A Surgical Approach to Giant Cell Tumor of Lower End of Tibia with Curettage and Reconstruction by Bone Grafting Harvested from Left Iliac Crest and K-wire Fixation: A Case Report

Introduction: Giant cell tumor (GCT) is a distinctive lesion characterized by the proliferation of multinucleate giant cells in a stroma of mononuclear cells; it is generally seen in skeletally mature individuals. GCT is usually found in the long bones around the knee or in the distal radius but distal end of tibia, proximal humerus, vertebrae of young adults are unusual location. We report a case of GCT of the distal end of tibia, with a secondary aneurysmal bone cyst, in a 26-year-old female. Based on our review of the medical literature, it appears that the occurrence of a GCT along with a secondary aneurysmal bone cyst (ABC) in distal end of tibia is less typical with challenging task for full tumor resection and restoration of ankle function to normal. Case Summary: 26 year old female presented with pain&swelling over left ankle since last six month. Biopsy was suggestive of GCT with ABC of lower third tibia. We managed this case with intralesional curettage using phenol and burr and bone graft harvested from left iliac crest for reconstruction of defect along with kwire fixation to achieve optimum anatomical restoration. Conclusion: In cases of GCT, the management depends upon the various factors such as site, age, involvement of the bone, extent of bone involvement and whether there is articular involvement or not. Here Intra-articular GCT is managed with extended intralesional curettage with phenol. Bone graft plays a role of agent for reconstruction of the defect and kwire for anatomical reduction.

RECURRENCE OF ANEURYSMAL BONE CYST OF THE MANDIBLE: A CASE REPORT

Аneurysmal bone cysts are benign osteolytic lesions with rapid growth, thin walls containing numerous blood-filled cavities. They occur mainly in the pediatric population but are rarely diagnosed in the facial skeleton. Although benign, the condition can be locally aggressive and cause significant weakening of the affected bone structure. This case report presents a 14-year-old boy with Burkitt's tumor (Non-Hodgkin's lymphoma), previously diagnosed with an aneurysmal bone cyst a year ago. He was admitted for treatment at the Clinic of Maxillo-Facial Surgery of the University Hospital "St. George" Plovdiv due to pain and swelling in the left molar area of the mandibula, dating from 2 days. A recurrence of an aneurysmal bone cyst measuring 55/25 mm, which does not require resection of the mandible, was found. After a decision for surgical removal of the formation, under general anesthesia, and preparation of a three-cornered mucoperiosteal flap, the mandibular bone, which is lysed and thinned by the formation, was trepanned. The roots of the affected teeth were resected, and the formation was extirpated. A gauze drain was placed in the formed cavity, and the wound was sutured. Drug therapy included Cefotaxime 2x1.0 - 10 days, starting 3 days before surgery, and Paracetamol 2x1 – 3 days, 2 days before and 1 day after surgery. Prophylactic examinations were scheduled on day 3, 7, 10, 15 after the operation, as well as 3, 6, and 12 months post-op, due to the recurrent nature of the formation.

A rare cause of insidious shoulder pain in a young female: A soft tissue aneurysmal bone cyst in supraspinatus muscle

Aneurysmal bone cyst (ABC) is an expansile cystic lesion which may affect any bone of the skeleton. Although extremely rare, lesions with histomorphological characteristics of an ABC occur in the soft tissue. Herein, we report the first case of ABC involving the supraspinatus muscle and mimicking common pathologies, such as myofascial pain syndrome or subacromial impingement syndrome.

Cisto ósseo aneurismático da mandíbula

It is described a case of aneurysmal bone cyst located in mandible.