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1.
Childs Nerv Syst ; 40(6): 1925-1929, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38388791

RESUMEN

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.


Asunto(s)
Quistes Óseos Aneurismáticos , Imagen por Resonancia Magnética , Neuritis Óptica , Humanos , Femenino , Quistes Óseos Aneurismáticos/cirugía , Quistes Óseos Aneurismáticos/diagnóstico por imagen , Adolescente , Neuritis Óptica/diagnóstico por imagen , Diagnóstico Diferencial
2.
J Pediatr Orthop ; 44(1): e79-e83, 2024 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-37815299

RESUMEN

BACKGROUND: Aneurysmal bone cysts (ABCs) are benign active tumors often requiring intralesional curettage with or without adjuvants. The primary aim of this study was to analyze whether recurrence is influenced by the use of surgical adjuvants in pediatric patients with ABCs. Secondary aims examined recurrence rates based on age, sex, and physeal contact. METHODS: A retrospective review was performed at a tertiary pediatric hospital from 2004 to 2020. Inclusion criteria consisted of patients treated surgically for histologically confirmed ABCs with a minimum of 6 months follow-up. Patients with treatment for a recurrent tumor or incomplete records were excluded. Patient demographics, location of the lesion, treatment technique, and incidence of recurrence were collected. Statistical analyses were performed using STATA. RESULTS: There were 129 patients (74 males and 55 females) with a mean age of 11.5 ± 4.1 years and an average follow-up of 29.0 ± 25.4 months. The most common locations for ABCs were the femur and tibia. Of the patients, 53.5% had tumors abutting the physis, 28.7% had no physeal contact, and 17.8% had insufficient imaging to evaluate physeal contact. Surgical adjuvants (high-speed burr, coagulation, liquid nitrogen, and/or hydrogen peroxide) were used in 91 of the 129 cases (70.5%). There was no significant difference in recurrence when comparing those who received an adjuvant and those who did not (25.3% vs 23.7%, P = 1.000). Physeal contact was also not significantly associated with recurrence ( P = 0.146). Finally, patients younger than 6 years old were significantly more likely to have recurrence compared with those 6 years old or older (66.7% vs 21.7%, P = 0.007). CONCLUSION: Our study found no association between the use of surgical adjuvants and the risk of recurrence after intralesional curettage for ABCs. Although our study did demonstrate that patients 6 years old or younger had an increased rate of recurrence, no significant association was found regarding physeal contact or sex. These data indicate that surgical adjuvant may not affect the recurrence rates of pediatric patients with ABCs. LEVEL OF EVIDENCE: Level III. This retrospective review compares rates of recurrence based on the choice of surgical adjuvant.


Asunto(s)
Quistes Óseos Aneurismáticos , Masculino , Femenino , Humanos , Niño , Adolescente , Quistes Óseos Aneurismáticos/cirugía , Quistes Óseos Aneurismáticos/patología , Resultado del Tratamiento , Recurrencia Local de Neoplasia/epidemiología , Estudios Retrospectivos , Legrado/métodos
3.
J Craniofac Surg ; 35(4): 1062-1064, 2024 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-38408320

RESUMEN

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.


Asunto(s)
Quistes Óseos Aneurismáticos , Fibroma Osificante , Imagen por Resonancia Magnética , Humanos , Quistes Óseos Aneurismáticos/complicaciones , Quistes Óseos Aneurismáticos/diagnóstico por imagen , Quistes Óseos Aneurismáticos/cirugía , Quistes Óseos Aneurismáticos/diagnóstico , Masculino , Adolescente , Fibroma Osificante/cirugía , Fibroma Osificante/complicaciones , Fibroma Osificante/diagnóstico por imagen , Fibroma Osificante/diagnóstico , Neoplasias del Seno Maxilar/complicaciones , Neoplasias del Seno Maxilar/diagnóstico por imagen , Neoplasias del Seno Maxilar/cirugía , Seno Maxilar/diagnóstico por imagen , Seno Maxilar/cirugía , Seno Maxilar/patología
4.
Zhonghua Bing Li Xue Za Zhi ; 53(3): 243-249, 2024 Mar 08.
Artículo en Zh | MEDLINE | ID: mdl-38433051

RESUMEN

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.


