The aneurysmal bone cyst: report of a recent case encountered in dental practice.

BACKGROUND

A sixteen year-old African male with a large, hard swelling at the left gonial angle, presented at a private dental clinic in January 2009. The swelling felt warm, pulsating and was intermittently symptomatic. The unilocular, expansile lesion seen on a panoramic radiograph was provisionally diagnosed as an aneurysmal bone cyst on the basis of age, symptoms and clinical features. However, ameloblastoma was included in the differential diagnosis.

METHODS

The histological examination of an incisional biopsy specimen revealed multiple blood-filled spaces separated by septa of fibrous tissue containing fibroblasts and multinucleated giant cells, thereby confirming the diagnosis of aneurysmal bone cyst.

RESULTS

Unexpectedly, the patient failed to attend an appointment for curettage of the aneurysmal bone cyst by a maxillofacial surgeon.

CONCLUSIONS

Over the past sixty-eight years, it had been postulated that the origin of the aneurysmal bone cyst was a secondary change in a large variety of pre-existing conditions. Other authors, however, have presented convincing evidence of the aneurysmal bone cyst as a primary lesion. More recently a cytogenetic aetiology for primary aneurysmal bone cysts has been postulated. Many factors in the aetiology of this rare and perplexing condition, however, still remain unclear.