Simple Bone Cyst Research Articles

Primary Benign Neoplasms of the Spine.

Benign tumours comprise the majority of primary vertebral tumours, and these are often found incidentally on imaging. Nonetheless, accurate diagnosis of these benign lesions is crucial, in order to avoid misdiagnosis as more ominous malignant lesions or infection. Furthermore, some of these tumours, despite their benign nature, can have localised effects on the spine including neural compromise, or can be locally aggressive, thus necessitating active management. Haemangiomas and osteomas (enostosis) are the commonest benign tumours encountered. Others include osteoid osteoma, osteoblastoma, fibrous dysplasia, osteochondroma, chondroblastoma, haemangioma, simple bone cysts, aneurysmal bone cysts, giant cell tumours, eosinophilic granuloma and notochordal rests. The majority of lesions are asymptomatic; however, locally aggressive lesions (such as aneurysmal bone cysts or giant cell tumours) can present with nonspecific symptoms, such as back pain, neurological deficits and spinal instability, which may be indistinguishable from more commonly encountered mechanical back pain or malignant lesions including metastases. Hence, imaging, including radiography, computed tomography (CT) and magnetic resonance imaging (MRI), plays a critical role in diagnosis. Generally, most incidental or asymptomatic regions are conservatively managed or may not require any follow-up, while symptomatic or locally aggressive lesions warrant active interventions, which include surgical resection or percutaneous treatment techniques. Due to advances in interventional radiology techniques in recent years, percutaneous minimally invasive techniques such as radiofrequency ablation, sclerotherapy and cryoablation have played an increasing role in the management of these tumours with favourable outcomes. The different types of primary benign vertebral tumours will be discussed in this article with an emphasis on pertinent imaging features.

CLINICAL PATHOLOGIC CONFERENCE CASE 1: A MULTILOCULAR RADIOLUCENCY OF THE RIGHT MANDIBLE

CLINICAL PATHOLOGIC CONFERENCE CASE 1: A MULTILOCULAR RADIOLUCENCY OF THE RIGHT MANDIBLE

A case of multiple cemento-osseous dysplasia associated with simple bone cysts resembling bone cavities

A case of multiple cemento-osseous dysplasia associated with simple bone cysts resembling bone cavities

Novel method to biopsy aneurysmal bone cysts in children.

The thin and friable septations composing aneurysmal bone cysts (ABC) may be challenging to target for percutaneous biopsy. The purpose of this study was to describe and evaluate a novel method of ABC biopsy using endomyocardial biopsy forceps as an attempt to capture larger fragments of tissue for diagnosis. This was a retrospective study performed over a 17-year period. Patients <18 years old who underwent percutaneous biopsy for a presumed ABC, based on pre-procedure imaging, were included. Medical records were reviewed to identify age, sex, lesion location, biopsy procedure details, complications, and pathology results. A diagnostic biopsy was defined as conclusive histologic confirmation. Inconclusive findings or findings suggestive of but not diagnostic of an ABC were treated as non-diagnostic, even if imaging and clinical findings were characteristic. Biopsy device selection and quantity of tissue obtained was at the discretion of the pediatric interventional radiologist. Fisher's exact test was used to compare the diagnostic yield of standard biopsies to those employing biopsy forceps. Twenty-three biopsies were performed in 18 patients (11 female) with a median age of 14.7 years (IQR 10.6-15.6). Lesions were located in the extremities (7, 30.4%), chest (6, 26.1%), pelvis (5, 21.7%), spine (4, 17.4%), and mandible (1, 4.3%). Specimens were obtained using a 13- or 15-gauge bone coring needle (11, 47.8%); 14-, 16-, or 18-gauge soft tissue needle (6, 26.1%); or a combination of bone and soft tissue (4, 17.4%) needles. Endomyocardial biopsy forceps were utilized in 7 cases (30.4%), 2 in which it was the only device used. Overall, a conclusive pathologic diagnosis was made in 13/23 (56.5%) biopsies. Of the diagnostic biopsies, 1 was a unicameral bone cyst and all others were ABCs. No malignancy was identified. Compared to the standard approach, the use of forceps was more likely to result in a diagnostic biopsy (40.0% vs 100.0%, p = 0.008). There were no complications. Endomyocardial biopsy forceps offer an additional, novel technique to biopsy presumed ABCs and may improve diagnostic yield.

