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Head and Neck Pathology Mar 2020Giant cell-rich lesions represent a heterogeneous group of tumors and non-neoplastic lesions, usually arising in bone, which harbor varying number of reactive... (Review)
Review
Giant cell-rich lesions represent a heterogeneous group of tumors and non-neoplastic lesions, usually arising in bone, which harbor varying number of reactive osteoclastic-type multinucleate giant cells as a common feature. Among these entities, some are confined to the head and neck region (e.g., central giant cell granuloma and mimicking lesions, i.e., peripheral giant cell granuloma and cherubism) or show a relative predilection for this region (e.g., aneurysmal bone cyst and brown tumor of hyperparathyroidism), while others are rare but associated with distinct underlying disease (e.g., giant cell tumor of bone) or histology (e.g., tenosynovial giant cell tumor of the temporomandibular joint and phosphaturic mesenchymal tumor of the jaws) when occurring in the head and neck. Collectively, these lesions pose great challenge in the pathologic diagnosis, which often requires combinatory assessment from the clinical, histopathologic, and/or molecular aspects. This review provides a summary of pertinent clinical and pathologic features and an update of recent molecular and genetic findings of these entities. The considerations in differential diagnosis as well as the effects of the emerging therapeutic RANKL-antagonizing antibody denosumab will also be addressed.
Topics: Bone Cysts, Aneurysmal; Bone Neoplasms; Giant Cell Tumors; Granuloma, Giant Cell; Head; Humans; Hyperparathyroidism; Neck; Soft Tissue Neoplasms
PubMed: 31950466
DOI: 10.1007/s12105-019-01086-2 -
The Journal of International Medical... May 2022Aneurysmal bone cyst is a type of benign bone pathology with expansile and osteolytic features whose etiology remains unclear. Graves' disease is an autoimmune disease...
Aneurysmal bone cyst is a type of benign bone pathology with expansile and osteolytic features whose etiology remains unclear. Graves' disease is an autoimmune disease characterized by diffuse goiter and hyperthyroidism. Moyamoya disease is a progressive cerebral vasculopathy. It has been reported that Graves' disease and Moyamoya disease share a similar etiology involving cytokines and autoimmune and genetic factors. There are no previous reports regarding the relationship between aneurysmal bone cyst and Graves' disease. Here, we present the rare case of a 25-year-old woman with suspected aneurysmal bone cyst of the left proximal femur and a definite preoperative diagnosis of Graves' disease, in whom lesion resection combined with left total hip replacement was indicated. Biopsy confirmed the diagnosis of aneurysmal bone cyst. Three days postoperatively, the patient developed acute ischemic cerebral infarction owing to Moyamoya disease, which was subsequently confirmed. This case elucidates the potential interaction among aneurysmal bone cysts, Graves' disease, and Moyamoya disease and provides lessons regarding appropriate perioperative preparation for patients with Graves' disease who require surgery to avoid potential severe complications.
Topics: Adult; Bone Cysts, Aneurysmal; Brain Ischemia; Female; Femur; Graves Disease; Humans; Moyamoya Disease
PubMed: 35579208
DOI: 10.1177/03000605221097669 -
Orthopaedics & Traumatology, Surgery &... Feb 2016A fracture is defined as pathological when it arises in a bone tissue that has been modified and reshaped by a local or systemic pathological process. In children,... (Review)
Review
A fracture is defined as pathological when it arises in a bone tissue that has been modified and reshaped by a local or systemic pathological process. In children, pathological fractures can be secondary to several conditions, ranging from metabolic diseases to tumors, infections or neuromuscular pathologies. History, clinical examination and radiologic assessment are essential to making a diagnosis, to identifying the underlying cause and to planning the right treatment of a pathological fracture. Treatment must be tailored to both the fracture and the underlying cause. The objective of this work is to present the diagnostic approach and the course to follow when a child presents with a pathological fracture. The most common causes of pathological fractures, as well as their characteristics, will be described. Pathological fractures occurring in osteogenesis imperfecta and in abused children as well as stress fractures will not be discussed.
Topics: Adolescent; Bone Cysts; Bone Neoplasms; Child; Child, Preschool; Fractures, Spontaneous; Humans; Infant; Infant, Newborn; Osteomyelitis; Pseudarthrosis
PubMed: 26774903
DOI: 10.1016/j.otsr.2015.05.010 -
BMC Musculoskeletal Disorders Jan 2021The unicameral bone cyst (UBC) is a kind of benign tumor whose clinical treatments and efficacy are controversial. The purpose of this study was to evaluate the efficacy...
BACKGROUND
The unicameral bone cyst (UBC) is a kind of benign tumor whose clinical treatments and efficacy are controversial. The purpose of this study was to evaluate the efficacy of the elastic stable intramedullary nail (ESIN), the injection of autologous bone marrow (ABM), and the combination of ESIN and ABM in the treatment of bone cyst in children.
