Abstract
Albeit rare, the majority of identified bone lesions in pregnancy spare the pelvis. Once encountered with a pelvic bone lesion in pregnancy, the obstetrician may face a challenging situation as it is difficult to determine and predict the effects that labor and parturition impart on the pelvic bones. Bone changes and pelvic bone fractures have been well documented during childbirth. The data regarding clinical outcomes and management of pregnancies complicated by pelvic ABCs is scant. Highly suspected to represent an aneurysmal bone cyst, the clinical evaluation of a pelvic lesion in the ilium of a pregnant individual is presented, and modes of delivery in such a scenario are discussed.
Highlights
Case IllustrationOur patient is a 26-year-old primigravid, obese, otherwise healthy female. She had originally presented to our obstetrics clinic as a transfer of care by recommendations from her primary obstetrician
As mentioned by Mintz et al, aneurysmal bone cysts (ABCs) were first described by Jaffe and Lichtenstein in 1942 [1]
MR imaging can narrow the differential diagnosis of ABC by demonstrating characteristic multiple fluid-fluid levels within a multiloculated nonhomogenous lesion best seen on T2-weighted images; this finding is not pathognomonic for ABC [3]
Summary
Our patient is a 26-year-old primigravid, obese, otherwise healthy female. She had originally presented to our obstetrics clinic as a transfer of care by recommendations from her primary obstetrician. The patient had been diagnosed with a left ilium bone lesion 2 years prior to pregnancy This was discovered as an incidental finding on computed tomography (CT) and plain radiography imaging of the pelvis performed during a work-up for low abdominal and pelvic pain in an emergency department visit. The pathology report returned as endometriotic implants Her postoperative course was uneventful, and she was discharged home with her infant on postoperative day 2 in a stable condition with instructions to follow up in 2 and 6 weeks for an incision and postpartum check, respectively. Her abdominal incision was healing well, and her interval history was uneventful on follow-up examination with no complaints of any pelvic bone pain. A levonorgestrel intrauterine device was inserted 3 months postpartum, and the patient was released from our care with instructions to follow up with her primary obstetrician and orthopedic surgeon
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