Peritrochanteric Unicameral Bone Cyst in A 9-year-old Girl: A Case Report and Review of Literature

Introduction: The Unicameral Bone Cyst (UBC) is a benign osteolytic lesion primarily found in the metaphyseal part of long bones in children. It is important as it can involve growth plate involvement, cause pathological fractures and deformities of the affected limb. We report this case to emphasize that hip area pathologies can be represented with knee pain and discomfort. Case Presentation: The patient was a 9-year-old girl with a bone cyst in the right proximal femur, with functional knee pain and limping. The diagnosis was made after two years of pain in the knee area. As the cyst was symptomatic and the signs of impending pathological fracture were seen, the lesion was managed by curettage and fibular strut allograft and proximal humerus locking plate. Conclusions: The patient has been examined for knee joint problems for a long time, and her femur bone cyst was diagnosed after two years of pain. However, it could become a pathologic fracture or involve the growth plate and stop the limb’s growth, thus affecting the patient’s quality of life. Therefore, in children with chronic knee pain, careful assessment of the hip area is recommended.

Malignant Transformation Of Fibrous Dysplasia In Combination With Bone Cyst: A Case Report.

Background: Fibrous dysplasia and Simple bone cyst are all common benign lesions. A case of osteosarcoma developing from fibrous dysplasia in combination with unicameral bone cyst will be discussed. The radiologic, histologic characteristics and clinical prognostic of the patient will be described. As far as we know, this is the first case report of malignant transformation secondary to fibrous dysplasia in combination with unicameral bone cyst, which is extremely rare and worthy of clinical attention or vigilance. Case presentation: This study describes a case of a 20-years-old male who suffered a 7-years history of intermittent pain in his right proximal tibia, obvious after activity and progressively worsening. Clinical symptoms and imaging examination were consistent with the characteristics of benign primary bone tumor. He underwent a successful curettage operation. Pathological diagnosis was fibrous dysplasia in combination with unicameral bone cyst. After the curettage surgery, the pain in his right knee quickly disappeared and function activities returned to normal during a regular follow-up postoperative. However, He was diagnosed with a recurrence of fibrous dysplasia in combination with unicameral bone cyst and osteosarcoma malignant transformation by chief complaint symptoms of pain and swelling in the right proximal tibia, adequate imaging examination, and pathological diagnosis at 2 years follow-up. Then the patient undergo a limb salvage with tumor prosthesis reconstruction of the right knee. Unfortunately, multiple and unresectable lymph nodes distant metastases happened even with two weeks localized inguinal radiotherapy treatment and one course of neoadjuvant chemotherapy monthly. He eventually received cancer hospice care and died eight months after the diagnosis as malignant transformation and systemic multiple organ metastasis.Conclusions: Although malignant transformation of fibrous dysplasia in combination with unicameral bone cyst is very rare, patients with this disease should be monitored and received lifelong follow-up to obtain early detection, diagnosis and treatment to maximize the efficacy of treatment and survival time. The histological and immunohistochemical findings is very important but not enough. Further research is required to clarify the pathogenesis and prevent malignant transformation.

Case Report: First Evidence of a Benign Bone Cyst in an Adult Teckel Dog Treated With Shark Teeth-Derived Bioapatites

Bone cysts are a very rare orthopedic pathology in veterinary medicine, the general prevalence of which is unknown. A unicameral bone cyst was diagnosed in an adult female Teckel dog with a limp that was treated surgically by filling the defect with marine bioapatites. The treatment was effective and at 8 weeks the defect had remodeled 50.24%. Eighteen months after surgery, the defect had remodeled 94.23%. The limp disappeared after surgery, and functional recovery was good in all stages after surgery. No adverse reactions were observed at the local or systemic level. This is the first report of a benign bone cyst in an lame adult female Teckel successfully treated with a novel marine bioapatite.

Outcomes in Unicameral Bone Cyst Management Utilizing a Decision Tree Algorithm Approach

Objective To determine if utilization of a decision tree algorithm could improve the healing rate of unicameral bone cysts (UBCs).Methods Creation of the decision tree algorithm was based on previous literature and assessment of our clinical practice. Demographic, treatment, and radiographic data were collected retrospectively. Radiographic healing was determined using the Neer classification. Healing rate, as well as clinical/radiographic characteristics, were compared based on adherence to the treatment algorithm.Results Forty-seven subjects were included. Mean age at initial surgery was 10.0 ± 3.3 years in children following the algorithm and 9.1 ± 3.2 years in those deviating from the algorithm (p = 0.393). Follow-up was found to be similar among those following the algorithm (37.5 ± 15.8 months) and those deviating from the algorithm (45.2 ± 24.6 months), p = 0.38. Children who followed the algorithm healed at a rate of 75%, while children who deviated from the algorithm healed at a rate 67% (p = 0.552).Conclusions Although we reject our hypothesis that a decision tree algorithm for the management of UBCs in the pediatric population could improve the healing rate, we believe that we uncovered some utility in applying an algorithm to this pathology. Our algorithm was designed to minimize risk to the child and maximize healing with the least number of surgical events. Treating surgeons should consider this proposed pathway to determine the best treatment and to help families understand that these lesions rarely heal with a single-event surgery.