No NFATC2 fusion in simple bone cyst of the jaw.

Simple Bone Cysts (SBCs) predominantly occur in long bones and 59% harbour NFATC2 rearrangements. Jaw SBC is rare and was previously referred to as traumatic bone cyst. It can rarely occur in association with cemento-osseous dysplasia (COD). To determine whether jaw SBCs represent the same entity as SBC of the long bones, or if they have a different molecular signature, we collected 48 jaw SBC cases of 47 patients to assess NFATC2 rearrangement. Out of the 48 cases, 36 could be used for fluorescence in-situ hybridization (FISH), of which nine (two of which associated with COD) were successful using an NFATC2 split probe. The remaining cases failed to show adequate FISH signals. All nine cases lacked NFATC2 rearrangement and five of these showed no detectable gene fusions using Archer FusionPlex. In our study, NFATC2 rearrangement is absent in solitary jaw SBC (n = 7) and COD-associated SBC (n = 2). Our findings suggest that SBC presenting in the jaw is molecularly different from SBC in long bones. Future molecular studies may confirm the absence of clonal molecular aberrations in SBC of the jaw which would support a non-neoplastic, reactive origin.

Bovine Grafting: An Effective Alternative after Curettage of Benign Bone Tumors

We retrospectively reviewed 28 patients (15 women and 13 men) with benign bone tumors or pseudotumors treated with curettage and filling with freeze-dried bovine bone graft Orthogen (Baumer S/A, São Paulo, Brazil). The aim of the study was to evaluate the rate of incorporation of Orthogen into the host bone, as well as to describe the outcomes of bone healing (quality, time, and complications). General characteristics, tumor volume, size, site, complications, percent filled, and healing quality at 6 and 12 months were assessed through radiographs. Mean patient age was 20.5 (range 4.7-75.1) years. The most common lesion type was simple bone cyst (12/28), and the most common sites were the tibia (7/28) and humerus (7/28). There were no postoperative pathologic fractures. Two cases (7.1%) of serous fluid leakage through the wound occurred. Mean cavity volume was 20.1 (range 2.7-101.4) cm3. At 6 and 12 months, 75% and 77.8% of cavities, respectively, showed complete bone healing. At 12 months, 81% of cavities filled >90% with graft showed complete bone healing vs. only 19% of those filled <90%. Filling with bovine bone graft resulted in few complications and excellent healing after curettage of benign bone tumors or pseudotumors. Complete healing occurred in most cases by 12 months. Cavities with a higher percentage of filling had a higher rate of complete radiographic incorporation.

MR angiography facilitates the differentiation of aneurysmal from unicameral bone cysts.

The objective of this work was to evaluate the incremental value of MR angiography over plain radiographs and MRI for the differentiation of aneurysmal bone cysts (ABCs) from unicameral bone cysts (UBCs). Thirty-six juvenile patients with histologically secured primary ABCs or UBCs were included in this retrospective study. Two radiologists assessed all obtained images in a blinded fashion using a catalog of previously suggested imaging findings. A second readout with supplementary MR angiography images was performed after 8 weeks to prevent observer recall bias. Diagnostic accuracy parameters were calculated for individual imaging findings, and overall diagnostic accuracy and diagnostic confidence were assessed for all readouts. Receiver operating characteristic (ROC) curve comparison was used to determine the incremental value of MR angiography. Of 16 imaging features, only abnormal vascularization in MR angiography provided sufficient diagnostic accuracy for the identification of ABCs. Other imaging features such as fluid-fluid levels and internal septations were insufficient for the differentiation of UBCs from ABCs. Availability of MR angiography images significantly increased diagnostic accuracy (94.4 vs 75.0% and 83.3 vs 69.4%, respectively, p < 0.05) and diagnostic confidence (4.5 vs 3.7, p < 0.05) of reading radiologists. The presence of arterial feeders in MR angiography can accurately discriminate primary ABCs from UBCs and increases the diagnostic accuracy and diagnostic confidence of reporting radiologists. Radiographic differentiation of cystic bone lesions such as ABCs and UBCs remains challenging. We demonstrate that MR angiography provides incremental value and suggest inclusion in standard examination protocols.

