Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Contacts Login 
Print this page Email this page Users Online: 210

 Table of Contents  
CASE REPORT
Year : 2014  |  Volume : 3  |  Issue : 3  |  Page : 199-201

Extraosseous aneurysmal bone cyst: A rare presentation


Department of Radiology, Government General Hospital, Bhudhawarapeta, Kurnool, Andhra Pradesh, India

Date of Web Publication17-Sep-2014

Correspondence Address:
Onteddoo Joji Reddy
Department of Radiology, Government General Hospital, Bhudhawarapeta, Kurnool, Andhra Pradesh
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2277-8632.140948

Rights and Permissions
  Abstract 

A 55-year-old female developed a gradually increasing soft-tissue mass with peripheral calcifications in the lower thigh. The mass was surgically removed. The lesion was histologically identical to an aneurysmal bone cyst (ABC), therefore, it was diagnosed as an extraosseous ABC. The differential diagnoses and a review of the literature are presented.

Keywords: Aneurysmal bone cyst, extraosseous, myositis ossificans


How to cite this article:
Reddy OJ, Gafoor JA, Suresh B, Prasad PO. Extraosseous aneurysmal bone cyst: A rare presentation. J NTR Univ Health Sci 2014;3:199-201

How to cite this URL:
Reddy OJ, Gafoor JA, Suresh B, Prasad PO. Extraosseous aneurysmal bone cyst: A rare presentation. J NTR Univ Health Sci [serial online] 2014 [cited 2020 Apr 4];3:199-201. Available from: http://www.jdrntruhs.org/text.asp?2014/3/3/199/140948


  Introduction Top


Aneurysmal bone cyst (ABC) is a common benign bone tumor if it arises from bones. But aneurysmal bone cyst arising from soft-tissues is very rare. Histologically aneurysmal cysts of soft-tissue are very similar to ABCs arising from the bone. They are characterized by blood filled spaces separated by connective tissue septa containing fibroblasts, osteoclast-like giant cells, and reactive woven bone. [1] A search of the English literature found only few case reports of soft-tissue ABC.


  Case report Top


A 55-yr-old female attended our department with the chief complaints of swelling over lower medial aspect of right thigh since 1 year and was associated with vague pain. On examination, approximately 10 cm × 5 cm mass lesion noted in the lower thigh on the medial aspect, and it was partly mobile. It did not restrict movement of the thigh. X-ray lower thigh showed a well-defined oval shaped mass lesion with peripheral calcified wall and septations were present [Figure 1]. Contrast enhanced computed tomography (CT) showed a well-defined predominantly cystic mass lesion with wall calcification and internal septations filled with fluid [Figure 2]a and b]. Peripheral wall and septations showed moderate enhancement [Figure 2]c]. Magnetic resonance imaging (MRI) (0.3 T) showed heterogenous cystic mass lesion with hypointense wall in all sequences and with internal fluid intensity [Figure 3]a-c]. Based on the imaging findings myositis ossificans and calcified hydatid cyst was considered as differential diagnosis. Excision of the lesion was done. The lesion was located in intermuscular planes in the medial compartment group of muscles and there was no communication with the bone either radiologically or pre-operatively. The cut surface of the specimen showed multi-loculated cystic mass with internal septations filled with blood and serous fluid [Figure 4]. Histopathology showed typical ABC like picture, cystic spaces filled with blood and the wall consists of fibrous tissue, multinucleate giant cells, trabaculae of mature bone, and focal areas showed necrotic bone [Figure 5]a and b].
Figure 1: X-ray lower thigh showing a well-defi ned oval shaped mass lesion with peripheral calcifi ed wall and septations

Click here to view
Figure 2:

Click here to view
Figure 3:

Click here to view
Figure 4: The cut surface of the specimen showing multi-loculated cystic mass with internal septations fi lled with blood and serous fl uid

Click here to view
Figure 5:

Click here to view



  Discussion Top


Unlike the more common primary bone lesion, soft-tissue ABC is rare. Soft-tissue aneurysmal bone cysts are known to occur in subcutaneous tissues, skeletal muscle and rare sites such as larynx [2] and arterial walls. [3]

Radiologically ABCs appear as heterogenous in appearances due to varying amounts of blood, fluid, and fibrous tissue in CT and MRI. In general, ABCs have areas of internal septations with areas of bright signal on T1, T2W and gradient echo images, depending on the chronicity of associated hemorrhage. The radiological differential diagnosis of soft-tissue aneurysmal cysts includes giant cell tumors of soft-tissues, extraskeletal osteogenic sarcoma, [4] myositis ossificans circumscripta and calcified intramuscular hydatids when they occur in muscles. Myositis ossificans circumscripta and extraosseous ABC share some common etiological, morphological and histopathological characteristics. Unidentified repetitive micro trauma to the soft-tissues may be the predisposing factor for this soft-tissue ABCs and myositis ossificans. Radiographically and histologically myositis ossificans circumscripta shows zonal phenomenon during maturation. This type of zonal phenomenon is not seen in extraosseous ABCs. Definitive diagnosis is made only by histopathological examination. The exact etiology of these soft-tissue ABCs are not clearly known until now. Karkuzhali et al. described neoplastic nature of multiple soft-tissue aneurysmal bone cysts. [4]


  Conclusion Top


The case is reported for its rarity and to create awareness of several primary bone lesions, that can arise from soft-tissues exclusively or in combination with underlying bone lesions.

 
  References Top

1.Leithner A, Machacek F, Haas OA, Lang S, Ritschl P, Radl R, et al. Aneurysmal bone cyst: A hereditary disease? J Pediatr Orthop B 2004;13:214-7.  Back to cited text no. 1
    
2.Della Libera D, Redlich G, Bittesini L, Falconieri G. Aneurysmal bone cyst of the larynx presenting with hypoglottic obstruction. Arch Pathol Lab Med 2001;125:673-6.  Back to cited text no. 2
    
3.Petrik PK, Findlay JM, Sherlock RA. Aneurysmal cyst, bone type, primary in an artery. Am J Surg Pathol 1993;17:1062-6.  Back to cited text no. 3
    
4.Karkuzhali P, Bhattacharyya M, Sumitha P. Multiple soft tissue aneurysmal cysts: An occurrence after resection of primary aneurysmal bone cyst of fibula. Indian J Orthop 2007;41:246-9.  Back to cited text no. 4
[PUBMED]  Medknow Journal  


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5]



 

Top
 
 
  Search
 
Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
Access Statistics
Email Alert *
Add to My List *
* Registration required (free)

 
  In this article
Abstract
Introduction
Case report
Discussion
Conclusion
References
Article Figures

 Article Access Statistics
    Viewed2210    
    Printed46    
    Emailed0    
    PDF Downloaded208    
    Comments [Add]    

Recommend this journal