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Aneurysmal bone cyst of the orbit.

Wang JC, Zhang M, Zhao XX - Chin. Med. J. (2015)

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei 050011, China.

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Aneurysmal bone cyst (ABC) is an uncommon benign lesion with a reported incidence rate of 0.14 cases for every 1,000,000 people... ABC can occur in any part of the skeletal system but is mainly detected in the long bones... Coronal and axial computed tomography (CT) scans showed an expansive 3.5 cm × 4.5 cm pyramidal tumor... Bone destruction was present in the superior and posterior walls of the right orbit [Figure 1a and 1b]... A 33-year-old woman with a 7 years history of progressive, painless proptosis of the left eye was presented to Fourth Hospital of Hebei Medical University in May 2012... She did not have any history of injury... Systemic examination results were within normal limits... CT of the orbit revealed an expansile lytic lesion with a thinned-out cortex and a bone window showing an osteolytic lesion with a bony enlargement and cortical thinning [Figure 1d]... In 1942, ABCs were first described by Jaffeand and Lichtenstein as “peculiar blood-containing cysts of large size. ” ABC is a rare benign lesion with a complicated pathogenesis... The development of focal dynamic changes with secondary venous hypertension may cause a slow expansion of the cortex... Dabezies et al. studied cases of ABC secondary to trauma and concluded that the disease represented an osseous manifestation of a posttraumatic arteriovenous fistula... Although ABCs are known to occur in any part of the skeletal system, the long bones, such as the femur, tibia, humerus, pelvis, and fibula, are most frequently affected... Meanwhile, secondary ABCs are formed from preexisting bone lesions such as angioma, nonossifying fibroma, osteoblastoma, giant cell tumors, chondroblastoma, and fibrous dysplasia... In this report, the two patients diagnosed with primary ABC did not show any preexisting bone lesions.

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For the 49-year-old woman, the horizontal section (a) and coronal section (b) of computed tomography (CT) scan indicating a cystic lesion in the orbital roof; and histopathological assessment of the aneurysmal bone cyst (c) revealing numerous blood-filled sinusoidal spaces without endothelial linings and multiple giant cells within the walls of fibrous capsule (H and E, original magnification ×200). For the 33-year-old woman, CT bone window (d) showing an osteolytic lesion with bony enlargement and cortical thinning.
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Figure 1: For the 49-year-old woman, the horizontal section (a) and coronal section (b) of computed tomography (CT) scan indicating a cystic lesion in the orbital roof; and histopathological assessment of the aneurysmal bone cyst (c) revealing numerous blood-filled sinusoidal spaces without endothelial linings and multiple giant cells within the walls of fibrous capsule (H and E, original magnification ×200). For the 33-year-old woman, CT bone window (d) showing an osteolytic lesion with bony enlargement and cortical thinning.

Mentions: A 49-year-old woman with a 5 years history of painless swelling of the right orbital rim was admitted to Fourth Hospital of Hebei Medical University in March 2009. She had no prior injury and no history of cranial tumors. Upon physical examination, her vision tested 0.12 in the right eye and 0.6 in the left eye. A 5 cm large swelling was seen around the right orbital rim. A 4 mm proptosis of the right eye was observed, but eye movement was not restricted. No retinal or optic nerve change was detected. Results of examinations on the left eye as well as of a systemic examination were within the normal range. Coronal and axial computed tomography (CT) scans showed an expansive 3.5 cm × 4.5 cm pyramidal tumor. Bone destruction was present in the superior and posterior walls of the right orbit [Figure 1a and 1b]. The average attenuation of the mass was 16.5 Hounsfield unit (HU). A cystic mass approximately 4.5 cm × 3.5 cm × 3.0 cm in size and containing hemorrhagic fluid was surgically removed on March 20, 2009. Histopathological analysis showed that the lesion was confined within a fibrous capsule, which consisted of numerous blood-filled sinusoidal spaces devoid of endothelial linings [Figure 1c]. The fibrous capsule and septations contained a number of multinucleate giant cells as well as hemosiderin-laden macrophages and cellular fibrous tissue containing some bony trabeculae. This structural composition confirmed the diagnosis of ABC. The postsurgical course was uneventful, and no evidence of recurrence was detected after 54 months of surgery.


Aneurysmal bone cyst of the orbit.

