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PubMed1997

Solitary unicameral bone cyst.

This study discusses the results of the 24 patients who had unicameral bone cyst treated by the author surgically and conservatively between 1982 and 1992. The patients were sixteen males and eight females giving a male to female ratio of 2:1. Their ages ranged from two to 34 years with a mean age of 18 years. The long bones were commonly affected as follows: humerus in eight patients; femur in six patients; tibia in two patients. All were affected on the proximimal part of the bones, and there were three cysts found in the calcaneus. The main complaint was mild dull pain on the affected site. In some cases the pain was severe and associated with inability to use the affected limb. X-ray findings showed medullary cavity and adjacent inner cortical destruction with mild subperiosteal new bone formation causing an expansile appearance and multiloculation. At surgery, an area of bone expansion was found with weakened periosteum and underlying thin cortex which easily collapsed on pressure leading to a cavity containing yellowish fluid. The wall consisted of a thin membrane with ridges which was histologically reported as connective tissue with a few bone spicules. Surgical results were graded as "good" in 73% and "poor" in 27% due to recurrent, shortening or occurrence of sepsis. The bone metabolism studies and total blood count were normal.

Adolescent↗
PubMed1977

Recurrent aneurysmal bone cysts in children. Discussion on the treatment of three cases.

Three children presented with recurrence of aneurysmal bone cyst. In two of these patients the lesion was localized in the superior metaphyses of the tibia and humerus respectively. Total resection was performed followed by the introduction of autoplastic transplants of cortical and spongy bone. In the third case prosthetic substitution of the upper fourth of the ulna was preferred. Healing was obtained in all cases. The indications, operative technique and the final results are discussed.

Bone Cysts↗
PubMed1981

Bilateral aneurysmal bone cysts of the maxilla.

A case of bilateral maxillary aneurysmal bone cysts in a 55-year-old woman is described. A brief review of the literature is presented. The diagnosis was based on the characteristic radiographic, macroscopic, and microscopic findings. Both lesions responded well to curettement. Followup showed no recurrence after five years.

Bone Cysts↗
PubMed1982

The treatment of unicameral or solitary bone cysts by the injection of corticosteroids.

Methylprednisolone acetate injections into bone cysts are as effective a treatment as curettement and packing. More than one injection may be necessary since recurrences have been seen in half the cases treated with a single injection. Fracture of the cystic part may occur before or after injection if bony filling has not taken place. The fracture may be serious if it involves the neck of the femur. The method is safe and does not result in an unsightly scar. Solitary eosinophilic granulomata of bone also reportedly respond positively to direct injections fo methylprednisolone into the lesion by signs of healing and with relief of pain.

Adolescent↗
PubMed2005

Aneurysmal bone cyst as a rare cause of spinal cord compression in a young child.

STUDY DESIGN: Case report. OBJECTIVES: To report: 1) one of the youngest cases of aneurysmal bone cysts presenting with cord compression at the cervicothoracic junction with 7-year follow-up; and 2) the technique we used to stabilize such a small spine. SUMMARY OF BACKGROUND DATA: Aneurysmal bone cyst is an uncommon but well-recognized tumor affecting the spine of children. The mean age of presentation is 16 years. It has hardly been reported below the age of 4 years. All data are in the form of case reports or series. Surgical or nonoperative management can be used. Spinal implant systems are not designed for use in very small children. METHODS: Clinical data analysis. RESULTS: A girl presented at age 2 years and 3 months with cord compression at the cervicothoracic junction. After an inconclusive biopsy, a formal excision and reconstruction of the C7 and T1 were performed anteriorly and posteriorly. We used a fibular graft, internal fixation with crossed plates from the maxillofacial implant tray and a Cervifix rod contoured into a rectangle with sublaminar titanium cables. Postsurgery, she had a left Horner syndrome that has never recovered and motor weakness of the right arm that improved but did not fully recover. She developed a staphylococcal infection 6 months postsurgery that was managed by removal of the rectangle. She developed a posterior recurrence 10 months postsurgery, which was managed surgically. Follow-up has been for 7 years without further evidence of recurrence. CONCLUSIONS: Both surgical and nonsurgical management has been advocated for these tumors. The cord compression at presentation forced us toward surgical management. It is likely that observational data are the only evidence available for clinical decision-making. In this case, we were able to obtain good access to the front of the upper thoracic spine by a supraclavicular approach. Tiny plates are available to maxillofacial surgeons that can be adapted for use in the spines of small children.

