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An aneurysmal bone cyst is a tumor-simulating bone lesion, the etiology of which is still unclear and probably inhomogeneous. This type of lesion is mainly observed during the second decade of life and is rarely diagnosed beyond the age of 30 years. It is characterized by hollow spaces consisting of several compartments filled with blood and partially divided by septs consisting of spindle-cell tissue with ample multinuclear giant cells and frequent reactive new bone formation. The locations of preference are the metaphyses of the long bones, the spine and flat bones; however, they can appear in every sort of bone. The radiological picture is characterized by osteolytic expansion of the bone with more or less distinct formation of trabeculae. In the CT image we can often find fluid formation; in MRT images alteration of signals can also be seen, indicating former or fresh bleeding. The primary aneurysmal bone cyst should be distinguished from its secondary counterpart; the latter one is occasionally found in giant cell tumors, chondroblastomas, chondromyxoid-fibromas, osteoblastomas, but also in osteosarcomas. When planning biopsy or therapy, this possibility should be also taken into account. The therapy of choice consists of accurate curettage and autologous or allogenous bone transplantation. To avoid recurrences, curettage should be followed by adjuvant therapy with phenol or cryotherapy. When there are extensive recurrences that can no longer be treated by the surgical method described above, embolization of the nutrient vessels may be curative.(ABSTRACT TRUNCATED AT 250 WORDS)

The authors describe the surgical anatomy of lateral approach to the upper cervical spine. The approach is retrovascular retropharyngeal extraoral allowing for anterolateral exposure of the upper cervical column, and it may be enlarged posteriorly on the homolateral posterior hemiarch of C1 and C2, and/or inferiorly on the lower cervical column. Absolute indications to this approach are anterolateral fusion with transarticular screws C1-C2 and excision of skeletal neoplasms adjacent to the vertebral artery. For other indications such as the treatment of anterior neoplasms and spinal cord decompression it is preferable to use pre-vascular extraoral approach or transoral approach.

Aneurysmatic cyst occurs in the ethmoid sinus rarely. Basing upon the case of 5-year old boy, the authors discuss the diagnosis, treatment and course of the disease.

Background: Aneurysmal bone cysts are rare vascular lesions that are most commonly found in the long bones. They are rare in the head and neck. Only two prior cases of aneurysmal bone cysts of the zygoma have been reported in the world literature., Results: We report a case of aneurysmal bone cyst arising in the zygomatic arch with intracranial extension treated with selective arterial embolization and complete excision via an intratemporal fossa approach. This is the first such case reported in the head and neck surgery literature., Conclusions: Selected cases of aneurysmal bone cyst may be safely treated with selective arterial embolization and complete resection.

Aneurysmal bone cysts are uncommon bony lesions of the spine. Two such patients are reported in the study. The first patient had involvement of first and second thoracic vertebrae, and a preoperative diagnosis was made possible due to the typical magnetic resonance imaging appearances. A total removal was achieved in two stages. In the second patient the C2 spinous process was involved, and this patient presented as atantoaxial dislocation. Removal of the abnormal tissue and posterior fusion was done. Both the patients showed neurologic improvement. The relevant literature is reviewed.

A case of aneurysmal bone cyst of the patella in a 15-year-old woman was presented. An ABC occurring in a female patient is rare, and to our knowledge this is the first report in the literature. All other reports of patellar ABCs reported have occurred in young black men [2, 3]. The radiographic findings and clinical presentation were stressed since they are typical of all benign patellar tumors. Although radiographic findings are usually typical of patellar tumors, CT and MRI may be used for staging and standardization of operative treatment. MRI is also helpful for examining the integrity of the patellar tendon and quadriceps since many of these patients present with malfunction of the extensor mechanism [14].