Wang JC, Zhang M, Zhao XX - Chin. Med. J. (2015)

For the 49-year-old woman, the horizontal section (a) and coronal section (b) of computed tomography (CT) scan indicating a cystic lesion in the orbital roof; and histopathological assessment of the aneurysmal bone cyst (c) revealing numerous blood-filled sinusoidal spaces without endothelial linings and multiple giant cells within the walls of fibrous capsule (H and E, original magnification ×200). For the 33-year-old woman, CT bone window (d) showing an osteolytic lesion with bony enlargement and cortical thinning.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4836266&req=5

Figure 1: For the 49-year-old woman, the horizontal section (a) and coronal section (b) of computed tomography (CT) scan indicating a cystic lesion in the orbital roof; and histopathological assessment of the aneurysmal bone cyst (c) revealing numerous blood-filled sinusoidal spaces without endothelial linings and multiple giant cells within the walls of fibrous capsule (H and E, original magnification ×200). For the 33-year-old woman, CT bone window (d) showing an osteolytic lesion with bony enlargement and cortical thinning.
Mentions: A 49-year-old woman with a 5 years history of painless swelling of the right orbital rim was admitted to Fourth Hospital of Hebei Medical University in March 2009. She had no prior injury and no history of cranial tumors. Upon physical examination, her vision tested 0.12 in the right eye and 0.6 in the left eye. A 5 cm large swelling was seen around the right orbital rim. A 4 mm proptosis of the right eye was observed, but eye movement was not restricted. No retinal or optic nerve change was detected. Results of examinations on the left eye as well as of a systemic examination were within the normal range. Coronal and axial computed tomography (CT) scans showed an expansive 3.5 cm × 4.5 cm pyramidal tumor. Bone destruction was present in the superior and posterior walls of the right orbit [Figure 1a and 1b]. The average attenuation of the mass was 16.5 Hounsfield unit (HU). A cystic mass approximately 4.5 cm × 3.5 cm × 3.0 cm in size and containing hemorrhagic fluid was surgically removed on March 20, 2009. Histopathological analysis showed that the lesion was confined within a fibrous capsule, which consisted of numerous blood-filled sinusoidal spaces devoid of endothelial linings [Figure 1c]. The fibrous capsule and septations contained a number of multinucleate giant cells as well as hemosiderin-laden macrophages and cellular fibrous tissue containing some bony trabeculae. This structural composition confirmed the diagnosis of ABC. The postsurgical course was uneventful, and no evidence of recurrence was detected after 54 months of surgery.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei 050011, China.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Aneurysmal bone cyst (ABC) is an uncommon benign lesion with a reported incidence rate of 0.14 cases for every 1,000,000 people... ABC can occur in any part of the skeletal system but is mainly detected in the long bones... Coronal and axial computed tomography (CT) scans showed an expansive 3.5 cm × 4.5 cm pyramidal tumor... Bone destruction was present in the superior and posterior walls of the right orbit [Figure 1a and 1b]... A 33-year-old woman with a 7 years history of progressive, painless proptosis of the left eye was presented to Fourth Hospital of Hebei Medical University in May 2012... She did not have any history of injury... Systemic examination results were within normal limits... CT of the orbit revealed an expansile lytic lesion with a thinned-out cortex and a bone window showing an osteolytic lesion with a bony enlargement and cortical thinning [Figure 1d]... In 1942, ABCs were first described by Jaffeand and Lichtenstein as “peculiar blood-containing cysts of large size. ” ABC is a rare benign lesion with a complicated pathogenesis... The development of focal dynamic changes with secondary venous hypertension may cause a slow expansion of the cortex... Dabezies et al. studied cases of ABC secondary to trauma and concluded that the disease represented an osseous manifestation of a posttraumatic arteriovenous fistula... Although ABCs are known to occur in any part of the skeletal system, the long bones, such as the femur, tibia, humerus, pelvis, and fibula, are most frequently affected... Meanwhile, secondary ABCs are formed from preexisting bone lesions such as angioma, nonossifying fibroma, osteoblastoma, giant cell tumors, chondroblastoma, and fibrous dysplasia... In this report, the two patients diagnosed with primary ABC did not show any preexisting bone lesions.

Show MeSH
Related in: MedlinePlus