scholarly journals Differential diagnosis of bone cysts of long tubular bones of the extremities in children

2021 ◽  
Vol 9 (1) ◽  
pp. 63-76
Author(s):  
Ihar E. Shpileuski
Keyword(s):  
Differential Diagnosis ◽  
Giant Cell ◽  
Fibrous Dysplasia ◽  
Bone Neoplasms ◽  
Benign Tumors ◽  
Bone Lesions ◽  
Bone Cysts ◽  
Giant Cell Tumors ◽  
Surgical Interventions ◽  
Aneurysmal Bone Cysts

BACKGROUND: Bone cysts are characteristic tumor-like bone lesions occurring in childhood. Overall, they represent 21% to 57% of all benign tumors and tumor-like bone lesions in children. Clinical and X-ray symptoms of aneurysmal and simple bone cysts are similar. Like some other, often occurring, benign bone lesions, such as enchondromas, giant cell tumors, fibrous dysplasia, and metaphysical fibrosis defects. AIM: This study aims to identify the main clinical and instrumental characteristics of simple and aneurysmal bone cysts that allow us to differentiate them from some similar destructive bone neoplasms (enchondromas, giant cell tumors, fibrous dysplasia, and metaphysical fibrosis defects) and to develop indications for various diagnostic surgical interventions. MATERIALS AND METHODS: A retrospective analysis of the results of the survey of 206 patients aged 3 to 18 years who were treated at our facility from 2000 to 2015 was performed. The features of the diagnostic tactics and their effectiveness were rated. RESULTS: The main clinical and instrumental diagnostic criteria have been established. They enable the differentiation of bone cysts from some similar benign bone lesions at the pre-morphological stage. The indications for diagnostic surgical interventions have been formulated. CONCLUSION: The main difficulties in the differential diagnosis of bone cysts and some similar benign bone lesions have been revealed. An algorithm for applying various diagnostic surgical interventions in patients with these diseases has been proposed.

scholarly journals Brown tumor of the iliac crest initially misdiagnosed as a giant cell tumor of the bone

2020 ◽  
Vol 2020 ◽  
Author(s):  
S Hamidi ◽  
S Mottard ◽  
M J Berthiaume ◽  
J Doyon ◽  
M J Bégin ◽  
...  
Keyword(s):  
Giant Cell Tumor ◽  
Giant Cell ◽  
Iliac Crest ◽  
Cell Tumor ◽  
Bone Lesions ◽  
Bone Cysts ◽  
Giant Cell Tumors ◽  
Surgical Interventions ◽  
Aneurysmal Bone Cysts ◽  
Brown Tumors

Summary Brown tumors (BTs) are expansile osteolytic lesions complicating severe primary hyperparathyroidism (PHPT). Clinical, radiological and histological features of BTs share many similarities with other giant cell-containing lesions of the bone, which can make their diagnosis challenging. We report the case of a 32-year-old man in whom an aggressive osteolytic lesion of the iliac crest was initially diagnosed as a giant cell tumor by biopsy. The patient was scheduled for surgical curettage, with a course of neoadjuvant denosumab. Routine biochemical workup prior to denosumab administration incidentally revealed high serum calcium levels. The patient was diagnosed with PHPT and a parathyroid adenoma was identified. In light of these findings, histological slices of the iliac lesion were reviewed and diagnosis of a BT was confirmed. Follow-up CT-scans performed 2 and 7 months after parathyroidectomy showed regression and re-ossification of the bone lesion. The aim of this case report is to underline the importance of distinguishing BTs from other giant cell-containing lesions of the bone and to highlight the relevance of measuring serum calcium as part of the initial evaluation of osteolytic bone lesions. This can have a major impact on patients’ management and can prevent unnecessary invasive surgical interventions. Learning points: Although rare, brown tumors should always be considered in the differential diagnosis of osteolytic giant cell-containing bone lesions. Among giant cell-containing lesions of the bone, the main differential diagnoses of brown tumors are giant cell tumors and aneurysmal bone cysts. Clinical, radiological and histological characteristics can be non-discriminating between brown tumors and giant cell tumors. One of the best ways to distinguish these two diagnoses appears to be through biochemical workup. Differentiating brown tumors from giant cell tumors and aneurysmal bone cysts is crucial in order to ensure better patient care and prevent unnecessary morbid surgical interventions.

