Soft tissue aneurysmal bone cyst of left hemithorax: An extremely rare case

Aneurysmal bone cyst (ABC) is a benign expansile cystic lesion that can affect any bone of the skeleton, especially the femur, tibia, and humerus. Lesions with histologic features of an ABC can be originated within soft tissue in exceedingly rare cases. Extra-skeletal ABC may mimic a variety of benign and malignant lesions and can be confused with other common or rare giant cell-rich tumors of soft tissue. Clinical, radiological and histologic correlation are crucial in reaching the correct diagnosis. Here we report a case of an extra-skeletal ABC arising in left hemithorax in a 13-year-old girl and discuss the common differential diagnosis of this rare entity.

Estudio radiológico simple de quiste óseo simple y aneurismático: diagnóstico diferencial / Plain radiologic assessment of unicameral and aneurysmal bone cyst: differential diagnosis

OBJETIVO Dar a conocer nuestra experiencia en el diagnóstico diferencial de los quistes óseos simple y aneurismático mediante estudio radiológico simple. MATERIALES Y METODOS Se incluyeron pacientes menores de 20 años con radiografía de quiste óseo simple o aneurismático histológicamente confirmado pertenecientes al Registro Nacional de Tumores Óseos. Las radiografías fueron analizadas por dos radiólogos experimentados. Se compararon las variables demográficas de los pacientes, y las variables clínicas y radiológicas de ambos quistes. RESULTADOS Un total de 97 pacientes cumplieron los criterios de inclusión (65% presentaba quistes óseos simples y 35%, aneurismáticos). No se observaron diferencias en cuanto a la edad, al hueso comprometido, al tamaño de la lesión, a la expansión ósea, ni al adelgazamiento cortical. El género, la forma de presentación, la presencia de interrupción de la cortical, y la localización de la lesión en los ejes longitudinal y transversal del hueso son parámetros que podrían ser útiles en el diagnóstico diferencial de ambos quistes. DISCUSIÓN Los quistes óseos simple y aneurismático son lesiones benignas frecuentes que, de acuerdo con la literatura, serían difíciles de diferenciar únicamente con radiografía simple. La resonancia magnética permite una mejor caracterización anatómica, y aporta sensibilidad y especificidad al diagnóstico. Sin embargo, debe ser precedida por la radiografía simple, y su disponibilidad es limitada. CONCLUSIÓN Aun en centros con disponibilidad de resonancia magnética, la radiografía simple sigue siendo el estudio inicial de elección en el diagnóstico de tumores óseos. Ciertas características demográficas y radiográficas permiten orientar el diagnóstico diferencial inicial entre el quiste óseo simple y el aneurismático

OBJETIVE To describe our experience in the differential diagnosis of unicameral and aneurysmal bone cysts using plain radiography. PATIENCES AND METHODS We included patients under 20 years of age with radiographs of histologically-confirmed unicameral or aneurysmal bone cysts found on the Chilean National Bone-Tumor Registry. The radiographs were evaluated by two experienced radiologists. We compared the demographic variables of the patients, and the clinical and radiological variables of both tumors.. RESULTADOS A total of 97 patients met the inclusion criteria, 65% of whom had simple bone cysts, and 35%, aneurysmal bone cysts. No differences were found regarding age, the bone affected, the size of the lesion, bone expansion, nor cortical thinning. Gender, clinical presentation, cortical interruption, and location of the lesion on the longitudinal and transverse bone axes are parameters that could be used in the differential diagnosis of both cysts. DISCUSSION According to the literature, unicameral and aneurysmal bone cysts are frequent benign lesions that are difficult to differentiate merely through plain radiographs. Magnetic resonance imaging enables a better anatomical characterization and provides sensitivity and specificity to the diagnosis. However, its availability is limited, and it should be preceded by plain radiography. CONCLUSION Plain radiography is still the initial imaging study of choice in patients with clinical suspicion of bone tumor, even in those centers where magnetic resonance imaging is available. Certain demographic and radiological characteristics guide physicians in the differential diagnosis of unicameral and aneurysmal bone cysts.

