Frecuencia de la cavidad ósea de Stafne. Un análisis retrospectivo en radiografías panorámicas / Frequency of Stafne's bone cavity. A retrospective analysis in panoramic radiographs

Introducción: La cavidad ósea de Stafne es una variante anatómica poco frecuente, radiolúcida y bien delimitada, que usualmente se presenta en la región molar cerca del ángulo mandibular y por debajo del canal para el nervio dentario inferior. Es frecuente que sea erróneamente diagnosticada con otras entidades de carácter patológico. Objetivo: Determinar la frecuencia de la cavidad ósea de Stafne en las radiografías panorámicas del Servicio de Radiología Oral y Maxilofacial del Centro Dental Docente "Cayetano Heredia", desde 2015 hasta 2019. Métodos: Se realizó un estudio observacional, descriptivo, transversal y retrospectivo de una muestra de 17875 radiografías panorámicas. Se consideraron las variables demográficas como el sexo, la edad, la localización y la forma, posteriormente se realizaron tablas de contenido para el análisis de los datos. Resultados: Entre los 17875 pacientes, solo 24 (0,13 por ciento) presentaban cavidad ósea de Stafne, incluidos 16 hombres y 8 mujeres. La octava década de vida presentó la mayor cantidad de casos con 6 (0,4 por ciento). La localización posterior derecha contó con 13 (54,17 por ciento), la posterior izquierda con 7 (29,17 por ciento) y la anterior con 4 (16,67 por ciento). La forma ovalada con 23 (95,83 por ciento) y la redonda solo con 1 (4,17 por ciento). Conclusiones: La frecuencia de la cavidad ósea de Stafne fue de 0,13 por ciento con predilección del sexo masculino, la octava década de vida, la localización posterior derecha y la forma ovalada(AU)

Introduction: Stafne's bone cavity is a rare, radiolucent, well-demarcated anatomic variant that usually occurs in the molar region near the mandibular angle and below the canal for the inferior dental nerve. It is frequently misdiagnosed with other pathological entities. Objective: To determine the frequency of Stafne's bone cavity in panoramic radiographs of the Oral and Maxillofacial Radiology Service of the Teaching Dental Care Center "Cayetano Heredia", from 2015 to 2019. Methods: An observational, descriptive, cross-sectional and retrospective study was performed on a sample of 17875 panoramic radiographs. Demographic variables such as gender, age, location and shape were considered; subsequently tables of contents were performed for data analysis. Results: Among the 17875 patients, only 24 (0.13 percent) had Stafne's bone cavity, including 16 males and 8 females. The eighth decade of life presented the highest number of cases with 6 (0.4 percent). The right posterior location accounted for 13 (54.17 percent), the left posterior with 7 (29.17 percent) and the anterior with 4 (16.67 percent). The oval shape with 23 (95.83 percent) and round with only 1 (4.17 percent). Conclusions: The frequency of Stafne's bone cavity was 0.13 percent with male sex predilection, eighth decade of life, right posterior location and oval shape(AU)

Quiste óseo unicameral de calcáneo derecho / Unicameral Bone Cysts of the Calcaneus

Introducción: El quiste óseo unicameral es una lesión pseudotumoral benigna de contenido líquido, que representa el 3 por ciento de todos los tumores primarios. El calcáneo es una localización poco frecuente y el tarso, es el hueso más afectado. Objetivo: Presentar un caso de quiste óseo unicameral del calcáneo derecho que se diagnosticó y trató en el Hospital Universitario Manuel Ascunce Domenech de Camagüey con evolución clínica favorable. Presentación del caso: Paciente masculino de 22 años, con antecedentes de salud y dolor en el calcañal derecho de dos meses de evolución, que se incrementó hasta dificultarle la marcha. A la exploración física se constató dolor a la palpación de la cara lateral del calcañal derecho, y no se recogió otro dato de interés. La tomografía axial computarizada mostró una lesión hipointensa osteolítica, amplia, con fractura anterosuperior, adelgazamiento de las corticales y con tabicado de la cámara del quiste. Se decidió tratamiento quirúrgico para excéresis y toma de muestra para biopsia, la cual reveló tejido fibroso vascularizado con osteoclastos, células gigantes multinucleadas, cristales de colesterol y hemosiderina, consistente con quiste óseo unicameral. Conclusiones: El quiste óseo unicameral es una lesión pseudotumoral benigna pero potencialmente invalidante, cuyo diagnóstico puede ser fortuito o por alguna fractura patológica. La evacuación con curetaje amplio e injerto óseo, o sus derivados, es la técnica más empleada. El paciente evolucionó de forma favorable y se clasificó como curado(AU)

