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Phan T, Tong J, Krivanek M, Graf N, Dexter M, Tumuluri K. Aneurysmal Bone Cyst of the Orbit With USP6 Gene Rearrangement. Ophthalmic Plast Reconstr Surg 2023; 39:206-210. [PMID: 36356178 DOI: 10.1097/iop.0000000000002287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
PURPOSE Aneurysmal bone cyst (ABC) of the orbit is a very rare tumor, occurring mostly in the pediatric population, and can result in sight threatening complications and disfigurement. This review discusses previously reported cases with a focus on evolving treatment options and molecular genetics. METHODS We report the youngest case of an orbital ABC with a confirmed gene fusion: a 17-month-old girl, with confirmed FGFR-UPS6 (Fibroblast Growth Factor Receptor 1-ubiquitin specific peptidase 6/tre-2). A literature search for relevant publications on the topic was performed via Medline and PubMed, with the appropriate data extracted. RESULTS Thirty-two cases of orbital aneurysmal bone cyst were identified in the literature. Presentations are varied and can include pain, proptosis, decreased vision, and extraocular motility disturbance. Typical imaging and histopathology findings are discussed, in particular the usefulness of identifying USP6 gene arrangements. Treatment modalities are reviewed including surgery, embolization, and receptor activator of nuclear factor kappa-B ligand (RANKL) inhibitors. Recurrences can occur, usually within 2 years. CONCLUSIONS Orbital ABC is a neoplasm that presents unique diagnostic and treatment challenges. Gene rearrangements can confirm primary ABC and rule out other underlying pathology. Disfigurement and sight threatening complications can occur due to both the disease process and with treatment. Outcomes may be improved with the use of systemic therapy.
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Affiliation(s)
- Tracey Phan
- The Department of Ophthalmology, Children's Hospital Westmead, Sydney, NSW, Australia
| | - Jessica Tong
- The Department of Ophthalmology, Children's Hospital Westmead, Sydney, NSW, Australia
- Faculty of Medicine, Save Sight Institute, University of Sydney, Sydney, NSW, Australia
| | - Michael Krivanek
- Department of Histopathology, Children's Hospital Westmead, Sydney, NSW, Australia
| | - Nicole Graf
- Department of Histopathology, Children's Hospital Westmead, Sydney, NSW, Australia
- University of Western Sydney, Sydney, NSW, Australia
- University of Sydney, Sydney, NSW, Australia
| | - Mark Dexter
- Department of Neurosurgery, Children's Hospital Westmead, Sydney, NSW, Australia
| | - Krishna Tumuluri
- The Department of Ophthalmology, Children's Hospital Westmead, Sydney, NSW, Australia
- Faculty of Medicine, Save Sight Institute, University of Sydney, Sydney, NSW, Australia
- Faculty of Medicine, Macquarie University, Sydney, NSW, Australia
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Elghobashy MK, Askoura AM, Mahmoud MS, Ashour MM. Endoscopic Assisted Caldwell-Luc Approach for Total Excision of an Extensive Aneurysmal Bony Cyst of the Maxillary Sinus. Indian J Otolaryngol Head Neck Surg 2023; 75:901-905. [PMID: 37206712 PMCID: PMC10188719 DOI: 10.1007/s12070-022-03435-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 12/21/2022] [Indexed: 01/30/2023] Open
Abstract
Aneurysmal bone cysts (ABCs) are uncommon lesions in head and neck area that could be primary or secondary in origin. The main problem with the traditional curettage and debridement is the high rates of recurrence, and cosmetic disfigurement with the open approach. In this article, we describe the use of a combined endoscopic sinus surgery and endoscopic assisted Caldwell approach to achieve a complete surgical excision of left maxillary sinus ABC extending to the left infratemporal fossa, and to avoid facial disfigurement in a 13-year-old female patient presented to our hospital with diplopia, facial pain, and headache. The patient had uneventful post-operative recovery period with resolution of the presenting symptoms with no complications. Hence, we recommend this combined endoscopic surgical approach in such cases.