Characteristics and postoperative recurrence factors of aneurysmal bone cyst in children′s limbs / 中华实用儿科临床杂志

Objective:To analyze the characteristics of aneurysmal bone cysts (ABC) and related factors of postoperative recurrence, so as to improve the clinical diagnosis and treatment level of ABC in children.Methods:The clinical data of children pathologically diagnosed as ABC after surgery in the Affiliated Hospital of Zunyi Medical University from January 2010 to December 2018 were retrospectively analyzed.Clinical characteristics of the patients, including age, gender, lesion sites, and main clinical manifestations (pain, swelling, local tenderness, joint dysfunction and pathological fracture) were analyzed and summarized.Before operation, imaging Enneking staging was carried out, cyst volume was estimated, and the distance from cysts to the epiphyseal plate was measured.During surgery, patients received lesion curettage, local cautery and bone grafting, and the pathological fractures were treated with auxiliary internal fixation.Results were determined by Neer imaging grading after surgery, and grades Ⅰ and Ⅱ were postoperative recurrence.Possible recurrence factors were analyzed statistically by Fisher′ s exact test. Results:A total of 29 cases meeting the criteria were included, including 19 males and 10 females.The age ranged from 3.6 to 14.0 years old, averaging 9.2 years old; 12 patients were smaller than 10 years old and 17 patients were older than 10 years old.The cysts of 9 cases were located in proximal femur (31.0%), 5 cases in proximal humerus (17.2%), and 4 cases in proximal fibula (13.8%); The other 11 cases (37.9%) occurred in the middle and distal end; 26 cases (89.7%) had local tenderness, 25 cases (86.2%) showed varying degrees of pain, 18 cases (62.1%) presented local swelling, 15 cases (51.7%) were accompanied by joint dysfunction, and 12 cases (41.4%) were combined with pathological fractures.According to Enneking staging results, 18 cases (62.1%) were at rest stage, 7 cases (24.1%) at active stage, and 4 cases (13.8%) at invasive stage.Cyst volume was estimated to be 3.3-172.0 cm 3, with a median of about 50.8 cm 3.The distance from cysts to the epiphyseal plate was 0-85.0 mm, with a median of 20.8 mm.All children were followed up for 2.2-10.1 years (averaging 3.8 years). There were 6 cases (20.7%) of grades Ⅰ and Ⅱ according to Neer grading standard, and they suffered from recurrence about 2.5-20.3 months after surgery (averaging 12.5 months). The recurrence rate was higher in patients with cyst volume >50.8 cm 3 (42.9%, 6/14 cases) as well as in patients at active stage and invasive stage (45.5%, 5/11 cases) ( P<0.05). There was no statistical difference between the recurrence rate of ABC in different gender, age, the distance from cysts to the epiphyseal plate and pathological fractures. Conclusions:ABC is prone to occur in the proximal metaphysis of the long bones of children′s extremities.Main manifestations are pain, swelling, local tenderness and joint dysfunction, and ABC is frequently accompanied by pathological fractures.A higher postoperative recurrence rate is related to a larger cyst size and the active and invasion phases of the cyst, but gender, age, the distance from the cyst to the epiphyseal plate and pathological fractures are not significantly related to the postoperative recurrence rate.

Quistes óseos de localizacion inusual como causa de lumbalgia crónica en adultos / Bone cyst of unusual location as a cause of chronic back pain in adults

Se presenta el caso de un paciente con quistes en el hueso iliaco como causa atípica de lumbalgia crónica a la cual se puede enfrentar el reumatólogo, y se hará una revisión de la literatura sobre los tipos de quistes óseos y sus diagnósticos diferenciales. También se hará mención de sus opciones de tratamiento.

The case of a patient with cysts in the iliac bone is presented as an atypical cause of chronic low back pain that the rheumatologist may face, and a review of the literature on the types of bone cysts and their differential diagnoses will be made. Mention will also be made of your treatment options.

