Comparison of the Imaging and Pathological Features of Telangiectatic Osteosarcoma and Aneurysmal Bone Cyst of Long Tubular Bones

Background: The clinical, imaging and pathological features of telangiectatic osteosarcoma (TOS) in long bones are helpful for differentiation from aneurysmal bone cysts (ABC). Objectives: To investigate the clinical, imaging and pathological features of TOS in comparison with ABC in long bones. Patients and Methods: Seventeen patients with TOS and 17 patients with ABC in our hospital were analyzed in the clinical, imaging and pathological features for proper diagnosis. Results: For plain radiographs in 17 TOS cases, a soft tissue mass was detected in 14 cases, lytic bone destruction in 13, ill-defined border in 12, periosteal reaction in eight, formation of the Codman triangle in five, pathological fracture in three, and calcification in one. In 17 cases with ABC, an ill-defined border was found in fifteen cases, lytic and expansile destruction in eleven, thinned sclerotic rim in twelve, eccentrically location in ten, coarse septations in eight, a soft tissue mass in three, pathological fracture in three, periosteal reaction in two, and ill-defined border in two cases. In CT imaging of TOS, multiple cysts were in twelve cases, and fluid-fluid levels in three. In ABC, multiple cysts were in eleven cases while fluid-fluid levels in four. In MRI presentations of TOS, low and medium signal was present in the T1-weighted imaging (T1WI), whereas mixed (9/12) or high signal (3/12) was presented in the T2 WI with inhomogeneous signal. Four cases had multiple cysts and fluid-fluid levels in the bone destruction and soft tissues. The cysts had long T1 and long T2 signal with isointense signal in the septations (5/12). Fat inhibition sequence showed clear cystic changes. In ABC, low complete or incomplete signal was demonstrated in all lesions with a higher incidence of fluid-fluid levels (8/11). The lesion was of low and medium inhomogeneous signal in the T1 WI but mixed signal in T2 WI (6/11) including hyperintense signal in the upper part but mixed signal in the lower part in four cases or hyperintense signal (1/11) in T2 WI. The histopathological features of TOS were bleeding inside the lesion, highly atypia tumor cells of malignancy in the septa and tumorous bone tissue. The septa of ABC were composed of proliferative fibroblasts with dispersed polykaryocytes, reactive woven bone but no atypical cells. Conclusion: The clinical, imaging and pathological characteristics should be combined to make a correct differential diagnosis between telangiectatic osteosarcoma and aneurysmal bone cyst.

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The Diagnosis of Iliac Bone Destruction in Children: 22 Cases from Two Centres

BioMed Research International ◽

10.1155/2016/2131859 ◽

2016 ◽

Vol 2016 ◽

pp. 1-6

Author(s):

Xiangshui Sun ◽

Yue Lou ◽

Xiaodong Wang

Keyword(s):

Clinical Features ◽

Eosinophilic Granuloma ◽

Correct Diagnosis ◽

Bone Cyst ◽

Bone Destruction ◽

Iliac Bone ◽

Histopathological Diagnosis ◽

Imaging Features ◽

Imaging Data ◽

Tissue Mass

Iliac bone destruction in children is uncommon and presents various imaging features. Correct diagnosis based on clinical and imaging features is difficult. This research aimed to retrospectively explore the clinical features, imaging, and histopathological diagnosis of children with iliac bone destruction. A total of 22 children with iliac bone destruction were enrolled in this retrospective analysis from two children’s hospitals during July 2007 to April 2015. Clinical features, imaging, and histopathological findings were analysed. The mode of iliac bone destruction, lesion structure, and the relationship between the range of soft tissue mass and cortical destruction were determined based on imaging data. The data were analysed using descriptive methods. Of the iliac bone destruction cases, eight cases were neuroblastoma iliac bone metastasis, seven cases were bone eosinophilic granuloma, two cases were Ewing’s sarcoma, two cases were osteomyelitis, one case was bone cyst, one case was bone fibrous dysplasia, and one case was non-Hodgkin’s lymphoma. Iliac bone destruction varies widely in children. Metastatic neuroblastoma and eosinophilic granuloma are the most commonly involved childhood tumours.

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Do multiple fluid-fluid levels on MRI always reveal primary benign aneurysmal bone cyst?

Journal of Neurosurgical Sciences ◽

10.23736/s0390-5616.16.03794-2 ◽

2018 ◽

Vol 62 (2) ◽

Author(s):

Marco Girolami ◽

Silvio Caravelli ◽

Valentina Persiani ◽

Riccardo Ghermandi ◽

Alessandro Gasbarrini

Keyword(s):

Aneurysmal Bone Cyst ◽

Bone Cyst ◽

Fluid Levels

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Medial malleolar osteotomy for intralesional curettage and bone grafting of primary aneurysmal bone cyst of the talus

BMJ Case Reports ◽

10.1136/bcr-2021-242452 ◽

2021 ◽

Vol 14 (5) ◽

pp. e242452

Author(s):

Sujit Tripathy ◽

Paulson Varghese ◽

Sibasish Panigrahi ◽

Lubaib Karaniveed Puthiyapura

Keyword(s):

Aneurysmal Bone Cyst ◽

Cystic Lesion ◽

Articular Surface ◽

Weight Bearing ◽

Bone Cyst ◽

Lytic Lesion ◽

Intralesional Curettage ◽

Medial Malleolar Osteotomy ◽

Fluid Levels

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.