A 3-year-old girl developed sudden complete paraplegia because of an aneurysmal bone cyst of the fourth thoracic vertebra. We performed a two-step surgical procedure resulting in complete neurological recuperation and no cyst recurrence within 2.5-year follow-up. Although the literature shows the prognosis of such a condition to be poor, this case reveals the positive effect of rapid surgical decompression and of postponing assessment by magnetic resonance imaging until before the second surgical stage. Furthermore, this case is an example of cure with neither interbody fusion nor postoperative radiotherapy, despite the total involvement of the vertebrae by the lesion.

We present a case of subperiosteal giant-cell reparative granuloma followed over six years showing the complete evolution from the early phase of subperiosteal haematoma to the end stage of an ossified haematoma. Such lesions, although they are histologically similar to true giant-cell tumours, can be distinguished by the patients' age, their location on the diaphysis, and by their radiological and histological features.

An aneurysmal bone cyst of fourth metacarpal which occurred in a 7-year-old girl was explored by MRI. MRI findings such as fluid-fluid levels were compared to literature. These levels are inconstant and not pathognomonic of aneurysmal bone cyst. They could occur within others bone tumors. Even if fluid-fluid levels are highly suggestive of aneurysmal bone cyst only pathological study asserts the diagnosis. MRI procedure might be a good procedure for post surgery follow up.

Aneurysmal bone cysts (ABC) are rare bone tumors of controversial pathogenesis. In 15% of cases, they are localized in the vertebrae. Despite the absence of anaplasia, their volume and localization are often responsible for incomplete surgical resection. The authors present 5 cases of primary vertebral ABC, 4 females and one male, localized in cervical (3 cases), dorsal (1 case) and lumbar (1 case) spine. Symptoms included rachialgia and torticollis. Radiological and histopathological examination disclosed the typical features of ABC. Pre-operative embolization (in 3 cases) and surgery (complete exeresis in all cases except one) were the therapeutic procedures. During a 39 month median period of follow-up, there was one local recurrence. The only case of incomplete exeresis show not did any evidence of progression until 36 months after operation.

A 43-year-old man with presumed renal cell carcinoma who was found to have an asymptomatic hot spot in his right zygoma on a bone scan during a metastatic evaluation. At the time of nephrectomy, an excisional biopsy of the lateral orbital wall was performed to rule out solitary metastasis of his renal cell carcinoma. The lateral wall was reconstructed with a rib autograft and multiple rigid fixation. Histopathologic examination of the specimen showed a fibrous matrix with large, dilated, sinusoidal, vascular channels typical of an aneurysmal bone cyst. In the absence of metastasis, the five-year survival rate is approximately 90% with nephrectomy alone.

The authors present an aneurysmal bone cyst of the pelvis which was unusual in its radiographic aspects. Its aggressive features made it difficult to distinguish from a malignant lesion. We develop the imaging methods contribution in positive and differential diagnosis and underline the modern methods interest (CT scan, MR imaging). Biopsy is necessary to confirm the diagnosis and recognize possible causal malignant tumor.

Aneurysmal bone cyst (ABC) usually affects older children or young adults. The radiological appearance is of a purely osteolytic expansile metaphyseal lesion with thinned out cortex and internal septations. We present a case of ABC in a 5-year-old girl which showed internal calcification and was initially diagnosed as enchondroma. However, pathological examination revealed typical appearance of ABC with large area of dystrophic calcification.

The radiologic and MR appearances of cystic fibrous dysplasia (FD) along with pathologic correlation are reported in a symptomatic patient. As a guide for operative intervention, MRI is helpful in both characterizing the lesion and its internal structure and determining the extent of osseous involvement. Cystic FD without an aneurysmal bone cyst component has not been previously reported in the radiologic literature.

A case of extensive aneurysmal bone cyst of the maxilla is described, with a recurrence 2 years after surgical curettage, treated by new curettage and radiotherapy. The pathogenesis of this pseudo-cyst is yet obscure. While CT (and MR) demonstrate characteristic fluid-fluid levels, the diagnosis remains histological. A long survey, based on radiography, is necessary to detect recurrence.

