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The purpose of this case report is to describe a previously unpublished association between focal cemento-osseous dysplasia (FCOD) and an aneurysmal bone cyst (ABC) and review the literature with regard to associated benign fibro-osseous lesions and cysts. A 41-year-old woman without a history of trauma presented with asymptomatic swelling in the right side of the mandible. Radiographs of the region revealed a unilocular radiolucent area with radiopaque foci. After aspiration of the lesion was positive for serosanguineous fluid, complete excision of the lesion was performed. Microscopic examination revealed a hybrid ABC and FCOD. The 12-month follow-up showed significant bone repair and no signs of recurrence. A review of the English-language literature from 1980 to 2012 revealed 1 retrospective study, 4 case series, and 18 single-case reports on the topic of cemento-osseous dysplasias, fibro-osseous lesions, and aneurysmal bone cysts. Of 59 cases, none reported an association between an ABC and FCOD. Although fibro-osseous lesions do not require intervention, surgical excision is recommended when they are associated with cysts. This case, in which an ABC and FCOD were associated, reinforces the need for a careful diagnostic process in radiographically mixed lesions that respond positively to aspiration biopsy.

Aneurysmal bone cyst is a benign pseudocystic osseous lesion characterized by a fibrous connective tissue stroma with cellular fibrous tissue, multinucleated giant cells, and large blood-filled spaces with no endothelial lining. The entity is uncommon in facial bones, and it rarely involves the mandibular condyle. Resection of the lesion is the most accepted treatment. The present case is the 11th reported case of aneurysmal bone cyst of the mandibular condyle in the existing literature and the first where, rather than using conventional extra oral approach, sagittal split ramus osteotomy was used to excise the lesion successfully with no recurrence after 3 years of follow-up.

Aneurysmal bone cyst, commonly reported in the second and third decades of life, is characterized by a rapid growth pattern with resultant bony expansion and facial asymmetry. Interestingly, these lesions can occur in association with other primary bone pathologies, where they are referred to as "hybrid lesions" or "ABC-Plus." Their rarity, especially in the head and neck region, may pose a diagnostic challenge to clinicians. Following is a discussion of one such enigmatic lesion that includes description of a unique case of ABC-Plus that affected the right mandible of a young male.

An aneurysmal bone cyst (ABC) in the right mandibular condyle and ramus of a 37-year-old woman was surgically resected and immediately reconstructed with a costochondral graft. She was followed up for 5 years. A review of the 10 cases of condylar-ABC available in the literature revealed mean age of 16.8 (± 7.6) years, with equal distribution between men and women. In all cases symptoms included swelling and asymmetry, while temporomandibular disorder/dysfunction symptoms were reported in 50%. Parasthesia was not reported, except for self-limited postoperative neuropathy. Curettage or resection was employed equally and recurrence rates were 60% after curettage, 20% after resection; which are higher than reported in non-condylar-ABC's. All recurrences occurred within 12 months. Thus close post-operative follow up, for at least 12 months, is warranted., (Copyright © 2011 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.)

Aneurysmal bone cysts (ABCs) are relatively rare but well-described expansile, osteolytic psuedocysts are most commonly seen in the long bones, pelvis, and vertebra. Although a well-described lesion, much confusion exists in its pathogenesis especially of the associations of this lesion with other lesions. Approximately, one-third of patients with ABC present simultaneously with another bone pathology. The aim of this paper is to describe a rare case of simultaneously occurring ABC of the maxilla and mandible with the mandibular lesion occurring predominantly as a giant cell granuloma. The paper discusses the various histopathological variations of ABC as well as different lesions associated with ABC and tries to provide a review of different pathogenesis theories of this interesting lesion.

