Price Anthony, Fredricks Nathan, Bartman Mason, D'Souza Preston, Hayworth Miranda, Campbell Gerald, Kan Peter, Lall Rishi
John Sealy School of Medicine, The University of Texas Medical Branch at Galveston, Texas.
Department of Neurosurgery, The University of Texas Medical Branch at Galveston, Texas.
J Neurosurg Case Lessons. 2024 Nov 18;8(21). doi: 10.3171/CASE24471.
Aneurysmal bone cysts (ABCs) are rare, benign, yet locally aggressive lesions that contain blood-filled channels that rarely occur in the thoracic spine of adults. The literature on the treatment of spinal ABCs is sparse, but the consensus is to achieve gross-total resection (GTR) due to these lesions being locally aggressive and to prevent recurrence.
This report describes a 35-year-old female admitted with back pain and right T5 dermatome radiculopathy without any inciting events. Magnetic resonance imaging revealed a 3.0 × 4.3 × 4.0-cm solid, enhancing, multicystic lesion with multiple fluid levels centered in the right posteromedial chest wall, involving the right fifth rib and costovertebral junction. Because of the high suspicion for an ABC, later found to be secondary to an osteoblastoma, surgical intervention was planned via preoperative embolization and T4-6 fusion with right T5 laminectomy and costotransversectomy to obtain GTR.
This case of an ABC secondary to osteoblastoma of the spine showcases a strategy for unique surgical management, given the limited information on treatment considerations for secondary ABCs. https://thejns.org/doi/10.3171/CASE24471.
动脉瘤样骨囊肿（ABCs）是一种罕见的良性但具有局部侵袭性的病变，其含有充满血液的通道，在成人胸椎中很少见。关于脊柱ABCs治疗的文献较少，但由于这些病变具有局部侵袭性且为预防复发，共识是实现全切除（GTR）。
本报告描述了一名35岁女性，因背痛和右侧T5皮节神经根病入院，无任何诱发事件。磁共振成像显示一个3.0×4.3×4.0厘米的实性、强化、多囊性病变，有多个液平面，位于右后内侧胸壁中央，累及右第五肋骨和肋椎关节。由于高度怀疑为ABC，后来发现继发于骨母细胞瘤，计划通过术前栓塞以及T4 - 6融合术加右T5椎板切除术和肋横突切除术进行手术干预以实现GTR。
鉴于关于继发性ABCs治疗考虑的信息有限，本例脊柱骨母细胞瘤继发ABC展示了一种独特的手术管理策略。https://thejns.org/doi/10.3171/CASE24471。
