The solid variant of aneurysmal bone cyst (solid ABC) is rarely encountered in long bones and appropriate treatment for this disease remains unclear. We experienced a 13-year-old boy suffering from ...pain in his left knee caused by solid ABC. Simple curettage of the bone lesion without any adjuvant therapy and a bone graft gave immediate pain relief. Histological examination of the surgical specimen showed typical features of solid ABC, and cycloxygenase-2 (COX-2) expression was confirmed in giant cells with a background of spindle cells by immunohistochemistry. Magnetic resonance imaging showed that soft tissue edema surrounding the lesion was improved two months after surgery and there was no indication of recurrence two years after surgery. If COX-2 secreted from the tumor induces soft tissue edema, simple curettage of the bone lesion seems to be a reasonable treatment for solid ABC and is able to minimize invasive treatment of the patients.
Abstract Treatment for conditions of the mandible may require resection of the affected segment, and this may need reconstruction. There are case reports of spontaneous regeneration of segments of ...excised mandibles that resulted in reduced or no need for reconstruction, and we present four such cases. The age at presentation ranged from 6 to 12 years. In all cases the periosteum was preserved during resection. All patients showed evidence of spontaneous regeneration, both clinically and radiographically, between 3 and 5 months after resection. The planned delayed reconstruction meant that these patients either did not need any bony reconstruction, or needed less than had originally been anticipated. Such regeneration is mostly reported in children, and is thought to be the result of an intact periosteal layer. In patients having planned mandibular resections, where the periosteum is preserved, some spontaneous regeneration should be anticipated and final reconstruction delayed until this is complete.
Everyone likes to see, hear, and know about rare things. An aneurysmal bone cyst (ABC) is an uncommon non-neoplastic lesion of the bone, mostly affecting long bones and spine. This rare jaw lesion ...usually affects the mandible but origin from the maxillary anterior region is even rarer. This paper describes a case of an ABC in an 8-year-old female child with a progressively increasing swelling in the right nasomaxillary region developed over a period of 1.5 months. Treatment consisted of the excision and enucleation of the lesion through an intraoral approach under general anesthesia. The higher prevalence in young adulthood has made the role of pedodontists vital in diagnosing ABCs, at the earliest.
Aneurysmal bone cyst (ABC) is blood filled expansile cystic lesion that most commonly occurs in patients during the second decade of their lives. Traditionally it has been described as a benign ...lesion but can be locally aggressive and result in the destruction of the involved bone. Treatment methods include surgical excision and curettage with or without bone grafting. We report a proximal femur aneurysmal bone cyst, which resulted in the amputation of the lower extremity, even though all available classic methods of treatment were applied for it.
Aneurysmal bone cyst of the foot is extremely rare and the involvement of medial cuneiform has never been reported in the literature. In this report, we describe a 15-year-old boy who presented with ...a 6-month history of pain and swelling in his left foot. Radiograph demonstrated a lytic lesion in the medial cuneiform extending on to the middle cuneiform, the navicular bone and the base of the first metatarsal. En bloc resection of the lesion was performed using a dorsal longitudinal incision along the first ray. Tricortical iliac crest graft was harvested and shaped to fill the defect. Two drill holes were made and the tibialis anterior tendon was attached to the graft. Prepared, morcellised allograft was placed along the junction of autograft and host bone. At 1-year follow-up, the patient was pain free, the medial arch of the foot was maintained and the graft had united with the host bone.
The authors analyzed a series of 15 pelvic aneurysmal bone cysts (9 boys and 6 girls) in children and adolescents who were reviewed with an average follow-up of 50.3 months. Pain and limp were the ...main symptoms. Four patients had no treatment after the open biopsy. Eleven patients were treated with curettage. Preoperative selective arterial embolization was performed in three cases before curettage. Two recurrences were noted after curettage; recurrences were treated successfully with further curettage. As a result, the authors recommend curettage; more aggressive operative intervention does not appear to be indicated. No major intraoperative vascular complications occurred. Spontaneous healing in a few cases (even in active or aggressive lesions) argues for clinical and radiologic observation after biopsy when possible. In case of a propitious evolution, observation must be continued and surgery might be avoided, but if the lesion increases, treatment must be proposed.
The differential between aneurysmal bone cysts and unicameral bone cysts usually is clear clinically and radiographically. Occasionally there are cases in which the diagnosis is not clear. Because ...natural history and treatment are different, the ability to distinguish between these two entities before surgery is important. The authors reviewed, in a blinded fashion, the preoperative magnetic resonance images to investigate criteria that could be used to differentiate between the two lesions. All patients had operative or pathologic confirmation of an aneurysmal bone cyst or unicameral bone cyst. The authors analyzed the preoperative magnetic resonance images of 14 patients with diagnostically difficult bone cysts (eight children with unicameral bone cysts and six children with aneurysmal bone cysts) and correlated these findings with diagnosis after biopsy or cyst aspiration and contrast injection. The presence of a double density fluid level within the lesion strongly indicated that the lesion was an aneurysmal bone cyst, rather than a unicameral bone cyst. Other criteria that suggested the lesion was an aneurysmal bone cyst were the presence of septations within the lesion and signal characteristics of low intensity on T1 images and high intensity on T2 images. The authors identified a way of helping to differentiate between aneurysmal bone cysts and unicameral bone cysts on magnetic resonance images. Double density fluid level, septation, and low signal on T1 images and high signal on T2 images strongly suggest the bone cyst in question is an aneurysmal bone cyst, rather than a unicameral bone cyst. This may be helpful before surgery for the child who has a cystic lesion for which radiographic features do not allow a clear differentiation of unicameral bone cyst from aneurysmal bone cyst.
The purpose of this study was to review the demographic data of children and adolescents with aneurysmal bone cysts (ABCs). The authors performed a retrospective, multicenter, pediatric ...population-based analysis of 156 patients with primary ABCs. Only patients with histologic confirmation of the diagnosis were included. A review of French and English literature of 255 children and adolescents was included regarding sex, location of the lesion and age at diagnosis. There were 212 boys and 199 girls with a median age at diagnosis of 10.2 years (range, 1.5-17 years). Forty-four patients were under 5 years of age; 111 patients were between 5 and 10 years of age, and 139 were older than 10 years of age. The femur, tibia, spine, humerus, pelvis and fibula were the most common locations. In 256 cases (62.7%), ABCs occurred in long bones. We also studied the data and location of 161 ABCs of the mobile spine (13 cases from our series and 148 from the literature review). There were 48 ABCs in the cervical spine, 48 in the thoracic spine, and 65 in the lumbar spine. We found no main differences in site distribution and sex, between the children and the general population.
An 18-year-old Man with Knee Pain Siegel, Herrick J; Lopez-Ben, Robert; Said-Al-Naief, Nasser ...
Clinical orthopaedics and related research,
09/2007, Letnik:
462
Journal Article
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