Pseudocysts of the jaw: a retrospective study of 41 cases from a single institution

ObjectiveThe purpose of this retrospective study was to investigate and compare the clinical, radiographic, pathological, pathogenesis, and therapeutic features of simple bone cysts (SBCs) and aneurysmal bone cysts (ABCs) of the jaw.Methods35 patients with SBCs and 6 patients with ABCs who received treatment at the Department of Oral and Maxillofacial Surgery, Zhejiang University School of Medicine from 2017 to 2022 were followed up and reviewed retrospectively.ResultsThe study included 41 patients, accounting for 2.14% of all jaw pathologies, with 35 patients having SBCs and 6 patients having ABCs; their average ages were 26.63 ± 13.62 years and 17.83 ± 7.88 years, respectively. The prevalence of SBC and ABC did not differ significantly by sex. The mandible was the most vulnerable area to be involved. Only 5.71% (2/35) of patients with SBCs and 16.7% (1/6) of patients with ABCs reported histories of previous trauma in the same region of the pseudocysts. A total of 42.86% (15/35) of SBC cases and 66.67% (4/6) of ABC cases had malocclusions. The radiographic features of pseudocysts varied in shape, were associated with the root, and unilocular or multilocular. All patients had curettage with or without bone graft or substitute implantation, and recurrences did not occur in 94.29% (33/35) of SBC patients and 100% (6/6) of ABC patients after a mean follow-up time of 26.23 ± 15.47 months and 21.67 ± 19.75 months, respectively.ConclusionsPseudocysts, including SBCs and ABCs, are benign osteolytic lesions without an epithelial lining that occur occasionally in the jaw, mostly in adolescents and young adults, and their incidence did not significantly differ by sex. The most vulnerable site of involvement is the mandible, and they are generally not overtly aggressive. Trauma has a less significant role in pseudocysts, but minor trauma, such as malocclusion, has the potential to influence pseudocyst development. The clinical presentation of pseudocysts lacks specificity, and most patients are asymptomatic and found incidentally during radiographs. Dental panoramic radiographs and CBCT cannot accurately distinguish between SBC and ABC, and the final diagnosis depends on pathological diagnosis. Curettage combined with bone grafting is currently the best treatment for both, with a 5.71% (2/35) recurrence rate for SBC and no recurrence found for ABC.

Injection of a Bone Substitute in the Treatment of Unicameral Bone Cysts.

Simple bone cysts are benign bony lesions. Treatment strategies are varied for this particular pathology. It remains controversial as to what the ideal treatment strategy is. Recently, bony substitute injections have emerged as a potential option for treatment. This paper aimed to describe our institution's experience in using bony substitute injections to treat unicameral bone cysts. A retrospective review of consecutive patients over an 84-month period at a tertiary paediatric hospital was performed. Information regarding patients' presentation, diagnosis, and management was recorded and summarised. A total of 15 patients were included in our study, with a mean follow-up of 118 weeks. 86.7% of patients demonstrated clinical resolution (absence of pain at the latest follow-up) and 80% of patients demonstrated radiographic resolution. Only one patient sustained a subtrochanteric fracture post-index operation, whilst two others demonstrated redevelopment of cystic architecture on follow-up. This study demonstrates that bone substitute injection is potentially a minimally invasive and seemingly successful technique in the treatment of unicameral bone cysts and other simple bone lesions. Further randomised and comparative studies are required to confirm and validate our findings.

