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PubMed1990

Treatment options in unicameral bone cysts.

Curettage and bone grafting has been the traditional treatment for unicameral bone cysts. Aspiration followed by injection of methylprednisolone acetate has been successfully used by Scaglietti et al. We reviewed 59 patients treated for unicameral bone cysts. The patients were subsequently evaluated for healing with regard to age, activity of cyst, and bone graft origin. The healing rate for curettage and bone graft was 53%. For patients with methylprednisolone acetate injection after aspiration, the healing rate was 70%. This difference was not statistically significant. The methylprednisolone acetate injection method has comparable efficacy to that of the more traditional curettage and bone graft method, and it is safe and cost-effective.

Adolescent↗
PubMed2005

[Aneurysmal bone cyst of the frontal bone].

BACKGROUND: Aneurysmal bone cyst (ABC) is a benign, expansive, osteolytic lesion that mainly occurs in young people, and involves the skull bones only exceptionally. The origin of ABC is controversial: secondary reactive bone lesion, or primary disease that represents an independent nosological entity. Blunt head trauma was suggested as a possible etiological factor. CASE REPORT: A case of a 19-year-old man with primary ABC of the right frontal bone was reported. The lesion was totally excised through frontal craniotomy, and the skull bone defect primarily reconstructed with an acrilate cranioplasty. Five years after the surgery, the patient was without signs of local recurrence. CONCLUSION: Clinical and neuroradiological presentation of the skull ABC was not specific. Pathohistology confirmed the diagnosis. Total excision was the treatment of choice.

Adult↗
PubMedDate not supplied

Aneurysmal bone cyst of the temporal bone associated with reversible hemifacial paralysis.

Aneurysmal bone cyst (ABC) is an uncommon lesion of the temporal bone (TB), with only 20 cases reported. Facial paralysis is a rare complication (2 cases); however, no cases have been reported with preoperative reversal of paralysis. We report a 60-year-old man with a history of remote head trauma, who presented with serious otitis media and right hemifacial paralysis, which resolved with nonsurgical therapeutic measures. Magnetic resonance imaging and computed tomography showed a destructive and expansile lesion of the TB. The lesion was surgically removed, and ABC was diagnosed histologically. The patient had an uneventful recovery and demonstrated no recurrence at 1 year of follow-up. This report presents an unusual presentation of ABC in the TB, with a review of the clinical, radiological, pathological, and therapeutic features of this entity.

Bone Cysts, Aneurysmal↗
PubMed1989

Aneurysmal bone cyst of the zygomatic bone.

Aneurysmal bone cysts are a rare finding in the facial bones and jaws. Only one previous case of this entity affecting the malar bone could be found in the literature. Ultrasound and isotope scan features of this entity are described.

Bone Cysts↗
PubMedDate not supplied

Elastic stable intramedullary nailing is the best treatment of unicameral bone cysts of the long bones in children?: Prospective long-term follow-up study.

Since Virchow first described the unicameral bone cyst (UBC) in 1876, several methods for management were proposed. Currently performed surgical procedures include curettage combined with bone grafting, allografting with freeze-dried crushed cortical bone, use of homologous cancellous bone chips, the application of high-porosity hydroxyapatite, and cryosurgery. Decompression with multiple drill holes and intralesional injections of either steroids or bone marrow have also been used to treat UBC, with variable success rates. Elastic stable intramedullary nailing for the treatment of UBC in long bones has been rapidly gaining popularity. Elastic stable intramedullary nailing for the treatment of a UBC was performed in 56 patients between 1994 and 2003. The follow-up is between 2.1 and 11 years. Nine children were excluded because of short period of follow-up or were lost. The study population consisted of 47 children. The cyst was located in the humerus in 36 patients, in the femur in 11. The mean age of the patients at the time of surgery was 8.9 years. Results were evaluated on plain radiographs according to the classification system of Capanna et al. In our study population of 47 UBCs, 31 (65.9 %) were classified as completely healed, and 16 (34.1%) were healed with residual radiolucency. No recurrence or no response was observed. Each lesion responded to treatment after the nailing. This method can solve in time the pathology, and we feel that, with skilled hands, this method is the best one for UBC treatment in the long bones of the children.