Introduction: The unicameral bone cyst is a benign pseudotumoral lesion with liquid content, accounting for 3 percent of all primary tumors. The calcaneus is a rare location and the tarsus is the most affected bone. Objective: to report a case of unicameral bone cyst in a right calcaneus, which was diagnosed and treated at Manuel Ascunce Domenech Universitary Hospital in Camagüey with favorable evolution. Case report: This is the case of a 22-year-old male patient with health history of pain in his right calcaneus for two months. The pain increased and made it possible to walk. Physical examination revealed pain on palpation of the lateral aspect of the right heel, and no other data of interest was collected. A wide, hypointense osteolytic lesion was revealed by computerized axial tomography showing an anterosuperior fracture, cortical thinning, and septation of the cyst chamber. Surgery was decided for excising and biopsy sampling that revealed vascularized fibrous tissue with osteoclasts, multinucleated giant cells, cholesterol crystals and hemosiderin, consistent with a unicameral bone cyst. Conclusions: The unicameral bone cyst is a benign but potentially disabling pseudotumoral lesion. The diagnosis may be fortuitous or due to some pathological fracture. Removal with wide curettage and bone grafting, or its derivatives, is the most widely used technique. This patient evolved positively and he was classified as cured(AU)

Estudio radiológico simple de quiste óseo simple y aneurismático: diagnóstico diferencial / Plain radiologic assessment of unicameral and aneurysmal bone cyst: differential diagnosis

OBJETIVO Dar a conocer nuestra experiencia en el diagnóstico diferencial de los quistes óseos simple y aneurismático mediante estudio radiológico simple. MATERIALES Y METODOS Se incluyeron pacientes menores de 20 años con radiografía de quiste óseo simple o aneurismático histológicamente confirmado pertenecientes al Registro Nacional de Tumores Óseos. Las radiografías fueron analizadas por dos radiólogos experimentados. Se compararon las variables demográficas de los pacientes, y las variables clínicas y radiológicas de ambos quistes. RESULTADOS Un total de 97 pacientes cumplieron los criterios de inclusión (65% presentaba quistes óseos simples y 35%, aneurismáticos). No se observaron diferencias en cuanto a la edad, al hueso comprometido, al tamaño de la lesión, a la expansión ósea, ni al adelgazamiento cortical. El género, la forma de presentación, la presencia de interrupción de la cortical, y la localización de la lesión en los ejes longitudinal y transversal del hueso son parámetros que podrían ser útiles en el diagnóstico diferencial de ambos quistes. DISCUSIÓN Los quistes óseos simple y aneurismático son lesiones benignas frecuentes que, de acuerdo con la literatura, serían difíciles de diferenciar únicamente con radiografía simple. La resonancia magnética permite una mejor caracterización anatómica, y aporta sensibilidad y especificidad al diagnóstico. Sin embargo, debe ser precedida por la radiografía simple, y su disponibilidad es limitada. CONCLUSIÓN Aun en centros con disponibilidad de resonancia magnética, la radiografía simple sigue siendo el estudio inicial de elección en el diagnóstico de tumores óseos. Ciertas características demográficas y radiográficas permiten orientar el diagnóstico diferencial inicial entre el quiste óseo simple y el aneurismático

OBJETIVE To describe our experience in the differential diagnosis of unicameral and aneurysmal bone cysts using plain radiography. PATIENCES AND METHODS We included patients under 20 years of age with radiographs of histologically-confirmed unicameral or aneurysmal bone cysts found on the Chilean National Bone-Tumor Registry. The radiographs were evaluated by two experienced radiologists. We compared the demographic variables of the patients, and the clinical and radiological variables of both tumors.. RESULTADOS A total of 97 patients met the inclusion criteria, 65% of whom had simple bone cysts, and 35%, aneurysmal bone cysts. No differences were found regarding age, the bone affected, the size of the lesion, bone expansion, nor cortical thinning. Gender, clinical presentation, cortical interruption, and location of the lesion on the longitudinal and transverse bone axes are parameters that could be used in the differential diagnosis of both cysts. DISCUSSION According to the literature, unicameral and aneurysmal bone cysts are frequent benign lesions that are difficult to differentiate merely through plain radiographs. Magnetic resonance imaging enables a better anatomical characterization and provides sensitivity and specificity to the diagnosis. However, its availability is limited, and it should be preceded by plain radiography. CONCLUSION Plain radiography is still the initial imaging study of choice in patients with clinical suspicion of bone tumor, even in those centers where magnetic resonance imaging is available. Certain demographic and radiological characteristics guide physicians in the differential diagnosis of unicameral and aneurysmal bone cysts.

Cisto ósseo simples: relato de 7 casos / Simple bone cyst: report of 7 cases / Quiste óseo simple: reporte de 7 casos

Introdução: O cisto ósseo simples (COS) é definido como uma cavidade intraóssea de etiologia desconhecida, desprovida de revestimento epitelial e vazia ou preenchida com líquido. Na região facial, o COS é mais comumente observado no corpo da mandíbula. Objetivo: O objetivo deste artigo é relatar uma série de casos de COS, discutindo aspectos relevantes das características clínicas e terapêutica adequada. Relato de caso: A série de casos demonstrou que a presença de lesões radiolúcidas assintomáticas nos maxilares, nos quais os diagnósticos clínico, laboratorial e imaginológico não foram conclusivos, a realização de uma biópsia é sempre indicada. Considerações finais: Os casos de múltiplas lesões de COS, ou quando estão associadas a displasias cemento-ósseas, uma abordagem cirúrgica torna-se imperiosa... (AU)

