Yalcinkaya Merter, Lapcin Osman, Arikan Yavuz, Aycan Osman Emre, Ozer Devrim, Kabukcuoglu Yavuz Selim
Orthopedics. 2016 Sep 1;39(5):e897-903. doi: 10.3928/01477447-20160623-02. Epub 2016 Jul 1.
Aneurysmal bone cyst originating from the surface of the bone, either within the cortex or subperiosteally, is an uncommon anatomic subtype. This article reports the clinical and radiologic evaluations and treatment outcomes of 10 patients with surface aneurysmal bone cysts that were surgically treated between 1982 and 2014. Mean age at the time of surgery was 22.4 years (range, 11-44 years). According to Capanna's radiographic evaluation criteria, 6 of the lesions were classified as type V and 4 were classified as type IV. Radiographically, periosteal shell formation was observed to be complete in 4 patients, partial in 3, and absent in 3, and 6 patients had Codman's angle or buttress formation. In 1 patient, computed tomography scan showed birdcage-like ossification attached to the surface of bone. Magnetic resonance imaging showed fluid-fluid levels in 5 patients. All of the patients had standard curettage and high-speed burr application as an adjuvant. No patient had local recurrence at the end of the follow-up period of 98.4 months (range, 13-288 months). These findings show the importance of careful radiologic evaluation and biopsy to better plan a treatment strategy when surface aneurysmal bone cyst is included in the differential diagnosis. The finding of fluid-fluid levels on magnetic resonance imaging or computed tomography is not pathognomonic for primary aneurysmal bone cyst; however, the absence of this finding does not rule out the diagnosis. The rate of local recurrence after curettage plus high-speed burr is reasonably low, and other adjuvant procedures should be used whenever needed. [Orthopedics. 2016; 39(5):e897-e903.].
起源于骨表面（皮质内或骨膜下）的动脉瘤样骨囊肿是一种罕见的解剖学亚型。本文报告了1982年至2014年间接受手术治疗的10例表面动脉瘤样骨囊肿患者的临床、放射学评估及治疗结果。手术时的平均年龄为22.4岁（范围11 - 44岁）。根据卡潘纳（Capanna）的放射学评估标准，6个病变被分类为V型，4个被分类为IV型。放射学检查显示，4例患者骨膜壳形成完整，3例部分形成，3例未形成，6例患者有科德曼（Codman）角或骨痂形成。1例患者的计算机断层扫描显示骨表面附着有鸟笼样骨化。磁共振成像显示5例患者有液 - 液平面。所有患者均接受了标准刮除术并辅以高速磨钻应用。在98.4个月（范围13 - 288个月）的随访期结束时，无患者出现局部复发。这些发现表明，当表面动脉瘤样骨囊肿纳入鉴别诊断时，仔细的放射学评估和活检对于更好地制定治疗策略很重要。磁共振成像或计算机断层扫描上液 - 液平面的发现并非原发性动脉瘤样骨囊肿的特征性表现；然而，该表现的缺失并不能排除诊断。刮除术加高速磨钻后的局部复发率相当低，必要时应采用其他辅助程序。[《骨科学》。2016；39(5):e897 - e903。]