Adolescent↗
PubMedDate not supplied

[Calcaneal cyst: a classical simple bone cyst?].

INTRODUCTION: In the calcaneus differentiation between a solitary cyst and intraosseus lipoma is difficult. Radiologists frequently diagnose an intraosseus lipoma, whereas histology shows the classical signs of a solitary bone cyst. We present 12 cases of a solitary cyst of the calcaneus. MATERIAL AND METHODS: Between 1993 and 2001 we operated on 12 patients (8 men, 4 women, median age 28 +/- 14 years) with calcaneal cysts. 9 patients received a curretage and an autologous, one patient a homologous, one patient a mixed autologous-homologous bone-grafting and one patient only a curretage (due to the small diameter of the cyst) of their cysts. RESULTS: No case revealed the histological picture of a fatty formation, which appears to be typical for an intraosseus lipoma. All of the microscopic findings resembled the characteristics seen in cysts of the long bones. A pathological fracture has not been observed. CONCLUSION: The histologically confirmed calcaneal cysts showed the radiological signs that are supposed to be typical for an intraosseous lipoma. It cannot be decided whether the histologically diagnosed calcaneal lipomas described by others can be interpreted as fatty degeneration of a calcaneal cyst, or whether fatty areas of the bone marrow have given a wrong impression. Since the literature only describes single isolated cases of a pathological fracture of the calcaneal cyst or lipoma, asymptomatic patients should be treated non-operatively.

Adolescent↗
PubMed2002

Treatment of active unicameral bone cysts with percutaneous injection of demineralized bone matrix and autogenous bone marrow.

BACKGROUND: The treatment of unicameral bone cysts varies from open bone-grafting procedures to percutaneous injection of corticosteroids or bone marrow. The purpose of this study was to evaluate the feasibility and effectiveness of percutaneous injection of a mixture of demineralized bone matrix and autogenous bone marrow for the treatment of simple bone cysts. METHODS: Twenty-three patients with an active unicameral bone cyst were treated with trephination and injection of allogeneic demineralized bone matrix and autogenous bone marrow. The patients were followed for an average of fifty months (range, thirty to eighty-one months), at which time pain, function, and radiographic signs of resolution of the cyst were assessed. RESULTS: The average time until the patients had pain relief was five weeks, and the average time until the patients returned to full, unrestricted activities was six weeks. Bone-healing at the site of the injection was first seen radiographically at three to six months. No patient had a pathologic fracture during this early bone-healing stage. Cortical remodeling was seen radiographically by six to nine months, and after one year the response was usually complete, changing very little from then on. Five patients required a second injection because of recurrence of the cyst, and all five had a clinically and radiographically quiescent cyst after an average of thirty-six additional months of follow-up. Seven of the twenty-three patients had incomplete healing manifested by small, persistent radiolucent areas within the original cyst. None of these cysts increased in size or resulted in pain or fracture. CONCLUSIONS: Percutaneous injection of allogeneic demineralized bone matrix and autogenous bone marrow is an effective treatment for unicameral bone cysts.

Adolescent↗
PubMed1993

Aneurysmal bone cyst of the occipital bone: case report.

A 21-year-old male with a painful, expanding mass in the occipital bone was operated on. The clinical findings were suggestive of a malignant tumor. However, appearance and histological examination of the operative specimen identified it as being an aneurysmal bone cyst, a rather rare nonneoplastic lesion of unknown origin. Besides demonstration of the case, a review of the relevant literature is presented.

Adult↗
PubMed1995

Aneurysmal bone cyst of the temporal bone presenting as hearing loss in a child.

We present an unusual case of a temporal bone and skull base tumor in a ten-year-old child. The patient presented with unilateral hearing loss and headaches. Radiologic, surgical, and histologic findings were consistent with an aneurysmal bone cyst. This is the first report on this rare entity to document its appearance in the temporal bone and skull base using magnetic resonance imaging. Treatment consisted of surgical removal, cranioplasty, and reconstruction of the external auditory canal.