Introduction: Simple bone cyst (COS) is defined as an intraosseous cavity of unknown etiology, devoid of epithelial lining and empty or filled with fluid. In the facial region, COS is most commonly seen in the body of the mandible. Objective: The aim of this article is to re port a series of COS cases, discussing relevant aspects of the clinical characteristics and adequate treatment. Case report: The case series demonstrated that the presence of asymptomatic radiolucent lesions in the jaws, in which clinical, laboratory and imaging diagnoses were not conclusive, a biopsy is always indicated. Final considerations: In cases of multiple COS lesions, or when they are associated with cemento-osseous dysplasias, a surgical approach is imperative... (AU)

Introducción: El quiste óseo simple (COS) se define como una cavidad intraósea de etiología desconocida, desprovista de revestimiento epitelial y vacía o llena de líquido. En la región facial, la COS se observa con mayor frecuencia en el cuerpo de la mandíbula. Objetivo: El objetivo de este artículo es reportar una serie de casos de COS, discutiendo aspectos relevantes de las características clínicas y el tratamiento adecuado. Caso clínico: La serie de casos demostró que ante la presencia de lesiones radiotransparentes asintomáticas en los maxilares, en las que los diagnósticos clínicos, de laboratorio y de imagen no fueron concluyentes, siempre está indicada una biopsia. Consideraciones finales: En casos de múltiples lesiones de COS, o cuando se asocian a displasias cemento-óseas, es imprescindible un abordaje quirúrgico... (AU)

A Simple Bone Cyst of the Acromion: Case Report / Cisto ósseo simples do acrômio: Relato de caso

Abstract Simple bone cysts rarely occur in the scapula, and, to our knowledge, they have not been reported in the acromion. In the present report, we present the case of a 24-year-old female patient who was successfully treated by curettage and grafting using xenografting. No recurrence findings were observed during the follow-up six months postoperatively, the patient had recovered full range of motion, and she was able to perform all routine activities satisfactorily.

Resumo Cistos ósseos simples são raros na escápula, e, pelo que sabemos, não foram relatados no acrômio. Aqui, apresentamos uma paciente do sexo feminino, de 24 anos, submetida com sucesso ao tratamento composto por curetagem e xenoenxerto. Não foram observados achados de recidiva no acompanhamento pós-operatório de seis meses, quando a paciente apresentou amplitude total de movimento e foi capaz de realizar todas as atividades rotineiras de maneira satisfatória.

Quistes óseos de localizacion inusual como causa de lumbalgia crónica en adultos / Bone cyst of unusual location as a cause of chronic back pain in adults

Se presenta el caso de un paciente con quistes en el hueso iliaco como causa atípica de lumbalgia crónica a la cual se puede enfrentar el reumatólogo, y se hará una revisión de la literatura sobre los tipos de quistes óseos y sus diagnósticos diferenciales. También se hará mención de sus opciones de tratamiento.

The case of a patient with cysts in the iliac bone is presented as an atypical cause of chronic low back pain that the rheumatologist may face, and a review of the literature on the types of bone cysts and their differential diagnoses will be made. Mention will also be made of your treatment options.

Quistes y pseudoquistes de rodilla. Clasificación y algoritmo diagnóstico y terapéutico / Knee cysts and pseudocysts. Classification and diagnostic-therapeutic algorithm

Introducción: La aparición de la resonancia magnética y su evolución en la calidad de las imágenes ha guiado el diagnóstico de patologías poco habituales. El objetivo de este trabajo fue evaluar imágenes quísticas y pseudoquísticas en una serie de resonancias magnéticas de pacientes atendidos en nuestro centro, clasificándolas y analizando su frecuencia de aparición y el desarrollo y aplicación de un algoritmo diagnóstico y terapéutico. Materiales y métodos: fueron evaluadas las historias clínicas y resonancias magnéticas de 1808 pacientes cuyo motivo de consulta fue gonalgia de diversa etiología. Se aplicaron criterios de inclusión y exclusión. Se valoró la presencia de imágenes quísticas y pseudoquísticas, y se registró la localización, frecuencia, el tratamiento aplicado y su recidiva. Fueron incluidos en este trabajo quinientos treinta hombres y trescientas once mujeres, con edades comprendidas entre once a ochenta y cuatro años (con un promedio de cuarenta y uno). Se obtuvieron ochocientas noventa y cuatro rodillas de un total de ochocientos cuarenta y un pacientes, donde se observaron 1128 imágenes compatibles con quistes o pseudoquistes. Resultados: en ciento tres pacientes observamos dos o más imágenes. Diecisiete pacientes requirieron tratamiento quirúrgico por vía artroscópica; de estos, catorce fueron quistes asociados a lesión meniscal y tres, gangliones de la vaina del ligamento cruzado anterior. Un quiste de la inserción de la pata de ganso y dos colecciones prerrotulianas se resolvieron de manera abierta. No registramos ninguna recidiva. Conclusión: los quistes y pseudoquistes de rodilla son patologías habituales, consideramos importante el correcto análisis clínico imagenológico para evitar errores de apreciación y tratamiento. La RM es la principal herramienta de estudio para patologías de rodilla, permite evaluar imágenes de difícil observación por otro método y posibilita así un diagnóstico más certero. Consideramos fundamental estar familiarizado con la anatomía específica, conocer su ubicación, entender la relación con estructuras adyacentes y comprender el análisis de las características y patrones de las diferentes lesiones observadas en la RM para poder establecer un diagnóstico correcto.Tipo de estudio: Artículo original. Nivel de evidencia: IV