Asunto(s)
Quistes Óseos Aneurismáticos , Quistes Óseos , Femenino , Masculino , Humanos , Niño , Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , Quistes Óseos Aneurismáticos/diagnóstico por imagen , Quistes Óseos Aneurismáticos/genética , Quistes Óseos Aneurismáticos/cirugía , Hibridación Fluorescente in Situ , Estudios Retrospectivos , Quistes Óseos/diagnóstico por imagen , Quistes Óseos/genética , Diagnóstico Diferencial
5.
Kyobu Geka ; 77(1): 76-79, 2024 Jan.
Artículo en Japonés | MEDLINE | ID: mdl-38459850

RESUMEN

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.


Asunto(s)
Quistes Óseos Aneurismáticos , Femenino , Humanos , Adulto , Quistes Óseos Aneurismáticos/diagnóstico por imagen , Quistes Óseos Aneurismáticos/cirugía , Quistes Óseos Aneurismáticos/patología , Costillas/diagnóstico por imagen , Costillas/cirugía , Radiografía , Tomografía Computarizada por Rayos X , Tomografía Computarizada por Tomografía de Emisión de Positrones
6.
Ideggyogy Sz ; 77(1-2): 69-72, 2024 Jan 30.
Artículo en Húngaro | MEDLINE | ID: mdl-38321851

RESUMEN

Aneurysmal bone cysts are benign but locally aggressive bone tumours, most often affecting children and young adults. In this case report, we present the clinical  picture of a 15-year-old boy with progressive, chronic back pain. An MRI of thoracic spine  confirmed a T2 cystic spinal tumour. After considering potential options surgical removal was our choice and gross total removal was achieved with T1-3 short-segment fixation. Aneurysmal bone cysts are often rapidly expanding lesions with vascular  transformation. In order to avoid irreversible damage, in addition to early diagnosis, it is necessary to carefully consider the therapeutic options, perform surgical removal and stabilization as necessary. In case of the presented patient, extensive surgical removal and short-segmentation were performed. At 18 months of follow-up, he had no complaints and was asymptomatic. Follow-up imaging studies showed no residual or recurrent tumour to date.

.


Asunto(s)
Quistes Óseos Aneurismáticos , Enfermedades de la Columna Vertebral , Masculino , Adulto Joven , Humanos , Niño , Adolescente , Enfermedades de la Columna Vertebral/diagnóstico , Enfermedades de la Columna Vertebral/cirugía , Quistes Óseos Aneurismáticos/diagnóstico , Quistes Óseos Aneurismáticos/patología , Quistes Óseos Aneurismáticos/cirugía , Estudios de Seguimiento , Vértebras Torácicas , Imagen por Resonancia Magnética
7.
J Orthop Res ; 42(6): 1369-1375, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38146068

RESUMEN

Curettage with or without the use of adjuvants is the standard of care in the treatment of an aneurysmal bone cyst (ABC). Historically, our approach combined curettage, high-speed burr drilling, and cryoablation. However, treatments varied based on age, tumor location, and surgeon preference. We asked: (1) Does cryoablation in addition to curettage and burr drilling decrease the local recurrence rates? (2) Are there any risk factors for the local recurrence rate? (3) Does cryoablation improve postsurgical functional outcomes in these patients? Patients treated for an ABC, between January 2006 and December 2019 were included in this retrospective analysis. Patient and surgical characteristics, such as age, gender, tumor location, type of treatment, time of follow-up, recurrence rate, and functional outcome measured by the Musculoskeletal Tumor Society Score 1993 (MSTS93) score were compared between those treated with and without cryoablation. Both groups, without cryoablation (n = 88) and with cryoablation (n = 42), showed no significant difference in local recurrence rates (9.1% vs. 7.1%, p = 0.553) and functional outcomes as measured by the MSTS93 score (28.9 vs. 27.8, p = 0.262). Risk factors analyzed did not significantly affect local recurrence risk, except for secondary ABC diagnosis (p = 0.017). The cryoablation group had a more extended follow-up (45.6 vs. 73.2 months, p < 0.001), reflecting a shift in practice over time. We found no significant difference in local recurrence rate or functional outcome in patients treated with or without cryoablation. Formal curettage with additional high-speed burr drilling provides effective tumor control and favorable functional outcomes, negating the need for adjuvant cryoablation.