Aneurysm↗
PubMed1984

[Aneurysmal bone cyst of the temporal bone].

The authors describe two cases of aneurysmal bone cysts of the os temporale. Subtotal removal of the lesions seemed to stop the disease since twenty months and five years respectively. Differential diagnosis for this benign but recurrent osteolytic bone lesion includes various neoplasms. Diagnosis can only be established through biopsy of the cystwall because clinical and radiological criteria are often misleading.

Adolescent↗
PubMed2006

[Assessment of therapeutic results for simple bone cyst with percutaneous injection of autogenous bone marrow].

OBJECTIVE: To evaluate the therapeutic results of percutaneous injection of autogenous bone marrow for simple bone cyst and to analyze the prognostic factors of the treatment. METHODS: From March 2000 to June 2005, 31 patients with simple bone cysts were treated by percutaneous injection of autogenous bone marrow. Of 31 patients, there were 18 males and 13 females, aged 5 years and 7 months to 15 years. The locations were proximal humerus in 18 cases, proximal femur in 7 cases and other sites in 6 cases. Two cases were treated with repeated injections. The operative process included percutaneous aspiration of fluid in the bone cysts and injection of autogenous bone marrow aspirated from posterior superior iliac spine. The mean volume of marrow injected was 40 ml (30-70 ml). RESULTS: No complications were noted during treatment. Thirty patients were followed for an average of 2.2 years (1-5 years) with 2 cases out of follow-up. After one injection of bone marrow, 9 cysts (29.0%) were healed up completely, 7 cysts (22.6%) basically healed up, 13 cysts (41.9%) healed up partially and 2 (6.5%) had no response. The satisfactory and effective rates were 67.7% and 93.5% respectively. There was significant difference between active stage group and resting stage group(P<0.05). There were no statistically significant difference in therapeutic results between groups of different ages, lesion sites or bone marrow hyperplasia(P>0.05). CONCLUSION: Percutaneous injection of autogenous bone marrow is a safe and effective method to treat simple bone cyst, but repeated injections is necessary for some patients. The therapeutic results are better in cysts at resting stage than those at active stage.

Adolescent↗
PubMed2002

Fibrous dysplasia in combination with aneurysmal bone cyst of the occipital bone and the clivus: case report and review of the literature.

OBJECTIVE AND IMPORTANCE: Fibrous dysplasia of the cranium is a relatively uncommon disorder that affects primarily the anterior cranial region; its occurrence in the cranial base in combination with aneurysmal bone cyst (ABC) constitutes an extremely rare condition, only two cases of which have been reported previously in the literature. It is important to recognize and treat these cases properly because of the special location in the cranial base and the possibility of neural structure impingement. CLINICAL PRESENTATION: We report the case of a 19-year-old man with a slowly enlarging mass of the occiput, with computed tomographic and magnetic resonance imaging revealing involvement of petrous and basisphenoid bone and growing ABC. INTERVENTION: Open biopsy confirmed the diagnosis of fibrous dysplasia. Partial excision of the lesion and removal of the ABC were performed in a second stage after embolization. CONCLUSION: ABC associated with fibrous dysplasia of the cranial base may enlarge rapidly after puberty and require excision. This is facilitated by preoperative embolization.

Adult↗
PubMed1989

A small aneurysmal bone cyst restricted to the cortical bone of the femur resembling so-called subperiosteal giant cell tumor or subperiosteal osteoclasia.

We report a 16-year-old Japanese girl with a cystic lesion restricted to the cortical bone under the periosteum of the diaphysis of the left femur. Roentgenograms showed a long, oval translucent lesion in frontal view and an eccentric erosive lesion in lateral view. Computed tomography showed a distinct intracortical lesion. The lesion, which was excised en bloc, measured 3 x 2 x 2 cm. The outer layer of the cortical bone was eroded eccentrically. From the margin of the eroded bone, thin fragile bony tissue and preserved periosteum extended like the roof of a dome. Multicystic structures, filled with blood, were lined with fibrous granulation and occasional giant cells. Histologically, this lesion falls within the category of aneurysmal bone cyst. However this case is of a rare type, since the lesion was relatively small, and showed a very specific intracortical location, in marked contrast to typical aneurysmal bone cyst. Additionally, this lesion is similar to so-called subperiosteal giant cell tumor or subperiosteal osteoclasia described in the literature.

