aneurysmal bone cyst

动脉瘤性骨囊肿
  • 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: Case Reports
    背景:右侧股骨近端动脉瘤性骨囊肿(ABC)样变化相关的纤维发育不良发生率较低。与单个纤维发育不良相比,早期诊断更困难。
    方法:一名14岁的女性因前2个月的右髋部持续疼痛和步态异常而入院。她没有现在或过去的病史。术前摄影,增强计算机断层扫描,磁共振成像显示毛玻璃外观,皮质扇贝状,右侧股骨近端和股骨颈扩张。术前穿刺活检病理检查显示右股骨近端纤维发育不良。患者根据病史诊断为纤维发育不良,体检,和实验室的结果,影像学和病理学检查。根据最终病理检查,患者被诊断为与ABC相关的右股骨近端纤维发育不良.对与ABC样变化相关的纤维发育不良进行刮除和同种异体移植以及加压螺钉固定。无明显的同种异体移植物吸收,固定松动,在6个月的随访中观察到或继发性骨折,并通过X线平片和计算机断层扫描进行重新检查。与右股骨近端ABC样改变相关的纤维发育不良发生率低,早期诊断被认为比单个纤维发育不良更困难。
    结论:我们报告了一例右股骨近端纤维发育不良与ABC样改变相关的病例,行刮治和同种异体髋关节加压螺钉移植治疗。
    BACKGROUND: Fibrous dysplasia associated with aneurysmal bone cyst (ABC)-like changes in the right proximal femur has a low incidence. It is considered more difficult to make early diagnosis than for single fibrous dysplasia.
    METHODS: A 14-year-old woman was admitted because of persistent pain in the right hip and abnormal gait over the previous 2 mo. She had no history of present or past illness. Preoperative photography, enhanced computed tomography, and magnetic resonance imaging showed ground-glass appearance with cortical scalloping and expansion of the right proximal femur and femoral neck. Pathological examination by preoperative puncture biopsy revealed fibrous dysplasia of the right proximal femur. The patient was diagnosed with fibrous dysplasia based on medical history, physical examination, and results of laboratory, imaging and pathological examinations. According to final pathological examination, the patient was diagnosed with fibrous dysplasia of the right proximal femur associated with ABC. Curettage and allograft along with fixation of compression screws was performed for fibrous dysplasia associated with ABC-like changes. No obvious allograft absorption, loosening of fixation, or secondary fracture were observed during 6-months\' follow-up with re-examination by plain radiography and computed tomography. Fibrous dysplasia associated with ABC-like changes in the right proximal femur has a low incidence and early diagnosis is considered more difficult than for single fibrous dysplasia.
    CONCLUSIONS: We report a cases of fibrous dysplasia associated with ABC-like changes in the right proximal femur treated with curettage and allograft along with hip compression screws.
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  • 文章类型: Case Reports
    动脉瘤性骨囊肿(ABC)是一种良性,扩张,溶骨性和局部侵袭性骨肿瘤,主要与创伤有关。大约1%的骨肿瘤是ABCs,在青少年中最普遍,通常在脊柱和长管状骨骼中检测到。ABC的诊断主要依靠组织病理学,恶性转化是罕见的,如果有多次复发,恶性肿瘤的机会增加。由于罕见的ABCs恶性转化为骨肉瘤的报道,关于适当的治疗策略仍有相当多的争论。本文介绍了一例恶性骨肉瘤的动脉瘤样骨囊肿,以及治疗措施,为恶性骨肉瘤的ABCs的诊断和治疗提供专业知识。
    Aneurysmal bone cyst (ABC) is a benign, distending, osteolytic and locally aggressive bone tumor that is mostly associated with trauma. Approximately 1% of bone tumors are ABCs, which are most prevalent in adolescents and are usually detected in the spine and long tubular bones. The diagnosis of ABC mainly relies on histopathology, malignant transformation is rare, and the chance of malignancy increases if there are multiple recurrences. Due to the rarity of reports of malignant transformation of ABCs into osteosarcoma, there is still considerable debate on the appropriate treatment strategy. The current paper presents a case of aneurysmal bone cyst malignant to osteosarcoma and the therapeutic measures to provide expertise for the diagnosis and treatment of ABCs that are malignant to osteosarcoma.