Aneurysmal Bone Cysts and Giant Cell Tumors of the Spine

2009 ◽  
Vol 21 (2) ◽  
pp. 106-111 ◽  
Author(s):  
Sigurd Berven ◽  
Shane Burch
Keyword(s):  
Giant Cell ◽  
Bone Cysts ◽  
Giant Cell Tumors ◽  
Aneurysmal Bone Cysts

p63 Expression in Giant Cell–Containing Lesions of Bone and Soft Tissue

2011 ◽  
Vol 135 (6) ◽  
pp. 776-779 ◽  
Author(s):  
Gustavo de la Roza
Keyword(s):  
Soft Tissue ◽  
Giant Cell Tumor ◽  
Giant Cell ◽  
Predictive Value ◽  
Cell Tumor ◽  
Bone Cysts ◽  
Giant Cell Tumors ◽  
Aneurysmal Bone Cysts ◽  
Tumors Of Bone ◽  
Pigmented Villonodular

Abstract Context.—Previous studies have demonstrated p63 overexpression in giant cell tumors of bone and advocate its use as a potential diagnostic marker. Although routine histology is often all that is required to diagnose giant cell tumor of bone, immunohistochemistry could prove useful to distinguish it from other benign and malignant giant cell–containing lesions of bone and soft tissue on needle biopsies and unusual clinical settings. Objective.—To assess p63 expression in giant cell–containing lesions of bone and soft tissue. Design.—p63 immunohistochemistry was performed in 23 giant cell tumors of bone, 8 primary aneurysmal bone cysts, 12 chondroblastomas, 4 giant cell reparative granulomas, 4 osteosarcomas, 15 tenosynovial giant cell tumors, 6 nonossifying fibromas, and 4 pigmented villonodular synovitides. Results.—p63 overexpression was identified in 20 of 23 giant cell tumors of bone (86.9%), 5 of 8 primary aneurysmal bone cysts (62.5%), 10 of 12 chondroblastomas (83.3%), 4 of 4 giant cell reparative granulomas (100%), 2 of 4 osteosarcomas (50%), 1 of 15 tenosynovial giant cell tumors (6.6%), 1 of 6 nonossifying fibromas (16.6%), and 1 of 4 pigmented villonodular synovitides (25%). The sensitivity, specificity, positive predictive value, and negative predictive value of p63 immunohistochemistry for the diagnosis of giant cell tumor of bone were 86.95%, 53.36%, 45.45%, and 91.17%, respectively. Conclusions.—This study shows that although p63 is expressed by most giant cell tumors of bone, its lack of specificity limits its use as an immunohistochemical marker in the differential diagnosis of giant cell–containing lesions of bone and soft tissue.

Giant Cell Tumors and Aneurysmal Bone Cysts of the Spine

1970 ◽  
Vol 63 (2) ◽  
pp. 218-221 ◽  
Author(s):  
WARD W. STEVENS ◽  
EDGAR N. WEAVER
Keyword(s):  
Giant Cell ◽  
Bone Cysts ◽  
Giant Cell Tumors ◽  
Aneurysmal Bone Cysts

scholarly journals Hypercalcaemia after treatment with denosumab in children: bisphosphonates as an option for therapy and prevention?

2020 ◽  
Vol 16 (5) ◽  
pp. 520-527 ◽  
Author(s):  
Carmen Sydlik ◽  
Hans Roland Dürr ◽  
Susanne Bechtold-Dalla Pozza ◽  
Claudia Weißenbacher ◽  
Julia Roeb ◽  
...  
Keyword(s):  
Giant Cell ◽  
High Dose ◽  
Bone Cysts ◽  
Preventive Strategies ◽  
Giant Cell Tumors ◽  
Severe Hypercalcemia ◽  
Aneurysmal Bone Cysts ◽  
Tumors Of Bone ◽  
Denosumab Treatment

