Cases reported "Bone Cysts, Aneurysmal"

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1/4. Aneurysmal bone cysts of the sacrum. Clinical report and review of the literature.

    BACKGROUND: Aneurysmal bone cysts, first described by Jaffe and Lichtenstein in 1942, are benign lesions that may easily be mistaken for a malignant tumor both radiographically and pathologically. These diagnostic problems are due to their rapid growth, extensive destruction of bone, wide extraosseous tumor masses, and marked cellular exuberance. The differential diagnosis of aneurysmal bone cysts including giant cell tumor, calcified solitary bone cysts, low-grade osteosarcoma, and teleangiectatic osteosarcoma becomes even more complicated when the lesion arises at sites other than the long bones and presents with extensive extraosseous, soft-tissue tumor masses. The latter cases--especially when they occur as sacral or presacral tumors--present challenges with respect to successful treatment, which should combine surgical removal of the entire lesion following oncological criteria to prevent recurrences and osteosynthesis to guarantee the biomechanical stability of the spinal-pelvic junction. Here we report on the clinical case of a female patient with an aneurysmal bone cyst of the sacrum and extensive extraosseous tumor masses. The report includes the diagnostic challenges, the surgical options of sacral and/or presacral tumors, the histopathological findings, and long-term clinical and radiographic surveillance. methods: The patient was treated by a combination of preoperative adjuvant selective arterial embolization, radical surgical excision through an anterior approach followed by subsequent osteosynthesis and stabilization through a posterior approach. RESULTS: Clinical and radiographic follow-up for 2 years was uneventful, and the patient is still free of recurrence or any complaints. CONCLUSION: The current report documents the diagnostic and surgical challenge of a gigantic aneurysmal bone cyst of the sacrum and its successful management.
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2/4. Aneurysmal bone cyst of the sacrum: value of three-phase imaging.

    Aneurysmal bone cyst is an uncommon nonneoplastic lesion that occurs predominantly during the first 2 decades of life. Angiographic- and tissue-phase imaging provided more striking evidence of this unexpected lesion than skeletal-phase imaging in a 13-year-old girl with pain in the right buttock and posterior thigh.
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keywords = sacrum
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3/4. Assessment of sacrum scalloping in neurofibromatosis type 1 caused by a giant cell lesion of the sacrum.

    BACKGROUND: Neurofibromatosis type 1 (NF-1) is the most common of the neurocutaneous disorders. It leads to significant orthopedic complications and spinal deformities. Scalloping in NF-1 may be caused by weakness of the mesodermal dysplasia, which develops through the inherited mutation of chromosome 17. Aneurysmal bone cysts (ABCs) are rare, rapidly expanding, locally destructive, and often misdiagnosed lesions. Assessment of sacrum scalloping in NF-1 caused by aneurysmal bone cyst is described. CASE DESCRIPTION: A 15-year-old male was a patient with NF-1. He presented with cramping pain of the left soleus muscle, which had developed over the previous 3 months. The magnetic resonance imaging of the lumbar-sacrum region revealed a well-circumscribed multiloculated lesion located in the dorsal sacrum region and causing posterior vertebral scalloping and compression of nerve roots. The preoperative clinical suspicion was of a neurofibroma, a giant cell granuloma, or a lymphoma. However, the histopathologic diagnosis was consistent with ABC of the sacrum. This differed from our preoperative suspicion. CONCLUSION: The etiology of ABCs is still unknown. Some researchers have described ABCs with chromosomal abnormalities of 16q22 and/or 17p13. This is consistent with NF-1, which develops through the inherited mutation of chromosome 17. Therefore, mutation of the chromosome may play an important role in the development of NF-1 and ABCs. Adequate diagnosis is necessary before treatment or biopsy of ABCs because bleeding may occur during operation or biopsy. Surgery is the treatment of choice for most ABCs. Adjuvant megavoltage radiotherapy is indicated for patients with recurrent tumors and whose tumors are inoperable.
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keywords = sacrum
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4/4. MR imaging of a malignant schwannoma and an osteoblastoma with fluid-fluid levels. Report of two new cases.

    One case of malignant schwannoma of the sacrum and another of occipital osteoblastoma were evaluated by MR imaging. Both tumors showed fluid-fluid levels with different signal intensities in the sequences performed. Pathologic examination revealed hemorrhagic fluid in both tumors. Malignant schwannoma and osteoblastoma should be included in the list of bone and soft-tissue with fluid-fluid levels. Our data confirm the non-specificity of this finding, which only suggests the presence of previous intratumoral hemorrhage.
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keywords = sacrum
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