Quiste Óseo Aneurismático en Clavícula: Reporte de un caso / Clavicle Aneurysmal Bone Cyst, Case Report

Introducción:El quiste óseo aneurismático es una neoplasia benigna poco común de aparición en edad temprana. Tiene mayor incidencia en huesos largos y en la columna vertebral. Su etiología es incierta, aunquesuele asociarse a traumatismo, probablemente debido a obstrucción venosa o a la formación de fístulas que se producen tras la contusión. Caso:En este estudio se presenta el caso de un paciente de 15 años sin antecedentes de trauma que presenta un quiste óseo aneurismático en clavícula, localización poco habitual para esta patología. Evolución: Se le brindótratamiento con terapia esclerosante con Polidocanol al 3% por 8 ocasiones con respuesta favorable.No ha requerido cirugía hasta el momento. Conclusión:El tratamientoesclerosante fue exitoso en este informe de casos

Introduction: The aneurysmal bone cyst is a rare benign neoplasm that appears at an early age. It has a higher incidence in long bones and in the spine. Its etiology is uncertain, although it is usually associated with trauma, probably due to venous obstruction or the formation of fistulas that occur after contusion. Case: This study presents the case of a 15-year-old patient with no history of trauma who presents with an aneurysmal bone cyst in the clavicle, an unusual location for this pathology. Evolution: Treatment with sclerosing therapy with 3% Polidocanol was given 8 times with a favorable response. He has not required surgery so far. Conclusion: Sclerosing treatment was successful in this case report

Chondroblastoma of the Talus Mimicking an Aneurysmal Bone Cyst: A Case Report / 대한족부족관절학회지

Chondroblastoma is a rare benign tumor that produces giant cells and cartilage matrix. The tumor occurs in people between 10 and 25 years with slightly higher incidence in males. The condition occurs in the proximal epiphysis of the tibia and humerus, distal epiphysis of the femur, but its occurrence in the talus is relatively rare, accounting for 4% of the total number of chondroblastoma cases. Chondroblastoma is often misdiagnosed as a primary aneurysmal bone cyst, giant cell tumor, chondromyxoid, and lesion of a secondary aneurysmal bone cyst by fibrous dysplasia. The most commonly used surgical method for chondroblastoma is broad curettage with bone grafting. In general, an aneurysmal bone cyst is associated with a second degree chondroblastoma, which is approximately 20%. Chondroblastoma of the talus and secondary aneurysmal bone cysts can be misdiagnosed as primary aneurysmal bone cysts. This paper reports a case of a young male patient with chondroblastoma of the talus, which was initially misdiagnosed as an aneurysmal bone cyst with involvement of the talo-navicular joint.

Single-Staged Transoral Intra-Lesional Excision of Aneurysmal Bone Cyst of Axis (C2) Vertebra and Temporary Stabilization of Upper Cervical Spine in an Adolescent: A Case Report

@#Aneurysmal bone cyst (ABC) infrequently occurs within the upper cervical vertebrae. Various therapeutic options have been reported in the literature. We would like to share our experience in managing a case of a 16-year-old girl diagnosed with ABC at the body of axis (C2) vertebra. Serious attention had to be given on the stability of the cervical spine following tumour resection, which can be affected by the mode of treatment chosen. Instability can have a detrimental effect on the cervical spine, in which case may necessitate further surgery. We performed a single-staged intra-lesional curettage via a transoral approach and temporary non-fusion posterior stabilization of C1 lateral mass screw and C2 pedicle screw. The implants were removed after six months once ossification of C2 has taken place to regain full motion of the neck. There was no evidence of recurrence or instability of the cervical spine three years following surgery.

Aneurysmal Bone Cyst after Femoral Derotational Osteotomy: A Case Report

@#Aneurysmal bone cysts rather than local aggressive lesions of the bone which may arise in any part of the axial or appendicular skeleton. Although several theories are available in the literature, the pathogenesis is still conflicting. We report an exceptional case of an aneurysmal bone cyst in the distal femur of a female cerebral palsy patient who underwent bilateral distal femoral derotational osteotomy and plate-screw fixation operations when she was 11 years old. Twenty-four months after the operation, radiographs showed a cystic lesion in the distal portion of the right femur around the osteotomy site. The diagnosis of Aneurysmal Bone Cyst (ABC) was made and the lesion was treated by curettage with cement application. After 36 months of follow-up, there was no recurrence. This is the first case reported in literature which raises the possibility that an osteotomy could be a cause in the development of an aneurysmal bone cyst.

Quiste óseo aneurismático localizado en el techo acetabular en un varón de 11 años / Aneurysmal bone cyst located on the acetabular roof in an 11-year-old male

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.