A rare case of simple bone cyst in proximal humerus in skeletally matured patient-case report

A simple bone cyst is a common, benign bone tumor that primarily occurs in children and adolescents. In most cases, simple bone cysts are not painful and are often discovered incidentally when an X-ray is obtained for another reason. In this report, we present a case of SBC in 26yr older man who is skeletally mature, with pain in his left shoulder and arm for a 1-month duration. Although operative management is always a welcome move for symptomatic benign tumors like a simple bone cyst, simple bone cysts are very rare after skeletal maturity, but we should keep in mind that not all simple bone cysts present to us early.

Incidental findings involving the temporomandibular joint on computed tomography and magnetic resonance imaging.

The temporomandibular joint (TMJ) is frequently imaged in head and neck computed tomography (CT) and magnetic resonance imaging (MRI) studies. Depending on the indication for the study, an abnormality of the TMJ may be an incidental finding. These findings encompass both intra- and extra-articular disorders. They may also be related to local, regional or systemic conditions. Familiarity with these findings along with pertinent clinical information helps narrow the list of differential diagnoses. While definitive diagnosis may not be immediately apparent, a systematic approach contributes to improved discussions between clinicians and radiologists and better patient management.

Bone and soft tissue tumors: clinicoradiologic-pathologicmolecular-genetic correlation of novel fusion spindled, targetable-ovoid, giant-cell-rich, and round cell sarcomas.

New entities in the classification of bone and soft tissue tumors have been identified by use of advanced molecular-genetic techniques,including next-generation sequencing. Clinicoradiologic and pathologic correlation supports diagnostic classification. Tumors from four morphologically grouped areas are selected to enhance diagnosis and awareness among the multidisciplinary team. These include select round cell tumors, spindle cell tumors, targetable tyrosine kinase/RAS::MAPK pathway-ovoid (epithelioid to spindled)tumors, and giant-cell-rich tumors of bone and soft tissue. Round cell tumors of bone and soft tissue include prototypical Ewing sarcoma, newer sarcomas with BCOR genetic alteration and CIC-rearranged, as well as updates onFUS/EWSR1::NFATc2, an EWSR1 non-ETS tumor that is solid with additional amplified hybridization signal pattern of EWSR1.This FUS/EWSR1::NFATc2 fusion hasnow been observed in seemingly benign to low-grade intraosseous vascular-rich and simple (unicameral) bone cyst tumors. Select spindle cell tumors of bone and soft tissue include rhabdomyosarcoma with FUS/EWSR1::TFCP2, an intraosseous high-grade spindle cell tumor without matrix. Targetable tyrosine-kinase or RAS::MAPK pathway-tumors of bone and soft tissue include NTRK, ALK, BRAF, RAF1, RET, FGFR1, ABL1, EGFR, PDGFB,and MET with variable ovoid myopericytic to spindled pleomorphic features and reproducible clinicopathologic and radiologic clues to their diagnosis. Giant-cell-rich tumors of bone, joint, and soft tissue are now respectivelycharacterized by H3F3A mutation, CSF1 rearrangement (targetable), and HMGA2::NCOR2 fusion. This article is an update for radiologists, oncologists, surgeons, and pathologists to recognize these novel ovoid, spindled, giant-cell-rich, and round cell tumors, for optimal diagnostic classification and multidisciplinary team patient care.

Implementation of Copy Number Variations-Based Diagnostics in Morphologically Challenging EWSR1/FUS::NFATC2 Neoplasms of the Bone and Soft Tissue.

