a nonoperative rehabilitation program. At arthroscopy, the senior author transported an autogenous bone graft from the bare area of the humeral head to fill the glenoid cyst arthroscopically. At second-look arthroscopy approximately 1 year after the index procedure, the bone graft had consolidated within the original cystic defect and the surface was covered with fibrocartilage. The graft harvest site posteriorly on the humeral head had healed with a small amount of scar tissue at the articular margin. Comfortable motion and function were restored.
An unusual case of several recurrences of multiple and bilateral "idiopathic, traumatic, hemorrhagic" bone cysts in the same patient, with long-term follow-up, is presented. The etiology and pathogenesis of idiopathic bone cysts are discussed. It is recommended that patients be followed for a longer period of time after treatment.
38 children between 5 and 14 years of age with juvenile bone cysts were followed up to a maximum of 20 years. In two-thirds of the cases the diagnosis was made on the occasion of a fracture in the cyst region. One child received conservative treatment, 37 children were operated on. The roentgenological diagnosis of all children operated on was confirmed histologically. The operative procedure consisted in milling out the cysts and filling the cavities with autogenous, allogenous or xenogenous spongiosa. Because of the high recurrence rate (10-40% in the literature and 19% from our own experience) we suggest a modified surgical procedure assuring complete recovery. Subtotal diaphysectomy with interposition of a corticospongious splinter and allogenous spongiosa using a stable osteosynthesis in the case of large primary cysts in metadiaphyseal position is discussed.
Aneurysmal bone cyst is a benign but locally destructive lesion of bone. We present two cases of ABC in uncommon locations in two children. The first case concerns a 14 year old boy who had a mass located in the internal side of the talus. An ABC type V of Campanacci's classification is diagnosed. Complete curettage was carried out with a high-speed burr. We implanted an Orthofix external fixation with a mobil bottom bolster and distal pins located in the calcaneum. Case 2 concerns an ABC in the clavicle of a 9 years old boy. A selective arterial embolization (SAE) with polyvinyl alcohol was carried out. Curettage of the lesion and filling with a cortico-spongy graft were implemented. Two years later, both of the patients are asymptomatic. We believe that external fixation with a bolster is an efficient and valid alternative to traditional immobilization with a cast. The use of SAE also prevented profuse bleeding of the lesion during surgical procedure.
A case is presented of a three-year-old child with an aneurysmal bone cyst at the right distal femoral metaphysis, a rare lesion in children in this age group. Treatment of the lesion which included thorough curettage and packing of the cyst cavity with crushed cortical bone is described. The literature is reviewed.
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Various hypotheses for the etiology of unicameral bone cysts are discussed. The unique documentation of a lesion which developed as a result of a bullet wound appears to lend credence to trauma as an inciting agent.