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Active Unicameral Bone Cysts in the Upper Limb are at Greater Risk of Fracture

Journal of Orthopaedic Surgery ◽

10.1177/230949900901700206 ◽

2009 ◽

Vol 17 (2) ◽

pp. 157-160 ◽

Cited By ~ 19

Author(s):

Inn Kuang Tey ◽

Arjandas Mahadev ◽

Kevin Boon Leong Lim ◽

Eng Hin Lee ◽

Saminathan Suresh Nathan

Keyword(s):

Growth Plate ◽

Lower Limb ◽

Pathological Fracture ◽

Bone Cyst ◽

Lower Limbs ◽

Unicameral Bone Cyst ◽

Pathological Fractures ◽

Risk Of Fracture ◽

History Of ◽

Index 2

Purpose. To elucidate the natural history of unicameral bone cyst (UBC) and risk factors for pathological fracture. Methods. 14 males and 8 females (mean age, 9 years) diagnosed with UBC were reviewed. Cyst location, symptoms, and whether there was any fracture or surgery were recorded. Cyst parameters were measured on radiographs, and included (1) the cyst index, (2) the ratio of the widest cyst diameter to the growth plate diameter, and (3) the adjusted distance of the cyst border from the growth plate. Results. There were 11 upper- and 11 lower-limb cysts. 13 patients had pathological fractures and 9 did not. 20 patients were treated conservatively with limb immobilisation; 2 underwent curettage and bone grafting (one resolved and one did not). Seven cysts resolved (5 had fractures and 2 did not). The risk of fracture was higher in the upper than lower limbs (100% vs 18%, p<0.001). Fractured cysts were larger than unfractured cysts (mean cyst index, 4.5 vs. 2.2, p=0.07). Active cysts were more likely to fracture. Conclusion. Conservative management had a 30% resolution rate. Surgery should be considered for large active cysts in the upper limbs in order to minimise the fracture risk.

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Atypical Simple Bone Cyst of the Jaws — Multiple Cysts and Repeated Recurrence

Asian Journal of Oral and Maxillofacial Surgery ◽

10.1016/s0915-6992(03)80023-7 ◽

2003 ◽

Vol 15 (2) ◽

pp. 138-141 ◽

Cited By ~ 2

Author(s):

Goichi Tsukamoto ◽

Akira Sasaki ◽

Hiroshi Mese ◽

Tomohiro Matsumara

Keyword(s):

Bone Cyst ◽

Simple Bone Cyst ◽

Multiple Cysts

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CT and pathological features in renal parenchymal malakoplakia: a case report and review of the literature

Aktuelle Urologie ◽

10.1055/a-1300-5892 ◽

2021 ◽

Author(s):

Yuanfen Yang

Keyword(s):

Ct Scan ◽

Soft Tissue Mass ◽

Left Kidney ◽

Underlying Disease ◽

Pathological Features ◽

Rare Form ◽

Tissue Mass ◽

Enhanced Ct ◽

Immunocompromised Status ◽

Solid Part

AbstractRenal malakoplakia is a rare form of chronic inflammatory granulomatous disease in the kidney. It occurs in adult patients with immunocompromised status or debilitating disease. In the present study, we reported a case of a 50-year-old woman with no underlying disease. This report describes the CT and pathological features of renal malakoplakia in a 50-year-old woman. Plain CT scan showed a large soft tissue mass at the middle and upper pole of the left kidney. Enhanced CT scan showed delayed enhancement in the solid part of the mass. Our results might provide some useful information for the diagnosis of renal parenchymal malakoplakia.

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Simple bone cyst with pathological fracture of humerus treated with extensive curettage followed by incorporation of fibular strut-graft

Saudi Journal of Sports Medicine ◽

10.4103/1319-6308.164321 ◽

2015 ◽

Vol 15 (3) ◽

pp. 295

Author(s):

Arunima Chaudhuri ◽

Dipankar Sen ◽

Soumya Ghosh ◽

Chiranjit De

Keyword(s):

Pathological Fracture ◽

Bone Cyst ◽

Simple Bone Cyst ◽

Strut Graft ◽

Fibular Strut

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The differentiation between aneurysmal bone cyst and telangiectatic osteosarcoma: a clinical, radiographic and MRI study

Skeletal Radiology ◽

10.1007/s00256-020-03432-w ◽

2020 ◽

Vol 49 (9) ◽

pp. 1375-1386 ◽

Cited By ~ 3

Author(s):

Umme Sara Zishan ◽

Ian Pressney ◽

Michael Khoo ◽

Asif Saifuddin

Keyword(s):

Aneurysmal Bone Cyst ◽

Bone Cyst ◽

Telangiectatic Osteosarcoma ◽

Mri Study

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Challenges in the Diagnosis and Treatment of Aneurysmal Bone Cyst in Patients with Unusual Features

Advances in Orthopedics ◽

10.1155/2019/2905671 ◽

2019 ◽

Vol 2019 ◽

pp. 1-9 ◽

Cited By ~ 4

Author(s):

Ziyad M. Mohaidat ◽

Salah R. Al-gharaibeh ◽

Osama N. Aljararhih ◽

Murad T. Nusairat ◽

Ali A. Al-omari

Keyword(s):

Aneurysmal Bone Cyst ◽

Pathological Fracture ◽

Plate Osteosynthesis ◽

Frozen Section ◽

Bone Cyst ◽

Recurrence Risk ◽

Late Recurrence ◽

Diagnosis And Treatment ◽

Wide Resection ◽

Proximal Fibula

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.

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