Abstract Background Pharmacologic options for treatment of osteolytic diseases especially in children are limited. Although not licensed for use, denosumab, a fully humanized antibody to RANKL, is used in children with good effects. Among others, one possible indication are giant cell tumors and aneurysmatic bone cysts. However, there are reports of severe hypercalcemia during weeks to months after termination of denosumab, that are rarely seen in adults. Methods We collected data of four patients, aged 6–17 years, who experienced severe hypercalcemia after completion of treatment with denosumab for unresectable giant cell tumors of bone or aneurysmal bone cysts and methods of their treatment. The detailed case information were described. Results One patient was treated with long-term, high-dose steroid therapy, leading to typical Cushing’s syndrome. Another patient was restarted on denosumab repeatedly due to relapses of hypercalcemia after every stop. Finally, in two patients, hypercalcemia ceased definitely after treatment with bisphosphonates. However, several applications were necessary to stabilize calcium levels. Conclusions There is a considerable risk of hypercalcemia as an adverse effect after denosumab treatment in children. Therapeutic and, preferably, preventive strategies are needed. Bisphosphonates seem to be an option for both, but effective proceedings still remain to be established.

scholarly journals Mineral and Bone Consequences of High Dose Denosumab Therapy to Treat an Aneurysmal Bone Cyst, a Child Case Report

2021 ◽  
Vol 12 ◽  
Author(s):  
Giulia Del Sindaco ◽  
Pablo Berlanga ◽  
Laurence Brugières ◽  
Eric Thebault ◽  
Giovanna Mantovani ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Young Patients ◽  
Reference Network ◽  
Bone Lesions ◽  
High Dose ◽  
Bone Modeling ◽  
Bone Cysts ◽  
Bone Homeostasis ◽  
Giant Cell Tumors ◽  
Aneurysmal Bone Cysts

Aneurysmal bone cysts (ABCs) are rare benign pseudotumoral bone lesions with potential aggressive behavior due to the extensive destruction of surrounding bone. Traditionally, these tumors were treated with open surgery, but there is more and more a shift to less invasive procedures. In particular, treatment for spinal ABCs is generally unsatisfactory due to the risk of morbidity, neurological impairment and recurrence, and there is a need for innovative therapies. Denosumab has been reported as a useful treatment in giant cell tumors of bone (GCTB), so its efficacy has been tested also in other fibro-osseus lesions affecting children and adolescents, such as spinal aneurysmal bone cysts. The pediatric literature is limited to case reports and small series, all of which highlight the efficacy of this treatment on lesions growth and associated bone pain. Some of these reports have already reported well known side effects associated with denosumab, such as hypocalcemia at the beginning of the treatment, and rebound hypercalcemia at the discontinuation. The latter seems to be more frequent in children and adolescents than in adults, probably due to the higher baseline bone turnover in children. In addition, the use of denosumab in young patients could affect both bone modeling and remodeling, even if the consequences on the growing skeleton have not been reported in detail. Here we describe the case of a spinal ABC diagnosed in an 8-year old young boy which was not accessible to surgery but responded favorably to denosumab. Our aim is to describe the rapid changes in mineral and bone homeostasis in this patient, that required advice from the experts of the European Reference Network (ERN) for rare bone and endocrine diseases.

Giant Cell Tumor of the Talar Neck

2007 ◽  
Vol 97 (3) ◽  
pp. 225-228 ◽  
Author(s):  
Hakan Selek ◽  
Hamza Özer ◽  
Sacit Turanli ◽  
Özlem Erdem
Keyword(s):  
Giant Cell Tumor ◽  
Giant Cell ◽  
Clinical Signs ◽  
Cell Tumor ◽  
Giant Cell Tumors ◽  
Radiographic Appearance ◽  
Aneurysmal Bone Cysts ◽  
Tumors Of Bone ◽  
Brown Tumors ◽  
Small Bones

We describe a patient with a giant cell tumor in the talar head and neck of the left foot who was diagnosed as having osteochondritis dissecans and treated with arthroscopic drilling in this same location 3 years earlier. Giant cell tumors can be confused with several conditions, including giant cell reparative granulomas, brown tumors, and aneurysmal bone cysts. Giant cell tumors of bone typically occur in the epiphysis of long bones, including the distal femur and proximal tibia. They are uncommonly found in the small bones of the foot or ankle, and talar involvement is rare. Despite this rarity, the radiographic appearance and clinical signs of talar lesions should be considered in the differential diagnosis of nontraumatic conditions in the foot. (J Am Podiatr Med Assoc 97(3): 225–228, 2007)

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