Giant cell tumor of bone with secondary aneurysmal bone cyst does not have a higher risk of local recurrence

BACKGROUND

Fluid-fluid levels (FFLs) is found in 10%-16% of giant cell tumor of bone (GCTB), and the presence of FFLs raises the suspicion of GCTB with secondary aneurysmal bone cyst (ABC), which can lead to increased intraoperative bleeding and, blurring the operative field, be associated with a risk of local recurrence. The first objective of this study is to determine whether secondary ABC is associated with a higher risk of local recurrence after curettage in patients with GCTB of the extremities. The second objective of this study is to investigate the sensitivity, specificity, positive predictive value, and negative predictive value of the presence of FFLs detected on magnetic resonance imaging (MRI) to diagnose secondary ABC associated with GCTB.

METHODS

Two hundred and eighty patients with GCTB of the extremities who underwent curettage at the authors' institutions between 1980 and 2021 were included in this study.

RESULTS

Secondary ABC was found in 36 of 280 patients (12.9%) and local recurrence occurred in 66 of 280 patients (23.6%). Multivariate analysis showed no significant correlation between secondary ABC and local recurrence (hazard ratio [HR]: 1.87 (95% confidence interval [CI]: 1.00-3.53]; p = 0.051). Preoperative MRI revealed FFLs in 13 of 82 patients (15.9%). Sensitivity, specificity, positive predictive value, and negative predictive value of FFLs detected on preoperative MRI to diagnose secondary ABC were 36.8%, 90.5%, 53.8%, and 82.6%, respectively.

CONCLUSION

The results of this study showed that secondary ABC does not increase the risk of local recurrence after curettage in patients with GCTB of the extremities. Although rare, FFLs were present in patients with GCTB and half of those with FFLs detected on preoperative MRI had secondary ABC.

Aneurysmal bone cyst of the ethmoid sinus: A case report

BACKGROUND

Aneurysmal bone cyst is an expansile bone lesion, non-neoplastic in nature, occurring most commonly in long bones. It is uncommon in facial bones and exceptionally rare in ethmoid bone. Ten cases of aneurysmal bone cysts of ethmoid bone have been reported so far.

CASE REPORT

A young adolescent presented with decreased vision and pain in the right eye. MRI revealed an expansile lesion having conspicuous fluid levels with a multiloculated appearance in the right ethmoid bone extending to the right orbit. CT was done to characterize better bone details. Both biopsy of the lesion and histopathology of resected specimen confirmed aneurysmal bone cyst.

CONCLUSIONS

A characteristic appearance on MRI and CT examinations helped to confidently diagnose a relatively common lesion in an exceedingly rare location.