Hip Pelvis.  2014 Sep;26(3):202-205. 10.5371/hp.2014.26.3.202.

Primary Aneurysmal Bone Cyst in the Iliac Bone: A Case Report

• Kim CG
• Kweon SH

• KMID: 2054187
• DOI: http://doi.org/10.5371/hp.2014.26.3.202

Abstract

Symptomatic aneurysmal bone cysts with expansible lesions in the pelvis are rare in children. The management of an aggressive vascular lesion in a female child is challenging. The standard treatment for aneurysmal bone cysts is accompanied by a high risk of local recurrence. A 12-year-old female presented with a history of pelvic pain for 5 months. Plain radiographs and magnetic resonance imaging showed a very large expansile lytic lesion arising from the right iliac bone. Intralesional curettage, electric cauterization, chemical sclerotherapy and allogeneic bone graft were performed through the window of the iliac crest. At a follow-up consultation 3.5 years post-surgery, the child had painless full-range movement in the hip joint with no recurrence. Although many treatment options are described, our patient was treated successfully using curettage and allogeneic bone graft without recurrence.

Keyword

Pelvic iliac bone; Aneurysmal bone cysts; Curettage; Electric cauterization; Chemical sclerotherapy

MeSH Terms

Aneurysm*
Bone Cysts*
Bone Cysts, Aneurysmal
Cautery
Child
Curettage
Female
Follow-Up Studies
Hip Joint
Humans
Magnetic Resonance Imaging
Pelvic Pain
Pelvis
Recurrence
Sclerotherapy
Transplants

Figure

• 

  Fig. 1 Pre-operative anteroposterior radiograph of the pelvis showing an expansile osteolytic lesion involving to the superior border of the acetabulum with multiple septation.

• 

  Fig. 2 T2-weighted magnetic resonance imaging coronal view (A) shows 11×9×5 cm large, well defined lesion and axial view (B) shows multiseptations forming cysts containing fluid-like signal intensity.

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  Fig. 3 Histological features composed of hemorrhagic spaces of blood-filled cavities surrounded by fibrotic septa, inflammatory cells and osteoclast cells that are distributed around the cystic spaces (H&E stain, 40×).

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  Fig. 4 Follow-up radiograph at 3 years and 6 months post-surgery. The radiograph shows good remodeling and no involvement of the hip joint.

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