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.

A 19-year-old girl was admitted with a history of difficulty in moving her neck for several years and a sudden onset of neck pain three months before. Plain radiographs of the cervical spine revealed destruction of the left half of the 6th cervical body with an expansive soap-bubble appearance. Neurological examination on admission was within normal limits. The angiography and bone scintigraphy revealed no abnormality. MRI of T1-weighted image showed a cystic lesion with various signal intensities. T2-weighted image demonstrated a hyperintense balloon-like lesion in the vertebral body and left lamina. At surgery, a cystic tumor was fully extirpated by the posterior approach and the bony defect was packed with apatite granules. She was discharged without any neurological deficits. This disease should be considered as one of the etiologies when a patient with difficulty in neck movement is encountered in young generation.

Key findings that aid in the diagnosis of an aneurysmal bone cyst are: 1) typically the patients are young individuals less than 20 years old; 2) an expansile bone lesion is bordered by a thin, low signal intensity rim mass; 3) the lesion is inhomogenously increased in signal on T2-weighted images; and 4) multiple fluid-fluid levels are seen with the mass on T2-weighted magnetic resonance imaging scans.

Aneurysmal bone cysts considered as a benign lesion are extremely rare in the skull or in the vertebral column. In the last 29-years were admitted to Department of Neurosurgery in Poznań 11 patients with aneurysmal bone cysts involving the skull in 4 and the spine in 7 cases. All but one patients were female, aged between 4 and 37 years. Location of skull cysts were: parietal in 1, occipital in 1, and parietotemporal in two cases. In patients with spinal affection the position of vertebral cysts were: cervical -2, dorsal -4 and lumbar -1 case. All patients suffered severe pain radiating to the adjacent area and showed local deformity of bone structure. Paraparesis or paraplegia were observed in cases with spinal involvement. In all patients, total surgical removal of the aneurysmal bone cysts was possible. Skull defect was covered with plastic materials. In the repair of the vertebral defect, pelvic bone grafts were used and fixed with wire suture. In follow-up ranging from 1 to 25 years there was no tendency for recurrence.

Aneurysmal bone cyst is a nosologic entity of low frequency that appears with greater incidence in large bones. Its presence in the upper maxilla is very rare, even more so in a thirteen year old boy. The author presents the case of an aneurysmal bone cyst of the upper maxilla, together with its investigations and the surgical treatment practiced in 1987. A comment is added on the surgical technique he might adapt nowadays for approaching this type of tumors.

The authors have analysed a series of aneurysmal bone cysts (A.B.C.) in children and adolescents which were reviewed at an average follow-up of 4 years 2 months (6 months-15 years). The average age at diagnosis was 8 years (3-19 years). Pathological fractures were the main reason for consultation, probably due to the predominance of central lesions. If conventional radiology remains indispensable to diagnosis, magnetic resonance imaging is nevertheless the most important examination in determining the extent of the affection. The diagnosis remains anatomopathological, even if this may be difficult due to associated lesions (A.B.C. illness and A.B.C. symptoms). In long bones lesions, we observed recurrence after curettage in 3 out of 7 cases. For this reason the recommend simple resection or reconstructive resection rather than curettage whenever possible. 5 lesions in contact with growth plate were observed. In such cases we recommend its conservation by careful curettage, especially in young children. We feel that subsequent recurrence is easier to treat than an epiphysiodesis bridge. The surgical techniques employed to conserve the plate are described along with methods of bone reconstruction after surgery.

One case of a benign osteoblastoma, localised on the proximal phalanx of right thumb is reported. Three points are emphasized: the low frequency in the hand, only six observations are reported in the English literature, one from Jaffe (1932) and four from Lichtenstein (1964) and one from Mosher and coll (1978). The non-specificity of the signs and X-ray are must consider chondroma, giant cell tumor, chondrosarcoma or aneurysmal cyst. The lesion is benign and so the treatment must be conservative.