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Aneurysmal bone cyst
Dr K Sai Vineesh
Pg 1
M.S Orthopaedics
Definition
An aneurysmal bone cyst is a benign expansile lesion with blood filled cavities
seperated by septa of trabecular bone or fibrous tissue containing osteoclast gaint
cells
Sponge like tumour containing numerous gaint cells
Etiology
1. Unknown
2. Arises spontaneously
3. After degeneration or haemorrhage in some other lesion
Site : Any site may be involved
Most common proximal humerus, distal femur, proximal tibia and spine
Age : < 20 years
Sex : Slight Female dominance
Symptoms
1. Mild to moderate pain for weeks
to several months
2. Rapid growth occur and clinically
mimic malignancy
3. Spine lesions cause neurological
deficit and Radicular pain
X Ray
1.Expansile lytic lesion that elevates the
Periosteum, but remained contained by
a thin shell of cortical bone.
2. Well defined margins or permeative
appearance that minics malignacy
Bone scan
Shows diffuse or peripheral uptake
with a central area of decreased
uptake
CT scan
Helpful in ares of complex anatomy
such as spine or pelvis
In addition the thin rim of bone
surrounding the cyst can be
identified
MRI Scan
Multiloculated cavities and fluid levels
Double density fluid level and
intralesional septations usually
indicate aneursymal bone cyst
Hisptopathology
A curetted aneurysmal bone cyst from
distal metaphysis of tibia; blood filled
cystic spaces with cellular giant cell rich
cyst wall.
Differential diagnosis
1. Aneursymal bone cyst
2. Gaint cell tumor
3. Chondroblastoma
4. Osteoblastoma
5. Fibrous dysplasia
6. Non ossifying fibroma
7. Chondromyxoid fibroma
Treatment
Surgery :
1. Extended curettage and grafting with a bone graft substitute
2. For expendable bones marginal resection done
3. Treated with pre operative embolisation to minimize blood loss
4. Arterial embolisation is definitive treatment in cases where curettage of
aneursymal bone cyst is difficult.
5. Recurrance after curettage is 10 to 20 percent
Factors associated
with recurrance
1. Younger age < 15
years
2. Centrally located cyst
3. Incomplete removal of
cystic cavity contents
Recurrent cyst treated as same
approach as primary lesion
Radiotherapy
1. Low dose irradiation is effective method of treatment
2. Not used regularly as potential of turning out into malignancy
3. Associated with rapid ossification
References
Thank you

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Aneurysmal bone cyst.pptxavhndbjamnxivsbxhbd

  • 1. Aneurysmal bone cyst Dr K Sai Vineesh Pg 1 M.S Orthopaedics
  • 2. Definition An aneurysmal bone cyst is a benign expansile lesion with blood filled cavities seperated by septa of trabecular bone or fibrous tissue containing osteoclast gaint cells Sponge like tumour containing numerous gaint cells
  • 3. Etiology 1. Unknown 2. Arises spontaneously 3. After degeneration or haemorrhage in some other lesion Site : Any site may be involved Most common proximal humerus, distal femur, proximal tibia and spine Age : < 20 years Sex : Slight Female dominance
  • 4. Symptoms 1. Mild to moderate pain for weeks to several months 2. Rapid growth occur and clinically mimic malignancy 3. Spine lesions cause neurological deficit and Radicular pain
  • 5. X Ray 1.Expansile lytic lesion that elevates the Periosteum, but remained contained by a thin shell of cortical bone. 2. Well defined margins or permeative appearance that minics malignacy
  • 6. Bone scan Shows diffuse or peripheral uptake with a central area of decreased uptake
  • 7. CT scan Helpful in ares of complex anatomy such as spine or pelvis In addition the thin rim of bone surrounding the cyst can be identified
  • 8. MRI Scan Multiloculated cavities and fluid levels Double density fluid level and intralesional septations usually indicate aneursymal bone cyst
  • 9. Hisptopathology A curetted aneurysmal bone cyst from distal metaphysis of tibia; blood filled cystic spaces with cellular giant cell rich cyst wall.
  • 10. Differential diagnosis 1. Aneursymal bone cyst 2. Gaint cell tumor 3. Chondroblastoma 4. Osteoblastoma 5. Fibrous dysplasia 6. Non ossifying fibroma 7. Chondromyxoid fibroma
  • 11. Treatment Surgery : 1. Extended curettage and grafting with a bone graft substitute 2. For expendable bones marginal resection done 3. Treated with pre operative embolisation to minimize blood loss 4. Arterial embolisation is definitive treatment in cases where curettage of aneursymal bone cyst is difficult. 5. Recurrance after curettage is 10 to 20 percent
  • 12. Factors associated with recurrance 1. Younger age < 15 years 2. Centrally located cyst 3. Incomplete removal of cystic cavity contents Recurrent cyst treated as same approach as primary lesion
  • 13. Radiotherapy 1. Low dose irradiation is effective method of treatment 2. Not used regularly as potential of turning out into malignancy 3. Associated with rapid ossification