In the last decade, new tumor entities have been described, including EWSR1/FUS::NFATC2-rearranged neoplasms of different biologic behavior. To gain further insights into the behavior of these tumors, we analyzed a spectrum of EWSR1/FUS::NFATC2-rearranged neoplasms and discuss their key diagnostic and molecular features in relation to their prognosis. We report five patients with EWSR1/FUS::NFATC2-rearranged neoplasms, including one simple bone cyst (SBC), two complex cystic bone lesions lacking morphological characteristics of SBC, and two sarcomas. In three cases, fluorescence in situ hybridization (FISH) and in all cases copy number variation (CNV) profiling and fusion analyses were performed. All patients were male, three cystic lesions occurred in children (aged 10, 14, and 17 years), and two sarcomas in adults (69 and 39 years). Fusion analysis revealed two FUS::NFATC2 rearrangements in two cystic lesions and three EWSR1::NFATC2 rearrangements in one complex cystic lesion and two sarcomas. EWSR1 FISH revealed tumor cells with break-apart signal without amplification in one complex cystic lesion and EWSR1 amplification in both sarcomas was documented. CNV analysis showed simple karyotypes in all cystic lesions, while more complex karyotypes were found in NFATC2-rearranged sarcomas. Our study supports and expands previously reported molecular findings of EWSR1/FUS::NFATC2-rearranged neoplasms. The study highlights the importance of combining radiology and morphologic features with molecular aberrations. The use of additional molecular methods, such as CNV and FISH in the routine diagnostic workup, can be crucial in providing a correct diagnosis and avoiding overtreatment.

Simple Bone Cysts of the Jaws: Case Series and Literature Review

Simple bone cysts (SBCs) of the jaws are benign intraosseous cavities empty or filled with serous, serohematic or blood fluid. They are characterized by the absence of an epithelial lining. Aim: To describe the clinical, radiographic and surgical findings of SBC through a series of 4 clinical cases and a literature review of previously published cases. Methods: A series of 4 case reports of our department were reported with presentation of the clinical, radiological and surgical investigations performed. In addition, a literature search of SBCs was conducted using the PubMed database for a period of 10 years. Results: 19 papers were returned; A total of 34 patients (including our 4 patients) with a total of 40 lesions were analyzed. SBC are generally observed around the second decade of life (68%) without gender predominance. They are preferentially located in the mandible and are frequently asymptomatic and of fortuitous discovery (82%). Radiologically, SBCs can be unilocular or multilocular with a characteristic scalloped appearance between the roots of the teeth. The management of these pseudocysts is based on surgical treatment. Discussion: Knowledge of these different characteristics of SBCs is essential to make the right diagnosis and to provide the best management, especially as these lesions may have similarities with other lesions considered more aggressive.

The prevalence of incidental findings on pelvis MRI of 8-13-year-old children.

The prevalence and clinical relevance of incidental findings (IF(s)) on imaging assessing the pelvis in children has not been well documented. Three-thousand two-hundred thirty-one children (mean age 10.2 (range 8.6-12.9) years) were evaluated with MRI of the hips, pelvis, and lumbar spine, as part of a prospective population-based pediatric cohort study. Scans were reviewed by trained medical staff for abnormalities. IFs were categorized by clinical relevance and need for further clinical evaluation. 8.3% (n = 267) of children featured at least one IF. One or more musculoskeletal IFs were found in 7.9% (n = 254) of children, however, only 0.8% (n = 2) of musculoskeletal IFs required clinical evaluation. Most frequent abnormalities were simple bone cysts 6.0%(n = 195), chondroid lesions 0.6% (n = 20), and perineural cysts 0.5% (n = 15). Intra-abdominal IFs were detected in 0.5% (n = 17) of children, with over half (n = 9) of these requiring evaluation. The three most common intra-abdominal IFs were a duplex collecting system 0.09% (n = 3), significant ascites 0.06% (n = 2), and hydroureteronephrosis 0.06% (n = 2). IFs on MRI of the lower abdominal and hip region are relatively common in children aged 8-13 years, most of these can be confidently categorized as clinically irrelevant without the need for additional clinical or radiologic follow up. Our research contributes greatly to the knowledge of the prevalence of (asymptomatic) pathology in children. We evaluated MR images of 3231 children, covering hip joints, pelvic skeleton, lower and mid-abdomen, and lumbar and lower thoracic spine as part of a population study. One or more musculoskeletal incidental finding were found in 7.9% of children. Most of these can be confidently categorized as clinically irrelevant without the need for additional follow up. However 0.8% of musculoskeletal findings required further evaluation. Intra-abdominal incidental findings were detected in 0.5% of children, with over half of the abdominal and urogenital findings requiring furtherevaluation.