Quiste óseo aneurismático en el húmero distal. Reporte de un caso y tratamiento actual / Aneurysmal bone cyst in distal humerus. Case report and current treatment

El quiste óseo aneurismático es una lesión ósea benigna que se presenta a edad temprana; su comportamiento suele ser agresivo por lo cual, la resección quirúrgica y la prevención de su recidiva son los pilares fundamentales de el tratamiento. Presentamos el caso de una paciente de 6 años de edad residente en Gualaceo, Ecuador, con masa de crecimiento progresivo y deformante en el codo izquierdo. Por las características de los exámenes de imagen y el cuadro sintomático se dignostica quiste óseo aneurismático que fue tratado con cirugía de resección intralesional y terapia adyuvante (fresado de alta velocidad, coagulación térmica y crioterapia). Se confirmó el diagnostico mediante el estudio histopatológico posquirúrgico

The aneurysmal bone cyst is a benign osseous lesion of presentation at an early age whose behavior is usually aggressive, so its surgical resection and the prevention of its recurrence is the fundamental pillar for the treatment. We present the case of a girl of 6 years of age living in Gualaceo, Ecuador, with a mass of progressive and deforming growth in the left elbow. By characteristics in the imaging tests and clinical picture it was considered as an aneurysmal bone cyst which was treated with intralesional resection surgery and adjuvant therapy (high speed burr, thermal coagulation and cryotherapy). The diagnosis was confirmed with postoperative histopathological study

Clinical diagnosis and treatment strategy for recurrent aneurysmal bone cysts of the extremities: a report of 29 cases / 中国肿瘤临床

Objective: To explore the clinical characteristics, imaging feature, surgical outcomes, and prognosis of recurrent aneurysmal bone cysts (RABC) of the extremities. Methods: Between January 2008 and January 2016, 29 patients histopathologically diagnosed with RABC were treated at our hospital. These patients included 15 males and 14 females. The mean age at the time of diagnosis was 17.4 years(range 4-42 years). The most common site of the RABC was the proximal tibia (12 cases), followed by the distal femur (11 cases), and 3 cases each with involvement of the proximal humerus and the proximal femur. Recurrence was most commonly ob-served within 24 months following the initial treatment. Intralesional re-curettage was performed in 24 patients and en bloc resection of the tumor and reconstruction in 5 patients. The medial tibial stress syndrome (MTSS) score was used to evaluate postoperative func-tion of the affected limb, and the comprehensive clinical efficacy was evaluated on the basis of the Mankin criteria. Results: The mean follow-up duration was 64 months (range 24-90 months). Re-recurrence occurred in 1 patient with a total re-recurrence rate of 3.4%. The postoperative MTSS score was 26-30 points (mean 29.1 points) in the intralesional re-curettage group and 21-27 points (mean 23.0 points) in the tumor resection group. Based on the Mankin criteria, excellent and good clinical outcomes were observed in 95.8% of patients in the intralesional and 60% of the patients in the tumor resection and reconstruction groups. Conclusions: Regular follow-up is essential for the early diagnosis of RABC. The re-recurrence rate following intralesional re-curettage was within an acceptable range, and postoperative limb function was satisfactory; therefore, intralesional re-curettage is the treatment of choice for RABC in-volving the extremities. Tumor resection can be performed in patients with severe articular surface destruction and repeated recur-rence, although long-term complications may occur.

Free Vascularized Fibular Graft for Femoral Head Collapse Combined with Ununited Pathologic Intertrochanteric Fracture / 대한정형외과학회잡지

Surgery for pathologic hip fracture poses significant challenges regarding the fixation of fracture and management of the original tumor lesion. An extensive destruction of the femoral neck and intertrochanteric region by benign or malignant lesions complicated by a pathological fracture generally necessitates total hip arthroplasty; however, in adolescents and young adults, preservation of the hip is preferable. We present a 14-year-old female patient, who sustained a pathological intertrochanteric fracture through a pre-existing aneurysmal bone cyst. Several operative interventions with internal fixation and bone graft were unsuccessful, and combined nonunion and progression of osteolysis around the compression hip screw eventually caused femoral head collapse, mimicking osteonecrosis. Hip preservation and resolution of the original tumor were achieved by free vascularized fibular graft.

Can ethanol be used as an adjuvant to extended curettage in order to reduce the recurrence rate of aneurysmal bone cyst? / O etanol pode ser usado como adjuvante na curetagem ampla a fim de reduzir a taxa de reincidência de cisto ósseo aneurismático?