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Affiliation(s)
| | - Anas Mohamed Askoura
- Department of Otorhinolaryngology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mohammad Salah Mahmoud
- Department of Otorhinolaryngology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Manar Maamoun Ashour
- Department of Radiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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Pelkey LJ, Canty BJ, Ferris SP, Mistry DT, Figueroa BE. Aneurysmal Bone Cyst of the Sphenoid Body Mimicking Craniopharyngioma: A Case Report. Cureus 2022; 14:e23128. [PMID: 35308188 PMCID: PMC8918117 DOI: 10.7759/cureus.23128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2022] [Indexed: 11/06/2022] Open
Abstract
An aneurysmal bone cyst is a locally destructive benign lesion that predominately affects the long bones. Sphenoid body involvement is rare. To date, only 19 primary aneurysmal bone cysts of the sphenoid body have been reported. We describe the case of an 18-year-old male with a one-week history of severe right eye pain and lacrimation, right-sided diplopia, right-sided headache, photophobia, nausea, and vomiting. Magnetic resonance imaging (MRI) demonstrated a lobulated lesion centered in the sphenoid body with expansion into the cavernous sinus, sellar region, and clivus. The lesion had a homogenous hyperintense T2 signal with enhancing sidewalls and minimal septations. Computed tomography (CT) angiography revealed a hypoattenuating lesion containing a substance of nine Hounsfield units, compatible with water density. The clinicoradiologic findings were consistent with a craniopharyngioma. Intraoperatively, the lesion was confirmed to contain clear fluid and have prominent arterial feeding vessels. The extradural tumor was then excised with intralesional curettage. The histopathologic analysis resulted in a diagnosis of an aneurysmal bone cyst. This case highlights the potentially non-specific and variable appearance of aneurysmal bone cysts and the need to consider it in the differential diagnosis of sphenoid bone lesions.
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Smith AJ, Choby G, Van Gompel JJ, Link MJ, Van Abel KM. Aneurysmal Bone Cysts of the Paranasal Sinuses: The Mayo Clinic Experience and Review of the Literature. Laryngoscope 2021; 131:E2525-E2533. [PMID: 33646602 DOI: 10.1002/lary.29478] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 02/11/2021] [Accepted: 02/15/2021] [Indexed: 01/23/2023]
Abstract
OBJECTIVE/HYPOTHESIS Aneurysmal bone cysts (ABCs) are benign, lytic bone lesions, which rarely present in the paranasal sinuses. There is no published consensus on the appropriate diagnostic or treatment approach. Our objective was to elucidate the clinical behavior, treatment, and outcomes for patients with ABCs of the paranasal sinuses (psABCs). STUDY DESIGN Retrospective case series and system review of the literature. METHODS A retrospective chart review was performed to identify patients evaluated at the authors' institution with psABC and consolidated with literature reports of psABC. RESULTS Eighty-nine patients met inclusion criteria. The most common presenting symptom was painless facial swelling (n = 35, 39%). The ethmoid sinuses were the most common site involved (n = 55, 62%). Surgical approach was reported in 74 cases including 20 endoscopic and 54 with an open or combined approach. Fifty-nine patients (71%) underwent gross total resection. Follow up data was reported for 67 patients. Fifteen patients (22%) were found to have recurrence or progression at follow up; 10/15 (66%) patients within the first 12 months, 14/15 (93%) within the first 24 months, and 1/15 (7%) greater than 24 months after treatment. Patients were more likely to have recurrence/progression if they presented with nasal discharge (P = .05), proptosis (P = .01), or orbital involvement (P = .03). CONCLUSIONS psABCs typically present with painless swelling or nasal obstruction. Orbital involvement is a negative prognostic indicator with these patients more likely to have recurrence after treatment. Recurrence or progression of disease is most likely to occur within 2 years after treatment. Therefore, patients should be monitored closely during this time. LEVEL OF EVIDENCE 4 Laryngoscope, 131:E2525-E2533, 2021.