Introduction: The appearance of magnetic resonance imaging and its evolution in the quality of the images, has led to the diagnosis of unusual pathologies. The objective of this work is to evaluate cystic and pseudocystic images in a series of magnetic resonance imaging of patients treated at our center, classifying and analyzing their frequency of appearance and the development and application of a diagnostic and therapeutic algorithm.Materials and methods: the clinical histories and magnetic resonances of 1808 patients whose reason for consultation was knee paint of different etiology were retrospectively evaluated. Inclusion and exclusion criteria were applied. The presence of cystic and pseudocystic images was assessed, location, frequency, applied treatment and recurrence were recorded. 530 men and 311 women were included in this study, aged between 11 and 84 years (with an average of 41 years). Results: 894 knees were obtained from a total of 841 patients, where 1128 images compatible with cysts or pseudocysts were observed. In 103 patients we observed two or more images. Seventeen patients required arthroscopic surgical treatment, of these, fourteen were cysts associated with meniscal injury and three were ganglions of the anterior cruciate ligament sheath. One hamstring cyst and two pre-patellar collections were openly resolved. We did not record any recurrence.Conclusion: knee cysts and pseudocysts are common pathologies, we consider the correct clinical imaging analysis important to avoid errors of appreciation and treatment. MRI is the main study tool for knee pathologies, allowing the evaluation of images that are difficult to observe by another method, thus enabling a more accurate diagnosis. We consider it essential to be familiar with the specific anatomy, know its location, understand the relationship with adjacent structures, and understand the analysis of the characteristics and patterns of the different lesions observed on MRI in order to establish a correct diagnosis. Level of evidence: IV

Quiste Óseo Aneurismático en Clavícula: Reporte de un caso / Clavicle Aneurysmal Bone Cyst, Case Report

Introducción:El quiste óseo aneurismático es una neoplasia benigna poco común de aparición en edad temprana. Tiene mayor incidencia en huesos largos y en la columna vertebral. Su etiología es incierta, aunquesuele asociarse a traumatismo, probablemente debido a obstrucción venosa o a la formación de fístulas que se producen tras la contusión. Caso:En este estudio se presenta el caso de un paciente de 15 años sin antecedentes de trauma que presenta un quiste óseo aneurismático en clavícula, localización poco habitual para esta patología. Evolución: Se le brindótratamiento con terapia esclerosante con Polidocanol al 3% por 8 ocasiones con respuesta favorable.No ha requerido cirugía hasta el momento. Conclusión:El tratamientoesclerosante fue exitoso en este informe de casos

Introduction: The aneurysmal bone cyst is a rare benign neoplasm that appears at an early age. It has a higher incidence in long bones and in the spine. Its etiology is uncertain, although it is usually associated with trauma, probably due to venous obstruction or the formation of fistulas that occur after contusion. Case: This study presents the case of a 15-year-old patient with no history of trauma who presents with an aneurysmal bone cyst in the clavicle, an unusual location for this pathology. Evolution: Treatment with sclerosing therapy with 3% Polidocanol was given 8 times with a favorable response. He has not required surgery so far. Conclusion: Sclerosing treatment was successful in this case report

Quiste óseo aneurismático secundario a linfoma: hallazgos imagenológicos. Reporte de casos / Aneurismatyc bone cyst secondary to lymphoma: Radiological findings and cases report

Resumen Objetivo: Presentar reportes de casos de Quístes óseos aneurismáticos secundarios a linfomas y breve revisión del tema. Materiales y métodos: Se analizaron las imágenes en el archivo del servicio de radiología e imágenes diagnósticas de pacientes que acudieron a la Fundación Oftalmológicas de Santander - Clínica Carlos Ardila Lülle (FOSCAL) a quienes se les diagnosticó quiste óseo aneurismático secundario a linfoma. Resultados: Se reportan 2 casos clínicos de pacientes a quienes se diagnosticó lesión tumor ósea expansiva correspondiente a quiste óseo aneurismático secundario a Linfoma. Conclusiones: El quiste óseo aneurismatico es un raro tumor que constituye solo el 1-2% de los tumores óseos. Afecta principalmente la metáfisis de los huesos largos y se da predominantemente en el paciente adulto joven que está cursando la segunda década de vida. A pesar de existir múltiples teorías acerca de su origen aún no se tiene una etiología clara. Se diagnosticó lesión tumor ósea expansiva correspondiente a quiste óseo aneurismático secundario a Linfoma. Conclusiones: el quiste óseo aneurismatico es un raro tumor que constituye solo el 1-2% de los tumores óseos. Afecta principalmente la metáfisis de los huesos largos y se da predominantemente en el paciente adulto joven que está cursando la segunda década de vida. A pesar de existir múltiples teorías acerca de su origen aún no se tiene una etiología clara. El abordaje diagnóstico es específicamente con resonancia magnética, sin embargo se debe confirmar el diagnóstico histo-patológico para conocer la etiología de base.

