A large mixed pattern aneurysmal bone cysts: An extremely rare case with unusual radiological findings and management sequela

Abstract

A mixed pattern of aneurysmal bone cysts (ABCs) is an extremely rare anatomic subtype. Typical ABCs usually arise in the metaphysis of long bones, predominantly in childhood-age patients. Here, we report a case of a 37-year-old female presenting with the left leg pain and mass for 2 years. Conventional radiographs and computed tomography scans revealed a well-demarcated expansile lytic lesion at the diaphysis of the left tibia. Magnetic resonance imaging showed fluid-fluid levels with associated bone edema. These findings were suggestive of ABC. An open incisional biopsy was done and was confirmatory. After 8 months, the patient showed radiographic complete ossification of the lesion with persistent symptoms. Excision and intralesional curettage of the lesion was performed and supported with a tibia locking plate. On 18 months of follow-up, the patient was asymptomatic, with no recurrence observed on conventional radiographs.