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1.
Folia Med (Plovdiv) ; 66(3): 402-408, 2024 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-39365632

RESUMO

Aneurysmal bone cysts are benign neoplastic lesions that are extensively vascularized and can occasionally exhibit destructive and expanding activity. They typically affect young people, with a small predilection toward females, and most frequently arise during the second decade of life. Aneurysmal bone cysts account for about 1% of all bone tumors and usually develop in long tubular bones, with the spine being much less commonly affected.


Assuntos
Cistos Ósseos Aneurismáticos , Humanos , Cistos Ósseos Aneurismáticos/diagnóstico por imagem , Cistos Ósseos Aneurismáticos/patologia , Feminino , Masculino , Adulto , Adolescente , Doenças da Coluna Vertebral/diagnóstico por imagem , Doenças da Coluna Vertebral/patologia , Adulto Jovem , Pessoa de Meia-Idade
2.
J Orthop Surg (Hong Kong) ; 32(3): 10225536241297105, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39445490

RESUMO

Background: Denosumab effectively treats RANKL-mediated bone disorders by inhibiting osteoclast activity. While approved for giant cell tumours, its role in aneurysmal bone cysts (ABC) remains unclear. This review explores denosumab's application in ABCs, focusing on its role, outcomes, and adverse effects. Methods: A scoping review adhering to PRISMA Extension for Scoping Reviews guidelines was conducted. The search involved five databases from inception until 31 December 2023. Results: From an initial 390 studies, 29 were selected post-screening involving 67 patients. The most common ABC sites were the spine (n = 42) and pelvis (n = 7). Denosumab served as primary treatment in 25 patients (37.3%), neoadjuvant in 11 (16.4%), second-line therapies after inadequate initial therapies in 24 (35.8%), and adjunct therapy in seven cases. All patients demonstrated favourable clinical and radiological responses post-denosumab. 10 patients (15%) experienced tumour recurrences: six after denosumab discontinuation (3-17 months post-cessation), three post-surgery following neoadjuvant denosumab, and one during ongoing treatment. Adverse effects reported were hypocalcaemia (n = 10), hypercalcemia (n = 14), and sclerotic metaphyseal bands (n = 2), all in the paediatric age group. While hypocalcaemia surfaced early in denosumab therapy, hypercalcaemia manifested 2.5-6 months post-discontinuation, mainly managed with bisphosphonates. Fewer than half of the studies had follow-ups that exceeded 2 years. Conclusion: Denosumab may be an effective therapy for ABC, especially for high-risk cases like spinal and pelvic tumours. It can also be utilized as a second-line for recurrence/failed initial intervention or as neoadjuvant therapy. Concerns exist about tumour recurrence and rebound hypercalcemia, necessitating careful monitoring, longer follow-up, and prophylactic measures. Prospective clinical trials are warranted for deeper insights.


Assuntos
Cistos Ósseos Aneurismáticos , Conservadores da Densidade Óssea , Denosumab , Denosumab/uso terapêutico , Humanos , Cistos Ósseos Aneurismáticos/tratamento farmacológico , Cistos Ósseos Aneurismáticos/diagnóstico por imagem , Conservadores da Densidade Óssea/uso terapêutico
3.
Medicine (Baltimore) ; 103(38): e39762, 2024 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-39312383

RESUMO

RATIONALE: Primary leiomyosarcoma of the bone (LMSB) is a rare aggressive sarcoma with limited treatment options. Histopathologic and immunohistochemical features are similar to their more common uterine and soft tissue counterparts. However, its broader spectrum of histopathologic features and rarity make diagnostic challenges. PATIENT CONCERNS: We present a case of LMSB in a 20-year-old female who presented with left shoulder aching pain for 3 months. An osteolytic intramedullary lesion was found in the left proximal humeral epi-metaphysis. DIAGNOSES: Initial open biopsy showed a giant cell tumor of bone with aneurysmal bone cyst (ABC)-like changes. However, an open biopsy followed by extended curettage showed LMSB with ABC-like changes. INTERVENTIONS: Wide excision of the lesion and bipolar hemiarthroplasty followed by concomitant chemoradiation therapy was conducted. The mass was completely removed without significant problems. OUTCOMES: Complete mass excision and symptomatic improvements were achieved, and no subsequent relapses were observed. LESSONS: The authors encountered a rare case of LMSB. Most occurrences are in the lower extremity and trunk, respectively. ABC-like changes in bone tumors can lead to misdiagnosis. In this case, the ABC-like changes developed from the underlying LMSB as a secondary alteration. A careful examination of the underlying bone tumor is crucial to avoid misdiagnosing it as ABC or exhibiting ABC-like changes. Moreover, there has been no case report of LMSB with secondary ABC-like changes in bone.