Asunto(s)
Quistes Óseos Aneurismáticos , Criocirugía , Legrado , Recurrencia , Humanos , Quistes Óseos Aneurismáticos/cirugía , Femenino , Masculino , Estudios Retrospectivos , Criocirugía/métodos , Adolescente , Niño , Legrado/métodos , Adulto , Adulto Joven
8.
Hip Int ; 34(3): 390-395, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38146063

RESUMEN

PURPOSE: To determine whether synthetic grafts are a satisfactory treatment option for pathological proximal femoral fractures in children. METHODS: Paediatric patients treated for pathological fractures of the proximal femur between 2013 and 2020 were evaluated retrospectively. 17 patients with a mean age of 10.7 years (range 6-16 years) were assessed. The definitive histopathological diagnoses were SBC (simple bone cyst) (12) and ABC (aneurysmal bone cyst) (5). The median duration of follow-up was 37 months (range 12-70 months). RESULTS: All patients returned to their normal daily routine within 3-8 months following surgery. The mean post-op recovery time was 3.2 months (range 3-6 months). Graft was incorporated at approximately 12 months. No significant radiographic healing was observed in 2 patients. In the remaining 15 patients, the mean duration of healing was 14 months (range 8-24 months). CONCLUSION: Synthetic grafts are a satisfactory treatment option for pathological proximal femoral fractures in children.


Asunto(s)
Trasplante Óseo , Fracturas de Cadera , Humanos , Niño , Masculino , Femenino , Adolescente , Estudios Retrospectivos , Fracturas de Cadera/cirugía , Trasplante Óseo/métodos , Resultado del Tratamiento , Fracturas Espontáneas/cirugía , Fracturas Espontáneas/etiología , Curación de Fractura , Quistes Óseos Aneurismáticos/cirugía , Quistes Óseos Aneurismáticos/diagnóstico por imagen , Estudios de Seguimiento
9.
Medicine (Baltimore) ; 103(2): e36210, 2024 Jan 12.
Artículo en Inglés | MEDLINE | ID: mdl-38215118

RESUMEN

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.


Asunto(s)
Quistes Óseos Aneurismáticos , Neoplasias Óseas , Humanos , Adulto , Femenino , Niño , Adolescente , Adulto Joven , Radio (Anatomía)/cirugía , Radio (Anatomía)/patología , Peroné/trasplante , Quistes Óseos Aneurismáticos/diagnóstico por imagen , Quistes Óseos Aneurismáticos/cirugía , Trasplante Óseo/métodos , Neoplasias Óseas/cirugía , Neoplasias Óseas/patología , Recurrencia Local de Neoplasia/patología , Articulación de la Muñeca/cirugía , Resultado del Tratamiento
10.
JBJS Case Connect ; 14(2)2024 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-38913790

RESUMEN

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.


Asunto(s)
Neoplasias Óseas , Peroné , Húmero , Sarcoma de Ewing , Humanos , Niño , Masculino , Peroné/trasplante , Peroné/cirugía , Femenino , Sarcoma de Ewing/cirugía , Neoplasias Óseas/cirugía , Húmero/cirugía , Trasplante Óseo/métodos , Quistes Óseos Aneurismáticos/cirugía , Quistes Óseos Aneurismáticos/diagnóstico por imagen , Procedimientos de Cirugía Plástica/métodos
11.
JBJS Case Connect ; 14(1)2024 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-38452160

RESUMEN

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.


