Arlet V, Rigault P, Padovani J P, Mallet J F, Finidori G, Touzet P
Service d'Orthopédie Traumatologie Infantile, Hôpital des Enfants Malades, Paris.
Rev Chir Orthop Reparatrice Appar Mot. 1987;73(5):337-48.
Twenty-eight aneurysmal bone cysts in children aged between 3 and 16 years, with a mean follow-up of five years, have been reviewed. The diagnosis in these uncommon lesions was straightforward in 22 cases, based on the clinical, radiological and macroscopic features. The histological characteristics confirmed the diagnosis. Apart from these typical lesions, there were some cases in which the diagnosis remained doubtful in spite of a review of the sections and a re-assessment of the radiological and clinical findings. For the surgeon, the diagnosis is primarily from a unicameral bone cyst, whose treatment is very different. For the pathologist, the diagnostic problem is not so much from benign dystrophies, which are often difficult to distinguish from them, but from rare lesions in children, such as telangiectatic sarcoma, which have a more serious prognosis. The high recurrence rate, in four cases out of eleven, after curettage led to a preference for more radical treatment whenever possible, such as excision or resection, which was performed in 14 cases and which limited the liability to recurrence. Aneurysmal bone cyst is a benign tumour whose severity depends on its site, especially in the spine, where there is a risk of neurological complications, on its size, which may render surgical removal difficult and on its proximity to the growth plate, which may result in disturbance to growth which not infrequently occurs.
回顾了28例年龄在3至16岁之间的儿童动脉瘤样骨囊肿，平均随访时间为5年。根据临床、放射学和大体特征，22例这些不常见病变的诊断明确。组织学特征证实了诊断。除了这些典型病变外，尽管对切片进行了复查并对放射学和临床发现进行了重新评估，但仍有一些病例的诊断存疑。对外科医生来说，诊断主要是与单房性骨囊肿相鉴别，二者治疗方法截然不同。对病理学家来说，诊断问题与其说是来自常难以与之区分的良性营养不良性病变，不如说是来自儿童罕见病变，如毛细血管扩张性肉瘤，其预后更严重。11例中有4例刮除术后复发率高，因此只要有可能就倾向于采取更彻底的治疗方法，如切除或根治性切除，14例进行了此类手术，降低了复发风险。动脉瘤样骨囊肿是一种良性肿瘤，其严重程度取决于其部位，尤其是在脊柱，存在神经并发症风险；取决于其大小，可能使手术切除困难；还取决于其与生长板的接近程度，这可能导致生长紊乱，这种情况并不少见。
