Bone cysts, aneurysmal

骨囊肿,动脉瘤
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    文章类型: Case Reports
    我们报告了一例起源于肋骨的动脉瘤性骨囊肿(ABC)。一名34岁的妇女被送进我们的医疗部门,以评估左肋骨疼痛和在胸部X线片上观察到的左第7肋骨的异常阴影。计算机断层扫描(CT)显示涉及左侧第7肋骨的溶骨性病变。正电子发射断层扫描/CT显示病变中轻微的氟脱氧葡萄糖摄取。我们在距肿瘤4厘米的边缘进行了第7次肋骨切除术,包括第六和第七间隙的肋间肌.切除标本的组织病理学检查显示多个充满血液的空间和纤维小梁,这证实了ABC的诊断。患者术后病程顺利。虽然罕见,临床医生在肋骨肿瘤的鉴别诊断中应考虑ABCs.
    We report a case of an aneurysmal bone cyst (ABC) originating in a rib. A 34-year-old woman was admitted to our medical department for evaluation of left rib pain and an abnormal shadow in the left 7th rib observed on chest radiography. Computed tomography (CT) revealed an osteolytic lesion involving the left 7th rib. Positron emission tomography/CT showed slight fluorodeoxyglucose uptake in the lesion. We performed 7th rib resection with a 4 cm margin from the tumor, including the intercostal muscles in the 6th and 7th interspaces. Histopathological examination of the resected specimen showed multiple blood-filled spaces and fibrous trabeculae, which confirmed the diagnosis of an ABC. The patient\'s postoperative course was uneventful. Although rare, clinicians should consider ABCs in the differential diagnosis of rib tumors.
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  • 文章类型: Case Reports
    方法:一名16岁男孩表现为复发性股骨远端动脉瘤性骨囊肿,并伴有膝关节矢状畸形(股骨前束20°和胫骨前束26.8°)和肢体缩短。术前计划后,治疗包括新的病灶内刮治,酚化,和同种异体骨填充。其他手术包括股骨远端延伸截骨术和钢板固定,胫骨近端截骨术,通过六足框架逐渐校正。在2年的随访中,下肢表现出正常对齐和相等的长度。
    结论:复杂的膝关节畸形可能发生在膝关节周围的肿瘤病变,但可以通过双截骨和应用六足框架有效解决。
    METHODS: A 16-year-old boy presented with a recurrent distal femur aneurysmal bone cyst accompanied by a combined sagittal knee deformity (20° of femoral antecurvatum and 26.8° of tibial recurvatum) and limb shortening. After preoperative planning, the treatment involved new intralesional curettage, phenolization, and bone allograft filling. Additional procedures included distal extension femoral osteotomy with plate fixation, and proximal tibial osteotomy with, gradually corrected through a hexapod frame. At 2-year follow-up, lower limbs exhibited normoalignment and equal length.
    CONCLUSIONS: Complex knee deformities may occur with tumoral lesions around the knee but can be effectively addressed through double osteotomy and application of a hexapod frame.
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  • 文章类型: Case Reports
    背景:动脉瘤样骨囊肿(ABC)并不常见,良性,血管多囊性骨病变,在生命的头二十年中最常见。长骨的干phy端,骨盆,和脊柱是最常见的位置。ABCs形成的确切潜在病理生理学仍不清楚;然而,据信创伤或血管紊乱后的反应过程可能起重要作用。颅底受累很少发生,颅内ABCs的患病率高达5%。
    方法:一位18岁的青春期女性,三个月前出现了进行性视力模糊的病史。脑和眼眶MRI未见异常发现。糖皮质激素治疗三个月后,诊断为多发性硬化症,左眼视力障碍突然恶化。该患者接受了MRI检查,影像学研究表明,前斜突有明确的30×22×20-mm病变,并延伸到视神经管和筛窦。病人接受了翼点开颅手术,肿瘤被切除了.组织病理学检查提示ABC。
    结论:对于早期单侧视力下降的年轻人,应考虑ABC和其他情况,并应在早期和随访期间进行影像学检查。
    BACKGROUND: Aneurysmal bone cyst (ABC) is an uncommon, benign, vascular multicystic bony lesion that most frequently develops in the first two decades of life. The metaphysis of long bones, pelvic, and vertebral column are the most common locations. The precise underlying pathophysiology of ABCs formation remains unclear; however, it is believed that reactive processes subsequent to trauma or vascular disturbance may play an important role. Involvement of the skull base rarely occurs with a prevalence of up to 5% of intracranial ABCs.