Objective: To evaluate the mandibular canal using volume interpolated breath-hold examination (VIBE) sequencing in patients with cysts and tumors of the mandible., Materials and Methods: Twenty-five patients with mandibular cysts and tumors were recruited for a study in the authors' institution to compare the role of multidetector row computed tomography with magnetic resonance imaging (MRI) in jaw lesions. Of these 25 patients, VIBE was performed in 12 patients (age range, 16 to 52 yrs; 11 male and 1 female patients) and formed the study group. The status (normal/destroyed/attenuated) and position of the inferior alveolar canal (normal/displaced) on panoramic reconstructed computed tomographic (CT) images and curved multiplanar reformatted (MPR) images reconstructed from VIBE images were analyzed. The contralateral normal mandibular canal was used as the control in these patients., Results: In all 12 patients, the inferior alveolar canal on the normal side was visualized as a hyperintense structure in relation to the hypointense bone on the curved MPR VIBE images. In 9 patients, the inferior alveolar canal was equally well visualized on panoramic CT and curved MPR VIBE images. In 2 patients, the inferior alveolar canal was better visualized on curved MPR VIBE images; in 1 patient, the course of the mandibular canal was better seen on panoramic CT images., Conclusions: MR reconstructions with VIBE sequencing as source images provide images comparable to CT reconstructed images for evaluation of the mandibular canal. Three-dimensional (3D) VIBE sequencing can be added to the MR protocol to visualize the inferior alveolar neurovascular bundle. 3D VIBE sequencing increases the diagnostic capabilities of MRI when used to image mandibular cysts and tumors., (Copyright © 2012 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)

A 33-year-old patient with a huge aneurysmal bone cyst (ABC) was imaged using cone-beam CT, MRI, and angiography. ABC is an uncommon non-neoplastic, expansile lesion of bone. Although common in the appendicular skeleton and spine, only 2% of the lesions occur in the craniofacial skeleton. The plain radiographic features of gnathic ABC may show an omni-expansile unilocular or multilocular radiolucency. Fluid-fluid levels have been reported in cystic compartments of ABCs; however, this feature is not diagnostically specific for ABC. In this article, we present a case of a rapidly growing, extraordinarily large ABC of the posterior mandible, with emphasis on comparative imaging features of this lesion in cone-beam CT, MRI, and carotid angiography., (Published by Mosby, Inc.)

Background: A sixteen year-old African male with a large, hard swelling at the left gonial angle, presented at a private dental clinic in January 2009. The swelling felt warm, pulsating and was intermittently symptomatic. The unilocular, expansile lesion seen on a panoramic radiograph was provisionally diagnosed as an aneurysmal bone cyst on the basis of age, symptoms and clinical features. However, ameloblastoma was included in the differential diagnosis., Methods: The histological examination of an incisional biopsy specimen revealed multiple blood-filled spaces separated by septa of fibrous tissue containing fibroblasts and multinucleated giant cells, thereby confirming the diagnosis of aneurysmal bone cyst., Results: Unexpectedly, the patient failed to attend an appointment for curettage of the aneurysmal bone cyst by a maxillofacial surgeon., Conclusions: Over the past sixty-eight years, it had been postulated that the origin of the aneurysmal bone cyst was a secondary change in a large variety of pre-existing conditions. Other authors, however, have presented convincing evidence of the aneurysmal bone cyst as a primary lesion. More recently a cytogenetic aetiology for primary aneurysmal bone cysts has been postulated. Many factors in the aetiology of this rare and perplexing condition, however, still remain unclear.

The aneurysmal bone cyst (ABC) is a rare benign lesion with an incidence of approximately 1% to 2% of bone tumors mainly in patients of 10 to 20 years of age and requires an operative procedure involving complete removal.We present a rare case of a large ABC in the angle and ramus of the mandible of a 14-year-old boy. The lesion had first been seen by a pediatrician 3 months before and turned out to be causing both a large and rapidly increasing swelling of the right face. Histology revealed a solid ABC, located in the angle and ramus of the mandible with cortical perforation and extrusion of the neighboring structures. A segmental resection of the mandible and soft-tissue excision of the lesion was performed. The mandible was primarily reconstructed by microvascular free-fibula transfer.The ABC did not show specific clinical or radiologic signs based on varying clinical examinations. The diagnosis was thus challenging, and other malignant tumors that can occur in the maxillofacial field had to be considered. Aneurysmal bone cysts mainly occur in patients 10 to 20 years old, so it is of clinical significance for pediatricians and pediatric dentists, who may well be the first to see such patients. This case report shows an ABC unusual in both its clinical findings and the therapy necessary. This article gives a conclusive review of diagnosis, pathogenesis, and treatment options.