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Affiliation(s)
- Alyssa J Smith
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A
| | - Garret Choby
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A
| | - Jamie J Van Gompel
- Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A
| | - Michael J Link
- Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A
| | - Kathryn M Van Abel
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A
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Wolf A, Koele W, Ratschek M, Lang-Loidolt D, Tomazic PV. Endoscopic surgery of an extensive aneurysmatic bone cyst of the paranasal sinuses in a 12-year-old patient. Braz J Otorhinolaryngol 2019; 85:803-808. [PMID: 27237617 PMCID: PMC9443026 DOI: 10.1016/j.bjorl.2016.04.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 04/07/2016] [Accepted: 04/14/2016] [Indexed: 11/30/2022] Open
Affiliation(s)
- Axel Wolf
- Medical University of Graz, Department of Otorhinolaryngology, Graz, Austria
| | - Wolfgang Koele
- Medical University of Graz, Department of Otorhinolaryngology, Graz, Austria
| | - Manfred Ratschek
- Medical University of Graz, Institute for Pathology, Graz, Austria
| | - Doris Lang-Loidolt
- Medical University of Graz, Department of Otorhinolaryngology, Graz, Austria
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Pure endoscopic endonasal removal of unusual anterior skull base aneursymal bone cyst extending to the frontal lobe. J Craniofac Surg 2016; 26:e232-4. [PMID: 25887207 DOI: 10.1097/scs.0000000000001497] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Aneurysmal bone cysts (ABCs) are benign, nonneoplastic, hemorrhagic, and expansile osseous lesions that present most frequently at age younger than 20 years. Aneurysmal bone cysts typically involve long bones of extremities, thorax, pelvis, or spinal column. Skull base involvement is very rare. The authors report the case of a 23-year-old woman with ABC of the skull base and total removal of lesion with pure endoscopic endonasal approach. The patient had presented with nasal obstruction for 6 months. Physical and neurological examination findings were normal except for bilateral anosmia. Cranial magnetic resonance imaging (MRI) revealed a tumor occupying ethmoid sinuses anterior skull base that extended into bilateral frontal lobes. The patient underwent pure endoscopic endonasal surgery, and the tumor was resected gross-totally. Histologic examination revealed ABC. Consequently, ABC should be considered in differential diagnosis of skull base pathologies. Endoscopic endonasal surgical approach is a safe, minimally invasive, and effective way in the treatment of these tumors.
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Hnenny L, Roundy N, Zherebitskiy V, Grafe M, Mansoor A, Dogan A. Giant Aneurysmal Bone Cyst of the Anterior Cranial Fossa and Paranasal Sinuses Presenting in Pregnancy: Case Report and Literature Review. J Neurol Surg Rep 2015; 76:e216-21. [PMID: 26623230 PMCID: PMC4648731 DOI: 10.1055/s-0035-1555017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Accepted: 04/19/2015] [Indexed: 11/02/2022] Open
Abstract
Background and Purpose Aneurysmal bone cysts (ABCs) rarely involve the cranium and have seldom been reported in pregnancy. Clinical Presentation We describe a case of a 28-year-old woman who presented at 37 weeks of gestation with 3 months of gradually worsening vision, 10 months of proptosis, and restricted ocular motility on the left. Brain imaging revealed a multicystic enhancing mass measuring 5.9 × 5.3 × 3.7 cm, centered on the cribriform plate on the left, extending into the anterior cranial fossa superiorly as well as the left nasal cavity, maxillary, sphenoid, and frontal sinuses. Her clinical course is described in detail; 3-month postoperative imaging demonstrated no residual mass. Conclusion A literature review revealed five previous cases of ABCs associated with pregnancy. We report a rare case of a giant ABC of fibrous dysplasia involving the paranasal sinuses and anterior cranial fossa. We postulate on the possible influence of pregnancy on the clinical course.
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Affiliation(s)
- Luke Hnenny
- Departments of Neurological Surgery, Oregon Health & Science University, Portland, Oregon, United States
| | - Neil Roundy
- Departments of Neurological Surgery, Oregon Health & Science University, Portland, Oregon, United States
| | - Victor Zherebitskiy
- Departments of Neurological Surgery, Oregon Health & Science University, Portland, Oregon, United States
| | - Marjorie Grafe
- Department of Pathology, Oregon Health & Science University, Portland, Oregon, United States
| | - Atiya Mansoor
- Department of Pathology, Oregon Health & Science University, Portland, Oregon, United States
| | - Aclan Dogan
- Departments of Neurological Surgery, Oregon Health & Science University, Portland, Oregon, United States
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Kim BJ, Lee EJ, Chang HW, Jung HR, Kim E, Sohn SI, Kim SP. Aneurysmal bone cyst in the temporal bone and complete resection with preoperative embolization. A case report. Interv Neuroradiol 2014; 20:609-13. [PMID: 25363264 DOI: 10.15274/inr-2014-10051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2013] [Accepted: 03/10/2014] [Indexed: 11/12/2022] Open
Abstract
We describe a rare case of aneurysmal bone cysts (ABCs) that occurred in the petrous portion of the temporal bone. The ABCs were treated with preoperative embolization and complete removal of the mass from the adjacent tissue. The technical details suggest that preoperative embolization is a good treatment option for ABCs.