Asunto(s)
Quistes Óseos Aneurismáticos , Deformidades Adquiridas de la Articulación , Masculino , Humanos , Adolescente , Quistes Óseos Aneurismáticos/complicaciones , Quistes Óseos Aneurismáticos/diagnóstico por imagen , Quistes Óseos Aneurismáticos/cirugía , Deformidades Adquiridas de la Articulación/complicaciones , Deformidades Adquiridas de la Articulación/cirugía , Fémur/diagnóstico por imagen , Fémur/cirugía , Fémur/anomalías , Tibia/diagnóstico por imagen , Tibia/cirugía , Articulación de la Rodilla/cirugía
12.
Medicine (Baltimore) ; 103(6): e37137, 2024 Feb 09.
Artículo en Inglés | MEDLINE | ID: mdl-38335421

RESUMEN

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.


Asunto(s)
Quistes Óseos Aneurismáticos , Neoplasias Óseas , Hemangioma , Traumatismos del Cuello , Cráneo/anomalías , Columna Vertebral/anomalías , Malformaciones Vasculares , Neoplasias Vasculares , Masculino , Humanos , Adulto Joven , Adulto , Hueso Hioides/diagnóstico por imagen , Hueso Hioides/cirugía , Quistes Óseos Aneurismáticos/diagnóstico por imagen , Quistes Óseos Aneurismáticos/cirugía , Cráneo/patología , Neoplasias Óseas/diagnóstico por imagen , Neoplasias Óseas/cirugía , Hemangioma/diagnóstico por imagen , Hemangioma/cirugía , Columna Vertebral/patología
13.
Oral Maxillofac Surg ; 28(2): 999-1004, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38378934

RESUMEN

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.


Asunto(s)
Quistes Óseos Aneurismáticos , Humanos , Femenino , Niño , Quistes Óseos Aneurismáticos/cirugía , Quistes Óseos Aneurismáticos/diagnóstico por imagen , Quistes Óseos Aneurismáticos/patología , Exoftalmia/etiología , Exoftalmia/cirugía , Tomografía Computarizada por Rayos X , Enfermedades Orbitales/cirugía , Enfermedades Orbitales/diagnóstico por imagen , Enfermedades Orbitales/patología , Imagen por Resonancia Magnética , Displasia Fibrosa Ósea/cirugía , Displasia Fibrosa Ósea/diagnóstico por imagen , Displasia Fibrosa Ósea/complicaciones , Mallas Quirúrgicas , Procedimientos de Cirugía Plástica/métodos
14.
BMJ Case Rep ; 17(4)2024 Apr 29.
Artículo en Inglés | MEDLINE | ID: mdl-38684351

RESUMEN

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.


Asunto(s)
Quistes Óseos Aneurismáticos , Descompresión Quirúrgica , Vértebras Lumbares , Imagen por Resonancia Magnética , Vértebras Torácicas , Humanos , Quistes Óseos Aneurismáticos/cirugía , Quistes Óseos Aneurismáticos/diagnóstico por imagen , Masculino , Vértebras Torácicas/cirugía , Vértebras Torácicas/diagnóstico por imagen , Adolescente , Vértebras Lumbares/cirugía , Descompresión Quirúrgica/métodos , Laminectomía/métodos , Resultado del Tratamiento , Dolor de Espalda/etiología , Dolor de Espalda/cirugía
15.
Acta ortop. mex ; 32(6): 361-365, nov.-dic. 2018. graf
Artículo en Español | LILACS | ID: biblio-1248620

RESUMEN

Resumen: El quiste óseo aneurismático es una tumoración benigna poco común, de aparición en la infancia generalmente y a nivel de extremidades. El tratamiento más habitual consiste en el curetaje y relleno con injerto. No obstante, localizaciones poco accesibles a la cirugía suponen un reto terapéutico. Se presenta el caso de un paciente de 11 años con cojera y dolor en cadera derecha sin antecedente traumático ni infeccioso. En los estudios de imagen con TAC y RM se evidencia una lesión lítica expansiva que ocupa todo el techo del acetábulo y pala ilíaca derecha, sugestiva de un quiste óseo aneurismático presentando fractura acetabular asociada. Se realizó una biopsia que confirmó el diagnóstico. Se trató mediante embolización guiada por angiografía debido al gran volumen y alto riesgo de fractura, después del curetaje y relleno con aloinjerto evolucionó satisfactoriamente y el paciente se encuentra asintomático al año de la intervención.