The aneurysmal bone cyst is a very infrequent, benign bone lesion in children which rarely can be found at the craniofacial skeleton. Here, we describe a case presenting in the mandible as an acute swelling of the cheek, which was initially misdiagnosed as osteomyelitis resulting in a delay to definitive surgical treatment. The cause of misleading diagnosis is often owing to the rapid growth of the lesion, sometimes associated with painful soft tissue swelling indicating an infectious origin or a malignant tumor. Magnetic resonance imaging revealed the classic characteristics of aneurysmal bone cyst with severe destruction of the mandible. Therefore, curative tumor embolization and complete surgical excision was successfully performed. The aneurysmal bone cyst is a curable condition by radical excision, although relapse may occur when only incomplete excision is obtained. Therefore, aneurysmal bone cyst should be considered early when children present with unusual, rapid-growing neoformations of the extremities or the facial region.

The aneurysmal bone cyst is a rare, expansive, osteolytic, pseudocystic lesion with an unknown etiology. It usually affects long bones and the spine. Two to 5 % of cases have mandibular localization (between 75 and 100 % present on the mandible) accounting for 1 % of all mandibular cysts. Less than 200 cases have been reported in English and French literature.

Aneurysmal bone cysts are rare benign lesions of bone tissue, infrequent in craneofacial skeleton with regard to other structures like long bones or the spine. They are composed of sinusoidal and vascular spaces blood-filled and surrounded by fibrous tissue septa. We present a case of a 29-year-old Caucasian male with a big swelling in the left mandible associated to pain and rapid growth. He referred previous extraction of the left inferior third molar. On the X-ray study, an expansive multilocular and high vascularized bony lesion within the mandibular angle was observed. It produced expansion and destruction of lingual and buccal cortex. An incisional biopsy was performed showing a fibrous tissue with blood-filled spaces lesion suggestive of an aneurysmal bone cyst. After selective embolization of the tumour, surgical resection was done with curettage and immediate reconstruction of the defect with an anterior iliac crest graft. Aneurysmal bone cysts are non-neoplastic but locally aggressive tumours with occasional rapid growth that may be differentiated from other multilocular process like ameloblastoma, ossifying fibroma, epithelial cyst, giant cell granuloma and sarcomas. Treatment of choice consists on conservative surgical excision of the mass with curettage or enucleation. When resection creates a big defect, primary surgical reconstruction is recommended.

A rare case of aneurysmal bone cyst (ABC) located in the mandibular condyle in a 10-year-old boy is presented. The patient came to our attention for a sudden swelling in the right temporomandibular region, the mouth opening was not reduced. A rapid growing mass, depicting soft tissue invasion, in the right condyle of the mandible was found. Clinically and radiographically it resembled to a malignant lesion. The surgical excision of the mandibular condyle allowed a complete removal of the lesion. The histological examination revealed a pseudocystic expanding osteolytic lesion containing blood-filled space separated by connective tissue and many osteoclastic giant cells, which was a conventional vascular ABC. The ABC is an infrequent bone lesion which can only be found very rarely at the craniofacial skeleton. There have been described about 160 cases of ABC originated in the molar region or in upper maxilla and even more rare is the location of this cyst in the mandibular condyle. Only 6 cases were reported in the literature to date. A complete surgical resection of this osteolytic lesion is the treatment of choice considering its high recurrence rate. The condyle was not replaced with any graft. Therefore a functional device was used after surgery to overcome the lack of the condyle and to stimulate the growth of the ramus.