Assuntos
Cistos Ósseos Aneurismáticos , Neoplasias Ósseas , Úmero , Leiomiossarcoma , Humanos , Feminino , Cistos Ósseos Aneurismáticos/diagnóstico , Cistos Ósseos Aneurismáticos/patologia , Cistos Ósseos Aneurismáticos/cirurgia , Cistos Ósseos Aneurismáticos/diagnóstico por imagem , Úmero/patologia , Úmero/diagnóstico por imagem , Neoplasias Ósseas/diagnóstico , Neoplasias Ósseas/patologia , Leiomiossarcoma/diagnóstico , Leiomiossarcoma/patologia , Adulto Jovem , Diagnóstico Diferencial , Erros de Diagnóstico
4.
J Vasc Interv Radiol ; 35(11): 1655-1661.e2, 2024 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-39111619

RESUMO

PURPOSE: To evaluate the clinical and imaging outcome of aneurysmal bone cysts (ABCs) in children using percutaneous cryoablation as the sole treatment. MATERIALS AND METHODS: This retrospective study included 7 children with a mean age of 8.7 years (range, 3.0-11.9 years) who underwent at least 1 cryoablation for ABC. Cryoablation needles were placed and guided by computed tomography (CT). Imaging follow-up and clinical examination were performed by radiography 1 and 6 months after the procedure and magnetic resonance (MR) imaging was performed 3 and 12 months after the procedure. Additional cryoablation was performed in case of MR imaging-detected recurrence. Data were analyzed by anatomical location, measurement of lesion volume, numbers of intralesional cysts, grade of mineralization (5-point Likert scale), pain (0 [none] to 4 [severe]), and grade of fluid-fluid levels (FFLs; 4-point Likert scale). RESULTS: Fourteen cryoablations were performed. Patients showed volume reduction, with 1 showing a complete response and 6 showing partial response. Following treatment, there was a substantial reduction in lesion volume compared with baseline, leading to a mean volume decrease of 81.9% (range, 66.8%-100%). The grade of mineralization (3.2 [SD ± 1.2] after therapy vs 1.1 [SD ± 0.3] at baseline), grade of FFL (1.6 [SD ± 0.5] after therapy vs 3.4 [SD ± 1.1] at baseline), and pain (0.29 [SD ± 0.4] after therapy vs 1.86 [SD ± 0.7] at baseline) significantly improved after therapy (all P < .05). One severe adverse event occurred. CONCLUSIONS: Cryoablation is an effective treatment option for ABC in children. Further research is needed to compare it with other techniques.


Assuntos
Cistos Ósseos Aneurismáticos , Criocirurgia , Estudos de Viabilidade , Imageamento por Ressonância Magnética , Humanos , Criocirurgia/efeitos adversos , Cistos Ósseos Aneurismáticos/cirurgia , Cistos Ósseos Aneurismáticos/diagnóstico por imagem , Criança , Estudos Retrospectivos , Masculino , Pré-Escolar , Feminino , Resultado do Tratamento , Tomografia Computadorizada por Raios X , Fatores de Tempo , Recidiva
5.
Acta Med Port ; 37(10): 725-730, 2024 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-39153197

RESUMO

Aneurysmal bone cysts are vascular benign fibroblastic lesions usually found in bone that are locally destructive, with a greater incidence in the first and second decades of life. Patients usually undergo curettage or, less frequently, surgical resection, which may lead to growth disturbances and deformities in cases of large or complex lesions. Minimally invasive techniques such as sclerotherapy and endovascular embolization have been developed as an alternative or complement to surgery, with promising results. The authors present a rare case of an extraskeletal aneurysmal bone cyst successfully treated with minimally invasive techniques followed by surgical resection and provide a literature review of the current treatment options.