Abstract: The aneurysmal bone cyst is a benign rare tumor, which usually develops during childhood and it's more often found in limbs. The most accepted treatment consists in curetagge and filling with graft. However, certain locations may be inaccesible for surgery and represent therapeutical challenges. We present the case of an 11 year-old male patient with limping and right hip pain without any traumatic nor infectious record. In the image studies with CT and MRI a lytic and expansive lession was found in the upper part of the right acetabulum and right iliac wing, all of which suggested an aneurysmal bone cyst with an associated acetabular fracture. A biopsy was performed which confirmed the diagnosis. He was treated with a CT-guided embolization and, due to its size, curetagge and allograft filling afterwards. He was asymptomatic after1 year of follow-up.


Asunto(s)
Humanos , Masculino , Niño , Quistes Óseos Aneurismáticos/cirugía , Quistes Óseos Aneurismáticos/diagnóstico , Acetábulo/cirugía , Biopsia , Tomografía Computarizada por Rayos X , Ilion
16.
Arq. bras. med. vet. zootec ; 69(1): 106-110, jan.-fev. 2017. ilus
Artículo en Portugués | LILACS, VETINDEX | ID: biblio-834124

RESUMEN

Este trabalho descreve o diagnóstico e o tratamento instituído para um cão com um raro cisto ósseo aneurismático originado em tecido mole. O paciente foi apresentado para atendimento no Hospital de Clínicas Veterinárias da Universidade Federal do Rio Grande do Sul devido à dificuldade de locomoção, fraqueza nos membros pélvicos e disquesia havia 15 dias. Já estava recebendo tratamento medicamentoso sem sucesso. Ao exame clínico, notou-se aumento de volume sólido na região perineal direita, e foram solicitados exames complementares de imagem. A radiografia da região sugeriu hérnia perineal direita ou neoplasia. O cão foi encaminhado para cirurgia, na qual foi removida uma estrutura tumoral, arredondada, de aspecto ossificado. O exame histopatológico diagnosticou a estrutura como um cisto ósseo aneurismático em tecido mole, e o paciente recuperou-se totalmente após a excisão cirúrgica.(AU)


This paper describes the diagnosis and treatment of a dog with a rare aneurysmal bone cyst in soft tissue. The patient was attended in the Veterinary Clinic Hospital at the Fedral University of Rio Grande do Sul due to limited mobility, weakness in hind limbs, and dyschezia for 15 days. It was already receiving medical treatment without success. Upon clinical examination a solid increase volume in the right perineal region was detected, and complementary imaging tests were requested. Radiography of the region suggested right perineal hernia or neoplasia. The dog was submitted to surgery, and a rounded and ossified tumoral structure was removed. The histopathological exam diagnosed the structure as an aneurysmal bone cyst in soft tissue, and the patient recovered fully after surgical excision.(AU)


Asunto(s)
Animales , Masculino , Perros , Quistes Óseos Aneurismáticos/diagnóstico , Quistes Óseos Aneurismáticos/cirugía , Neoplasias de los Tejidos Blandos/cirugía , Perineo/patología
17.
Artículo en Español | LILACS, BINACIS | ID: lil-789904

