scholarly journals A Reconstruction of pelvic ring after Hemipelvectomy and Fibular graft at 39 – years – old man with Aneurysmal Bone Cyst at Iliac bone

2020 ◽  
Vol 3 (1) ◽  
pp. 1-10
Author(s):  
Hendy Rachmat Primana Lubis

Abstract   Introduction: The ABC (Aneurysmal Bone Cysts) lesion has been reported in the orthopedic literature for more than 60 years; it was first described in 1942 by Jaffe and Lichtenstein.  Aneurysmal bone cyst (ABC) in pelvic is a benign, expansile osteolytic lesion that typically affects the metaphysis of long bones in the second decade of life and occurring in patients less than 20 years. The Several ABC treatment modalities had been utilized including wide resection, intralesional resection/curettage with or without different adjuvants, radiation, embolization, intralesional sclerotherapy. Case Report: We present a rare case of a huge aneurysmal bone cyst (ABC) in the iliac bone, occurring in the male patient 4th decade of life. The patient presented with a history of pain and huge pelvic mass size 8x6x5 cm extend to abdominal region for 5 years. Plain radiograph and computed tomography showed expansile lytic lesion arising from the all right iliac bone extend to Lumbar 5. A biopsy was performed and histology confirmed diagnosis of aneurysmal bone cyst. The patient was managed surgically with hemipelvectomy type 1 and Autogenous bone graft from fibula and reconstruction with plate and screw for pelvic ring with and re-attach the muscle on it. Follow up 5 months after surgery the patient can squat and stand maximally with no pain, nor recurrence and can return to normal activity. Conclusion: Early diagnosis and complete resection of tumor and treatment of relevant symptoms represent a viable treatment for this rare disorder to achieve increased life expectancy, low recurrence of tumor and improved quality of life.   Keywords: Aneurysmal bone cyst, Pelvis, hemipelvectomy

Sarcoma ◽  
2003 ◽  
Vol 7 (3-4) ◽  
pp. 177-182 ◽  
Author(s):  
Matthias Honl ◽  
Florian Westphal ◽  
Volker Carrero ◽  
Michael Morlock ◽  
Karsten Schwieger ◽  
...  

A case of lytic lesion of the pelvis in a 23-year-old woman is presented. A biopsy led to the diagnosis aneurysmal bone cyst (ABC). Due to the histologically very aggressive growth of the tumor, a low malignant osteosarcoma could not be excluded. In an initial operation the tumour, affecting the sacrum, the iliac crest and the lower lumbar spine was resected. Temporary restabilisation of the pelvic ring was achieved by a titanium plate. The histological examination of the entire tumour confirmed the diagnosis ABC. After 6 months, the MRI showed no recurrence. The observed tilt of the spine to the operated side on the sacral base prompted a second surgical procedure: a transpedicular fixation of L5 and L4 was connected via bent titanium stems to the ischium, where the fixation was achieved by two screws. This construction allowed the correction of the base angle and yielded a stable closure of the pelvic ring. The patient has now been followed for 6 years: the bone grafts have been incorporated and, in spite of radiological signs of screw loosening in the ischium, the patient is fully rehabilitated and free of symptoms. Pedicle screws in the lower spine can be recommended for fixation of a pelvic ring discontinuity.


2017 ◽  
Vol 141 (6) ◽  
pp. 867-871 ◽  
Author(s):  
Wenqian Chen ◽  
Lisa M. DiFrancesco

Chondroblastoma is a rare primary bone tumor of young people that typically arises in the ends of the long bones. Radiologic investigations show a small, circumscribed, lytic lesion. The tumor is characterized histologically by the proliferation of chondroblasts along with areas of mature cartilage, giant cells, and occasionally, secondary aneurysmal bone cyst formation. Chondroblastoma, however, may also present with atypical features, such as prominent hemosiderin deposition, numerous giant cells, or the presence of a large aneurysmal bone cyst component. Malignant entities such as clear cell chondrosarcoma and chondroblastic osteosarcoma must also be considered. Recently, immunohistochemical stains such as DOG1 and SOX9 have been described in chondroblastoma, and K36M mutations in either the H3F3A or H3F3B genes have also been identified. While generally regarded as a benign entity, chondroblastoma manifests an intermediate type of behavior, given its ability to recur locally, and rarely, metastasize.