Pain and dysfunction in the temporomandibular joint (TMJ) region represent a diagnostic challenge. Temporomandibular disorders (TMD) are usually diagnosed by means of a thorough patient history and comprehensive clinical examination. However, additional diagnostic tests, such as imaging of the TMJ area, are necessary in cases where the signs do not explain the symptoms. Neoplasms and pseudotumors of the TMJ are quite uncommon, but their early recognition is necessary in order prevent the delay of correct treatment. This report describes 3 cases of different intraosseous lesions of the mandibular condyle in which the patient was erroneously first treated for a TMD.

Case: We report the case of a 24-year-old woman presenting with a rapidly growing mass in the right masseteric region. MRI suggested a diagnosis of a rhabdomyosarcoma but CT-scan evoked a benign lesion such as chondroblastoma or aneurismal bone cyst. The biopsy specimen proved the diagnosis of aneurismal bone cyst and the patient was treated by surgical curettage. There was no recurrence after 4 years of follow-up., Discussion: The aneurismal bone cyst of the jaw is a rare pseudocystic lesion, characterized by replacement of the normal bone with fibro-osseous tissue containing blood-filled sinusoidal or cavernous spaces. The lesion generally affects young persons under 20 years of age. The molar region, the angle, and the ascending ramus of the mandible are the predominantly affected sites. The lesion does not have any clinical or radiological specificity and surgical curettage is the standard treatment. Recurrence is rare and occurs within 30 months after surgery.

Introduction: Aneurysmal bone cyst (ABC) is a pseudotumor of bone consisting of a septated cystic cavity filled with blood., Case: We report a case of aneurysmal bone cyst of the left mandibular condyle discovered in a 10-year-old child with a history of mandibular trauma which had occurred one year earlier. The treatment consisted in surgical excision of the lesion and reconstruction using a chondro-costal graft. The post operative development led to a chondral hyperplasia., Discussion: We discuss the pathogenesis of the ABC centered on three theories, traumatic, vascular and tumoral of primary lesion. There are several complementary examinations to establish the diagnosis of ABC but the histopathological examination is the only way to confirm the diagnosis. The differential diagnosis of ABC is not an easy task. Surgical management with removal followed by immediate reconstruction is preferred.

Aneurysmal bone cyst is a benign lesion that is more commonly seen in long bones and the vertebra. Its occurrence in the craniofacial region is rare. A nine-year-old boy presented with a well-demarcated, painless, fixed mass, 3 x 3 cm in size, in the left preauricular region, with no fluctuation or crepitation. Computed tomography showed a lesion in the left mandibular ramus with a fluid-fluid level, extending to the mandibular condyle, with erosion to the adjacent cortex. Total curettage was performed via a transoral approach under general anesthesia. Histopathologic diagnosis was made as an aneurysmal bone cyst. No recurrence or complication were seen during a follow-up period of four years.

Aneurysmal bone cyst is a rare, rapidly expanding, locally destructive, and often misdiagnosed lesion. It accounts for about 1-2% of primary biopsied bone tumours. About 60-70 cases have been reported in the jaws; particularly the molar regions. Eighty percent of patients are under 20 years of age. Aneurysmal bone cyst exists as a primary or secondary lesion. It may be conventional (95%) or solid (5%). The solid variant is more difficult to recognize. The practical importance of aneurysmal bone cyst lies in the fact that it must be differentiated from malignant tumours: mainly with giant cell tumours and teleangiectatic osteosarcoma.

