Surgical Management of Aneurysmal Bone Cyst of the Pubis: A Case Report and Review of Literature

Abstract

Introduction Aneurysmal bone cysts (ABC) are expansile, lytic, and benign but locally aggressive lesions. Pelvic ABCs are rare and sometimes difficult to manage surgically. Case Report A 17-year-old female presented with progressive pain and swelling in the right inguinal region. Pelvis radiograph showed a lytic expansile lesion of the superior pubic ramus. A multiloculated cystic lesion was evident on magnetic resonance imaging, and postoperative histopathological evaluation confirmed the diagnosis of ABC. The patient was treated successfully with an intralesional curettage and bone grafting. The postoperative course was uncomplicated with complete healing and no recurrence after 14 months of follow-up. Conclusion ABC of the pubic ramus is a rare entity. Complete intralesional curettage and bone ‎grafting ‎is an effective treatment for pubic ABC. An individualized management approach ‎considering ‎the surgical team expertise, tumor size, and proximity to neighboring structures ‎is recommended.‎.

Acetabular Aneurysmal Bone Cyst During the Syrian Conflict: A Case Report of Surgical Treatment and Outcomes

“…Open surgical methods have consistently emerged as the most effective means to eradicate the disease. For pelvic ABCs in children and adolescents, precise curettage and bone grafting have been recognized as the best therapeutic choices [8][9][10][11].…”

Aneurysmal bone cyst of the mandible: a rare case report and literature review

“…Patients with ABCs commonly present clinically with a local swelling, which is usually tender 11 . The swelling tends to pulsate if the lesion breaks through the inner table of the cranium 5 .…”

Aneurysmal Bone Cyst of the Pelvis in Children and Adolescents: Effectiveness of Surgical Treatment with Curettage, Cryotherapy and Bone Grafting

“…Aneurysmal bone cysts (ABCs) are rare but rapidly and locally aggressive benign tumors. ABCs occur more commonly in skeletally immature patients, particularly in the first and second decades of life [1]. According to the 2020 WHO Classifications of Tumors of Bone, ABCs are classified as osteoclastic giant cell-rich tumors and can be either primary lesions (about 70% of all cases) or secondary to other bone neoplasms (30%) [2][3][4].…”

“…Although cases of spontaneous healing or healing after biopsy have been described [3], the medical literature agrees that most aneurysmal bone cysts require targeted treatments to control or eradicate the disease. Minimally invasive treatments, such as curopsy, the injection of sclerosing agents, radiofrequency thermal ablation (RFTA), selective arterial embolization (SAE) and the systemic use of bisphosphonates or denosumab, have often been used-either as exclusive or adjuvant treatment-especially at the most challenging surgical sites, including the pelvic region [1,3,10,11]. More invasive treatments, such as en bloc resections of the whole involved bone segment, can provide good results with meager recurrence rates but may lead to unsatisfactory functional outcomes [1].…”

“…Minimally invasive treatments, such as curopsy, the injection of sclerosing agents, radiofrequency thermal ablation (RFTA), selective arterial embolization (SAE) and the systemic use of bisphosphonates or denosumab, have often been used-either as exclusive or adjuvant treatment-especially at the most challenging surgical sites, including the pelvic region [1,3,10,11]. More invasive treatments, such as en bloc resections of the whole involved bone segment, can provide good results with meager recurrence rates but may lead to unsatisfactory functional outcomes [1]. For this reason, intralesional curettage and bone grafting represent the treatment of choice in most cases, as they dovetail a reasonable risk of local recurrence with good post-operative functional outcomes [3,10].…”