Diagnosis Of Aneurysmal Bone Cyst Research Articles

Spinal aneurysmal bone cysts – case series

Aneurysmal bone cysts are benign neoplastic lesions that are extensively vascularized and can occasionally exhibit destructive and expanding activity. They typically affect young people, with a small predilection toward females, and most frequently arise during the second decade of life. Aneurysmal bone cysts account for about 1% of all bone tumors and usually develop in long tubular bones, with the spine being much less commonly affected. We present here three cases of aneurysmal bone cysts in the spinal cord that were surgically treated at the Department of Neurosurgery between 2009 and 2022. These patients were admitted to the clinic with symptoms of spinal cord or vascular compression. The volume of operative intervention was total or subtotal resection of the formation. No postoperative neurological deficits were observed, and no early complications were recorded after the interventions. All patients were discharged from the department with clinical improvement. One underwent reoperation after 4 years because of a cyst recurrence. The diagnosis of aneurysmal bone cyst was confirmed by histological examination in all cases.

A Case of Aneurysmal Bone Cyst of Fourth Metacarpal Bone: A Rare Entity at Unusual Location

An Aneurysmal Bone Cyst (ABC) is a locally aggressive, rapidly growing, rare benign bone tumour that typically occurs in children and early adulthood. It usually occurs in the first and second decades of life, with a female predominance. The long bones of the lower extremities and spine are common sites for ABC, with rare involvement of the small bones of the hand. An 18-year-old female presented to the hospital with progressive swelling over her left hand for 4 to 5 months, associated with pain. Local examination elicits pain and tenderness over the 4th metacarpal bone with restricted movement at the Metacarpophalangeal (MCP) joint. A histopathological diagnosis of ABC was made due to the presence of osteoclastic giant cells lining a cyst, along with areas showing a pool of haemorrhage and stromal cells. The postoperative period remained uneventful, with no complaints of pain and good healing of the operation site noted during follow-up. Metacarpal bones are rare sites for ABCs.

Solitary Bone Cyst and Aneurysmal Bone Cyst: Perplexing Pseudocysts of the Jaws

Pseudocysts of the jaws include two very significant lesions – Solitary bone cyst (SBC) and Aneurysmal bone cyst (ABC). Both these cysts have very similar clinical and radiological findings. Histopathology aids in differentiating the two pathologies, with MRI findings offering confirmatory diagnosis of ABC. Differentiating between the two cysts and establishing a definitive diagnosis cannot be over emphasised as prognosis depends on the correct treatment modality after the diagnosis. A lot of updates with regards to the treatment of these cysts in long bones is available, with the same lacking in the cysts of the jaws. This probably could be due to the relative rarity of these cysts in the jaws. This article aims to address the various aspects of these two enigmatic pseudocysts of the jaws. Keywords: Pseudocysts, Solitary Bone Cyst, Aneurysmal Bone Cyst, Pathogenesis, Hemorrhage, Head & Neck, Oral

Aneurismal bone cyst of the medial cuneiform bone: a case report of a new surgical approach and literature review

Introduction An aneurysmal bone cyst (ABC) is a rare, non-neoplastic, destructive, hemorrhagic, and expansile lesion accounting for 1 % of all bone tumors. ABC of the foot is very rare. Patients with foot ABC usually complain of pain and swelling of the affected area. Radiographs and MRI may be helpful in the diagnosis of ABC. No single surgical procedure has gained wide acceptance in the treatment of foot ABC.Purpose To show new effective surgical approach in the treatment of patient with ABC of the medial cuneiform bone.Material and methods We present the case of a 47-year-old woman with a 10-months history of pain and swelling in her right foot. Postoperative histopathological evaluation of resected tissues confirmed the diagnosis of ABC. An en bloc resection (total extraction of the remnant of the medial cuneiform bone) was performed and the defect was replaced with a fibular bone graft from the right leg. Allograft (Bio-Ost®) was placed along the autograft. Tibialis anterior tendon was attached to the fibular bone graft. We performed fixation of the foot and ankle using the Ilizarov original apparatus for prevention of bone graft instability and opportunity for early weight-bearing on the operated foot.Results The postoperative period was uncomplicated with complete healing of the bone defect without recurrence after 12 months of observation. AOFAS score increased significantly from 34 points preoperatively to 92 at 1-year follow-up.Discussion The optimal treatment of this lesion is still under discussion. Different treatment modalities have been described in the literature: wide resection, curettage with or without adjuvants, arterial embolization, intralesional sclerotherapy. Biological reconstruction using bone graft seems to be the best option, but fractures and nonunion are common complications of bone grafting.Conclusion The combination of Ilizarov external fixation and bone grafting provided favorable conditions for the healing of foot bone defect due to ABC without complications, allowed mobility and early weight-bearing of the patient. Recurrence was not detected radiologically. Harvesting of the fibular bone graft did not affect the position of the foot and its movements. Our surgical approach should be considered as a treatment option in similar cases.

