Chhawra Sanjay, Jain Raman, Aggarawal Rajiv, Pandey Ashish
Department of Orthopaedics, Jaipur Golden Hospital, 2 Institutional Area Sector 3 Rohini, New Delhi-, India.
J Orthop Case Rep. 2019 Jan-Feb;9(1):23-27. doi: 10.13107/jocr.2250-0685.1292.
Aneurysmal bone cysts (ABCs) are benign aggressive bone lesions arising predominantly in the second decade of population in long bones at metaphyseal region which can cause local pain, swelling, and pathologic fracture. With two types, primary and secondary. diagnosis is made with various imaging modalities, although biopsy is important for diagnosis. Currently, the standard treatment is curettage or excision. Along with adjuvant therapy, chemical physical radiotherapy pharmacological to decrease recurrence was more in previous decades.
A 40-year-old male presented with the complaint of pain swelling over the right elbow but no fever for the past10days with a history of trauma 15 days back. In the past, history of tuberculosis of the elbow treated 10 years back on antituberculosis therapy, antitubercular drugs, and surgery was done and recovered with satisfactory result. On investigation X-ray -pathological fracture of radial head with eccentric ballooned expanded radiolucency margin well circumscribed lesion bone cyst. Surgery aim was to excise diseased part and get good functional recovery. Wide excision of tumor was done via anterolateral approach with injection of phenol at excised tumor site Tumor bone soft tissues was send for biopsy after surgery. Post-operative recovery was satisfactory with good reasonable range of movement of elbow was achieved.
A rare case of primary ABC at epiphyseal region rarest site less common bone involved radius has been reported with no reconstruction done due to it extensive extent with local predisposing factor apart from genetic. ABCs are aggressive benign lesions with high rates of recurrence challenging treatment, but it is curable when approached with multimodality treatment surgical along with radiotherapy pharmacological chemical physical.
骨动脉瘤样囊肿（ABCs）是一种良性侵袭性骨病变，主要发生在人群的第二个十年，位于长骨干骺端区域，可引起局部疼痛、肿胀和病理性骨折。分为原发性和继发性两种类型。虽然活检对诊断很重要，但通过各种影像学检查手段进行诊断。目前，标准治疗方法是刮除或切除。在前几十年，除了辅助治疗外，化学、物理、放射治疗、药理学等方法用于降低复发率的情况更为常见。
一名40岁男性，主诉右肘疼痛肿胀，过去10天无发热，15天前有外伤史。过去，10年前因肘部结核接受抗结核治疗、抗结核药物治疗及手术，术后恢复良好。经检查，X线显示桡骨头病理性骨折，伴有偏心性气球样膨胀的透亮区，边缘清晰的病变骨囊肿。手术目的是切除病变部位并实现良好的功能恢复。通过前外侧入路广泛切除肿瘤，并在切除的肿瘤部位注射苯酚。术后将肿瘤骨及软组织送检做活检。术后恢复满意，肘关节活动范围良好。
本文报告了一例罕见的原发性ABC位于骨骺区域（最罕见的部位，较少累及的骨骼为桡骨），由于其范围广泛且存在除遗传因素外的局部易感因素，未进行重建。ABCs是具有高复发率的侵袭性良性病变，对治疗具有挑战性，但采用手术联合放疗、药理学、化学、物理等多模式治疗时可治愈。