    METHODS: An 18-year-old adolescent female with a history of progressive blurred vision since three months ago presented to our office. The brain and orbital MRI demonstrated no abnormal findings. After three months of glucocorticoid treatment with the diagnosis of multiple sclerosis, the visual impairment of the left eye deteriorated abruptly. The patient underwent an MRI and the imaging study demonstrated a well-defined 30 × 22 × 20-mm lesion at the anterior clinoid process with an extension to the optic canal and ethmoid sinus. The patient underwent pterional craniotomy, and the tumor was resected. The histopathological examination was suggestive of ABC.
    CONCLUSIONS: ABC and other conditions should be considered in young-age people with an early unilateral decline in vision and imaging studies should be obtained in early stages and during follow-ups.
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  • 文章类型: Journal Article
    目的:我们报告了一例纤维发育不良(FD)伴动脉瘤样骨囊肿(ABC)样改变的儿童眼眶受累,审查相关案件,并讨论临床特征,治疗,和这种疾病的预后。
    方法:一名10岁女孩右眼球突出(眼球突出程度:OD16mm,OS13mm)和有限的视力(视力:OD1.0,OS0.8),无外伤。术前CT显示右侧颅眶交通瘤5.0*4.3cm。MRI显示明确的多囊性肿块,流体水平分散,肥皂泡样改变。患儿接受了全肿瘤切除和眶壁钛网重建。在20个月的随访中,孩子已经从眼部问题中恢复过来,肿瘤没有复发.
    结论:FD合并ABC很少发生在眼眶,通常以眼部症状开始。病因尚不确定。早期诊断和手术至关重要。建议尽可能完全切除,因为残留病变可能会复发。
    OBJECTIVE: We report a case of fibrous dysplasia (FD) with aneurysmal bone cyst (ABC)-like change in a child with orbital involvement, review the related cases, and discuss clinical features, therapy, and prognosis of this disease.
    METHODS: A 10-year-old girl had right proptosis (degree of exophthalmos: OD 16 mm, OS 13 mm) and limited vision (visual acuity: OD 1.0, OS 0.8) without trauma. Preoperative CT showed a 5.0*4.3 cm right-sided crania-orbital communicating tumor. MRI indicated a well-defined multicystic mass with scattered fluid levels and soap bubble-like alterations. The child underwent total tumor resection and orbital parietal titanium mesh reconstruction. At 20 months of follow-up, the child has recovered from ocular problems, and the tumor has not recurred.
    CONCLUSIONS: FD combined with ABC rarely occurs in orbit and generally begins with ocular symptoms. The etiology is uncertain. Early diagnosis and surgery are essential. Complete resection is suggested whenever possible because residual lesions may recur.
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  • 文章类型: Review
    背景:骨内血管瘤是一种罕见的骨良性血管瘤,可影响身体任何部位;然而,最常见的部位是椎骨,其次是颅骨。
    方法:我们介绍了一例23岁男性骨内血管瘤的病例,该病例在3个月内出现咽部饱胀感。舌骨水平具有约5cm的硬块。细针抽吸显示5mL深色带血抽吸物。磁共振图像显示舌骨体中5.3cm混合信号强度病变。
    方法:组织病理学检查显示骨内血管瘤伴舌骨动脉瘤样骨囊肿(ABC)样改变。
    方法:团块被完全去除而没有显著问题。
    结果:获得了完整的肿块切除和症状改善,并且没有观察到随后的复发。
    结论:作者经历了一例伴有ABC样改变的骨内血管瘤。没有舌骨骨内血管瘤的病例报道。这种情况显示了从潜在的骨肿瘤发展为继发性变化的ABC样变化的光谱模式。骨肿瘤的ABC样变化可能会误导诊断。仔细检查肿瘤对于正确诊断ABC或ABC样变化至关重要。
    BACKGROUND: Intraosseous hemangioma is a rare benign vascular tumor of the bone that can affect any body part; however, the most common site is the vertebra, followed by calvarial bones.
