Tsirikos Athanasios I, Bowen J Richard
Alfred I. Dupont Hospital for Children, Wilmington, Delaware 19899, USA.
J Spinal Disord Tech. 2002 Oct;15(5):440-3. doi: 10.1097/00024720-200210000-00017.
Unicameral bone cysts affecting the spine are extremely rare and tend to be misdiagnosed. We report on a 17-year-old female patient who presented with a 2-year history of persistent low back pain. The radiographic evaluation and bone scan failed to reveal a pathologic process. Magnetic resonance of the painful area and subsequent computed tomography scan showed a well-circumscribed osteolytic lesion originating from the spinous process and extending into both laminae of T9 vertebra. Aneurysmal bone cyst or osteoblastoma was considered to be the most probable diagnosis. The patient underwent excisional biopsy of the tumor. The intraoperative findings were suggestive of solitary bone cyst, a diagnosis that was confirmed histologically. Because the tumor had not invaded the articular facets, no posterolateral spine fusion was required. The patient had an unremarkable postoperative clinical course. Her symptoms resolved and she returned to her previous level of physical activities. Unicameral bone cysts, although uncommon, should be included in the differential diagnosis of an osteolytic lesion involving the spine.
累及脊柱的单房性骨囊肿极为罕见，且往往容易被误诊。我们报告一例17岁女性患者，她有持续两年的下腰痛病史。影像学评估和骨扫描均未发现病理过程。疼痛部位的磁共振成像及随后的计算机断层扫描显示，有一个边界清晰的溶骨性病变，起自棘突并延伸至T9椎体的双侧椎板。动脉瘤样骨囊肿或骨母细胞瘤被认为是最可能的诊断。患者接受了肿瘤切除活检。术中所见提示为孤立性骨囊肿，组织学检查证实了这一诊断。由于肿瘤未侵犯关节突，因此无需进行后外侧脊柱融合术。患者术后临床过程平稳。她的症状消失，恢复到了之前的身体活动水平。单房性骨囊肿虽然不常见，但在涉及脊柱的溶骨性病变的鉴别诊断中应予以考虑。