Aneurysmal bone cyst: Is selective arterial embolization effective as curettage and bone grafting?

Aneurysmal bone cyst (ABC) is a lytic benign bone lesion representing about 1% of all primary bone tumors. Method to treat ABC's have developed over time. The standard of care cure for ABC has been curettage with or without bone grafting of the defect but is burdened by recurrence rates of approximately 25%-31%. Based on the assumption that ABCs usually supplied by one or more pathological feeding arteries, selective arterial embolization has been described as an adjuvant preoperative procedure to reduce intra-operative hemorrhage, and as primary treatment for lesions in difficult surgical access. In the current study, we therefore asked whether (1) a single or a repeat selective arterial embolization (SAE) for treating ABCs would produce comparable healing rates compared with curettage and bone grafting; (2) evaluated the relationship of recurrence in relation to the site of the cyst, the age, and gender of the patients; and (3) the two techniques differ in term of long-term complication. We retrospectively reviewed 265 patients who underwent curettage and bone grafting or SAE performed at our institute from 1994 to 2018. The diagnosis of ABC was always established with percutaneous CT-guided biopsy or open biopsy. Patients were followed clinically with plain radiographs or CT scan at 3, 6, 9, and 12 months then annually in the absence of symptoms. Treatment success was determined evaluating pre- and postprocedural imaging according to Chang classification. Two hundred and nineteen were treated with curettage and bone grafting (curettage group), and 46 with SAE Group. Of the 219 patients treated with Curettage and bone grafting (curettage group), 165 out of 219 (75.3%) experienced bone healing, while local recurrence was observed in 54 cases (24.7%) after 12 months on average (range: 3-120 months) from surgery. After the first SAE, bone ossification was seen in 27 (58.7%), without needing any further treatment. Eleven recurred patients were treated with SAE (four patients need two while seven need three SAE to heal), and eight patients with curettage and bone grafting. Thirty-eight out of 46 (82%) patients experienced bone ossification regardless the number of SAE. The overall rate of local recurrence for all patients was 26.7%. SAE group presented a lower complication rate (6%) where two patients experienced skin necrosis, and one limb-length discrepancies (2% of all cohort). The use of SAE is an attractive option to treat ABC as it combines on one hand a lower complication rate than curettage and bone grafting, on the other it can be carried out in case of nonresectable ABCs, significantly reducing the size of viable ABC lesions, fostering bone remodeling and mineralization, and most importantly, significantly improving the patient's quality of life.

Epidemiology of benign tumors and pseudo tumoral lesions of the femur based on an analysis of patients receiving orthopedic care