Abstract Objective: To Present case reports and a brief review of aneurysmal bone cysts secondary to lymphomas. Material and Methods: Images from the archive of the Radiology and Diagnostic imaging department were obtained from patients seen at the Fundación Oftalmológica de Santander - Carlos Ardila Lülle Clínic (FOSCAL) being diagnosed of an aneurysmal bone cyst secondary to lymphoma. Results: Two clinical cases were reported on patients who developed a cystic bone tumor corresponding to an aneurysmatic bone cyst secondary to lymphoma. Conclusions: The aneurysmatic bone cyst is a rare tumor that constitutes only 1-2% of bone tumors. It mainly affects the metaphysis of long bones and occurs predominantly in young adult patients who are in the second decade of life. Despite the existence of multiple theories about its origin, there is still no clear etiology. The diagnostic approach is radiological, specifically with magnetic resonance images however, the diagnostic must be confirmed with histopathological studies.

Jaffe-Lichtenstein syndrome associated with a simple bone cyst: unprecedented rare case report

Abstract Lesions denominated fibro-osseous lesions of the jaw constitute a diversified group of disorders, in which the normal bone architecture is replaced by fibroblasts, collagen fibers and immature bone. At present, the World Health Organization recognizes four variants of these lesions, namely: bone-cement dysplasia, fibrous dysplasia, ossifying fibroma and Familial gigantiform cementoma. Fibrous dysplasia may present in the monostotic form, affecting one single bone or an isolated craniofacial region; and in the Polyostotic form, involving two or more bones of the skeleton, and eventual association with syndromic conditions. The patient, C.P.G., 43 years old, sought attendance due to symptomatic increase in the region of the mandibular body on the right side. Imaging exams revealed craniofacial areas with ground-glass aspect, beyond the extensive mandibular radiolucent lesion. During the physical exam, spots of the Café au lait type disposed on the right side of the body were identified, in addition to uncoordinated gait with distinct shortening of the right leg. Additional radiographic exams showed evidence of skeletal dissemination of the disease. The patient denied any sexual precocity, and the final diagnosis was fibrous dysplasia, expressed by means of the Jaffe-Lichtenstein syndrome, in association with a simple bone cyst.

Resumo As denominadas lesões fibro-ósseas dos maxilares constituem um grupo diversificado de desordens nas quais a arquitetura óssea normal é substituída por fibroblastos, fibras colágenas e osso imaturo. Atualmente a Organização Mundial de Saúde reconhece quatro variantes destas lesões, sendo elas: a displasia cemento-óssea, a displasia fibrosa, o fibroma ossificante e cementoma gigantiforme familiar. A displasia fibrosa pode ser apresentar na forma monostótica, acometendo um único osso ou a região craniofacial isoladamente, e a forma poliostótica, envolvendo dois ou mais ossos do esqueleto, com eventual associação com condições sindrômicas. Paciente C.P.G., 43 anos, procurou atendimento devido aumento volumétrico sintomático na região de corpo mandibular do lado direito. Exames imaginológicos revelaram áreas craniofaciais com aspecto de vidro fosco ou despolido, além de extensa lesão radiolúcida mandibular. Durante o exame físico foram identificadas manchas do tipo café com leite dispostas do lado direito do corpo, além de marcha descoordenada com nítido encurtamento da perna direita. Novos exames radiográficos evidenciaram a disseminação esquelética da doença. O paciente negou qualquer precocidade sexual e o diagnóstico final foi de displasia fibrosa, expressa por meio da síndrome de Jaffe-Linchtenstein, em associação com um cisto ósseo simples.

Prótesis total de fémur en un paciente con quiste óseo hidatídico complicado. Reporte de un caso / Total femoral replacement in patient with complicated bone hydatid cyst. Case report

Resumen Se presenta un caso de un hombre de 31 años con fractura de fémur. Los estudios complementarios mostraron una imagen compatible con lesión quística. El primer estudio por biopsia de dicho quiste informó erróneamente un quiste simple. Se realizó una osteosíntesis con enclavado endomedular. El paciente tuvo una evolución tórpida asociada a imágenes líticas diafisarias y pérdida de la reducción de la fractura. Se retiró el material y se tomaron muestras del canal endomedular, cuyo cultivo reveló Pseudomonas aeruginosa y restos de quistes hidatídicos en la anatomía patológica. En nuestro centro, fue tratado por una seudoartrosis infectada secundaria a un quiste óseo hidatídico complicado. Se le colocó un megaespaciador de cemento con antibiótico y, luego, una prótesis total de fémur como tratamiento definitivo. El compromiso óseo es muy raro y de difícil diagnóstico, y puede llevar a una diseminación severa. Si bien no hay consenso ni tratamiento de elección para los casos graves, el reemplazo femoral total en dos tiempos representa una opción alentadora para conservar el miembro, con resultados satisfactorios a corto y mediano plazo.

Abstract We report the case of a 31-year-old male patient presenting a femoral fracture whose complementary studies revealed an image consistent with a cystic lesion. The first biopsy study of this cyst erroneously reported a simple cyst. Osteosynthesis with intramedullary nailing was performed. The patient had a poor postoperative course associated with diaphyseal osteolytic images and loss of fracture reduction. The material was removed and intramedullary canal specimens were taken, which were positive for Pseudomonas aeruginosa and revealed remains of hydatid cysts through pathologic examination. The patient was referred to our center for the treatment of an infected pseudarthrosis secondary to a complicated hydatid bone cyst. A two-stage procedure was performed. The first stage involved the placement of an antibiotic-impregnated cement mega-spacer and the second stage involved the implantation of a total femur prosthesis as definitive treatment. The bone hydatidosis involves a challenging diagnosis, is very rare, and can cause severe dissemination. While there is no consensus or gold standard treatment for severe cases, two-stage total femoral replacement represents an encouraging option for limb preservation, showing satisfactory short- and medium-term outcomes.