Adolescent↗
PubMed1983

Aneurysmal bone cyst of the first metatarsal bone mimicking malignant tumor.

The clinical results of roentgenographic examination in an eight-year-old girl with a large tumor in the first metatarsus suggested malignancy. The definitive pathologic diagnosis was atypical aneurysmal bone cyst. Massive bone grafting and preservation of the surrounding joints were successful, and a functional foot was obtained two years after operation.

Bone Cysts↗
PubMed1995

[Aneurysmal bone cysts].

An aneurysmal bone cyst is a tumor-simulating bone lesion, the etiology of which is still unclear and probably inhomogeneous. This type of lesion is mainly observed during the second decade of life and is rarely diagnosed beyond the age of 30 years. It is characterized by hollow spaces consisting of several compartments filled with blood and partially divided by septs consisting of spindle-cell tissue with ample multinuclear giant cells and frequent reactive new bone formation. The locations of preference are the metaphyses of the long bones, the spine and flat bones; however, they can appear in every sort of bone. The radiological picture is characterized by osteolytic expansion of the bone with more or less distinct formation of trabeculae. In the CT image we can often find fluid formation; in MRT images alteration of signals can also be seen, indicating former or fresh bleeding. The primary aneurysmal bone cyst should be distinguished from its secondary counterpart; the latter one is occasionally found in giant cell tumors, chondroblastomas, chondromyxoid-fibromas, osteoblastomas, but also in osteosarcomas. When planning biopsy or therapy, this possibility should be also taken into account. The therapy of choice consists of accurate curettage and autologous or allogenous bone transplantation. To avoid recurrences, curettage should be followed by adjuvant therapy with phenol or cryotherapy. When there are extensive recurrences that can no longer be treated by the surgical method described above, embolization of the nutrient vessels may be curative.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed2004

Deposition of intraosseous fat in a degenerating simple bone cyst.

A simple bone cyst in the proximal humerus of an 18-year-old man was treated by percutaneous ablation with alcohol irrigation. Subsequent involution of the cyst was associated with fatty replacement within the intraosseous defect. A possible relationship between involuting bone cyst and apparent intraosseous lipoma is discussed.

Adipose Tissue↗
PubMed2005

[A long-term follow-up of treatment of adult unicameral bone cysts with allograft of lyophilized cancellous bone].

OBJECTIVE: To investigate the long-term clinical results of treatment of adult unicameral bone cyst with cancellous allograft. METHODS: From 1993 to 1998, 15 patients with unicameral bone cyst were treated by allograft with lyophilized cancellous bone. Among 15 patients, there were 5 males and 10 females, aging 19-41 years with an average of 27 years. The average follow-up time was 7.5 years (6-11 years). The X-ray films were taken and the CT scanning were carried out. RESULTS: The X-ray films showed that the allograft particles became vague 2-3 months after operation, that the allograft particles fused and began to form new bone and the bone density increased 5 months after operation, and that new bone formation completed after 7 months of operation. At the end of follow-up, remodelling in new bone occurred. Recurrence was not found in all patients. The symptom of pain disappeared or relieved obviously. CONCLUSION: Allograft of lyophilized cancellous bone is an effective treatment for adult unicameral bone cysts.

Adult↗
PubMed1992

Recurrence of a solitary bone cyst of the mandibular condyle in a bone graft. A case report.

The recurrence of a solitary bone cyst of the mandibular condyle in a costochondral bone graft is reported. A solitary bone cyst of the right condylar head and neck of a 10-year-old boy was treated by total resection and immediate reconstruction with a costochondral bone graft. Two years after the first operation, a recurrence of the solitary bone cyst within the bone graft was noted. An open treatment was performed. A review of the literature on solitary bone cysts and recurrences of solitary bone cysts shows that the case reported is unique. Possible reasons for the recurrence are discussed.

Bone Transplantation↗