RESUMEN

Antecedentes: Los pacientes con quiste óseo aneurismático plantean dificultades diagnósticas y terapéuticas. Se han descrito múltiples opciones terapéuticas. Objetivos: Evaluar los resultados obtenidos en pacientes tratados con curetaje y relleno con aloinjerto óseo. Materiales y Métodos: Se analizaron 16 quistes, correspondientes a 15 pacientes, con un seguimiento mínimo de 28 meses y una mediana de seguimiento de 83 meses. Resultados: La media de la edad era de 10 años (rango 3-16). La principal complicación fue la recidiva (37,5%), que fue más frecuente cuando existía compromiso fisario (62,5% frente al 12,5% sin compromiso; p = 0,05). La frecuencia de recidiva no varió en ambos sexos, para las distintas edades analizadas y respecto al uso o no de fresa de alta velocidad. Conclusión: Consideramos que el tratamiento realizado es seguro, pero tiene una alta tasa de recidivas, similar a las publicadas en otras series.


Backround: Patients with aneurysmal bone cyst pose diagnostic and therapeutic difficulties. Multiple therapeutic options have been described. Objective: To evaluate the results obtained in patients treated with curettage and filling with bone allograft. Methods: Sixteen cysts, corresponding to 15 patients were evaluated, with a minimum follow-up of 28 months and a median follow-up of 83 months. Results: Average age was 10 years (range 3-16). The main complication was recurrence in 37.5% of patients, being more frequent with physeal involvement (62.5% vs. 12.5% without involvement; p = 0.05). The recurrence rate was unchanged for both sexes, for different ages and regarding the use or not of high-speed burr. Conclusion: We think that the treatment performed is safe, but recurrence rate is high, similar to that reported in other series.


Asunto(s)
Niño , Aloinjertos , Quistes Óseos Aneurismáticos/cirugía
18.
Rev. cuba. estomatol ; 53(3): 176-183, jul.-set. 2016. ilus
Artículo en Español | LILACS | ID: lil-794140

RESUMEN

El quiste óseo aneurismático es definido como una lesión osteolítica expansiva que consiste en espacios llenos de sangre y canales divididos por tabiques de tejido conectivo, los cuales contienen tejido osteoide y células gigantes multinucleadas. El objetivo es presentar un caso clínico poco común de un quiste óseo aneurismático de la región del cuerpo mandibular. Se trata de una paciente femenina de 39 años de edad que acudió a consulta externa del Servicio de Cirugía Maxilofacial del Hospital Universitario General Calixto García por aumento de volumen en región mandibular derecha y dolor intenso de 1 mes de evolución. Radiográficamente se detectó un área radiolúcida unilocular de bordes bien definidos; se realizó curetaje de la cavidad, y estudio histopatológico de la lesión que informó la presencia de un quiste óseo aneurismático. Se concluye que el quiste óseo aneurismático es más común en los huesos largos y en la región del ángulo mandibular en el esqueleto facial, por lo que la presentación de este en el cuerpo mandibular resulta de interés(AU)


The aneurysmal bone cyst is defined as an expansive osteolytic lesion consisting of blood-filled spaces and divided by partitions of connective tissue, which contain bone tissue and giant cells channels. The objective is to present a rare case of an aneurysmal bone cyst in the region of the mandibular body. This is a case of a 39-year-old female who attended the outpatient Maxillofacial Surgery Service of General Calixto Garcia University Hospital due to an increased volume in right mandibular region and intense pain of a month, both in evolution. Radiographically, a unilocular radiolucent area with well-defined edges was detected; curettage of the cavity and histopathological examination of the lesion were performed, which reported the presence of an aneurysmal bone cyst. It is concluded that the aneurysmal bone cyst is most commonly presented in the long bones and in the region of the mandibular angle in the facial skeleton, so the presentation of this in the mandibular body is of interest(AU)


Asunto(s)
Humanos , Femenino , Adulto , Quistes Óseos Aneurismáticos/diagnóstico por imagen , Quistes Óseos Aneurismáticos/cirugía , Traumatismos Mandibulares/terapia
19.
Acta ortop. mex ; 29(1): 49-51, ene.-feb. 2015. ilus
Artículo en Español | LILACS | ID: lil-755665