Benign tumors and pseudo tumoral lesions of the bones belong to the largest group ofan abnormal growth of tissue in bone, which is characterized by many specific clinical, radiological and histological features. The study of data on the spread of pathology, localization, frequency of recurrence depending on gender and age characteristics helps to determine the category of people who need a more detailed examination. Aim: Determination of the incidence of an abnormal growth of tissue in bone, the most typical localization, as well as the likelihood of recurrence and malignancy in patients with benign abnormal growth of tissue in the femoral bone. Materials and methods: Materials obtained during the analysis of casesur, as well as radiographs of 465 patients operated in the Department of Traumatology and Orthopedics of the Astrakhan State Medical University from 2 years old to 70 years, from 1977 to 2018, using nonparametric analysis methods. Differences were considered significant at r 0.05. Results: Studying various tumors depending on age, it was found that the median age of patients with aneurysmal bone cyst (13.5) was significantly lower than the median age of patients with giant cell tumor (osteoclastoma) (25), respectively. When comparing persons suffering from a metaphyseal fibrous defect (non-ossifying fibroma) and a chondroma (enchondroma), a difference was noted in the average age values, which amounted to 13.5 years and 45 years, respectively. A significant difference was also found between those with a solitary bone cyst and chondroma (enchondroma), where average was 45 years. When analyzing the significance of differences in the incidence of tumors of certain localizations depending on the patients gender, it was found that the differences are not significantly significant in any of the compared groups. A certain dependence of the tumor localization on gender is not determined, which indicates that the localization of the tumor is not related to the sex of the patient. The frequency of recurrence of an abnormal growth of tissue in femoral bone is also not related to gender. Conclusions: The primary incidence of femorals tumor is predominantly characteristic of patients aged 15 years. In the groups of patients with aneurysmal bone cyst, osteochondroma (bone and cartilage exostosis) and solitary bone cyst, the median age of a person is the smallest. In the comparison of patients with giant cell tumor (osteoclastoma), metaphyseal-fibrous defect (non-ossifying fibroma), osteoid osteoma, chondroma (enchondroma), female patients predominated, and in patients with osteochondroma (osteocartilaginous exostosis) and osteoma, male patients predominated. The incidence of recurrence in the compared groups with a diagnosis of aneurysmal bone cyst, giant cell tumor (osteoclastoma), fibrous dysplasia and chondroma (enchondroma) was significantly higher than in other groups.

Giant Aneurysmal Bone Cyst of the Mandibular Condyle Mimicking Parotid Tumor: A Case Report and 22-Year Follow-Up

Background: Aneurysmal bone cyst (ABC) is a rare benign non-odontogenic cyst that occurs most commonly in the posterior mandible. Occurrence in the mandibular condyle is rare. We present a case that was initially misdiagnosed as a parotid gland tumor and later was found to be an ABC. Case Presentation: A 19-year-old man presents with a painless firm swelling on the right preauricular region. Panoramic imaging revealed a radiolucent lesion in the right condyle and ascending ramus of the mandible with complete erosion of the bony surface losing the condyle configuration. The lesion was excised, and the mandible was curetted. A split-thickness left clavicular joint graft was harvested for reconstruction of the right condyle of the mandible. The pathology report confirmed the diagnosis of aneurysmal bone cyst. The patient was followed for 22 years without any evidence of recurrence. Conclusions: Tumors of the jaws and cystic lesions may mimic benign salivary gland pathology. Appropriate clinical and radiographic examination should be utilized to exclude this from the differential diagnosis. Complete surgical excision of the lesion and reconstruction of the condyle may be utilized to provide patients with good results.

Does the preoperative neutrophil-to-lymphocyte ratio have a prognostic value in aneurysmal bone cysts?

The aim of this study was to evaluate the prognostic value of neutrophil-to-lymphocyte ratio (NLR), lymphocyte-tomonocyte ratio (LMR), and platelet-to-lymphocyte ratio (PLR) in aneurysmal bone cysts (ABCs). Between February 2001 and August 2019, a total of 86 patients (44 males, 42 females; mean age: 21.5±15.2 years; range, 2 to 73 years) with a histologically confirmed diagnosis of ABCs who did not receive cancer treatment previously and had a minimum follow-up period of 24 months were retrospectively analyzed. Data including age, sex, side, tumor location, pre-treatment complete blood count analysis results, preferred surgical method, follow-up period, presence of recurrence, and date of recurrence were recorded. Preoperative NLR, LMR and PLR values were calculated in all patients. The mean follow-up was 56.7±13.5 (range, 24 to 179) months. Forty-one (47.7%) ABCs were located in the lower extremities, 36 (41.8%) in the upper extremities, and nine (10.4%) in the pelvic girdle. A statistically significant difference was detected in the NLR values according to recurrence status (p=0.023). The PLR and LMR values were not significant for area under the curve, while NLR values were significant for recurrence. The cut-off value was determined as 2.054. Those with an NLR of ≥2.054 were found to have a 4.561-fold higher risk of recurrence than those with an NLR of <2.054 (odds ratio [OR]=4.561). Our study results suggest that NLR, which is the pre-treatment inflammatory index, is a prognostic factor in patients with ABCs. Although NLR alone is not decisive in patients with elevated NLR, it can be used to evaluate the clinical prognosis and recommend an appropriate treatment strategy.