Effect of decompression combined with curettage and autogenous bone cement implantation on large cysts of the jaw / 华西口腔医学杂志

Decompression and curettage can result are effective as treatments for large jaw cysts, which are common diseases in the clinic. Based on a treatment used in a previous study, this paper proposes a "three-step method" to treat large jaw cyst and repair the bone defect by decompression, curettage, and autologous dental bone powder implantation. This paper introduces the processes and key points of the operation involved in the abovementioned method.

Quiste óseo simple en el calcáneo: reporte de un caso / Simple osseous cyst of the calcaneus a case report

Las tumoraciones óseas son patologías producto de modificaciones en la estructura del hueso y en su contenido, pueden presentarse como lesiones tumorales benignas o malignas, primitivas o metastásicas, en dependencia de varios factores: la edad de presentación, localización, velocidad de crecimiento, reacción perióstica e infiltración a estructuras vecinas. Las publicaciones demuestran que los quistes óseos simples asintomáticos y pequeños no requieren tratamiento, hasta el 25% son de resolución espontánea posterior a una fractura patológica; mientras que quistes más grandes con corteza delgada, requieren de algún tipo de intervención. Se presenta el caso de una paciente de sexo femenino de 17 años de edad, que acude por presentar dolor de moderada intensidad en talón izquierdo que se intensifica a la deambulación, con un tiempo de 2 meses de evolución, posterior a un trauma contuso en esta región. Al examen físico se evidencia dolor a la digito presión y maniobras de movilización activa-pasiva en cara lateral externa a nivel de calcáneo de pie izquierdo. Se realiza radiografía lateral simple de calcáneo izquierdo, donde se evidencia una lesión lítica circular de 3 por 3 cm que compromete la región anteroinferior de calcáneo. En conclusión, el quiste óseo simple o solitario, es una patología benigna, que, aunque no ponga en peligro la vida de la persona puede afectar seriamente la funcionalidad del pie. En la actualidad no existe un tratamiento estandarizado para el manejo de esta patología, las técnicas quirúrgicas actuales en especial el curetaje y el autoinjerto óseo resultan muy prometedoras.

Bone tumors are pathologies resulting from modifications in the bone structure and its content, they can present as benign or malignant, primitive or metastatic tumor lesions, depending on various factors: age of presentation, location, growth rate, periosteal reaction and infiltration to neighboring structures. The publications show that small, asymptomatic and small bone cysts do not require treatment, up to 25% are spontaneous resolution after a pathological fracture; while larger cysts with thin bark require some type of intervention. The case of a 17-year-old female patient is presented, who presents for presenting moderate intensity pain in the left heel that intensifies on ambulation, with a time of 2 months of evolution, after a blunt trauma in this region. On physical examination, pain from the pressure digit and active-passive mobilization maneuvers were evidenced on the external lateral aspect at the calcaneus level of the left foot. A simplelateral radiograph of the left calcaneus was performed, showing a 3 by 3 cm circular lytic lesion involving the anteroinferior region of the calcaneus. In conclusion, simple or solitary bone cyst is a benign pathology that, although it does not endanger the person's life, can seriously affect the functionality of the foot. Currently, there is no standardized treatment for the management of this pathology, current surgical techniques, especially curettage and bone autograft are very promising.

Aneurysmal Patellar Bone Cyst: Case Reportt / Cisto Ósseo Aneurismático de Patela: Relato de Caso

Abstract Patellar tumors are rare. Commonly benign, giant-cell tumors and chondroblastomas are the most frequent types of this tumor. Aneurysmal bone cysts are a less common type, corresponding to less than 1% of the cases. The authors present a case of a 23-year-old male patient who presented left patellar pain and swelling for two years. The radiographic images suggested tumoral causes, and the biopsy was negative for neoplasm. The treatment approach was a complete patellectomy, without complications. The imaging follow-up showed no recurrence.

Resumo Os tumores patelares são uma condição rara. Comumente benignos, o tumor de células gigantes e o condroblastoma são os tipos mais frequentes. O tipo menos comum entre os tumores patelares é o cisto ósseo aneurismático, que corresponde a menos de 1% dos casos. Os autores relatam o caso de um paciente do sexo masculino, de 23 anos, com dor e aumento do volume da patela esquerda havia 2 anos. A radiologia sugeriu causas tumorais, e a biópsia foi negativa para neoplasia. A abordagem terapêutica escolhida foi uma patelectomia total, feita sem intercorrências. O acompanhamento com imagens não mostrou recorrência.