METHODS
Eighty-three cases with simple bone cyst were analyzed retrospectively. Twenty-eight cases were treated with ABM. Twenty-eight cases were treated with ESIN. Twenty-seven cases were treated with ABM and ESIN. All cases were diagnosed through X-ray, CT, or MRI scans. For the suspicious ones, the pathological biopsy was performed for an accurate diagnosis. X-ray examinations were carried out for the postoperative follow-up. Capanna criteria for bone cyst was used for postoperative evaluation of three methods.
RESULTS
All cases accomplished the follow-up. The effective rate of the ABM + ESIN group was significantly higher than that of the ABM group (P < 0.05), and the cure rates of the ESIN group and the ABM + ESIN group were higher than that of the ABM group (P < 0.05, respectively). The cure time in the ESIN group was lower than that of the other two groups (P < 0.05, respectively). The times for admission were 2.0 ± 0.0 in the ESIN group, 5.7 ± 1.9 in the ABM group, and 4.7 ± 2.4 in the ABM + ESIN group (P < 0.05 when compared with each other).
CONCLUSIONS
The method of ABM combined with ESIN for children's bone cyst has the highest effective rate and curative rate. For the individual method, ESIN has a higher effective rate and curative rate than that of ABM. Meanwhile, it has the fewest time of hospitalization.
Topics: Bone Cysts; Bone Nails; Child; Fracture Fixation, Intramedullary; Fracture Healing; Humans; Retrospective Studies; Treatment Outcome
PubMed: 33435945
DOI: 10.1186/s12891-020-03933-8 -
Head and Neck Pathology Sep 2010A classic solitary bone cyst is discussed. Radiology and histology is reviewed.
A classic solitary bone cyst is discussed. Radiology and histology is reviewed.
Topics: Bone Cysts; Humans; Male; Mandibular Diseases; Prognosis; Radiography, Panoramic; Young Adult
PubMed: 20405250
DOI: 10.1007/s12105-010-0179-1 -
BMJ Case Reports Oct 2013
Topics: Absorptiometry, Photon; Basal Cell Nevus Syndrome; Bone Cysts; Carcinoma, Basal Cell; Diagnosis, Differential; Female; Femur; Humans; Incidental Findings; Mesenteric Cyst; Middle Aged; Rare Diseases; Risk Assessment; Skin Neoplasms; Tomography, X-Ray Computed; United Kingdom
PubMed: 24172774
DOI: 10.1136/bcr-2013-201045 -
Experimental and Clinical... Nov 2022Aneurysmal bone cysts constitute 1% to 2% of all primary bone tumors.They are rapidly growing benign bone tumors. Nearly 80% of aneurysmal bone cysts occur in the first...
Aneurysmal bone cysts constitute 1% to 2% of all primary bone tumors.They are rapidly growing benign bone tumors. Nearly 80% of aneurysmal bone cysts occur in the first 20 years of life, and most are primary tumors. Aneurysmal bone cysts are mostly benign, locally aggressive, and highly vascularized tumors. Generally, the period required for postoperative recovery and new bone formation is long. The relapse rate can be up to 50%. Although computed tomography and magnetic resonance imaging scans are the preferred diagnostic methods, biopsy is the most necessary prerequisite to confirm diagnosis, as aspects of these cysts can show similarity to many other bone lesions. Correct histopathologic diagnosis is important since malignancies may be seen in transplant recipients.
Topics: Humans; Bone Cysts, Aneurysmal; Kidney Transplantation; Treatment Outcome; Neoplasm Recurrence, Local; Magnetic Resonance Imaging; Bone Neoplasms
PubMed: 31324137
DOI: 10.6002/ect.2019.0070 -
Scientific Reports Jun 2022Description of simple bone cyst (SBC) content has been controversial. This study aimed to assess and give a clearer picture of the SBC cavity contents. Between 2014 and...
Description of simple bone cyst (SBC) content has been controversial. This study aimed to assess and give a clearer picture of the SBC cavity contents. Between 2014 and 2016, 19 patients with SBC verified by histopathological examination were included in this study. SBC cavity content was investigated using clinical, radiographic, surgical, and laboratory findings. The difference in components among cavity fluid, blood, and serum was evaluated using a paired sample t-test for statistical analysis. All 19 SBC cases radiographically and surgically revealed a fluid-filled cavity. The patients' average age was 21.3 ± 13.2 years, with no sex predominance found. SBCs were found mostly in the anterior mandible (n = 12, 63.2%). All lesions were filled with clear straw-colored or blood-colored floods with low concentration. Although the fluid components were similar to those in the blood and serum in the laboratory analysis, the statistical analysis revealed that the fluid components were not significantly different only for eosinophil (p = 0.43) and basophil (p = 0.06) counts as blood components and sodium (p = 0.76), potassium (p = 0.08), and chloride (p = 0.13) concentration as serum components. The results show that SBC is a fluid-filled cavity, with the cavity fluid being more likely similar to serum rather than blood regarding internal components.