Assuntos
Cistos Ósseos Aneurismáticos , Coxa da Perna , Humanos , Cistos Ósseos Aneurismáticos/diagnóstico por imagem , Cistos Ósseos Aneurismáticos/cirurgia , Cistos Ósseos Aneurismáticos/terapia
7.
JBJS Case Connect ; 14(2)2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38913790

RESUMO

CASE: We describe 2 case studies, involving a 10-year-old girl with an aneurysmal bone cyst and a 12-year-old adolescent boy with Ewing sarcoma. The patient with Ewing sarcoma was previously managed with wide surgical excision and fibular graft reconstruction and subsequently experienced significant graft resorption, hardware failure, and fracture 24 months after operation. A revision limb salvage attempt was undertaken. In both cases, fibular strut grafts were harvested and fixed with intramedullary k-wires to recreate the medial and lateral columns of the distal humeral triangle. CONCLUSION: The technique achieved complete osseous integration, structural support, and functional restoration of the elbow in both cases, with good functional outcomes.


Assuntos
Neoplasias Ósseas , Fíbula , Úmero , Sarcoma de Ewing , Humanos , Criança , Masculino , Fíbula/transplante , Fíbula/cirurgia , Feminino , Sarcoma de Ewing/cirurgia , Neoplasias Ósseas/cirurgia , Úmero/cirurgia , Transplante Ósseo/métodos , Cistos Ósseos Aneurismáticos/cirurgia , Cistos Ósseos Aneurismáticos/diagnóstico por imagem , Procedimentos de Cirurgia Plástica/métodos
8.
BMJ Case Rep ; 17(4)2024 Apr 08.
Artigo em Inglês | MEDLINE | ID: mdl-38589235

RESUMO

Aneurysmal bone cyst (ABC) is a non-malignant, locally destructive, blood-filled lesion in the bone that tends to grow aggressively. A young girl presented with a rapid recurrence after aggressive surgery of a large symptomatic sacral-spinal ABC. After a multidisciplinary tumour board, she was successfully treated with sclerotherapy and monthly intravenous denosumab. The patient has maintained asymptomatic for over 36 months now and has returned to full activity and strength. She never required surgery and has had radiologic resolution of the lesions. Treatment of recurrent ABC requires a multidisciplinary team approach. We believe this to be the first report to use this combined therapy to provide an alternative to morbid surgery for children with ABCs.


Assuntos
Cistos Ósseos Aneurismáticos , Denosumab , Criança , Feminino , Humanos , Denosumab/uso terapêutico , Cistos Ósseos Aneurismáticos/diagnóstico por imagem , Cistos Ósseos Aneurismáticos/terapia , Escleroterapia , Sacro/patologia , Administração Intravenosa
9.
BMJ Case Rep ; 17(4)2024 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-38684351

RESUMO

Aneurysmal bone cysts (ABCs) are primary bone tumours that rarely occur in the spine and generally affect one vertebral level in adolescents. Here, we present an unusual case of a multilevel thoracolumbar ABC, which presented a unique surgical challenge due to its infiltrative and destructive nature. A teenage male presented with back pain, paresthesias and a mildly spastic gait. MRI of the thoracolumbar spine revealed an expansive, multicystic mass extending from the left T12-L1 vertebral bodies into adjacent musculature. The patient underwent a two-stage surgical approach with decompression of the spinal cord and instrumentation to stabilise the vertebral column. The first stage involved posterior decompression, laminectomy and facetectomies, followed by pedicle-based instrumentation from T10 to L3. This was followed by a vertebrectomy and anterior stabilisation with an expansile cage from T11 to L2. A gross total resection was achieved with the patient maintaining full neurological function.