2021 ◽  
Vol 14 (5) ◽  
pp. e242452
Author(s):  
Sujit Tripathy ◽  
Paulson Varghese ◽  
Sibasish Panigrahi ◽  
Lubaib Karaniveed Puthiyapura

Access to the cystic lesion of the talar body without damage to the articular surface is difficult. This case report is about a 23-year-old man who had a symptomatic huge cystic lesion in the left-sided talus bone. Radiograph and CT scan showed an expansile lytic lesion within the talar body. The MRI revealed a well-defined lesion with fluid-fluid levels. The needle biopsy aspirate was haemorrhagic, and hence a diagnosis of the aneurysmal bone cyst was made. As the lesion was beneath the talar dome with an intact neck and head, a medial approach with medial malleolar osteotomy was performed. The lesion was curetted out, and the cavity was filled up with a morselised bone graft. The limb was splinted for 6 weeks, and complete weight bearing was started after 3 months. At 1-year follow-up, the lesion was found to be healed up, and the patient was pain-free with no recurrence.


QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Rafeek Ahmed Sadek ◽  
Ashraf Mohamed El Seddawy ◽  
Hussein Mohamed Ahmed Gomaa

Abstract Background Aneurysmal bone cysts (ABCs), were first described by Drs. Jaffe and Lichenstein in 1942 when they described pelvic and spine lesions that when exposing the lesion and opening in to its thin wall, the surgeon was immediately confronted by a large hole containing much fluid blood. Aim of the Work To describe the efficacy of new line treatment modalities of (Aneurysmal Bone Cysts) compared to conventional lines of management regarding the: • Long term outcomes and healing rate. • Recurrence rates. • Complications after therapy. Patients and Methods Criteria for considering studies for this review: • Types of the studies: published observational analytical studies (case-control_ case-series _ RCT or cohort studies) which studied the efficiency of new lines in the management of aneurysmal bone cyst. • Types of participants: participants were children and young age (below the age of 50 yrs) with a diagnosis of aneurysmal bone cyst. • Types of interventions: drugs like (Bisphosphonate or denosumab) were administered for a time determined by the case improvement, or minimally invasive techniques like (cryosurgery or curopsy) was done. Results Through the results of our study that compared between these recent modalities according to healing, recurrence, and complications rate; we are able to say that recent strategies have a high rate of healing ranges from 78.57% with bisphosphonate to 100% with doxycycline and cryotherapy. Conclusion There are recent evolving trends in the management of ABC other than the classic ways of management, they are less invasive, have less recurrence rate reaches to 0 % like with bisphosphonate, less complications rate as well reaches to 0 % like with doxycycline and bisphosphonate, high healing rate reaches to 100 % like with doxycycline and taking in consideration how to handle cases of ABC that classic way of management can’t handle like spinal ABC.


2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Ziyad M. Mohaidat ◽  
Salah R. Al-gharaibeh ◽  
Osama N. Aljararhih ◽  
Murad T. Nusairat ◽  
Ali A. Al-omari

Objectives. Aneurysmal bone cyst (ABC) is a benign but locally aggressive tumor. It has several challenging features. The aim of this study is to identify challenges in the diagnosis and treatment of ABC especially in patients with unusual features. Methods. This retrospective study involved medical record review of primary ABC patients with one or more of the following features: unusual clinical presentation with a mass or a pathological fracture especially at an unusual age, rare locations, radiological findings suggesting other diagnoses especially sarcoma, and a nondiagnostic histopathology of biopsy samples. Results. 25 patients (17 males and 8 females) were included. Most patients were either younger than 10 or older than 20 years. 10 patients presented with a mass or a pathological fracture. Unusual locations include the scapula, the olecranon, the hamate, the calcaneus, and the first metatarsal bone. Extension into the epiphysis occurred in 2 patients with proximal fibula and olecranon ABCs. Two separate synchronous cysts existed in the proximal epiphysis and middiaphysis of one humerus. Radiological imaging suggested other primary diagnoses in 8 patients. Core needle biopsy was diagnostic in only 2 of 7 patients. The main treatment was intralesional resection/curettage with bone grafting. Wide resection was performed in 4 patients. Recurrence rate was 28%. Recurrence risk factors included the following: age less than 10 years, male gender, and proximal femur location. Late recurrence occurred in 3/7 patients. One patient with asymptomatic radiological recurrence showed subsequent spontaneous resolution one year later. Conclusions. This study presented multiple unusual features of ABC including: unusual age, rare locations, and nondiagnostic radiological and histopathological findings. These features can complicate the diagnosis and management. Given these features, especially with pathological fractures, a well-planned incision, the use of frozen section examination, and the application of either external fixation or plate osteosynthesis for fracture fixation can be recommended.