    METHODS: We present a case of intraosseous hemangioma in a 23-year-old male who presented a feeling of fullness in the throat for 3 months. The hyoid bone level had a hard mass of about 5 cm. Fine needle aspiration showed 5 mL dark bloody aspirates. Magnetic resonance image showed a 5.3 cm mixed signal intensity lesion in the hyoid body.
    METHODS: Histopathologic examination showed intraosseous hemangioma with aneurysmal bone cyst (ABC)-like changes in the hyoid bone.
    METHODS: The mass was completely removed without significant problems.
    RESULTS: Complete mass excision and symptomatic improvements were achieved, and no subsequent relapses were observed.
    CONCLUSIONS: The authors experienced a case of intraosseous hemangioma with ABC-like changes. There has been no case report of intraosseous hemangioma in the hyoid bone. This case showed a spectral pattern of the ABC-like changes developing from the underlying bone tumor as a secondary change. ABC-like changes in bone tumors can mislead the diagnosis. Careful examination of the tumor is essential for the correct diagnosis of ABC or ABC-like changes.
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  • 文章类型: Case Reports
    背景:动脉瘤性骨囊肿(ABC)是一种罕见的原发性或继发性肿瘤,通常发生在10至20岁之间的年轻女性中,主要在长管状骨和脊柱。然而,它的临床治疗没有明确的标准。据我们所知,这是一例年轻女性桡骨远端ABC患者首次报道,该患者通过肿瘤切除和自体腓骨头移植成功治疗.
    方法:一名28岁已婚中国女青年到我院就诊,右手腕肿胀疼痛2年,手腕活动受限加重1周。
    方法:病理活检证实ABC。
    方法:我们对右腕部肿瘤进行了病理检查,初步证实了ABC的诊断。通过在右腕关节中完全手术切除ABC肿瘤并自体腓骨头移植重建右腕关节。
    结果:在7年内的随访中,确认右手腕功能良好。肿瘤没有复发,右手腕的肿胀消失了,关节疼痛和运动受限明显改善,右手腕的功能在日常活动中没有受损。射线照相显示骨折已愈合。
    结论:我们的结果表明,自体腓骨头移植是重建桡骨远端ABC成年患者腕关节功能的有效治疗方法。
    BACKGROUND: Aneurysmal bone cyst (ABC) is a rare primary or secondary tumor that usually occurs in young women aged between 10 and 20 years, mostly in the long tubular bone and spine. However, there are no definite standards for its clinical treatment. To our knowledge, this is the first report of a young female patient with distal radius ABC who was successfully treated with tumor resection and autogenous fibular head transplantation.
    METHODS: A 28-year-old married Chinese young woman presented to our hospital with swelling and pain in her right wrist for 2 years and aggravation of wrist movement restriction for 1 week.
    METHODS: Pathological biopsy confirmed ABC.
    METHODS: We performed a pathological examination of the tumor on the right wrist and preliminarily confirmed the diagnosis of ABC. The right wrist joint was reconstructed by total surgical resection of the ABC tumor in the right wrist joint and autogenous fibular head transplantation.
    RESULTS: During follow-up within 7 years, good right wrist function was confirmed. The tumor did not recur, the swelling of the right wrist disappeared, the joint pain and limitation of movement significantly improved, and the function of the right wrist was not impaired in daily activities. Radiography showed that the fracture had healed.
    CONCLUSIONS: Our results suggest that autofibular head transplantation is an effective treatment for reconstruction of wrist function in adult patients with ABC of the distal radius.
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  • 文章类型: Case Reports
    背景:软组织动脉瘤样骨囊肿是一种极其罕见的肿瘤。这篇文章的目的是提出临床,放射学,和非常不寻常的软组织肿瘤的组织病理学特征。
    方法:一名13岁的男性患者出现疼痛,mobile,在他的左膝盖后内侧迅速增长。影像学研究显示,从缝匠肌远端内侧表面产生的肿块,延伸到皮下脂肪组织。这是一个界限清楚的实体瘤,在平片上有周围边缘钙化,计算机断层扫描,和超声波(带状现象)。在磁共振成像上,在T1加权图像(WI)和T2-WI上看到了异质质量,在两个序列中都有外围低信号边缘。检测到T2-WI上的突出水肿延伸到膝盖内侧隔室的软组织和肌肉。肿块被切除了,和“肿瘤模拟者”组织病理学和分子(下一代测序)诊断证实了软组织动脉瘤样骨囊肿。随访显示患者术后12个月无疾病。
    结论:软组织动脉瘤样骨囊肿是一种罕见的肿瘤。应进行适当的临床和放射学相关性,以将其与其他肿瘤模拟物区分开。
    BACKGROUND: A soft tissue aneurysmal bone cyst is an extremely rare tumor. The objective of the article is to present the clinical, radiological, and histopathological features of a very unusual neoplasm of soft tissues.