Assuntos
Cistos Ósseos Aneurismáticos , Descompressão Cirúrgica , Vértebras Lombares , Imageamento por Ressonância Magnética , Vértebras Torácicas , Humanos , Cistos Ósseos Aneurismáticos/cirurgia , Cistos Ósseos Aneurismáticos/diagnóstico por imagem , Masculino , Vértebras Torácicas/cirurgia , Vértebras Torácicas/diagnóstico por imagem , Adolescente , Vértebras Lombares/cirurgia , Descompressão Cirúrgica/métodos , Laminectomia/métodos , Resultado do Tratamento , Dor nas Costas/etiologia , Dor nas Costas/cirurgia
10.
Rev.Chil Ortop Traumatol ; 65(1): 34-39, abr.2024. ilus
Artigo em Espanhol | LILACS | ID: biblio-1554994

RESUMO

Presentamos un caso de quiste óseo aneurismático (QOA) de ubicación infrecuente y comportamiento agresivo en un paciente masculino de 28 años, en que la resección quirúrgica es controversial por el riesgo de iatrogenia y eventual recurrencia. El tratamiento con denosumab ha sido recientemente propuesto como una alternativa para el manejo de QOAs irresecables o recurrentes; sin embargo, la literatura disponible es escasa. Reportamos nuestra experiencia en un caso y analizamos la bibliografía disponible


We present a case of aneurysmal bone cyst (ABC) of infrequent location and aggressive behavior in a 28-year-old male patient, in which surgical resection is controversial due to the risk of iatrogenicity and eventual recurrence. Treatment with denosumab has been recently proposed as an alternative for the management of unresectable or recurrent ABCs; however, the available literature is sparse. We report our experience with one case and analyze the available literature


Assuntos
Humanos , Cistos Ósseos Aneurismáticos/tratamento farmacológico , Cistos Ósseos Aneurismáticos/diagnóstico por imagem , Conservadores da Densidade Óssea/uso terapêutico , Denosumab/uso terapêutico , Tomografia Computadorizada por Raios X/métodos
11.
JBJS Case Connect ; 14(1)2024 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-38452160

RESUMO

CASE: A 16-year-old boy presented with a recurrent distal femur aneurysmal bone cyst accompanied by a combined sagittal knee deformity (20° of femoral antecurvatum and 26.8° of tibial recurvatum) and limb shortening. After preoperative planning, the treatment involved new intralesional curettage, phenolization, and bone allograft filling. Additional procedures included distal extension femoral osteotomy with plate fixation, and proximal tibial osteotomy with, gradually corrected through a hexapod frame. At 2-year follow-up, lower limbs exhibited normoalignment and equal length. CONCLUSION: Complex knee deformities may occur with tumoral lesions around the knee but can be effectively addressed through double osteotomy and application of a hexapod frame.


Assuntos
Cistos Ósseos Aneurismáticos , Deformidades Articulares Adquiridas , Masculino , Humanos , Adolescente , Cistos Ósseos Aneurismáticos/complicações , Cistos Ósseos Aneurismáticos/diagnóstico por imagem , Cistos Ósseos Aneurismáticos/cirurgia , Deformidades Articulares Adquiridas/complicações , Deformidades Articulares Adquiridas/cirurgia , Fêmur/diagnóstico por imagem , Fêmur/cirurgia , Fêmur/anormalidades , Tíbia/diagnóstico por imagem , Tíbia/cirurgia , Articulação do Joelho/cirurgia
12.
Kyobu Geka ; 77(1): 76-79, 2024 Jan.
Artigo em Japonês | MEDLINE | ID: mdl-38459850

RESUMO

We report a case of an aneurysmal bone cyst (ABC) originating in a rib. A 34-year-old woman was admitted to our medical department for evaluation of left rib pain and an abnormal shadow in the left 7th rib observed on chest radiography. Computed tomography (CT) revealed an osteolytic lesion involving the left 7th rib. Positron emission tomography/CT showed slight fluorodeoxyglucose uptake in the lesion. We performed 7th rib resection with a 4 cm margin from the tumor, including the intercostal muscles in the 6th and 7th interspaces. Histopathological examination of the resected specimen showed multiple blood-filled spaces and fibrous trabeculae, which confirmed the diagnosis of an ABC. The patient's postoperative course was uneventful. Although rare, clinicians should consider ABCs in the differential diagnosis of rib tumors.


