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Case 2

History:

24 year old man with enlarging left face mass

Findings:

Non contrast CT showing an expansile osteolytic lesion with a thin wall and internal amorphous calcifications.

Diagnosis:

Show Diagnosis

Discussion:

Aneurysmal bone cyst (ABC) is a solitary, expansile bony lesion found most commonly during second decade with a 2:1 female to male ratio. The most common location is the metaphysis of the lower extremity long bones, more so than the lower extremity (24 percent) followed by upper extremity (22 percent). Skull and mandible are affected in 4 percent of cases. ABCs are thought to be a reactive process secondary to trauma or vascular disturbance. ABCs can be secondary to an underlying lesion such as non-ossifying fibroma or chondroblastoma. Symptoms usually include swelling, tenderness and pain.

CT shows the expansile nature of the lesion which is often reflected by a “blow-out” or “soap bubble” appearance. The MRI can show fluid levels. Most lesions can be treated with curettage. Local recurrence rates vary widely.

References:

  • Beltran J, Simon DC, Levy M.Aneurysmal bone cysts: MR imaging at 1.5 T.Radiology.Mar1986;158(3):689-90.
  • Buirski G, Watt I.The radiological features of "solid" aneurysmal bone cysts.Br J Radiol.Dec1984;57(684):1057-65.
  • Capanna R, Albisinni U, Picci P.Aneurysmal bone cyst of the spine.J Bone Joint Surg Am.Apr1985;67(4):527-31.
  • Capanna R, Van Horn JR, Biagini R.Aneurysmal bone cyst of the sacrum.Skeletal Radiol.1989;18(2):109-13.
  • Clough JR, Price CH.Aneurysmal bone cyst: pathogenesis and long term results of treatment.Clin Orthop.Nov-Dec1973;97:52-63.