An Aneurysmal Bone Cyst in the Skull Base

Jung, Dong Won; Pak, Min Gyoung; Song, Young Jin; Bae, Woo Yong

doi:10.1097/scs.0000000000003896

Cited by 12 publications

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“…2). 3,4,9,11–85 These case reports were published from years 1969 to 2018. Therefore, a total of 89 patients (81 cases from the literature search and 8 cases from the author's institution) met inclusion criteria.…”

Section: Resultsmentioning

confidence: 99%

Aneurysmal Bone Cysts of the Paranasal Sinuses: The Mayo Clinic Experience and Review of the Literature

et al. 2021

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Objective/Hypothesis Aneurysmal bone cysts (ABCs) are benign, lytic bone lesions, which rarely present in the paranasal sinuses. There is no published consensus on the appropriate diagnostic or treatment approach. Our objective was to elucidate the clinical behavior, treatment, and outcomes for patients with ABCs of the paranasal sinuses (psABCs). Study Design Retrospective case series and system review of the literature. Methods A retrospective chart review was performed to identify patients evaluated at the authors' institution with psABC and consolidated with literature reports of psABC. Results Eighty‐nine patients met inclusion criteria. The most common presenting symptom was painless facial swelling (n = 35, 39%). The ethmoid sinuses were the most common site involved (n = 55, 62%). Surgical approach was reported in 74 cases including 20 endoscopic and 54 with an open or combined approach. Fifty‐nine patients (71%) underwent gross total resection. Follow up data was reported for 67 patients. Fifteen patients (22%) were found to have recurrence or progression at follow up; 10/15 (66%) patients within the first 12 months, 14/15 (93%) within the first 24 months, and 1/15 (7%) greater than 24 months after treatment. Patients were more likely to have recurrence/progression if they presented with nasal discharge (P = .05), proptosis (P = .01), or orbital involvement (P = .03). Conclusions psABCs typically present with painless swelling or nasal obstruction. Orbital involvement is a negative prognostic indicator with these patients more likely to have recurrence after treatment. Recurrence or progression of disease is most likely to occur within 2 years after treatment. Therefore, patients should be monitored closely during this time. Level of Evidence 4 Laryngoscope, 131:E2525–E2533, 2021

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Section: Resultsmentioning

confidence: 99%

Aneurysmal Bone Cysts of the Paranasal Sinuses: The Mayo Clinic Experience and Review of the Literature

et al. 2021

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“…1,2,[18][19][20][21][22][23] This is usually associated with resolution of symptoms and an uneventful postoperative course; however, recurrences have been reported. Other options include the use of cement, phenol, cryotherapy, and sclerotherapy.…”

Section: Discussionmentioning

confidence: 99%

“…Per our review of the current literature, cases of aneurysmal bone cysts of the skull base are surgically resected. 1,2,[18][19][20][21][22][23] This is usually associated with resolution of symptoms and an uneventful postoperative course; however, recurrences have been reported. 19,21,22 Denosumab has been reported to provide meaningful clinical and radiological improvement in aneurysmal bone cysts.…”

Section: Discussionmentioning

confidence: 99%

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Massive aneurysmal bone cyst of the skull base treated with denosumab

et al. 2018

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Background Aneurysmal bone cysts are rare, benign expansile tumors most commonly involving long bones and vertebrae in patients younger than age 20. Skull base involvement is rare. Aneurysmal bone cysts shares radiological and histological features with other bone tumors, posing a diagnostic challenge. Methods/Results We report the case of a 32‐year‐old man who presented with facial pain, epistaxis, and cranial neuropathies secondary to a massive tumor of the maxillary sinus and anterior skull base. The tumor was originally misdiagnosed as osteosarcoma. However, genomic analysis revealed a rearrangement in the USP6 gene, elucidating a diagnosis of primary aneurysmal bone cysts. The patient was treated with denosumab. Within 5 months, the patient was asymptomatic with CT showing ossification of the tumor. Conclusions This case highlights (1) the utility of genomic analysis in aggressive bone tumors when the diagnosis is unclear and (2) the effectiveness of denosumab as a treatment for aneurysmal bone cysts when surgical resection is unfavorable.