Aneurysmal bone cyst (ABC) is a relatively rare, non-neoplastic expansile lesion of bone. Bleeding may occur during an operation or biopsy for ABC, as this cyst is an aneurys with numerous pools of blood. Therefore, it is necessary to diagnose ABC before treatment or biopsy. In the present report, we describe the characteristic computed tomography (CT) and magnetic resonance imaging (MRI) features of ABC in the mandible. Based on the literature and on our own experiences, we compare with the features of ABC with the corresponding features of other lesions showing similar conventional radiographic appearances. In the present case, bone-targeting CT showed the characteristic feature, which reflected the histopathological appearance of a partially cystic meshwork divided by coarse septa. MRI showed almost homogeneous intermediate signal intensity, including a partial slight low-signal-intensity area on the T1-weighted image, and homogeneous high signal intensity, which showed a 'bubbly' appearance, on T2-weighted image. On the enhanced T1-weighted image, the intermediate signal intensity areas apart from the areas that showed slight low-signal intensity on the non-enhanced T1-weighted image, were well enhanced. This creates a 'honeycomb' appearance. The 'meshwork' appearance on bone-targeting CT, the 'bubbly' appearance on the T2WI and the 'honeycomb' appearance on Gd-T1WI may be the characteristic features of ABC.

A rare case with aneurysmatic cyst located near the condylar process is described. The treatment consisted in curettage of the formation and filling of the cavity in the condylar process. The operation was performed through the mouth.

This article re-evaluates the various clinicopathological presentations and array of radiographic features displayed by aneurysmal bone cysts (ABCs) of the jaws. In this retrospective clinical study, 17 cases of ABCs of the jaws surgically treated during an 11-year period from 1986-1997 are evaluated. The age and sex distribution, diagnostic characteristics, mode of treatment and long-term surgical results are presented and compared with the international literature. Investigation included serial clinical examinations, appropriate radiographic evaluation, CT scans and angiograms when indicated. All the patients had mandibular lesions and were managed by complete surgical curettage of the lesions. Ten were in males (58.8%) and seven (41.2%) in females. The mean age of occurrence was 21.05 years, ranging from 7 to 58 years. Clinical presentation in these patients ranged from an asymptomatic incidental radiographic finding to an expanding, rapidly progressive and destructive lesion resulting in a pathological fracture. Radiographic findings varied from unicystic radiolucencies or moth-eaten radiolucencies to extensive multilocular lesions causing bilateral expansion and destruction of the mandibular cortices. Twelve of the patients (70.5%) could recall a history of trauma. Needle aspiration with a 16 or 18 guage needle was positive, producing syringes full of blood in all but two of the cases (88.2%). Six cases (35.2%) were extremely vascular and had increased rapidly in size, and three required angiographic studies for preoperative diagnosis and differentiation from other vascular entities. Nine of the cases (52.9%) were found in the mandibular angle-ramus area. Four cases (23.5%) required extraoral surgical access for curettage while the remainder were treated intraorally. During the follow-up period, which ranged from 2-11 years, no recurrences have occurred. Restoration of facial symmetry and bone formation has been favourable in all patients, despite the fact that grafts were not used. This 11-year study shows that ABCs present with varied clinicopathological and radiographic features and thus may pose a diagnostic dilemma. As we have not noted any recurrences following surgical curettage of mandibular lesions, we feel that initial surgical resection or bone grafting is not necessary, provided that adequate access and complete curettage can be obtained.

The aneurysmal bone cyst is an unusual cause of a jaw mass in children. Left untreated, this relatively benign lesion can lead to deformity and destructive bone changes. We report a nine-year-old patient with a large untreated aneurysmal bone cyst, and briefly discuss the differential diagnosis of head and neck masses in children.

The aneurysmal bone cyst is a nonmalignant lesion that by expanding disrupts the architecture of the affected bone and destroys surrounding tissue. Developing rarely in the craniofacial region, and more commonly affecting the long bones and the spine, the lesion has characteristic radiographic features but is definitively diagnosed only by pathologic characteristics. Complete surgical excision is used to treat aneurysmal bone cyst, with either curettage or composite resection. Recurrence is common in incompletely excised lesions. Adjunctive cryotherapy reduces the risk of recurrence, and radiotherapy is reserved for nonresectable lesions. The case we report of a young man seen for a large mandibular aneurysmal bone cyst demonstrates the complexity of diagnosing and treating this condition.