Assuntos
Cistos Ósseos Aneurismáticos , Feminino , Humanos , Adulto , Cistos Ósseos Aneurismáticos/diagnóstico por imagem , Cistos Ósseos Aneurismáticos/cirurgia , Cistos Ósseos Aneurismáticos/patologia , Costelas/diagnóstico por imagem , Costelas/cirurgia , Radiografia , Tomografia Computadorizada por Raios X , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada
13.
Zhonghua Bing Li Xue Za Zhi ; 53(3): 243-249, 2024 Mar 08.
Artigo em Chinês | MEDLINE | ID: mdl-38433051

RESUMO

Objective: To investigate the radiologic, pathologic, and molecular features of simple bone cysts (SBC), and their differential diagnoses. Methods: Fourteen cases of SBC were collected at the Department of Pathology, the First Affiliated Hospital of Nanjing Medical University from 2017 to 2022, and fluorescence in situ hybridization (FISH) was performed for retrospective analysis. Results: There were 14 patients, including 7 females and 7 males, with age range of 7 to 45 (median 29) years. The most common complaint was pain, including 4 cases with pathological fracture and 5 with history of previous trauma. The tumor size ranged from 3.4 to 13.5 (median 5.6) cm. The lesion involved the femur (n=4), humerus (n=5) and iliac bone (n=5). Radiologic diagnoses included SBC, aneurysmal bone cyst, and giant cell tumor of the bone or its combination with aneurysmal bone cyst-like region and fibrous dysplasia. Histologically, the cyst walls of the lesions were composed of fibrous tissue, fibrin-like collagen deposits, bone-like matrix and occasional woven bone. The lesional cells were spindled to ovoid, with scattered osteoclast-like giant cells, foamy histiocytes, hemosiderin deposits and cholesterol clefts. In 6 cases there were nodular fasciitis-like areas. Immunohistochemically, the spindled to ovoid cells were positive for SMA, EMA and SATB2 in varying degrees. FISH detection was performed in all 14 cases and EWSR1/FUS rearrangement were found in 9 cases. One case of FUS::NFATC2 fusion was detected by next-generation sequencing. Nine cases of SBC with the rearrangement were more cellular, and there were more mitotic figures in the recurrent FUS::NFATC2 fusion tumor. Clinical follow-up was obtained in all 14 cases with the time ranging from 5 to 105 (mean 46) months. Amongst them, the tumor with FUS::NFATC2 rearrangement had local recurrence twice after the first local excision, but had no more recurrence or metastasis 34 months after the subsequent segmental resection. The other 13 cases had no recurrence. Conclusions: EWSR1 or FUS rearrangement is most commonly identified in SBC, suggesting that SBC might be a neoplastic disease. In cases where the radiologic appearance and histomorphology are difficult to differentiate from aneurysmal bone cyst, FISH detection can aid in the definitive diagnosis.


Assuntos
Cistos Ósseos Aneurismáticos , Cistos Ósseos , Feminino , Masculino , Humanos , Criança , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Cistos Ósseos Aneurismáticos/diagnóstico por imagem , Cistos Ósseos Aneurismáticos/genética , Cistos Ósseos Aneurismáticos/cirurgia , Hibridização in Situ Fluorescente , Estudos Retrospectivos , Cistos Ósseos/diagnóstico por imagem , Cistos Ósseos/genética , Diagnóstico Diferencial
14.
Childs Nerv Syst ; 40(6): 1925-1929, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38388791

RESUMO

BACKGROUND: Aneurysmal bone cyst (ABC) is an uncommon, benign, vascular multicystic bony lesion that most frequently develops in the first two decades of life. The metaphysis of long bones, pelvic, and vertebral column are the most common locations. The precise underlying pathophysiology of ABCs formation remains unclear; however, it is believed that reactive processes subsequent to trauma or vascular disturbance may play an important role. Involvement of the skull base rarely occurs with a prevalence of up to 5% of intracranial ABCs. CASE PRESENTATIONS: An 18-year-old adolescent female with a history of progressive blurred vision since three months ago presented to our office. The brain and orbital MRI demonstrated no abnormal findings. After three months of glucocorticoid treatment with the diagnosis of multiple sclerosis, the visual impairment of the left eye deteriorated abruptly. The patient underwent an MRI and the imaging study demonstrated a well-defined 30 × 22 × 20-mm lesion at the anterior clinoid process with an extension to the optic canal and ethmoid sinus. The patient underwent pterional craniotomy, and the tumor was resected. The histopathological examination was suggestive of ABC. CONCLUSION: ABC and other conditions should be considered in young-age people with an early unilateral decline in vision and imaging studies should be obtained in early stages and during follow-ups.


