Saez Neil, Sharma Giriraj K, Barnes Christian H, Lu Yuxin, Hsu Frank P, Huoh Kevin C, Djalilian Hamid R, Lin Harrison W
1 University of California Irvine School of Medicine, Irvine, California, USA.
2 Department of Otolaryngology-Head and Neck Surgery, University of California Irvine Medical Center, Orange, California, USA.
Ann Otol Rhinol Laryngol. 2018 Apr;127(4):285-290. doi: 10.1177/0003489418757251. Epub 2018 Feb 13.
Aneurysmal bone cysts (ABC) are benign, rapidly growing osteolytic lesions. Solid variant of ABC (SVABC) is a rare subtype of ABC that has not been reported in the temporal bone.
We report the case of a 6-year-old boy presenting with a slowly enlarging bony protuberance over the right zygomatic/malar eminence region. Computed tomography and magnetic resonance imaging demonstrated a 2.6 × 5.8 × 5.1 cm temporal bone mass involving the right mastoid, petrous, and temporal squamosal calvarium, with extradural intracranial extension to the middle cranial fossa.
The patient underwent preoperative embolization of feeder arteries followed by combined neurosurgical and neurotologic resection. Histopathology revealed characteristic ABC features with interspersed areas of intralesional osteoid formation.
Solid variant of ABCs are rare lesions of the skull base that present a diagnostic challenge given their unique radiographic and histologic features. Thorough cytogenetic evaluation is warranted to rule out potential malignant secondary causes. Early surgical resection is essential due to the risk of intracranial extension. This is the first report of ABC of any type with concurrent involvement of the squamous, mastoid, and petrous portions of the temporal bone and the first report of SVABC of the temporal bone.
骨动脉瘤样囊肿(ABC)是一种良性、生长迅速的溶骨性病变。ABC实性变体(SVABC)是ABC的一种罕见亚型,颞骨中尚未见报道。
我们报告一例6岁男孩,其右侧颧/颧骨隆起区域有一个缓慢增大的骨性突起。计算机断层扫描和磁共振成像显示一个2.6×5.8×5.1 cm的颞骨肿块,累及右侧乳突、岩骨和颞鳞颅骨,硬膜外颅内延伸至中颅窝。
患者术前对供血动脉进行了栓塞,随后进行了神经外科和耳神经外科联合切除术。组织病理学显示具有特征性的ABC表现,病变内有散在的类骨质形成区域。
ABC实性变体是颅底罕见病变,因其独特的影像学和组织学特征,在诊断上具有挑战性。有必要进行全面的细胞遗传学评估以排除潜在的恶性继发原因。由于存在颅内延伸风险,早期手术切除至关重要。这是首例任何类型ABC同时累及颞骨鳞状、乳突和岩骨部分的报告,也是颞骨SVABC的首例报告。