Abstract:IntroductionAn aneurysmal bone cyst is a benign but often rapidly expanding osteolytic multi-cystic osseous lesion that occurs as a primary, secondary, intra-osseous, extra-osseous, solid or conventional lesion. It frequently coexists with other benign and malignant bone tumors. Although it is considered to be reactive in nature, there is evidence that some aneurysmal bone cysts are true neoplasms. The solid variant of aneurysmal bone cyst is a rare subtype of aneurysmal bone cyst with a preponderance of solid… Show more
“…Helpful histologic features differentiating S-ABC from GCT include the abundance of fibromyxoid tissue and presence of osteoid seen with S-ABC [7] . In addition, although GCT typically demonstrates a uniform distribution of giant cells, S-ABC more often presents with scattered or clustered giant cells [10] . In addition to immunohistochemical features and chromosomal abnormality present in this case, Takechi et al.…”
Solid variant aneurysmal bone cyst is a rare benign bone lesion, representing a small fraction of all aneurysmal bone cysts. The imaging appearance and histologic features may overlap with other benign and malignant neoplasms, posing a diagnostic dilemma for clinicians, pathologists, and radiologists. We present a case of solid variant aneurysmal bone cyst of the distal fibula and review the radiologic and histologic features important for diagnosis.
“…Helpful histologic features differentiating S-ABC from GCT include the abundance of fibromyxoid tissue and presence of osteoid seen with S-ABC [7] . In addition, although GCT typically demonstrates a uniform distribution of giant cells, S-ABC more often presents with scattered or clustered giant cells [10] . In addition to immunohistochemical features and chromosomal abnormality present in this case, Takechi et al.…”
Solid variant aneurysmal bone cyst is a rare benign bone lesion, representing a small fraction of all aneurysmal bone cysts. The imaging appearance and histologic features may overlap with other benign and malignant neoplasms, posing a diagnostic dilemma for clinicians, pathologists, and radiologists. We present a case of solid variant aneurysmal bone cyst of the distal fibula and review the radiologic and histologic features important for diagnosis.
The solid variant of aneurysmal bone cyst (SVABC) is very uncommon and frequently misdiagnosed. We reevaluated and summarized the clinicopathologic features of 17 SVABCs and further discussed the use of this nomenclature to differ SVABCs from extragnathic giant cell reparative granuloma (GCRG) in the setting of the USP6 rearrangement era. The immunohistochemical markers included α‐SMA, SATB2, AE1/AE3, Ki67, S100, CD68 and P63. USP‐6 status was detected by fluorescence in situ hybridization using a break‐apart probe. The 17 patients with SVABCs comprised 10 males and 7 females ranging in age from 4 to 70 years. The involved locations included the long bone (n = 11), hand (n = 4), rib (n = 1) and vertebra (n = 1). The lesions were characterized by proliferated spindle cells with scattered giant cells and hemorrhages with variable positive α‐SMA, SATB2, CD68 and Ki‐67 expression. All patients had USP6 rearrangements without H3F3A glycine 34 mutations. Our study reveals that SVABC shares similar clinical and histologic features with other bone lesions, which may lead to an erroneous diagnosis. The presence of an USP‐6 rearrangement contributes to the diagnosis SVABC; SVABC and most of the previously documented extragnathic GCRGs may be considered within the umbrella of primary aneurysmal bone cysts.
Aneurysmal bone cysts (ABCs) are considered to be rare benign tumors that may affect long bones or the vertebral column. Their incidence varies and is reported to be 1.4% of all benign skeletal tumors. The solid-variant aneurysmal bone cyst (S-ABC) is even rarer and constitutes 3.5% to 7% of all vertebral ABCs. We report the case of an Enneking stage 3 S-ABC in a 5-year-old boy at C7 that showed rapid local recurrence after primary excision from posterior and dorsal stabilization requiring ventral corpectomy and posterior excision of the right lateral mass and right posterolateral fusion. Histologic examination disclosed an S-ABC. To our knowledge, this is the first case of S-ABC described in the literature that used both anterior and posterior approaches and complete corpectomy. Over a 2-year period, the patient showed no radiologic or clinical signs of local recurrence with excellent neurologic function. Solid-variant aneurysmal bone cysts are difficult to diagnose and treat, and careful clinical and radiologic assessment should be done to tailor an appropriate surgical plan to prevent recurrence and neurologic sequelae. To the best of our knowledge, there are to date no publications that studied the behavior of this subtype.
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