Assuntos
Cistos Ósseos Aneurismáticos , Imageamento por Ressonância Magnética , Neurite Óptica , Humanos , Feminino , Cistos Ósseos Aneurismáticos/cirurgia , Cistos Ósseos Aneurismáticos/diagnóstico por imagem , Adolescente , Neurite Óptica/diagnóstico por imagem , Diagnóstico Diferencial
15.
J Craniofac Surg ; 35(4): 1062-1064, 2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38408320

RESUMO

BACKGROUND: Juvenile Psammomatoid Ossifying Fibroma (JPOF) is a type of noncancerous bone tumor that usually affects adolescents in the craniomaxillofacial area. Clinical manifestations are usually symptoms caused by the tumor's invasive compression of surrounding tissues. Aneurysmal Bone Cyst (ABC) is also a benign bone tumor, and it typically occurs in long bones and the spine. Only 2% to 3% of cases occur in the head and neck. Due to the rarity of this combination of clinical cases, clinicians face difficulties in comprehensively understanding this complex lesion. Therefore, a comprehensive review of the clinical manifestations and characteristic imaging findings is necessary for surgeons. CASE PRESENTATIONS: On April 6, 2019, a 13-year-old boy presented with left maxillofacial bulge and pain for 1 month. Magnetic resonance imaging of the paranasal sinuses showed an irregular hive-like mass signal in the left maxillary sinus, and cystic changes with fluid levels were seen in the lesion. After the initial diagnosis of JPOF with primary ABC, we decided to perform a facial mid-facial resection of maxillary sinus tumor to remove the tumor tissue. Finally, after 3 recurrences and 4 operations, there was no tumor recurrence for 20 months after the last operation, and the patient was still under continuous follow-up. CONCLUSIONS: This case provided a reference for the diagnosis and treatment of JPOF combined with ABC. In particular, a new understanding of the association between the two diseases and the management of recurrence were proposed, which had the potential to improve clinical understanding of this complicated condition.


Assuntos
Cistos Ósseos Aneurismáticos , Fibroma Ossificante , Imageamento por Ressonância Magnética , Humanos , Cistos Ósseos Aneurismáticos/complicações , Cistos Ósseos Aneurismáticos/diagnóstico por imagem , Cistos Ósseos Aneurismáticos/cirurgia , Cistos Ósseos Aneurismáticos/diagnóstico , Masculino , Adolescente , Fibroma Ossificante/cirurgia , Fibroma Ossificante/complicações , Fibroma Ossificante/diagnóstico por imagem , Fibroma Ossificante/diagnóstico , Neoplasias do Seio Maxilar/complicações , Neoplasias do Seio Maxilar/diagnóstico por imagem , Neoplasias do Seio Maxilar/cirurgia , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/cirurgia , Seio Maxilar/patologia
16.
Oral Maxillofac Surg ; 28(2): 999-1004, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38378934

RESUMO

PURPOSE: We report a case of fibrous dysplasia (FD) with aneurysmal bone cyst (ABC)-like change in a child with orbital involvement, review the related cases, and discuss clinical features, therapy, and prognosis of this disease. CASE PRESENTATION: A 10-year-old girl had right proptosis (degree of exophthalmos: OD 16 mm, OS 13 mm) and limited vision (visual acuity: OD 1.0, OS 0.8) without trauma. Preoperative CT showed a 5.0*4.3 cm right-sided crania-orbital communicating tumor. MRI indicated a well-defined multicystic mass with scattered fluid levels and soap bubble-like alterations. The child underwent total tumor resection and orbital parietal titanium mesh reconstruction. At 20 months of follow-up, the child has recovered from ocular problems, and the tumor has not recurred. CONCLUSION: FD combined with ABC rarely occurs in orbit and generally begins with ocular symptoms. The etiology is uncertain. Early diagnosis and surgery are essential. Complete resection is suggested whenever possible because residual lesions may recur.