    METHODS: A 13-year-old male patient presented a painful, mobile, and rapidly growing mass on the posteromedial aspect of his left knee. Imaging studies revealed a mass that arose from the medial surface of the distal sartorius muscle, with extension to the subcutaneous fat tissue. It was a well-circumscribed solid tumor with a peripheral rim calcification on plain film, computerized tomography, and ultrasound (zonal phenomenon). On magnetic resonance imaging, a heterogenous mass on T1-weighted images (WI) and T2-WI was seen, with a peripheral hypointense rim in both sequences. An outstanding edema on T2-WI extending to the soft tissue and muscles of the medial compartment of the knee was detected. The mass was resected, and the \"tumoral mimickers\" histopathological and molecular (next-generation sequencing) diagnoses confirmed a soft tissue aneurysmal bone cyst. A follow-up showed that the patient was free of disease 12 months after surgery.
    CONCLUSIONS: Soft tissue aneurysmal bone cyst is a rare tumor. Appropriate clinical and radiological correlation should be performed to differentiate it from other tumor mimickers.
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  • 文章类型: Case Reports
    纤维发育不良(FD)是一种罕见的骨骼疾病,其特征是异常的纤维骨结缔组织替代正常骨。尽管它的行为是良性的,颅面FD会导致形态学毁容,头痛,甚至由于产生的大规模效应而失明。当患者出现明显的临床症状或加重面部不对称时,建议手术切除。术后并发症已有报道,如血肿,手术部位感染,脓肿形成,用于重建的骨移植物的吸收,和复发。动脉瘤性骨囊肿(ABC)是一种罕见的良性骨性病变,可继发于先前存在的骨肿瘤。颅面FD中的继发性ABCs在文献中极为罕见,占30以下,全部为病例报告或系列。我们报告了因颅面FD引起的有症状的继发性ABC的极为罕见的病例,该病例被误诊为脓肿形成或复发,并通过手术切除。值得注意的是,从初次手术到二次ABC的并发症之间经过了17年。患者接受了二次ABC的完全切除。手术后,症状缓解,在6个月的随访中没有观察到复发。
    Fibrous dysplasia (FD) is a rare skeletal disorder characterized by abnormal fibro-osseous connective tissue replacing normal bone. Despite its benign behavior, craniofacial FD can cause morphological disfigurement, headache, and even blindness as a result of the produced mass effect. Surgical resection is recommended when the patient shows apparent clinical symptoms or aggravating facial asymmetry. Postoperative complications have been reported, such as hematoma, surgical site infection, abscess formation, resorption of the bone graft used for reconstruction, and recurrence. An aneurysmal bone cyst (ABC) is a rare benign bony lesion that can occur secondary to preexisting bone tumor. Secondary ABCs in craniofacial FD are extremely rare in the literature, accounting for less than 30, all of which are either case reports or series. We report an extremely rare case of symptomatic secondary ABC arising from craniofacial FD that had been misdiagnosed with abscess formation or recurrence and was surgically removed. Notably, 17 years elapsed between the primary surgery and the complication of secondary ABC. The patient underwent total removal of secondary ABC. After surgery, symptoms were relieved, with no recurrence observed during a 6-month follow-up.