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  • 文章类型: Case Reports
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  • 文章类型: Review
    脊柱巨细胞瘤(GCT)合并继发性动脉瘤样骨囊肿(ABC)是一种局部侵袭性原发性骨肿瘤。从未报道过完全脊椎切除术可治疗胸部GCT联合继发性ABC。我们回顾性分析了2例脊柱GCT合并继发性ABC的病例。一名41岁的男性患者因涉及T6椎体和椎管内占位性病变的不规则扩张性骨破坏而出现背痛。T6椎体全脊椎整块切除术,术后神经功能良好。一名29岁的女性患者由于涉及T5椎体和椎管内占位性病变的不规则扩张性骨破坏而出现右肩胛骨区域疼痛。T5椎体全脊椎整块切除术,术后神经功能良好。术后12个月或24个月随访无局部复发,辅助放疗。脊柱GCT合并继发性ABC似乎具有较高的局部复发率。因此,胸部GCT联合二次ABC治疗应采用全脊椎整块切除术。
    Spinal giant cell tumor (GCT) combined with secondary aneurysmal bone cyst (ABC) is a locally aggressive primary bone tumor. Total en bloc spondylectomy has never been reported to treat thoracic GCT combined with secondary ABC. We retrospectively reviewed two cases of spinal GCT combined with secondary ABC. A 41-year-old male patient was presented with back pain due to irregular expansive bone destruction involving the T6 vertebral body and intraspinal space-occupying lesion. Total en bloc spondylectomy of T6 vertebra was performed with good neurological status after the surgery. A 29-year-old female patient was presented with right scapular region pain due to irregular expansive bone destruction involving the T5 vertebral body and intraspinal space-occupying lesion. Total en bloc spondylectomy of T5 vertebra was performed with good neurological status after the surgery. Adjuvant radiation therapy was applied after the surgery without local recurrence at the 12-month or 24-month follow-up. Spinal GCT combined with secondary ABC appears to have a high local recurrence rate. Therefore, total en bloc spondylectomy should be applied to treat thoracic GCT combined with secondary ABC.
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  • 文章类型: Case Reports
    动脉瘤性骨囊肿是一种良性骨病理,具有膨胀性和溶骨性特征,其病因尚不清楚。Graves病是一种以弥漫性甲状腺肿和甲状腺功能亢进为特征的自身免疫性疾病。烟雾病是一种进行性脑血管疾病。据报道,Graves病和烟雾病具有相似的病因,涉及细胞因子和自身免疫和遗传因素。以前没有关于动脉瘤样骨囊肿与Graves病之间关系的报道。这里,我们介绍了一名25岁女性的罕见病例,疑似左股骨近端动脉瘤样骨囊肿,术前明确诊断为Graves病,病变切除联合左全髋关节置换术的患者。活检证实诊断为动脉瘤样骨囊肿。术后三天,患者因烟雾病而发展为急性缺血性脑梗死,随后得到证实。该病例阐明了动脉瘤性骨囊肿之间的潜在相互作用,严重的疾病,和烟雾病,并为需要手术以避免潜在严重并发症的Graves病患者提供适当的围手术期准备课程。
    Aneurysmal bone cyst is a type of benign bone pathology with expansile and osteolytic features whose etiology remains unclear. Graves\' disease is an autoimmune disease characterized by diffuse goiter and hyperthyroidism. Moyamoya disease is a progressive cerebral vasculopathy. It has been reported that Graves\' disease and Moyamoya disease share a similar etiology involving cytokines and autoimmune and genetic factors. There are no previous reports regarding the relationship between aneurysmal bone cyst and Graves\' disease. Here, we present the rare case of a 25-year-old woman with suspected aneurysmal bone cyst of the left proximal femur and a definite preoperative diagnosis of Graves\' disease, in whom lesion resection combined with left total hip replacement was indicated. Biopsy confirmed the diagnosis of aneurysmal bone cyst. Three days postoperatively, the patient developed acute ischemic cerebral infarction owing to Moyamoya disease, which was subsequently confirmed. This case elucidates the potential interaction among aneurysmal bone cysts, Graves\' disease, and Moyamoya disease and provides lessons regarding appropriate perioperative preparation for patients with Graves\' disease who require surgery to avoid potential severe complications.
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  • 文章类型: Journal Article
    In the past half-century, considerable attention has been paid to oral and maxillofacial skeletal cyst, however, aneurysmal bone cyst (ABC), unlike other common bone diseases, still contours numerous unanswered questions in terms of classification, etiology and pathological mechanism. The purpose of this article was to evaluate the proportion of primary ABC and secondary ABC, and to assess the recurrence of ABC and related factors. A methodical search of Embase, MEDLINE, Cochrane Library, Web of Science was conducted for well-documented jaw aneurysmal bone cyst (JABC) cases. One hundred thirty-one articles were identified after database searching and 31 of them were included in our study for further research with 44 JABC cases. All the articles were analyzed by two separate authors. About 25% of the reported jaw aneurysmal bone cyst was secondary. Both the pathological classification and surgical treatment had a significant influence on recurrence rate (P = 0.0082, P = 0.0022), while patients\' age or radiographic features rarely affected prognosis. Jaw aneurysmal bone cysts can present variable clinical and histological presentations. Recurrence may be attributed to omittance of underlying potential blood supply or conservative surgical protocol.
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  • 文章类型: Case Reports
    BACKGROUND: Chondroblastoma (CB) is a rare, primary, benign bone tumor that commonly affects men aged 15-20 years. It is usually detected in the epiphysis of the long bones, such as the proximal femur, humerus, and tibia. The patella is an infrequent site. CB with secondary aneurysmal bone cyst (ABC) is extremely rare in the patella, which can be easily confused with other common bone tumors of the patella. Thus, it is necessary to make the right diagnosis to get a good outcome.