Assuntos
Cistos Ósseos Aneurismáticos , Humanos , Feminino , Criança , Cistos Ósseos Aneurismáticos/cirurgia , Cistos Ósseos Aneurismáticos/diagnóstico por imagem , Cistos Ósseos Aneurismáticos/patologia , Exoftalmia/etiologia , Exoftalmia/cirurgia , Tomografia Computadorizada por Raios X , Doenças Orbitárias/cirurgia , Doenças Orbitárias/diagnóstico por imagem , Doenças Orbitárias/patologia , Imageamento por Ressonância Magnética , Displasia Fibrosa Óssea/cirurgia , Displasia Fibrosa Óssea/diagnóstico por imagem , Displasia Fibrosa Óssea/complicações , Telas Cirúrgicas , Procedimentos de Cirurgia Plástica/métodos
17.
Medicine (Baltimore) ; 103(6): e37137, 2024 Feb 09.
Artigo em Inglês | MEDLINE | ID: mdl-38335421

RESUMO

RATIONALE: Intraosseous hemangioma is a rare benign vascular tumor of the bone that can affect any body part; however, the most common site is the vertebra, followed by calvarial bones. PATIENT CONCERNS: We present a case of intraosseous hemangioma in a 23-year-old male who presented a feeling of fullness in the throat for 3 months. The hyoid bone level had a hard mass of about 5 cm. Fine needle aspiration showed 5 mL dark bloody aspirates. Magnetic resonance image showed a 5.3 cm mixed signal intensity lesion in the hyoid body. DIAGNOSIS: Histopathologic examination showed intraosseous hemangioma with aneurysmal bone cyst (ABC)-like changes in the hyoid bone. INTERVENTIONS: The mass was completely removed without significant problems. OUTCOMES: Complete mass excision and symptomatic improvements were achieved, and no subsequent relapses were observed. LESSONS: The authors experienced a case of intraosseous hemangioma with ABC-like changes. There has been no case report of intraosseous hemangioma in the hyoid bone. This case showed a spectral pattern of the ABC-like changes developing from the underlying bone tumor as a secondary change. ABC-like changes in bone tumors can mislead the diagnosis. Careful examination of the tumor is essential for the correct diagnosis of ABC or ABC-like changes.


Assuntos
Cistos Ósseos Aneurismáticos , Neoplasias Ósseas , Hemangioma , Lesões do Pescoço , Crânio/anormalidades , Coluna Vertebral/anormalidades , Malformações Vasculares , Neoplasias Vasculares , Masculino , Humanos , Adulto Jovem , Adulto , Osso Hioide/diagnóstico por imagem , Osso Hioide/cirurgia , Cistos Ósseos Aneurismáticos/diagnóstico por imagem , Cistos Ósseos Aneurismáticos/cirurgia , Crânio/patologia , Neoplasias Ósseas/diagnóstico por imagem , Neoplasias Ósseas/cirurgia , Hemangioma/diagnóstico por imagem , Hemangioma/cirurgia , Coluna Vertebral/patologia
18.
Clin Orthop Surg ; 16(1): 149-156, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38304208

RESUMO

Background: Aneurysmal bone cysts (ABCs) are infrequent, benign, and locally destructive lesions that most commonly occur during the first two decades of life. They usually affect the metaphysis of the long bones, but the pelvis is involved in 8%-12% of the cases. The management of pelvic ABCs is a challenging issue due to difficulties in choosing the appropriate approach, adjacent neurovascular bundles, the risk of intraoperative bleeding with difficulty achieving good hemostasis, and the risk of injury to the hip or sacroiliac joints. Limited data exist concerning the use of denosumab as a non-surgical treatment for pelvic ABCs. Our hypothesis was that denosumab might be an effective and safe solo treatment of cases with ABCs in the pelvis. Methods: We retrospectively assessed 20 patients with ABCs in the pelvis, who were treated by denosumab as a solo agent without surgery. Patients were assessed regarding disease control, the incidence of recurrence and non-oncological complications, and functional outcome. Results: The mean follow-up period was 38.5 months. Disease control was achieved in 16 patients (80%), with no local recurrence. Tolerable drug-related complications occurred in 15% of cases. The mean Musculoskeletal Tumor Society score was 92.3%. Conclusions: Denosumab may provide a reliable option in the nonsurgical treatment of ABCs of pelvic origin with expected lower morbidity than the surgical solution and tolerable complications. Further studies on the safety profile and long-term effects of denosumab especially in skeletally immature patients are required.