Comparison of three treatment methods for simple bone cyst in children

Background The unicameral bone cyst (UBC) is a kind of benign tumor whose clinical treatments and efficacy are controversial. The purpose of this study was to evaluate the efficacy of the elastic stable intramedullary nail (ESIN), the injection of autologous bone marrow (ABM), and the combination of ESIN and ABM in the treatment of bone cyst in children. Methods Eighty-three cases with simple bone cyst were analyzed retrospectively. Twenty-eight cases were treated with ABM. Twenty-eight cases were treated with ESIN. Twenty-seven cases were treated with ABM and ESIN. All cases were diagnosed through X-ray, CT, or MRI scans. For the suspicious ones, the pathological biopsy was performed for an accurate diagnosis. X-ray examinations were carried out for the postoperative follow-up. Capanna criteria for bone cyst was used for postoperative evaluation of three methods. Results All cases accomplished the follow-up. The effective rate of the ABM + ESIN group was significantly higher than that of the ABM group (P < 0.05), and the cure rates of the ESIN group and the ABM + ESIN group were higher than that of the ABM group (P < 0.05, respectively). The cure time in the ESIN group was lower than that of the other two groups (P < 0.05, respectively). The times for admission were 2.0 ± 0.0 in the ESIN group, 5.7 ± 1.9 in the ABM group, and 4.7 ± 2.4 in the ABM + ESIN group (P < 0.05 when compared with each other). Conclusions The method of ABM combined with ESIN for children’s bone cyst has the highest effective rate and curative rate. For the individual method, ESIN has a higher effective rate and curative rate than that of ABM. Meanwhile, it has the fewest time of hospitalization.

Comparison of three treatment methods for simple bone cyst in children

Background The unicameral bone cyst (UBC) is a kind of benign tumor whose clinical treatments and efficacy are controversial. The purpose of this study was to evaluate the efficacy of the elastic stable intramedullary nail (ESIN), the injection of autologous bone marrow (ABM), and the combination of ESIN and ABM in the treatment of bone cyst in children. Methods 83 cases with simple bone cyst were analyzed retrospectively. 28 cases were treated with ABM. 28 cases were treated with ESIN. 27 cases were treated with ABM and ESIN. All cases were diagnosed through X-ray, CT, or MRI scans. For the suspicious ones, the pathological biopsy was performed for an accurate diagnosis. X-ray examinations were carried out for the postoperative follow-up. Capanna criteria for bone cyst was used for postoperative evaluation of three methods. Results All cases accomplished the follow-up. The effective rate of the ABM+ESIN group was significantly higher than that of the ABM group (P<0.05), and the cure rates of the ESIN group and the ABM+ESIN group were higher than that of the ABM group (P<0.05, respectively). The cure time in the ESIN group was lower than that of the other two groups (P<0.05, respectively). The times for admission were 2.0±0.0 in the ESIN group, 5.7±1.9 in the ABM group, and 4.7±2.4 in the ABM+ESIN group (P<0.05 when compared with each other). Conclusions The method of ABM combined with ESIN for children’s bone cyst has the highest effective rate and curative rate. For the individual method, ESIN has a higher effective rate and curative rate than that of ABM. Meanwhile, it has the fewest time of hospitalization.

Comparison of three treatment methods for simple bone cyst in children

Background Unicameral bone cyst (UBC) is a benign tumor whose clinical treatments and efficacy are controversial. The purpose of this study was to evaluate the efficacy of the elastic stable intramedullary nail (ESIN), the injection of autologous bone marrow (ABM) and the combination of ESIN and ABM in the treatment of simple bone cyst of children. Methods 83 children with simple bone cyst were analyzed retrospectively. 28 cases were treated with ABM. 28 cases were treated with ESIN. 27 cases were treated with ABM and ESIN. All cases were diagnosed through X-ray, CT or MRI scans. For the suspicious ones, pathological biopsy was performed for an accurate diagnosis. X-ray examinations were carried out for the postoperative follow-up. Capanna criteria for bone cyst was used for the postoperative evaluation of the three methods. Results All the cases accomplished the follow-up. The effective rate of ABM+ESIN group was significantly higher than that of the ABM group (P<0.05), and the cure rates of ESIN group and ABM+ESIN group were higher than that of ABM group (P<0.05, respectively). The cure time in ESIN group was lower than that of the other two groups (P<0.05, respectively). The times for admission were 2.0±0.0 in ESIN group, 5.7±1.9 in ABM group and 4.7±2.4 in ABM+ESIN group (P<0.05 when compared with each other). Conclusions The method of ABM combined with ESIN for children bone cyst has the highest effective and curative rates. For individual method, ESIN has a higher effective rate and curative rate than that of ABM. Meanwhile, it has the fewest hospitalizations.

Comparison of three treatment methods for simple bone cyst in children

Background Unicameral bone cyst (UBC) is a benign tumor whose clinical treatments and efficacy are controversial. The purpose of this study was to evaluate the efficacy of the elastic stable intramedullary nail (ESIN), the injection of autologous bone marrow (ABM) and the combination of ESIN and ABM in the treatment of simple bone cyst of children.Methods 83 children with simple bone cyst were analyzed retrospectively. 28 cases were treated with ABM. 28 cases were treated with ESIN. 27 cases were treated with ABM and ESIN. All cases were diagnosed through X-ray, CT or MRI scans. For the suspicious ones, pathological biopsy was performed for an accurate diagnosis. X-ray examinations were carried out for the postoperative follow-up. Capanna criteria for bone cyst was used for the postoperative evaluation of the three methods.Results All the cases accomplished the follow-up. The effective rate of ABM+ESIN group was significantly higher than that of the ABM group (P<0.05), and the cure rates of ESIN group and ABM+ESIN group were higher than that of ABM group (P<0.05, respectively). The cure time in ESIN group was lower than that of the other two groups (P<0.05, respectively). The times for admission were 2.0±0.0 in ESIN group, 5.7±1.9 in ABM group and 4.7±2.4 in ABM+ESIN group (P<0.05 when compared with each other).Conclusions The method of ABM combined with ESIN for children bone cyst has the highest effective and curative rates. For individual method, ESIN has a higher effective rate and curative rate than that of ABM with the lowest time of admission.