Unusual presentation of an aneurysmal bone cyst: A case report and literature review

Aneurysmal bone cysts (ABCs) are non-neoplastic primary bone tumors, typically involving the long bones and vertebrae in the first 2 decades of life. ABCs require prompt diagnosis and intervention due to their rapidly expansile nature and ability to destroy the adjacent normal bone. ABCs rarely affect the rib. We report a case of a 51-year-old female presenting with chronic dry cough and right upper back pain. A chest X-ray and computed tomography scan revealed an expansile, lytic mass affecting the posterior aspect of the third right rib. The third right rib was resected using a posterolateral, Shaw-Paulson approach. Histopathology of the resected mass confirmed the diagnosis of ABC. There were no intra- or perioperative complications, and follow-up X-ray was normal.

Malignancy of Aneurysmal Bone Cyst in Osteosarcoma and Angiosarcoma: Series of 2 Cases and Literature Review

Aneurysmal bone cyst (ABC) is a rare benign bone tumor characteristic of the first decades of life. Malignization of ABC in the absence of risk factors such as radiotherapy is extremely rare, with few cases published in the literature. There are malignant tumors such as telangiectatic osteosarcoma with an initial clinical, radiological and anatomopathological resemblance that requires special attention in their differential diagnosis. We present two patients with an initial histologic diagnosis of ABC who developed true malignancy, in the absence of risk factors, into osteoblastic osteosarcoma and epithelioid angiosarcoma. In spite of its exceptional nature, in the presence of an aggressive type of ABC malignant degeneration should always be suspected and therefore, an open biopsy and wide resection performed for a correct diagnosis to avoid residual microscopic disease in case of aggressiveness. Epithelioid angiosarcoma from an ABC tumor malignancy has never been described before.

Aneurysmal bone cyst of the temporal bone presenting with reversible vestibular impairment.

Aneurysmal bone cysts are expansile benign lesions associated with compressive destruction and obscure pathogenesis. The most common sites of temporal bone involvement are the petrous apex, squamous portions and mastoid. This paper reports a right temporal aneurysmal bone cyst in a 51-year-old man who presented clinically with facial palsy, and hearing loss and impaired vestibular function. Magnetic resonance imaging and computed tomography findings were consistent with a diagnosis of aneurysmal bone cyst. Inter-operative findings showed that the lesion had caused compressive damage to the internal auditory canal. Following surgical excision, the patient experienced vertigo, indicating recovery of vestibular function. Follow-up imaging revealed complete resection without clinical recurrence. To our knowledge, this is the first report of aneurysmal bone cyst invasion of the inner auditory canal. Our clinical experience indicates that vestibular nerve damage recovery is relatively uncommon. This case report will hopefully inform future studies.

Aneurysmal bone cyst in the scapula of a young cat

AbstractA 2‐year and 6‐month‐old male neutered domestic long hair cat was referred for assessment of right thoracic limb lameness of approximately 3 months’ duration. Palpation of the right shoulder revealed a firm mass of approximately 6 cm diameter centred on the mid‐body of the scapula. Computed tomography (CT) showed a lytic expansile mass on the caudo‐dorsal aspect of the right scapula. Differential diagnoses included reactive or reparative processes, sarcoma‐like lesions and aneurysmal bone cyst (ABC). Due to the potential for malignancy, a total scapulectomy was performed, and histopathology confirmed the final diagnosis of ABC. The patient recovered uneventfully from surgery, and 11 months following surgery showed a good return to function and an excellent level of comfort.

Treatment of locally aggressive benign bone tumors by means of extended intralesional curettage without chemical adjuvants.

Objectives:The aim of this study is to present the clinical, oncological, and functional results of locally aggressive benign bone tumors treated with extended intralesional curettage without the use of adjuvant in a tertiary orthopedic oncology center.Method:A total of 172 patients treated with surgical curettage and high-speed burrs for the diagnosis of aneurysmal bone cyst, giant cell tumor, osteoblastoma, chondroblastoma, and chondromyxoid fibroma were included in the study. Demographic, radiological, and clinical data of the patients were analyzed.Results:One-hundred seventy two patients (101 (59%) female and 71 (41%) male) with a mean age of 23 years (6–84). The mean follow-up period was 48 months (18–108). In the study, a total of 8 (4.6%) patients had postoperative complications, 17 (9.9%) patients had recurrence in the postoperative period. Diameter greater than 5 cm was found to be a risk factor for recurrence (p < 0.004). The probability of developing complications was found to be significantly higher in patients with recurrence (p < 0.001). There was no significant relationship between recurrence and age, tumor type, and tumor stage.Conclusion:Successful treatment results can be obtained with extended surgical curettage, high-speed burr, and cauterization without the use of chemical adjuvants in locally aggressive bone tumors.