RESUMEN

El quiste óseo aneurismático es una lesión benigna que afecta la médula de huesos largos, supone 6% de las lesiones óseas primarias y puede surgir secundariamente con otros tumores óseos benignos o malignos. Presentamos el caso de una mujer de siete años de edad con un quiste óseo aneurismático, diagnosticado por clínica, radiología, tomografía axial computarizada y confirmado por histopatología. Se le realizó resección con técnica eggshell e injerto óseo no vascularizado de peroné izquierdo, su evolución fue satisfactoria hasta los cuatro años de operada, lo que concuerda con lo descrito en la literatura mundial.


An aneurysmal bone cyst is a benign lesion involving the marrow of long bones; it accounts for 6% of primary bone lesions and may occur as a secondary lesion with other benign or malignant bone tumors. We describe herein the case of a seven year-old female with an aneurysmal bone cyst which was diagnosed clinically, radiographically and with a CAT scan, and confirmed with histopathology. Resection was performed using the eggshell technique and a non-vascularized left fibular bone graft. The patient did well up to the fourth postoperative year, which is consistent with what has been reported in world literature.


Asunto(s)
Niño , Femenino , Humanos , Quistes Óseos Aneurismáticos/cirugía , Peroné/trasplante , Húmero/cirugía , Quistes Óseos Aneurismáticos/patología , Trasplante Óseo/métodos , Estudios de Seguimiento , Húmero/patología , Tomografía Computarizada por Rayos X
20.
Rev. cuba. ortop. traumatol ; 29(2): 183-191, jul.-dic. 2015. ilus
Artículo en Español | LILACS, CUMED | ID: lil-771820

RESUMEN

El quiste óseo aneurismático sólido es un tumor de naturaleza neoplásica indefinida, de comportamiento benigno, crecimiento rápido y agresivo. Representa menos del 8 % de todos los quistes óseos aneurismáticos. Se presenta un caso de quiste óseo aneurismático sólido de mediastino posterior con toma espinal torácica. La ausencia de signos característicos en las pruebas de imagen y la presencia de rasgos similares al tumor de células gigantes y el osteosarcoma, hacen imprescindible la confirmación anatomopatológica para un tratamiento adecuado de la enfermedad. La exéresis quirúrgica total de la tumoración, el aporte de injerto óseo y la fijación del segmento afecto constituyen el procedimiento de elección.


The solid aneurysmal bone cyst is a malignant tumor of undefined nature, benign behavior; it has fast and aggressive growth. It represents less than 8 % of all aneurysmal bone cysts. A case of posterior mediastinum solid aneurysmal bone cyst with thoracic spinal making is presented here. The absence of characteristic signs in the imaging and the presence of similar features of giant cell tumor and osteosarcoma, make it imperative the pathologic confirmation for proper treatment of the disease. Total surgical excision of the tumor, the bone grafting and fixation segment affection are the procedures of choice.


Le kyste osseux anévrismal solide est une tumeur de nature néoplasique indéfinie, caractérisée par un comportement bénin et une croissance rapide et agressive. Il représente moins de 8 % de tous les kystes osseux anévrismaux. Un cas de kyste osseux anévrismal solide au niveau de médiastin postérieur (d’atteinte spinale thoracique) est présenté. L’absence de signes caractéristiques dans l’imagerie RM et la présence de traits similaires à la tumeur à cellules géantes et à l’ostéosarcome rendent nécessaire la confirmation anatomopathologique pour un traitement approprié de cette pathologie. L’exérèse totale de la tumeur, la greffe osseuse et la fixation du segment affecté constituent la technique opératoire de choix.


Asunto(s)
Humanos , Femenino , Sacro/lesiones , Neoplasias Óseas/diagnóstico , Quistes Óseos Aneurismáticos/cirugía , Quistes Óseos Aneurismáticos/diagnóstico , Quistes Óseos Aneurismáticos/terapia , Tumores de Células Gigantes/cirugía
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