    METHODS: We have presented here the case of a 30-year-old man who was suffering from anterior knee pain for the past 6 months that had aggravated 2 weeks before the presentation. Osteolytic bone destruction in the patella could be detected in both his X-ray and computed tomography (CT) examinations, while the magnetic resonance imaging (MRI) detected a fluid level. Accordingly, secondary ABC was presumed. We diagnosed the condition as giant cell tumor (GCT) with secondary ABC and, accordingly, performed curettage inside the focus region with autogenous bone grafting following the patient\'s medical history, physical manifestations, results of physical and ancillary examinations, and the disease characteristics. However, the intraoperative and postoperative outcomes indicated that the patient\'s histopathology was consistent with that of typical CB, suggesting a definitive error in diagnosis. Accordingly, the patient was finally diagnosed with patella CB along with secondary ABC.
    CONCLUSIONS: Past studies have demonstrated that the 3 commonest bone tumors affecting the patella are GCT, CB, and ABC. CB with secondary ABC can be easily misdiagnosed as GCT with secondary ABC or ABC. Performing incision biopsy or excision biopsy and conducting histological examination may be the most effective method for suspected CB with secondary ABC.
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  • 文章类型: Journal Article
    本研究旨在描述临床特征,11例青少年原发性动脉瘤样骨囊肿(ABC)的手术流程图和治疗结果,并文献复习。我们回顾性地回顾了11例年轻的骶骨原发性ABC患者,2001年至2018年在我们的骨肿瘤中心获得了完整的临床和随访信息。文献综述基于谷歌学者,Medline,EMBASE和Pubmed数据库。使用“动脉瘤样骨囊肿”的术语进行搜索“骶骨肿瘤”,“骶骨肿瘤”“脊柱肿瘤”和“脊柱肿瘤”为1998年至2019年的文献综述。有6名男性和5名女性,平均年龄为13岁。平均随访时间为6.5年。无患者死于疾病和肺转移。两名患者有伤口并发症,包括一次手术部位感染和一次伤口开裂。无患者出现局部复发和神经功能缺损。在文献综述中,本文共复习11篇文献,包括45例骶骨原发性ABC。局部复发率可能高于我们的队列。我们提出了为患者准备手术的流程图。术前选择性动脉栓塞和术中主动脉球囊闭塞可以提供清晰的手术视野,并通过病灶内刮除确保完整的肿瘤切除。术前选择性动脉栓塞,术中主动脉球囊闭塞和病灶内刮除完全切除肿瘤可以获得满意的结果,并且在青少年患者中复发率低。
    The present study is aiming to describe clinical characteristics, surgical flowchart and treatment results of eleven adolescent patients with primary aneurysmal bone cyst (ABC) of sacrum and review in the literature. We retrospectively reviewed eleven young patients with sacral primary ABC, which had the intact clinical and follow-up information at our bone tumor center from 2001 to 2018. The literature review was based on Google Scholar, Medline, EMBASE and Pubmed databases. The search was performed using terms of \"aneurysmal bone cyst\", \"sacral tumor\", \"sacrum tumor\" \"spine tumor\" and \"spinal tumor\" for the literature review from 1998 to 2019. There were six male and five female with a mean age of 13 years old at the presentation. The mean follow-up duration was 6.5 years. No patient died of disease and had the pulmonary metastasis. Two patients had wound complications, including onesurgical site infection and one wound dehiscence. No patient had the local recurrence and neurologic deficit. In the literature review, 11 articles were reviewed and 45 cases with sacral primary ABC were included. The rate of local recurrence may be higher than that in our cohort. We proposed our flow chart for preparation of surgery for patients. Preoperative selective arterial embolization and intraoperative aortic balloon occlusion could provide the clear surgical vision and guarantee complete tumor excision by intralesional curettage. Preoperative selective arterial embolization, intraoperative aortic balloon occlusion and complete tumor excision by intralesional curettage can yield satisfactory results with a low rate of recurrence in adolescent patients with a sacral primary ABC.
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  • 文章类型: Journal Article
    The current study aimed to investigate the imaging manifestations of vertebral aneurysmal bone cyst (ABC), and examine the clinical value of interventional embolization. Imaging examinations of 5 patients with pathologically confirmed spinal ABC were analysed and arterial angiography and embolization were performed prior to surgery. The cases in this cohort exhibited different degrees of intrusion into the vertebral arch and spinous and transverse processes. Lesions that protruded into the spinal canal resulted in compression of the thecal sac and spinal cord. Enlargement of arteries was detected by digital subtraction angiography and decreased significantly following embolization. Blood loss during surgery was also significantly reduced. Preoperative embolization of ABC reduces bleeding and allows for easy access to tissue, which is of great clinical value.
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