2020 ◽  
Vol 25 (01) ◽  
pp. 114-118
Author(s):  
Anoop C. Dhamangaonkar ◽  
Ashwin Sathe ◽  
Subhashis Banerjee

Aneurysmal bone cysts associated with tubular bones of the hand are rare and even rarer in the paediatric age-group. They are rapidly growing, destructive benign bone tumors. Multiple treatment modalities for aneurysmal bone cyst have been reported in the literature, but controversy exists regarding optimal treatment. We report a case of aneurysmal bone cyst of proximal phalanx of middle finger in a 2 year old child treated at our tertiary care hospital. The diagnosis was confirmed with pre-operative MRI, FNAC and post-operative histopathology. Curettage of the lesion and autologous bone grafting was performed. The hand was immobilized in a short below elbow slab for 4 weeks followed by physiotherapy. Excellent radiological and functional outcomes were obtained with no recurrence at a 5 year of follow up.


2020 ◽  
Vol 8 (1) ◽  
pp. e000975
Author(s):  
Agustina Anson ◽  
Marta Soler ◽  
Miryam Martinez ◽  
Jose Murciano ◽  
Amalia Agut

A 3-month-old, 18 kg, female St Bernard breed dog was presented with recurrent left forelimb lameness and painful swelling of the antebrachium. A large expansile lytic lesion within the left ulna was observed on radiographs. Ultrasound examination revealed a cyst-like structure. Sanguineous fluid was obtained in association with ultrasound guidance. A presumptive diagnosis of aneurysmal bone cyst (ABC) was made. Percutaneous sclerotherapy (PS) with ethanol 95 per cent was performed. Follow-up radiographic examinations showed progressive remodelling. Limb function was normal after 9 months. PS with ethanol was a safe alternative to conventional surgery for the treatment of an ABC in this case.


2012 ◽  
Vol 5 (1) ◽  
pp. 59-63 ◽  
Author(s):  
Colin Perumal ◽  
Ashraf Mohamed ◽  
Avin Singh

The aneurysmal bone cyst (ABC) is a benign cystic and expanding osteolytic lesion consisting of bone-filled spaces of variable size, separated by connective tissue containing trabeculae of bone or osteoid tissue and osteoclast giant cells. Radiographic findings may vary from unicystic or moth-eaten radiolucencies to extensive multilocular lesions with bilateral expansion and destruction of mandibular cortices. Treatment modalities include curettage (with reported recurrences) and resection with immediate reconstruction. The main arterial and feeder vessels may be embolized to prevent profuse intraoperative blood loss and achieve a bloodless surgical field. Failed embolization may necessitate ligation of the external carotid artery of the affected side.


Author(s):  
Bhaskar Borgohain ◽  
Kashif A. Ahmed ◽  
Tashi G. Khonglah

<p>Aneurysmal bone cysts account for only 1% of all bone tumours and of these only a handful of reported cases occur in the foot. They can mimic other bone tumours on imaging studies, thus making histological diagnosis mandatory. Aneurysmal bone cyst of a metatarsal is very rare especially in children and only few cases have been reported in the literature. We report the novel management option for a rare case of an Aneurysmal bone cyst localized to the second metatarsal in a 5 years old boy who presented with limping, local pain, and minimal swelling in his left foot. Tissue diagnosis was confirmed on the basis of needle biopsy. Surgery was in the form of extended curettage using an endoscope with a high-speed burr and cautery. The remnant cavity was filled up with artificial bone graft. Histopathology analysis of the resected tissue was consistent with Aneurysmal bone cyst. There was complete healing at final follow-up at 2 years. Endoscopy assisted extended curettage appears to be an ideal treatment option as it provides a perfect visualisation of the interior of the entire cyst and use of cautery and burr more accurately under direct vision which potentially leaves only a minimal scope for recurrence. Use of artificial bone grafts instead of conventional autogenous bone grafts to reduce graft site morbidity in children and stimulate local foreign body reaction for enhancing residual tumour cell kill if any and also to promote bony sclerosis for healing.</p>


2005 ◽  
Vol 119 (6) ◽  
pp. 495-497 ◽  
Author(s):  
C E B Giddings ◽  
D Bray ◽  
S Stapleton ◽  
H Daya

The authors present the case of an 11-year-old boy with a painful, rapidly expanding lesion in the posterior triangle of the neck. There was no history of cervical trauma. Computerized tomography of the neck revealed a unicameral (single-chambered) aneurysmal bone cyst involving the C3 vertebra. Treatment was by open resection and curettage; no recurrence was seen at six months. We discuss the natural history, differential diagnosis, radiographic appearance and treatment modalities for this unusual, benign, expanding, osteolytic lesion containing blood-filled cystic cavities.


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