An unusual case of proximal humeral simple bone cyst in an adult from secondary cystic change

Abstract

Background: Simple bone cysts (SBC) have been documented to occur in adults with closed physeal plates, most commonly affecting the calcaneus in this patient subset. Although most authors theorize an association to trauma, etiology of simple bone cysts remains an enigma up to now. Case presentation: A 26-year-old kickboxing coach sought consult for a painful right shoulder which on radiographs and magnetic resonance (MR) imaging showed a proximal humeral lesion with signs of ossification. The patient was lost to follow-up but again sought consult after 3 years for the recurring complaint. On repeat radiographs, computed tomography (CT) scan, and MR images, tumor enlargement with cystic findings typical of simple bone cyst were documented. Diagnostic aspiration of the lesion was firstly done, revealing straw-colored fluid. The patient then underwent intralesional curettage with alpha-tricalcium phosphate cement reconstruction of the lytic defect. No perioperative complications were incurred, and on latest follow-up at 3 years postoperatively, Musculoskeletal Tumor Society (MSTS) and visual analog scale (VAS) pain scores were 30/30 and 0/10, respectively. Conclusions: The authors believe their report provides support to a possible association to trauma of simple bone cysts occurring in the adult population with closed physes and suggest this subset of patients may require a different treatment approach from that for juvenile simple bone cysts.

Comparative efficacy and safety profile for the treatment of humeral bone cysts in children: curettage and mixed bone grafting either with or without elastic intramedullary nailing

“…This type of lesion originates from intramedullary and concealed, which shows expansive growth. Indeed, it can interfere and destroy the formation of normal bone, reduce bone strength, and induce pathological fractures [ 1 , 2 ]. The current treatments for humeral cyst rely on hormone or bone marrow injection [ 3 ], focus elastic intramedullary nailing implantation [ 4 , 5 ], curettage and mixed bone graftin g[ 5 ], and hollow nail drilling and drainage [ 6 ].…”

Peritrochanteric Unicameral Bone Cyst in A 9-year-old Girl: A Case Report and Review of Literature

“…Nevertheless, it can lead to pathological fractures by destroying the bony structure from the medulla toward the cortex [4]. The lesion's etiology has remained unknown, but the most popular theories are blocked fluid drainage, intramedullary venous obstruction, nitric oxide, and some lytic processes [5,6].…”

“…Although the cyst is benign, it is essential to manage the problem because of the risk of pathological fractures and, less frequently, the growth plate involvement makes [4,7]. Symptoms consist of pain after pathologic fracture and limping, while most of the patients are asymptomatic, and the cyst is usually found incidentally or after a pathologic fracture [1,3,5,8].…”