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Case Report
Primary aneurysmal cyst bone: Case report and review of the literature
1 Military Hospital Mohammed V, Rabat, Morocco
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Kaoutar Imrani
Military Hospital Mohammed V, Rabat,
Morocco
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Article ID: 101094Z01KI2020
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Imrani K, Edderai M, Amil T, El Fenni J. Primary aneurysmal cyst bone: Case report and review of the literature. Int J Case Rep Images 2020;11:101094Z01KI2020.ABSTRACT
Introduction: Aneurysmal bone cyst (ABC) is benign osteolytic lesion expansile composed benign osteolytic expansile lesion composed of blood filled cystic cavities. It is mostly diagnosed in patients less than 20 years old. We report an aneurysmal cyst bone in the proximal phalanx of the fourth toe that was long considered as chondroma in X-rays finding.
Case Report: We report the case of a 24-year-old military male, with history of ankle traumatism since six months from falling from the stairs. He presented to the Radiology Department of the military hospital of Rabat where anteroposterior and lateral radiographs of the left foot were realized. They showed an osteolytic bone lesion in the proximal phalanx of the fourth toe, expansile, without periosteal reaction or calcifications, first diagnosed as chondroma and treated symptomatically by nonsteroidal anti-inflammatory drugs. The patient was referred a second time to our department for nonresolving dull aching pain in the left foot since the trauma. On physical examination, there was no palpable mass, no cutaneous sign, no motor deficit, and the local temperature was normal. Magnetic resonance imaging (MRI) was performed for further characterization of the lesion. It showed a cystic lesion that present with hypointense signal on the T1 weighted sequences and hyperintense signal on T2 weighted sequences. Contrast enhanced T1 weighted sequences showed a multicystic appearance with contrast enhancing cyst walls. There was no periosteal reaction and no extension into soft tissues. The diagnosis of aneurysmal cyst bone was made and confirmed by a biopsy. Histological data found multiple fragments of bone tissue containing areas of blood-filled cystic spaces lined by fibrous septa that are composed of uniform fibroblasts and multinucleated giant cells. The patient was treated with surgical curettage of the lesion. Evolution was marked by resolving pain.
Conclusion: In conclusion, ABC is a benign lesion revealed in most cases by pain. Magnetic resonance imaging is the best choice imaging. Fluid levels detected on the T2 weighted sequences are highly evocative. Differential diagnosis is sometimes difficult. A biopsy is necessary to confirm the diagnosis.
Keywords: Aneurysmal cyst, Bone, Osteolytic
SUPPORTING INFORMATION
Author Contributions
Kaoutar Imrani - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Final approval of the version to be published
Meryem Edderai - Revising it critically for important intellectual content, Final approval of the version to be published
Touria Amil - Revising it critically for important intellectual content, Final approval of the version to be published
Jamal El Fenni - Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest
Copyright© 2020 Kaoutar Imrani et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