Assuntos
Cistos Ósseos Aneurismáticos , Denosumab , Humanos , Denosumab/uso terapêutico , Cistos Ósseos Aneurismáticos/diagnóstico por imagem , Cistos Ósseos Aneurismáticos/tratamento farmacológico , Estudos Retrospectivos , Pelve , Osso e Ossos
19.
Medicine (Baltimore) ; 103(2): e36210, 2024 Jan 12.
Artigo em Inglês | MEDLINE | ID: mdl-38215118

RESUMO

RATIONALE: Aneurysmal bone cyst (ABC) is a rare primary or secondary tumor that usually occurs in young women aged between 10 and 20 years, mostly in the long tubular bone and spine. However, there are no definite standards for its clinical treatment. To our knowledge, this is the first report of a young female patient with distal radius ABC who was successfully treated with tumor resection and autogenous fibular head transplantation. PATIENT CONCERNS: A 28-year-old married Chinese young woman presented to our hospital with swelling and pain in her right wrist for 2 years and aggravation of wrist movement restriction for 1 week. DIAGNOSES: Pathological biopsy confirmed ABC. INTERVENTIONS: We performed a pathological examination of the tumor on the right wrist and preliminarily confirmed the diagnosis of ABC. The right wrist joint was reconstructed by total surgical resection of the ABC tumor in the right wrist joint and autogenous fibular head transplantation. OUTCOMES: During follow-up within 7 years, good right wrist function was confirmed. The tumor did not recur, the swelling of the right wrist disappeared, the joint pain and limitation of movement significantly improved, and the function of the right wrist was not impaired in daily activities. Radiography showed that the fracture had healed. LESSONS: Our results suggest that autofibular head transplantation is an effective treatment for reconstruction of wrist function in adult patients with ABC of the distal radius.


Assuntos
Cistos Ósseos Aneurismáticos , Neoplasias Ósseas , Humanos , Adulto , Feminino , Criança , Adolescente , Adulto Jovem , Rádio (Anatomia)/cirurgia , Rádio (Anatomia)/patologia , Fíbula/transplante , Cistos Ósseos Aneurismáticos/diagnóstico por imagem , Cistos Ósseos Aneurismáticos/cirurgia , Transplante Ósseo/métodos , Neoplasias Ósseas/cirurgia , Neoplasias Ósseas/patologia , Recidiva Local de Neoplasia/patologia , Articulação do Punho/cirurgia , Resultado do Tratamento
20.
Childs Nerv Syst ; 40(2): 569-573, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37778002

RESUMO

BACKGROUND: Aneurysmal bone cyst is composed of variable -sized cystic blood-filled spaces separated by connective tissue septae. First-line surgical resection of spinal aneurysmal bone cyst in a child with limited total blood volume can lead to massive intraoperative bleeding, thus limiting extent of resection. Our Centre's has good experience of using absolute alcohol as an effective immediate devascularizing agent during vertebral hemangioma surgery in children. MATERIAL AND METHODS: We report the first case of pediatric lumbar primary aneurysmal bone cyst in which completely blood-less piecemeal total resection of the lesion was performed after intraoperative absolute alcohol intralesional sclerotherapy. RESULTS: Completely blood-less piecemeal total resection of the lumbar aneurysmal bone cyst was performed after intraoperative absolute alcohol intralesional sclerotherapy. CONCLUSION: Intraoperative absolute alcohol intralesional sclerotherapy is a very effective devascularizing adjunct for complete piecemeal resection of spinal aneurysmal bone cyst in children with limited blood volume.


Assuntos
Cistos Ósseos Aneurismáticos , Escleroterapia , Criança , Humanos , Cistos Ósseos Aneurismáticos/diagnóstico por imagem , Cistos Ósseos Aneurismáticos/cirurgia , Resultado do Tratamento , Seguimentos , Etanol
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