Cisto residual ectópico em associação a corpo estranho: relato de caso / Ectopic residual cyst in association a foreign body: case report

Introdução: O cisto residual é uma lesão de origem inflamatória, associada a uma falta de curetagem adequada do alvéolo de um dente que mostrou lesão inflamatória periapical. Quando não existe fonte de estímulo, tende a regredir, acometendo, frequentemente, o sexo masculino de idade média avançada e com um ou mais dentes extraídos. Relato de caso: Este trabalho tem como intuito apresentar um relato de caso de um paciente do sexo masculino com 69 anos de idade que procurou a Clínica Escola de Odontologia do Centro Universitário CESMAC, com uma fístula de drenos ativos na região anterior de maxila, sem abaulamento ou crescimento dos tecidos circundantes. Ao exame clínico intrabucal, foi observado ausência de todos os dentes superiores, com fístula e drenagem ativa, sem abaulamento das corticais. O exame radiográfico panorâmico mostrou presença de lesão radiolúcida, unilocular, circunscrita por halo radiopaco semelhante a cisto residual. A biópsia excisional foi conduzida com remoção da raiz residual, além de corpos estranhos introduzidos pelo paciente. Considerações Finais: Diante do exposto, deve-se dar importância ao assunto para alertar o cirurgião-dentista quanto ao correto diagnóstico diferencial das lesões ósseas com associação clínica, radiográfica e histopatológica, possibilitando o tratamento adequado e evitando a permanência e crescimento da lesão... (AU)

Introduction: The residual cyst is a lesion of inflammatory origin associated with a lack of adequate curettage of the alveolus of a tooth that showed periapical inflammatory lesion. When there is no source of stimulation, it tends to regress. It frequently affects males from middle to advanced age and with one or more extracted teeth. Case report: This case report a male patient, 69 year old who sought out the Clinical School of Dentistry of the Centro Universitário CESMAC, with a fistula of active drains in the anterior region of the maxilla, without bulging or growth of the surrounding tissues. Intraoral buccal examination showed absence of all upper teeth, with fistula and active drainage without cortical bulging. Panoramic radiographic examination showed the presence of a radiolucent, unilocular lesion, circumscribed by radiopaque halo as a cystic residue. Excisional biopsy was performed with residual root removal in addition to the wooden barb introduced by the patient. Final considerations: In view of the above, it was developed as a reference for the dental surgeon's warning regarding the differential diagnosis of the lesions with the clinical, radiographic and histopathological association, allowing adequate treatment and remaining and lesion growth... (AU)

Caso Clínico: Quiste Óseo Aneurismático de Peroné Distal, Tratamiento con Aloinjerto Estructural / Case Report: Distal Fibula Aneurysmal Bone Cyst, Treatment with Structural Allograft

INTRODUCCIÓN: El quiste óseo aneurismático es una neoplasia benigna que aparece con mayor frecuencia en la segunda década de vida. Clínicamente se presenta como una masa que produce dolor y deformidad de la extremidad afectada; radiológicamente se caracteriza por lesiones líticas con tabicaciones internas y abombamiento de la cortical. Se presenta un caso donde se realizó un aloinjerto estructural para el tratamiento de esta patología. CASO CLÍNICO: Paciente de sexo masculino, de 18 años de edad; con historia de 5 meses de evolución de dolor e impotencia funcional de extremidad inferior derecha; al examen físico se evidenció masa de 15 x 6 cm en tobillo derecho. La radiografía simple demostró una lesión lítica de tercio distal de peroné con adelgazamiento e insuflación de la cortical. El examen histopatológico fue positivo para células gigantes de tipo osteoclasto, cambios simplásticos, estroma miofibroblástico y extravasación eritrocitaria; datos compatibles con quiste óseo aneurismático. EVOLUCIÓN: Se realizó la resección en bloque de la masa tumoral del peroné, para la reconstrucción se utilizó un aloinjerto estructural más estabilización con placa de compresión dinámica y tornillo transindesmal; se realizó además una reconstrucción ligamentaria utilizando la técnica de Watson Jones. El paciente tuvo una evolución favorable, a los 16 meses del procedimiento se observó consolidación completa, además de una función articular conservada; no se evidenció recidiva en los 5 años posteriores de control. CONCLUSIÓN: El quiste óseo aneurismático es una patología benigna que siendo tratada en etapas iniciales, conlleva un mejor pronóstico y requiere de la realización de procedimientos quirúrgicos menos complejos. En pacientes con tumores de gran tamaño no es posible la realización de tratamientos convencionales; siendo la resección en bloque más la colocación de aloinjerto y estabilización ligamentaria, una alternativa terapéutica válida que permita preservar la extremidad.(ua)

BACKGROUND: Aneurysmal bone cyst is a benign neoplasm that presents more frequently in the second decade of life. Clinically It manifests as a mass that causes pain and deformity of the affected limb; radiologically, it is characterized by lytic lesions with internal septations and bulging of the cortex. A case is presented where a structural allograft was performed for the treatment of this pathology. CASE REPORT: 18 year-old male patient, with 5 month history of pain and functional impotence of right lower extremity; physical examination revealed a 15 x 6 cm mass in right ankle. X-ray showed a lytic lesion in the distal third of the fibula, with thinning an insufflation of bone cortex. The histopathological report was positive for giant cells (osteoclast-like cells), symplastic changes, myofibroblastic stroma and erythrocyte extravasation; data compatible with aneurysmal bone cyst. EVOLUTION: An en-bloc resection of the fibular tumor was performed, for the reconstruction a structural allograft plus stabilization with dynamic compression plate and transindesmal screw was used; a ligament reconstruction was also performed using the Watson Jones technique. The patient had a favorable evolution, at 16 months complete consolidation in addition to a preserved joint function was observed; there was no recurrence in the 5 years after control. CONCLUSION: The aneurysmal bone cyst is a benign condition that if treated in initial stages, has a better prognosis and requires less complex surgical procedures. In patients with large tumors, conventional treatment is not possible; en bloc resection plus allograft placement and ligament stabilization, is a valid therapeutic alternative to save the limb.(au)