Bone Cysts, Aneurysmal↗
PubMed1990

Aneurysmal bone cyst of the sphenoid with orbital involvement.

We present a case of aneurysmal bone cyst involving the roof of the orbit and sphenoid bone, with plain film, computed tomography, and magnetic resonance imaging findings. The natural history and treatment depend on the presence of associated abnormalities such as fibrous dysplasia or a giant cell tumour. In this case the lesion was solitary and was successfully removed, so that possible complications from radiotherapy were avoided.

Bone Cysts↗
PubMed1991

Atypical multiple benign osteoblastomas accompanied by simple bone cysts. A case report.

A case of atypical benign osteoblastomas occurring at multiple sites in the maxilla and mandible of a 38-year-old woman, in association with simple bone cysts, is described. The tumors produced hazy or ground-glass-like semiradiolucent lesions with well-defined or poorly-defined margins on conventional radiographs. Histologically, the lesions were characterized by a proliferation of plump osteoblast-like cells forming trabeculae of osteoid and immature bone in a well-vascularized stroma. In addition, simple bone cysts associated with a radiolucent-radiopaque lesion consisting of lamellar bone and loose connective tissue were found next to one of the tumours. Possible pathogenesis of the tumours and cysts is discussed.

Adult↗
PubMed1996

[Aneurysmal bone cyst: diagnostic role of computerized tomography and magnetic resonance].

Aneurysmal bone cysts (ABC) are relatively uncommon benign expansile osteolytic lesions characterized by multiple cavities with serum-blood levels and delimited by a thin periosteal external border. The differential diagnosis is difficult to make with conventional radiography, while CT and MRI are elective techniques. Ten patients with ABC (7 central and 3 eccentric lesions) were examined with CT and MRI. Four cysts were localized at the proximal femur, 2 in calcaneal, 2 in vertebral (cervical and dorsal), 1 in tibial and 1 in iliac sites. Diagnostic criteria were the presence of fluid-fluid levels and a thin hyperdense peripheral border at CT, while hyperintense cavities on T2-weighted sequences, fluid-fluid levels, pseudodiverticular features and a low-signal border were found at MRI. Intralesional levels were detected in 9 patients at CT and in 10 at MRI; the 3 peripheral cysts exhibited a hyperdense extraosseous border at CT, corresponding to the periosteal shell, considered a benignity sign. To conclude, CT and MRI, thanks to their high resolution, clearly depict the anatomopathologic features of ABC, thus allowing this type of lesion to be differentiated from other benign and malignant osteolytic lesions.

Adolescent↗
PubMed1982

Clinical and radiological aspects of stifle bone cysts in the horse.

Thirty-three cases with subchondral bone cysts in the stifle are reported. The condition was most commonly seen in young Thoroughbreds and produced intermittent lameness of varying degree. Radiographically distinct areas of radiolucency were found in the distal femur or proximal tibia adjacent to the femorotibial joint. Lesions were usually unilateral but 5 horses had cysts in both stifles. The cases could be divided into 2 distinct groups. Horses in Group A (28 cases) had a large circular or dome-shaped cyst in the medial femoral condyle with a distinct communication with the femorotibial joint. In Group B (5 cases) the cysts were much more variable in shape, size and location. The common sites were the distal femur adjacent to the intercondyloid fossa or the proximal tibia just beneath the tibial spine. No evidence of radiological signs typical of osteochondrosis dissecans were seen in any of the cases. All the horses were treated conservatively with a 6 month rest period out at grass, followed by a gradual return to full training. Fourteen horses were re-examined 4 to 33 months after the initial examination and none of them showed disappearance of the cysts. There was a tendency to increased radiodensity of the cyst in some cases but this was only to a minor degree. The outcome of the 2 groups was different. In Group A just over half (14) made a complete recovery while a further 5 returned to full work although some persistence of mild lameness was still present. In Group B only one case was reported to have made a successful return to full work.

Animals↗
PubMed1989

Unicameral bone cysts. A comparison of treatment options.

Thirty-two unicameral bone cyst cases from various hospital centers in the San Francisco Bay Area were reviewed in order to compare the results of different treatment methods. Thirteen of the 32 cysts were latent and 19 were active, judged by their proximity to the growth plate. The average age at presentation was 8.9 years, and average follow-up was 5.6 years. Fifteen patients were treated surgically, 12 were given steroid injections, and five were treated nonoperatively. Comparative analysis of these methods supports previous studies which show that steroid injections are as effective as surgical intervention while having lower morbidity.