Recent Trends in the Management of Aneurysmal Bone Cyst

Abstract Background Aneurysmal bone cysts (ABCs), were first described by Drs. Jaffe and Lichenstein in 1942 when they described pelvic and spine lesions that when exposing the lesion and opening in to its thin wall, the surgeon was immediately confronted by a large hole containing much fluid blood. Aim of the Work To describe the efficacy of new line treatment modalities of (Aneurysmal Bone Cysts) compared to conventional lines of management regarding the: • Long term outcomes and healing rate. • Recurrence rates. • Complications after therapy. Patients and Methods Criteria for considering studies for this review: • Types of the studies: published observational analytical studies (case-control_ case-series _ RCT or cohort studies) which studied the efficiency of new lines in the management of aneurysmal bone cyst. • Types of participants: participants were children and young age (below the age of 50 yrs) with a diagnosis of aneurysmal bone cyst. • Types of interventions: drugs like (Bisphosphonate or denosumab) were administered for a time determined by the case improvement, or minimally invasive techniques like (cryosurgery or curopsy) was done. Results Through the results of our study that compared between these recent modalities according to healing, recurrence, and complications rate; we are able to say that recent strategies have a high rate of healing ranges from 78.57% with bisphosphonate to 100% with doxycycline and cryotherapy. Conclusion There are recent evolving trends in the management of ABC other than the classic ways of management, they are less invasive, have less recurrence rate reaches to 0 % like with bisphosphonate, less complications rate as well reaches to 0 % like with doxycycline and bisphosphonate, high healing rate reaches to 100 % like with doxycycline and taking in consideration how to handle cases of ABC that classic way of management can’t handle like spinal ABC.

Aneurysmal bone cyst in the proximal femur: Combined approach of management: a case report

Purpose of Study: To study the effectiveness of combined extended curettage and sclerosant therapy in the management of aneurysmal bone cyst of proximal femur. Materials and Methods: A 22 years old male presented with complaints of left hip pain since 20 days, was examined clinically and radiologically. On MRI, he was diagnosed to have a non-expansile lytic lesion in the left proximal femur with features suggestive of aneurysmal bone cyst or an unicameral bone cyst. Patient was planned and taken up for aspiration and curettage followed by a single sitting sclerosant therapy with 3% polidocanol, bone cementing combined with plating. Curetted sample was sent for histo-pathological examination. Patient was advised restricted weight bearing for a period of 4 weeks. Regular follow-ups of the patient was done at 1, 3, 12 and 18 months post-operatively to assess for recurrence. Results: Histo-pathological examination confirmed the diagnosis of aneurysmal bone cyst. With regular follow-ups, patient had a good functional outcome and no evidence of recurrence with this technique at 18 months follow-up. Conclusion: Aneurysmal bone cyst has a higher recurrence rate with curettage and bone grafting alone. Extended curettage along with sclerotherapy with 3% polidocanol has shown no evidence of recurrence at 18 months follow-up in our study. Hence, this combined approach can be recommended in the management of aneurysmal bone cyst.

A rare case of intraosseous lipoma of distal tibia – A case report and review of literature

Introduction: Intraosseous lipoma is a very rare neoplasm accounting for &lt; 0.1 % of primary bone tumors. Pain is the leading symptom in majority of the reported cases but it can be asymptomatic. There is slight male predominance in occurrence of this lesion. The plain radiological findings are not specific and requires differential diagnosis. The lesion is mostly diagnosed by histopathological examination. Case report: A 31-year-old male presented with localized pain around the medial aspect of right ankle joint for one week. Examination revealed mild tenderness over the distal part of the right tibia over the medial aspect. Plain radiograph of the right leg showed well-defined expansile osteolytic lesion with sclerotic rim and calcified matrix at metaphysis of distal tibia. MRI showed enhancing T1-weighted hypo intense and T2-weighted hyperintense lesion. For this case, radiological impression was giant cell tumor with differential diagnosis of aneurysmal bone cyst and fibrous dysplasia. However, the histopathological examination showed intraosseous lipoma, consistent with stage II of Milgram’s classification. Conclusions: Although the diagnosis of intraosseous lipoma can be very challenging due to its rarity and indistinct plain radiograph findings, combination of computed tomography or magnetic resonance imaging may be useful by being able to show the presence of fat within the lesion. However, the clinicians, surgeons and radiologist should be familiar and be aware of these findings to be able to come to a correct diagnosis since not all cases need surgery and can be managed conservatively.