Aneurysmal Bone Cyst of the Skull Base ­ Case Report

Introduction Aneurysmal bone cysts (ABCs) are pseudotumoral bone lesions of unknown etiology that are also hypervascularized, benign, and locally destructive. They are rare in the base of the skull. The present case report describes a case of aneurysmal bone cyst in the sella turcica. Case Report The present study was developed at the department of neurosurgery of the Hospital Universitário Professor Alberto Antunes of the Universidade Federal de Alagoas (HUPAA-AL, in the Portuguese acronym), Maceió, state of Alagoas, Brazil, and is accompanied by a review of the literature from the PubMed database. A 17-year-old female patient with bitemporal hemianopia and intense left hemicranial headache associated with symptoms from the cranial nerves contained in the cavernous sinus. Neuroimaging evidenced a large lesion in the suprasellar region with calcification foci, sellar erosion, and extension to the cavernous sinus. The patient was submitted to a partial lesion resection and the histopathological analysis showed an aneurysmal bone cyst. Conclusion A rare case of intracranial aneurysmal bone cyst, with the important differential diagnosis from pituitary adenoma.

Common conditions associated with displacement of the inferior alveolar nerve canal: A radiographic diagnostic aid

PURPOSE: This study reviewed the common conditions associated with displacement of inferior alveolar nerve canal. MATERIALS AND METHODS: General search engines and specialized databases including Google Scholar, Pub Med, Pub Med Central, Science Direct, and Scopus were used to find relevant studies by using keywords such as “mandibular canal”, “alveolar canal”, “inferior alveolar nerve canal”, “inferior dental canal”, “inferior mandibular canal” and “displacement”. RESULTS: About 120 articles were found, of which approximately 70 were broadly relevant to the topic. We ultimately included 37 articles that were closely related to the topic of interest. When the data were compiled, the following 8 lesions were found to have a relationship with displacement of mandibular canal: radicular/residual cysts, dentigerous cyst, odontogenic keratocyst, aneurysmal bone cyst, ameloblastoma, central giant cell granuloma, fibrous dysplasis, and cementossifying fibroma. CONCLUSION: When clinicians encounter a lesion associated with displaced mandibular canal, they should first consider these entities in the differential diagnosis. This review would help dentists make more accurate diagnoses and develop better treatment plans according to patients' radiographs.

Osteochondral Lesion in Diffuse Pigmented Villonodular Synovitis of the Knee

Pigmented villonodular synovitis (PVNS) is a rare benign condition that is locally aggressive and may destructively invade the surrounding soft tissues and bone causing functional loss of the joint and the limb. The knee is the most affected joint (range, 28% to 70%) but involvement of the bone is not a common feature seen at this site. We present a rare case of diffuse PVNS of the knee associated with subchondral cyst of the lateral femoral condyle. This posed a diagnostic dilemma because of bone invasion. The radiological image of synovitis was pathognomonic of PVNS but etiology of the osteolytic lesion was confirmed only on histopathology. The large osteochondral defect was eventually managed in a staged manner with bone grafting and osteochondral autograft transfer.

Treatment of long bone cyst in children by autologous bone marrow blood injection and elastic intramedullary needle / 中国骨伤

OBJECTIVE@#To observe the clinical effect of autologous bone marrow blood injection combined with elastic intramedullary needle implantation in the treatment of long bone cyst in children.@*METHODS@#From January 2010 to December 2015, 29 children with long bone cyst were treated with autologous bone marrow blood injection combined with elastic intramedullary nail implantation, including 22 males and 7 females, aged 2 to 12 years old with an average age of 7.7 years old, and the course of disease was 12 to 84 months. Among them, 17 cases were proximal humerus, 9 cases were proximal femur, 2 cases were distal femur and 1 case was proximal ulna. All children with bone cyst underwent preoperative X-ray examination and CT or MRI examination if necessary. After definite diagnosis, bone marrow blood injection combined with elastic intramedullary needle support and drainage were used as treatment methods. After operation, multiple X-ray examination and follow-up were carried out. The curative effect was evaluated with Capanna bone cyst treatment evaluation criteria.@*RESULTS@#Twenty-seven of 29 children were followed up for 12 to 60 months with an average of 31.8 months. According to the evaluation criteria of Capanna bone cyst, 26 cases were cured and 1 case was partially healed with residual lesions.@*CONCLUSIONS@#Autologous bone marrow blood injection combined with elastic intramedullary needle has the characteristics of definite curative effect, high cure rate, fewer complications and objectively controllable treatment process for simple long bone cyst in children.