Adolescent↗
PubMedDate not supplied

Aneurysmal bone cysts of the spine: excision and stabilization.

The treatment of aneurysmal bone cysts (ABCs) of the spine remains controversial in the literature. Treatment options have included radiation, curettage and bone graft, extirpation, and various combinations of these. Conspicuously missing in previously published articles and texts are guidelines for dealing with the instability and deformity that often accompany ABCs of the spine. The index case in this report highlights the potentially devastating effects of treating the tumor in isolation without addressing the concomitant deformity and instability. The status of the structural integrity of the spine must be assessed before initiating treatment. If instability or deformity or both are already present or if the amount of osseous tissue to be resected may render the spine unstable, then instrumentation and fusion should be performed at the time of surgical resection or before other forms of therapy. We present three cases of ABCs of the spine in which the tumor itself was treated with surgical extirpation and the associated deformity and instability were treated with spinal instrumentation and long fusions.

Adolescent↗
PubMed1995

Femoral head avascular necrosis associated with metaphyseal aneurysmal bone cyst.

A 12-year-old girl had an aneurysmal bone cyst in the proximal femoral metaphysis simultaneously with an avascular necrosis of the femoral head, as seen on radiological examination. No extension of the lesion across the growth plate into the femoral epiphysis was observed. The expansive behavior of this lesion (ABC) could have compromised the posterosuperior vascular supply of the femoral epiphysis, since no radiographic signs of fractures could be found. Vascular anomalies within the lesion that increase venous pressure could be another factor responsible for the decrease in the blood supply of the femoral epiphysis and could cause necrosis, hence compromising the morphology of the hip joint at maturity.

Bone Cysts, Aneurysmal↗
PubMed1981

Aneurysmal bone cysts with emphasis on roentgenologic diagnosis.

This paper was written to bring about an awareness of aneurysmal bone cysts--the etiology, signs and symptoms, and clinical manifestations. Emphasis is placed upon the roentgenologic appearance of bone tumors and the differentiation of aneurysmal cysts from other relatively common bone tumors. Treatment and pathologic interpretation are discussed briefly.

Adolescent↗
PubMedDate not supplied

Percutaneous intramedullary decompression, curettage, and grafting with medical-grade calcium sulfate pellets for unicameral bone cysts in children: a new minimally invasive technique.

Several treatment options exist for unicameral bone cysts (UBCs), including observation, steroid injection, bone marrow injection, and curettage and bone grafting. These are all associated with high recurrence rates, persistence, and occasional complications. Newer techniques have been described, most with variable success and only short follow-up reported. Because of these factors, a new minimally invasive percutaneous technique was developed for the treatment of UBCs in children. Twenty-eight children with UBCs who underwent percutaneous intramedullary decompression, curettage, and grafting with medical-grade calcium sulfate (MGCS) pellets by the senior author (J.P.D.) between April 2000 and April 2003 were analyzed as part of a pediatric musculoskeletal tumor registry at a large tertiary children's hospital. Four patients were lost to follow-up, and the remaining 24 patients had an average follow-up of 21.9 months (range 4-48 months). Twelve patients were followed for at least 24 months. Six of the 24 children had received previous treatment of their UBC, most often at an outside institution. Follow-up was performed through clinical evaluation and radiographic review. Postoperative radiographs at most recent follow-up showed complete healing, defined as more than 95% opacification, in 22 of 24 patients (91.7%). One patient (4.2%) demonstrated partial healing, defined as 80% to 95% opacification. One patient had less than 80% radiographic healing (4.2%). All 24 patients returned to full activities and were asymptomatic at most recent follow-up. The only complication noted was a superficial suture abscess that occurred in one patient; this resolved with local treatment measures. The new minimally invasive technique of percutaneous intramedullary decompression, curettage, and grafting with MGCS pellets demonstrates favorable results with low complication and recurrence rates compared with conventional techniques. The role of intramedullary decompression as a part of this percutaneous technique is discussed.

Administration, Cutaneous↗
PubMedDate not supplied

Unicameral bone cyst of the first metatarsal.

An unusual case of a unicameral bone cyst located in the head of the first metatarsal is presented with a review of the literature. This benign bone tumor is rarely found in the metatarsal bones. Pathologic, clinical, and radiographic findings, as well as a differential diagnosis will be discussed.

Bone Cysts↗