ABSTRACT OBJECTIVE: The best treatment of aneurysmal bone cyst (ABC) is still unclear. This study aimed to evaluate the usefulness of extended curettage and ethanol as an adjuvant to reduce local recurrence of ABCs. METHODS: Retrospectively, 68 cases treated for primary and secondary ABCs caused by benign tumors from 2003 to 2013 were enrolled to a follow-up visit between one to ten years after the surgery. The treatment protocol was en-bloc resection, biopsy and curettage, extended curettage consisted of curettage, high-speed burring, ethanol 96%, and electrocauterization (combined four-step alcohol-using approach) followed by defect filling, consecutively. RESULTS: Among 36 patients with primary ABCs (16 male, 20 female, mean age of 16 years, range 3-46 years), 29 cases were treated with the combined four-step alcohol-using approach, four patients with resection, and three with biopsy and curettage. Thirty-two cases had secondary ABCs on benign lesions (17 male, 15 female). The recurrence rate was 5.88 in all primary and secondary ABC cases; two recurrences among 29 patients with primary ABCs (6.9%) and one recurrence among the 22 cases with secondary ABCs (4.5%). CONCLUSIONS: It could be suggested that the combined four-step alcohol-using approach may result in a very low recurrence rate of primary and secondary ABC lesions.

RESUMO OBJETIVO: Ainda não se sabe qual o melhor tratamento para cistos ósseos aneurismáticos (COA). Este estudo teve como objetivo avaliar a utilidade da curetagem estendida e do etanol como adjuvante para reduzir a reincidência local de COAs. MÉTODOS: Retrospectivamente, 68 casos que receberam tratamento para COAs primários e secundários causados por tumores benignos entre 2003 e 2013 foram chamados para uma consulta de seguimento, em um intervalo entre um e dez anos após a cirurgia. O protocolo de tratamento foi ressecção em bloco, biópsia e curetagem; a curetagem estendida consistiu em curetagem, broqueamento em alta velocidade, etanol 96% e eletrocauterização (abordagem combinada em quatro etapas com álcool), seguida do preenchimento do defeito, de forma consecutiva. RESULTADOS: Entre os 36 pacientes com COAs primárias (16 do sexo masculino, 20 do feminino, média de 16 anos, intervalo 3-46), 29 casos foram tratados com a abordagem combinada em quatro etapas com álcool, quatro pacientes com ressecção e três com biópsia e curetagem; 32 casos apresentavam COAs secundárias em lesões benignas (17 do sexo masculino, 15 do feminino). A taxa de reincidência foi de 5,88 em todos os casos de COAs primárias e secundárias; duas reincidências foram observadas entre 29 pacientes com COAs primária (6,9%) e uma reincidência entre os 22 casos (4,5%) de COAs secundária. CONCLUSÃO: Sugere-se que a abordagem combinada em quatro etapas com álcool pode resultar em uma taxa de reincidência muito baixa em lesões COAs primárias e secundárias.

The value analysis for imaging diagnosis and differential diagnosis of upper femur aneurysmal bone cyst / 中国医学装备

Objective:To analyze imaging diagnosis and differential diagnosis of upper femur aneurysmal bone cyst.Methods: The pre-operation imaging appearances about digital radiography(DR), computerized tomography (CT) and magnetic resonance imaging (MRI) of 46 aneurysmal bone cyst cases confirmed by operation and pathology were retrospectively analyzed, and then these special imaging appearances were gained and analyzed.Results:①CT plain scans showed the irregular expansile lucency shadow in the upper femur with the uneven bone septum image; the complete or incomplete osteosclerosis edge can be found in some parts of lesions; some lesions extend to adjacent soft tissue, and the liquid-liquid level can be found in lesion of 8 cases, and their edge and separated intensity strengthening were visible after signals were enhanced.②MRI plain scans revealed that most lesions showed long T1, T2 signals, the periphery of lesions showed long T1, short T2 signal shadows, and septum image was visible within lesions, and the liquid-liquid level can be found in lesion of 8 cases; some lesions extend to adjacent soft tissue, and their edge and separated intensity strengthening were visible after signals were enhanced.Conclusion: Through combined examination of DR, CT and MRI, the specialty and diagnostic accuracy of aneurysmal bone cyst could be improved, and it was helpful in the differential diagnosis of other upper femur bone tumors.