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“…3 Skull is rarely affected. 4,5 The treatment modalities include selective arterial embolization, irradiation, intralesional curettage, intraoperative adjuvants, bone grafting, marginal resection or wide excision. Tumor has to be excised and all cystic lining curetted.…”

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confidence: 99%

Secondary Aneurysmal Bone Cyst of Base of Skull Associated with Chondroblastoma

Brohi¹,

Dilber²,

Mallah³

2019

J Coll Physicians Surg Pak

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Sir,Aneurysmal bone cysts (ABCs) are multi-cystic, osteolytic growths. The classic or standard form (95%) has blood filled spaces among bony trabeculae. Osteoid tissue and osteoclastic giant cells are found in the stromal tissue. The solid form (5%) shows fibroblastic proliferation, osteoid production and degenerated calcifying fibromyxoid elements. 1 ABCs are usually seen in younger patients. Around 80% of the patients are less than 20 years of age, more frequently in females. ABCs occurring de novo are called as primary ABCs. Secondary ABCs have accompanying tumors like chondroblastoma and giant cell tumor in 30% of patients. Other associated tumors or non-tumorous conditions include ossifying fibroma, osteosarcoma, chondrosarcoma, non-ossifying fibroma, chondromyxoid fibroma, unicameral or solitary bone cyst or trauma. 2 ABCs are commonly found in long bones, membranous bones of the thorax, pelvis and vertebra. In long tubular bones, these tend to be eccentrically located in the metaphysis. However, these can occur in any location, including the diaphysis and epiphysis, rarely, involving multiple bones simultaneously. 3 Skull is rarely affected. 4,5 The treatment modalities include selective arterial embolization, irradiation, intralesional curettage, intraoperative adjuvants, bone grafting, marginal resection or wide excision. Tumor has to be excised and all cystic lining curetted. Cryotherapy, phenol or cauterizations (intraoperative adjuvants) are used to remove microscopic tumor cells. Resulting bony defects may be replaced with homologous bone or cadaveric bone. We, herein, present a 50-year patient who was admitted with the complaints of headache, and rapidly enlarging swelling in the right temporal and mastoid area elevating the auricle. There was serosanguinous ear discharge and loss of hearing from right ear. There was no history of trauma. Swelling was non-tender, firm to hard and pulsatile. Cough impulse was negative and no bruit was audible. Right seventh nerve was paralysed with lower motor neuron features. No other body part was involved. CT scan brain with contrast and CT-angio brain revealed a vascular mass with bony outgrowth and cystic spaces involving right temporal petrous and mastoid area with midline brain shift (Figure 1). Patient underwent operation and lesion was excised and surrounding bony area was cauterised. Attached dura was coagulated with bipolar diathermy. Histopathology report confirmed the diagnosis of chondroblastoma with secondary ABC. Patient remained well for one year, however, he had recurrence of same growth after one year. Second operation was performed in the same way. He was then referred for radiotherapy. This case is unique as it presented at advanced age and in an unusual location. As mentioned above, skull is very rarely the primary site for this lesion. Both the primary tumour and the associated secondary ABC are rare at this age. Moreover, this case recurred after one year. Recurrence is not rare in ABCs. Most commonly, it results from incomplete removal of the...

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An Aneurysmal Bone Cyst in the Skull Base

Cited by 12 publications

References 11 publications

Aneurysmal Bone Cysts of the Paranasal Sinuses: The Mayo Clinic Experience and Review of the Literature

Aneurysmal Bone Cysts of the Paranasal Sinuses: The Mayo Clinic Experience and Review of the Literature

Massive aneurysmal bone cyst of the skull base treated with denosumab

Secondary Aneurysmal Bone Cyst of Base of Skull Associated with Chondroblastoma

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