Topics: Adolescent; Adult; Bone Cysts; Child; Humans; Mandible; Young Adult
PubMed: 35710821
DOI: 10.1038/s41598-022-13264-4 -
Medicina Oral, Patologia Oral Y Cirugia... Jan 2017Jaw pseudocysts are benign osseous lesions of unclear etiology. Among these, the simple bone cyst (SBC) and aneurysmal bone cyst (ABC) are intriguing bone pathologies...
BACKGROUND
Jaw pseudocysts are benign osseous lesions of unclear etiology. Among these, the simple bone cyst (SBC) and aneurysmal bone cyst (ABC) are intriguing bone pathologies still rarely studied together. This retrospective study aimed to present the long-term case series of patients with jaw pseudocysts focusing on the clinical, radiographic, and transoperative aspects.
MATERIAL AND METHODS
A retrospective case series of patients with SBC and ABC was performed. Clinical, radiographic, and transoperative aspects of both pseudocysts were reviewed from the histopathological archives of 20,469 cases between 1959-2012. All descriptive data were summarized.
RESULTS
Of 354 (15.25%) bone pathologies, 54 cases of jaw pseudocysts were found, with 42 (11.86%) SBC and 12 (3.39%) ABC cases. For both lesions, most of the sample were young Caucasian women with an asymptomatic posterior mandible lesion with undetermined time of evolution and none trauma history. A unique radiolucent scalloped lesion presenting an empty cavity were also observed for both conditions. However, some atypical findings were found for SBC including: the expansion of bone cortical, tooth resorption, displacement of the mandibular canal, and recurrence. The absence of painful symptoms and the lack of classical blood-filled cavity were observed in some cases of ABC.
CONCLUSIONS
The SBC and ABC are bone pathologies with few retrospective studies, no previous studies on the two conditions, varied nomenclature, and atypical aspects in some cases. Therefore, the knowledge of clinical, imaging, and transoperative features of such pseudocysts are clinically valuable as diagnosis hypothesis of radiolucent lesions of the jaws.
Topics: Adolescent; Adult; Aged; Bone Cysts; Bone Cysts, Aneurysmal; Brazil; Child; Female; Humans; Jaw Diseases; Male; Middle Aged; Retrospective Studies; Time Factors; Young Adult
PubMed: 27918745
DOI: 10.4317/medoral.21551 -
Medicine Aug 2021Simple bone cysts (SBCs) occur most frequently in the proximal aspect of the humerus and femur in growing age and are associated with intercurrent pathological fractures...
Simple bone cysts (SBCs) occur most frequently in the proximal aspect of the humerus and femur in growing age and are associated with intercurrent pathological fractures in up to 87%. Therapeutic management of SBCs remains controversial. The aim of this study was to examine the outcome of conservative and various surgical treatment modalities considering the specific anatomic location and integrity of the SBC.In this retrospective study, we analyzed 68 cases of SBCs who underwent a conservative or surgical treatment between 2009 and 2020 with a mean follow-up of 30.1 months. The epidemiological characteristics, complications, clinical, and radiographic outcome after conservative or surgical treatment were assessed.The study includes 50 male (73.5%) and 18 female (26.5%) patients with a mean age of 9.1 years. The most common locations were the proximal humerus (69.2%, n = 47) and femur (16.2%, n = 11). In 43 cases (63.2%; upper limb n = 40, lower limb n = 3) a pathological fracture occurred. Fifty patients (73.5%; upper limb n = 40, lower limb n = 10) underwent a conservative treatment. In 11 cases (16.2.1%; upper limb n = 4, lower limb n = 7) an intralesional curettage and defect reconstruction with bone substitute without stabilization were performed. Five patients (7.3%; upper limb n = 4, lower limb n = 1) received an osteosynthesis, in two cases (2.9%; upper limb 1; lower limb 1) combined with an intralesional curettage and defect reconstruction with bone substitute. All 32 pathological fractures treated conservatively (upper limb n = 31, lower limb n = 1) healed within 6 weeks; 17/43 patients (39.5%) suffered at least one second fracture. After intralesional curettage and defect reconstruction with bone substitute local recurrence was observed in 5/13 cases (38.5%). Spontaneous consolidation, at least partially, was observed in three cases (4.4%) following conservative treatment after fracture. No relevant secondary angular or torsional deformity was observed after treatment.The majority of SBCs can be treated conservatively, especially in the upper extremity. However, if a fracture is completely dislocated, joint affecting, unstable or open, surgical treatment is necessary. Load-dependent pain or the inability to mobilize timely after fracture can necessitate surgical treatment in SBCs affecting the lower extremity. Spontaneous resolution, especially after fracture, can be seen in rare cases.
Topics: Adolescent; Bone Cysts; Child; Child, Preschool; Conservative Treatment; Curettage; Female; Femur; Follow-Up Studies; Fracture Fixation, Internal; Fracture Healing; Fractures, Spontaneous; Humans; Humerus; Male; Orthopedic Procedures; Radiography; Plastic Surgery Procedures; Recurrence; Retrospective Studies; Treatment Outcome; Young Adult
PubMed: 34397806
DOI: 10.1097/MD.0000000000026703