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Affiliation(s)
- Byoung Je Kim
- Department of Radiology, Keimyung University Dongsan Medical Center; Daegu, Republic of Korea -
| | - Eun Ju Lee
- Department of Radiology, Keimyung University Dongsan Medical Center; Daegu, Republic of Korea
| | - Hyuk Won Chang
- Department of Radiology, Keimyung University Dongsan Medical Center; Daegu, Republic of Korea
| | - Hae Ra Jung
- Department of Pathology, Keimyung University Dongsan Medical Center; Daegu, Republic of Korea
| | - Ealmaan Kim
- Department of Neurosurgery, Keimyung University Dongsan Medical Center; Daegu, Republic of Korea
| | - Sung Il Sohn
- Department of Neurology, Keimyung University Dongsan Medical Center; Daegu, Republic of Korea
| | - Sang Pyo Kim
- Department of Pathology, Keimyung University Dongsan Medical Center; Daegu, Republic of Korea
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An endolymphatic sac tumor with imaging features of aneurysmal bone cysts: differential diagnostic considerations. Childs Nerv Syst 2014; 30:1583-8. [PMID: 24881035 DOI: 10.1007/s00381-014-2453-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Accepted: 05/23/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Endolymphatic sac tumors (ELSTs) are rare, slow-growing tumors of the petrous bone. Despite the typical localisation, their radiological diagnosis can be challenging due to the variety of other tumors potentially showing similar features. CASE REPORT We present a 16-year-old child with progressive hearing loss, vertigo, and tinnitus who had a large petrous bone lesion showing imaging features of both ELSTs and aneurysmal bone cysts (ABCs). The patient underwent preoperative embolization of the tumor-supplying vessels and subsequently a subtotal resection. Histological examination revealed an ELST. CONCLUSION Despite the rarity of petrous bone ABCs, they should be considered as a differential diagnostic alternative of ELSTs due to their similar imaging appearance.
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Yu JW, Kim KU, Kim SJ, Choi S. Aneurysmal bone cyst of the orbit : a case report with literature review. J Korean Neurosurg Soc 2012; 51:113-6. [PMID: 22500206 PMCID: PMC3322208 DOI: 10.3340/jkns.2012.51.2.113] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2011] [Revised: 08/10/2011] [Accepted: 02/07/2012] [Indexed: 11/27/2022] Open
Abstract
Aneurysmal bone cyst (ABC) is benign vascular lesion destructing the cortical bone by the expansion of the vascular channel in the diploic space that usually involve long bone and spine. Orbital ABC is rare and the clinical symptoms deteriorate rapidly after initial slow-progression period for a few months. A 12-year-old female patient visited ophthalmologist due to proptosis and upward gaze limitation of the right eye, and orbital mass was noted in the upper part of right eye on orbital MRI. Five months later, exophthalmos was worsened rapidly with other features of ophthalmoplegia. Orbital mass was enlarged on MRI with intracranial extension. Surgery was done through frontal craniotomy and intracranial portion of the tumor was removed. Destructed orbital roof and mass in the orbit was also removed, and surrounding bone which was suspected to have lesion was resected as much as possible. Histopathological diagnosis was aneurysmal bone cyst. Postoperative course was satisfactory and the patient's eye symptoms improved. Authors report a rare case of orbital ABC with review of the literature. Exact diagnosis by imaging studies is important and it is recommended to perform surgical resection before rapid-progressing period and to resect the mass completely to prevent recurrence.
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Affiliation(s)
- Jae Won Yu
- Department of Neurosurgery, College of Medicine, Dong-A University, Busan, Korea
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Muzumdar DP, Goel A, Mistry R, Gujral S, Fattepurkar S. Postoperative cerebellar herniation in a large intrapetrous aneurysmal bone cyst. J Clin Neurosci 2004; 11:534-7. [PMID: 15177404 DOI: 10.1016/j.jocn.2003.07.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2003] [Accepted: 07/01/2003] [Indexed: 10/26/2022]
Abstract
An 18-year old boy presented with a tumour involving a large part of the petrous bone. A radical resection of a petrous bone 'aneurysmal bone cyst' was achieved. A large defect in the dura adjoining the posterior surface of the petrous bone was made during surgery. Post-operative MR imaging showed complete tumour resection but herniation of cerebellum into the operative defect, a phenomenon probably assisting to seal the site of cerebrospinal fluid fistula.
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Affiliation(s)
- D P Muzumdar
- Department of Neurosurgery, King Edward VII Memorial Hospital and Seth G.S. Medical College, Parel, Mumbai 400012, India
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