From the Orthopedics and Traumatology Department, Cairo University, Egypt (Dr. Barakat), the Orthopedics Department, Alexandria University, Egypt (Dr. Alsingaby, Dr. Shousha, Dr. El Saghir), and Zentralklinik Bad Berka, Wirbelsäulenchirurgie, Bad Berka, Germany (Dr. Boehm).
J Am Acad Orthop Surg. 2018 May 15;26(10):369-375. doi: 10.5435/JAAOS-D-16-00315.
Aneurysmal bone cysts (ABCs) are considered to be rare benign tumors that may affect long bones or the vertebral column. Their incidence varies and is reported to be 1.4% of all benign skeletal tumors. The solid-variant aneurysmal bone cyst (S-ABC) is even rarer and constitutes 3.5% to 7% of all vertebral ABCs. We report the case of an Enneking stage 3 S-ABC in a 5-year-old boy at C7 that showed rapid local recurrence after primary excision from posterior and dorsal stabilization requiring ventral corpectomy and posterior excision of the right lateral mass and right posterolateral fusion. Histologic examination disclosed an S-ABC. To our knowledge, this is the first case of S-ABC described in the literature that used both anterior and posterior approaches and complete corpectomy. Over a 2-year period, the patient showed no radiologic or clinical signs of local recurrence with excellent neurologic function. Solid-variant aneurysmal bone cysts are difficult to diagnose and treat, and careful clinical and radiologic assessment should be done to tailor an appropriate surgical plan to prevent recurrence and neurologic sequelae. To the best of our knowledge, there are to date no publications that studied the behavior of this subtype.
动脉瘤样骨囊肿（ABC）被认为是罕见的良性肿瘤，可能影响长骨或脊柱。其发病率各不相同，据报道占所有良性骨肿瘤的 1.4%。实性变异型动脉瘤样骨囊肿（S-ABC）更为罕见，占所有脊柱 ABC 的 3.5%至 7%。我们报告了一例 5 岁男孩 C7 处 Enneking 分期 3 期的 S-ABC，在接受后路和背侧稳定的初次切除后，出现了快速的局部复发，需要进行前路椎体切除术以及右侧外侧块和右侧后外侧融合的切除。组织学检查显示为 S-ABC。据我们所知，这是文献中首例同时采用前路和后路以及完全椎体切除术治疗的 S-ABC 病例。在 2 年的时间里，患者没有出现局部复发的放射学或临床迹象，神经功能良好。实性变异型动脉瘤样骨囊肿的诊断和治疗较为困难，应仔细进行临床和影像学评估，制定合适的手术方案，以预防复发和神经后遗症。据我们所知，目前尚无研究该亚型行为的出版物。
