Haemothorax from aneurysmal bone cyst of the spine

Abstract

Aneurysmal bone cyst (ABC) is a benign bone tumour characterised by rapidly expanding osteolysis. The nomenclature was proposed by Jaffe and Lichtenstein (1942), who also determined the nature of the lesion. Between 9% and 12% of all aneurysmal bone cysts occur in the spine (Campanacci, Capanna and Picci 1986), presenting with back pain and symptoms resulting from cord or root compression and from vertebral collapse. Haemothorax is an unusual presentation and to our knowledge has never been reported in the English literature. Case report. A nine-year-old girl presented with a onemonth history of increasing dyspnoea and dull upper back pain, radiating to the left hemithorax. Radiographs showed a large quantity of fluid in the left pleural cavity (Fig. 1). This was drained and 1500 ml of haemorrhagic fluid was removed ; histologically there was no evidence of malignancy. Further radiographs indicated a tumour mass in the left superior and posterior part of the mediastinum and a CT scan showed a cystic lesion involving the body of the fourth thoracic vertebra (Fig. 2). Over the next six days, recurrence of the haemo