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  • 文章类型: Case Reports
    背景:动脉瘤样骨囊肿由大小可变的囊性血液填充空间组成,这些空间被结缔组织间隔隔开。手术切除脊柱动脉瘤样骨囊肿的患儿总血量有限,可导致术中大量出血,从而限制了切除的范围。我们中心在使用无水酒精作为儿童椎体血管瘤手术中有效的即时血运重建剂方面有很好的经验。
    方法:我们报告了第一例小儿腰椎原发性动脉瘤样骨囊肿,其中在术中无水酒精病灶内硬化治疗后,进行了完全无血的局部全切除。
    结果:术中无水酒精病灶内硬化治疗后,对腰椎动脉瘤样骨囊肿进行完全无血零碎全切除。
    结论:术中无水酒精病灶内硬化治疗是一种非常有效的断流辅助治疗方法,可用于在血容量有限的儿童中完全零碎切除脊髓动脉瘤样骨囊肿。
    BACKGROUND: Aneurysmal bone cyst is composed of variable -sized cystic blood-filled spaces separated by connective tissue septae. First-line surgical resection of spinal aneurysmal bone cyst in a child with limited total blood volume can lead to massive intraoperative bleeding, thus limiting extent of resection. Our Centre\'s has good experience of using absolute alcohol as an effective immediate devascularizing agent during vertebral hemangioma surgery in children.
    METHODS: We report the first case of pediatric lumbar primary aneurysmal bone cyst in which completely blood-less piecemeal total resection of the lesion was performed after intraoperative absolute alcohol intralesional sclerotherapy.
    RESULTS: Completely blood-less piecemeal total resection of the lumbar aneurysmal bone cyst was performed after intraoperative absolute alcohol intralesional sclerotherapy.
    CONCLUSIONS: Intraoperative absolute alcohol intralesional sclerotherapy is a very effective devascularizing adjunct for complete piecemeal resection of spinal aneurysmal bone cyst in children with limited blood volume.
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  • 文章类型: Case Reports
    目的:描述β-磷酸三钙(TCP)治疗马下颌动脉瘤性骨囊肿(ABCs)的临床、影像学特点及手术治疗。
    方法:3匹马(病例1、2和3)和1匹小马(病例4)经组织学证实为ABC。
    方法:所有病例均为下颌骨肿胀,邻近皮肤完整。病例1至3的身体状况评分为3/5,病例4的身体状况评分为2/5,并在咀嚼过程中显示出滴注,在口试中,大的齿间空间和松散的元素相邻的肿胀。所有病例均进行X线摄影或CT检查。在第1、3和4例中,可以看到对相邻皮质和牙齿有肿块影响的扩张性纵隔囊性占位性病变,而没有致密的骨破坏。病例2显示异质溶骨性肿块,多灶性皮质溶解和中断。病例4有严重的乳牙异常和恒牙前体。对ABCs进行手术治疗,仅填充TCP(病例3)或与自体骨髓结合使用(病例1、2和4)。
    结果:病例1至3显示ABC大小随着不透明度/衰减增加而无影响地减小。在病例4中,发生手术部位感染。去除TCP残留物后,ABC治疗得令人满意,但剩余的牙齿异常需要饮食调整以维持可接受的身体状况评分.
    结论:用TCP治疗ABCs具有良好的预后和良好的长期预后。在年轻的标本中,对邻近牙齿发育和萌出的膨胀效应可以影响和决定患病牙齿象限的最终功能。
    To describe clinical and imaging features and surgical treatment of equine mandibular aneurysmal bone cysts (ABCs) with β-tricalcium phosphate (TCP).
    3 horses (cases 1, 2, and 3) and 1 pony (case 4) with histologically confirmed ABC.
    All cases had mandibular swelling with intact adjacent skin. Cases 1 to 3 had a body condition score of 3/5 and case 4 had 2/5 and showed quidding during mastication and, at oral examination, large interdental spaces and loose elements adjacent to the swelling. Radiography or CT was performed in all cases. In cases 1, 3, and 4, an expansile septate cystic space-occupying lesion with mass effect on the adjacent cortices and teeth was seen without compact bone destruction. Case 2 showed a heterogeneous osteolytic mass with multifocal cortical lysis and interruption. Case 4 had severe dental abnormalities of deciduous and precursors of permanent teeth. ABCs were surgically treated and filled with only TCP (case 3) or in combination with autologous bone marrow (cases 1, 2, and 4).
    Cases 1 through 3 showed an uneventful reduction in ABC size with increased opacity/attenuation. In case 4, a surgical site infection occurred. After removal of TCP remnants, the ABC healed satisfactorily, but remaining dental abnormalities necessitated dietary adjustments to maintain an acceptable body condition score.
    Treatment of ABCs with TCP had a favorable outcome and good long-term prognosis. In young specimens, the expansile effect on the development and eruption of neighboring teeth can influence and determine final functionality of the diseased dental quadrant.
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