Iliac Telangiectatic Osteosarcoma - A Rare Presentation and Diagnostic Pitfall: A Case Report

Telangiectatic osteosarcoma is a rare variant of osteosarcoma and can be easily misdiagnosed as aneurysmal bone cyst. We report an atypical case of iliac telangiectatic osteosarcoma in a young healthy female, who presents with painful slow growing expansile lytic septate lesion in the left hemipelvis, which is initially treated as aneurysmal bone cyst. The diagnosis of aneurysmal bone cyst is made after histopathological examination of core needle biopsy. Her condition became unstable and massive bleeding is noted at the lesion site after sclerosant injection. She undergoes emergency hemipelvectomy and eventually the biopsy turns up to be telangiectatic osteosarcoma. Our case highlights that core needle biopsy is not useful in making diagnosis for iliac telangiectatic carcinoma. Hence, an open biopsy should be carried out in our case.This case also emphasises on careful evaluation for malignancy which is mandatory because bleeding from pelvis after an unsuitable treatment can be grave, to the extent that major amputation hemipelvectomy is an option. Even though telangiectatic osteosarcoma has the same prognosis and treatment with conventional osteosarcoma, the outcome of delayed treatment for telangiectatic osteosarcoma is not good due to the dilemma in establishing an early correct diagnosis.

A Reconstruction of pelvic ring after Hemipelvectomy and Fibular graft at 39 – years – old man with Aneurysmal Bone Cyst at Iliac bone

Abstract&#x0D; &#x0D; Introduction: The ABC (Aneurysmal Bone Cysts) lesion has been reported in the orthopedic literature for more than 60 years; it was first described in 1942 by Jaffe and Lichtenstein. Aneurysmal bone cyst (ABC) in pelvic is a benign, expansile osteolytic lesion that typically affects the metaphysis of long bones in the second decade of life and occurring in patients less than 20 years. The Several ABC treatment modalities had been utilized including wide resection, intralesional resection/curettage with or without different adjuvants, radiation, embolization, intralesional sclerotherapy.&#x0D; Case Report: We present a rare case of a huge aneurysmal bone cyst (ABC) in the iliac bone, occurring in the male patient 4th decade of life. The patient presented with a history of pain and huge pelvic mass size 8x6x5 cm extend to abdominal region for 5 years. Plain radiograph and computed tomography showed expansile lytic lesion arising from the all right iliac bone extend to Lumbar 5. A biopsy was performed and histology confirmed diagnosis of aneurysmal bone cyst. The patient was managed surgically with hemipelvectomy type 1 and Autogenous bone graft from fibula and reconstruction with plate and screw for pelvic ring with and re-attach the muscle on it. Follow up 5 months after surgery the patient can squat and stand maximally with no pain, nor recurrence and can return to normal activity.&#x0D; Conclusion: Early diagnosis and complete resection of tumor and treatment of relevant symptoms represent a viable treatment for this rare disorder to achieve increased life expectancy, low recurrence of tumor and improved quality of life.&#x0D; &#x0D; Keywords: Aneurysmal bone cyst, Pelvis, hemipelvectomy

Sclerotherapy treatment of an assumed aneurysmal bone cyst in a dog

A 3-month-old, 18 kg, female St Bernard breed dog was presented with recurrent left forelimb lameness and painful swelling of the antebrachium. A large expansile lytic lesion within the left...

Expansile Lytic Lesions of Rib: Two Rare Case Reports

Of all primary bony tumors, chest wall is involved in only 5 – 8 % cases. Chondroblastoma and aneurysmal bone cyst (ABC) rarely occur in chest wall. Here, we would be presenting two such rare cases .One, a 26 year old male presenting with history of chest pain for 1 ½ year and other a 37 year old male with the chief complaint of pain in left shoulder for 3 years. X –ray, CT scan and MRI was done followed by guided FNAC and diagnosis of aneurysmal bone cyst in case1 and chondroblastoma in case 2 was made.