Clinical analysis of aneurysmal bone cyst in jaw bone / 口腔疾病防治

Objective @#To investigate aneurysmal bone cyst (ABC) in oral and maxillofacial of clinical appearance, clinical treatment and prognosis.@* Methods @#From July 2003 to December 2015, 8 patients with aneurysmal bone cyst in jaw bone was treated and recorded with the general condition, clinical symptoms, imaging examinations, surgical treatment and prognosis.@*Results @#Among the 8 patients, there were 5 females and 3 males with the age from 5 to 48 years old. 5 cases happened in mandibular bone and 3 cases originated from the maxillary bone. All the patients were primary lesions and diagnosed by pathology. CT scan showed multilocular cystic expansive space occupying lesions, septa, residual bone crest and liquid-liquid form; enhanced imaging showed the tortuous and dilated small blood vessels. Cystic wall composed of spindle shaped fiber cells, tissues and cells, broken bone like multinucleated giant cells and chronic inflammatory cells form and a ribbon like structure, cysts separated by fibrous tissue containing bone and bone fragments, hemorrhage and hemosiderin deposition was observed which was confirmed under the light microscope. The main treatment of aneurysmal bone cyst was radical operation. After 1~6 years of follow-up, no patient was found recurrence. @* Conclusion@# The imaging findings of aneurysmal bone cyst in jaw bone was distintive, with diagnosis of the disease depended on pathology; the main treatment was radical operation with good prognosis.

Giant Cell Reparative Granuloma Mimicking Aneurysmal Bone Cyst in Proximal Phalanx of Toe

Giant Cell Reparative Granuloma (GCRG) of phalanx is uncommon. It is a benign osteolytic lesion but can be locally aggressive. GCRG has certain radiology and histological features that are similar to other giant cell lesions of the bone. We present a case report of a young patient with giant cell reparative granuloma of proximal phalanx of left third toe. The bone lesion was successfully treated surgically.

Tratamiento de quistes óseos aneurismáticos con aloinjerto / Treatment of aneurysmal bone cysts with allograft

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.

Bony window approach for a traumatic bone cyst on the mandibular condyle: a case report with long-term follow-up

Traumatic bone cyst (TBC) occurs preferentially on the mandibular symphysis and body, but rarely on the mandibular condyle. When TBC occurs in the condylar area, it can usually be related with or misdiagnosed as a temporomandibular joint disorder. A 15-year-old female patient visited the Temporomandibular Joint Clinic with a 5-year history of pain and noise localized in the left temporomandibular joint. On imaging, a well demarked oval-shaped radiolucent lesion was observed on the left condyle head. The patient underwent cyst enucleation and repositioning of the bony window on the lateral cortex of the affected condyle head under the impression of subchondral cyst or TBC; however, no cystic membrane was found. The bone defect resolved and showed no recurrence on the serial radiographic postoperative follow-up for 43 months after surgery.

Quiste óseo aneurismático sólido del raquis dorsal / Solid aneurysmal bone cyst of dorsal spine

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.

Cisto ósseo aneurismático parosteal / Parosteal aneurysmal bone cyst

O cisto ósseo aneurismático tem uma incidência de 0,14 a cada 100 mil indivíduos. O subtipo parosteal é o menos prevalente, representa 7% de todos. Apresentamos um paciente mas culino, 38 anos, com dor e abaulamento em braço direito havia oito meses. Diagnosticado previamente como tumor de células gigantes, teve sua lâmina revisada e então foi feito o diagnóstico de cisto ósseo aneurismático parosteal. O paciente foi tratado com infiltração intralesional de corticosteroide e calcitonina e evoluiu com melhoria clínica e radiológica já nas primeiras cinco semanas pós-operatórias.

The incidence of aneurysmal bone cysts is 0.14 cases per 100,000 individuals. Parosteal aneurysmal bone cysts are the least prevalent subtype and represent 7% of all aneurysmal bone cysts. We present the case of a 38-year-old male patient with pain and bulging in his right arm for eight months. He had previously been diagnosed as presenting giant-cell tumor, but his slides were reviewed and his condition was then diagnosed as parosteal aneurysmal bone cyst. The patient was treated with corticosteroid and calcitonin infiltration into the lesion and evolved with clinical and radiological improvement within the first five weeks after the operation.