Treatment of bone cysts by percutaneous injection of demineralized bone matrix mixed with bone marrow.

Bone cysts whether aneurysmal or simple, are known for their tendency to recur. To replace the classical aggressive surgeries, minimally invasive techniques were developed giving differing results based on variable radiographic criteria. No unique percutaneous treatment has proven effective on both types of cysts. The purpose of this study was to evaluate with volumetric MRI calculations the benefit of percutaneous injection of demineralized bone matrix mixed with autogenous bone marrow on both types of cysts. Twenty-seven cysts; 6 aggressive aneurysmal bone cysts (ABCs) and 21 active simple bone cysts (SBCs) were treated with our percutaneous treatment in this case series. Regular MRIs were performed to calculate their volumetric evolution starting before treatment and with a minimal two-year follow-up. A cyst was considered healed when its final residual volume shrank to less than 50%. To allow statistical comparison between both types of cysts, 13 previously reported ABCs treated with the same protocol in our institution were joined to the 6 present ABCs. Four ABCs healed with a single injection while the 2 others recurred. Five SBCs healed with a single injection, 9 others after a second injection and 2 others after a third injection. Five SBCs were considered non-healed. The present healing rate in 67% of ABCs is consistent with the previous series as there was no significant difference (p=0.37). The better global healing rate for ABC (79%) was not statistically different from the SBC healing rate (76%) (p=0.83). The percutaneous injection of demineralized bone matrix mixed with bone marrow is an effective treatment for both types of cysts.

Novel management of sizeable calcaneal UBC with autograft and allograft amalgamation: a case report and review of literature

Calcaneal unicameral bone cyst (UBC) is uncommon benign tumor that can be managed either conservatively or with different surgical interventions described in the literature. However, surgical intervention is usually preferred when the lesion is an active UBC significant in size, as there is the risk of pathological fracture due to thin bone, especially in load-bearing bones like the calcaneus. We report a case of calcaneal UBC considerable in size managed by open curettage and graft reconstruction using a combination of autograft and allograft in a 30-year-old male at two-years follow-up. Level of Evidence IV; Therapeutic Studies; Case Report.

Revisiting the differential diagnosis of the lucent bone lesion: A case of fibrous dysplasia discovered in a Polish medieval osteological collection

AbstractIn the short report published by Siek and Spinek, the femoral metaphyseal lesion in question was described as potentially the first described case of a simple bone cyst (SBC) from a Polish background. However, on review of the single radiograph available, we feel the primary and differential diagnoses offered are misleading from a radiographic perspective, with the imaging features overall favoring fibrous dysplasia—probable cystic subtype. As magnetic resonance imaging (MRI) or a histological diagnosis would not be possible in skeletonized remains, the diagnosis must rest on opinion‐based radiology. In this commentary, we illustrate why fibrous dysplasia is the most likely radiological diagnosis and describe why the differentials offered in the original article should not be entertained.

AN EXTENSIVE SIMPLE BONE CYST OF THE MANDIBLE: A CASE REPORT

Simple bone cyst (SBC) is a pathologic cavity of uncertain origin without lining epithelium commonly located in the mandibular marrow space. A 14-year-old White boy presented with an asymptomatic lesion in the right mandible that extended from the root of the canine to the first premolar. Radiographic examination revealed a radiolucent and unilocular lesion affecting the right mandible. Cone beam computed tomography showed slight expansion and thinning of the cortical margin with well-defined borders and scalloping contour among roots of involved teeth. No root resorption or tooth displacement was detected. After exploratory surgery, a nonpurulent fluid was aspirated, and curettage was performed. Microscopic examination revealed the presence of fibrous connective tissue, fibrinous exudate, and hemorrhagic foci neighboring fragments of dystrophic calcification. The final diagnosis of SBC was confirmed. The patient remains in follow-up without evidence of recurrence. Simple bone cyst (SBC) is a pathologic cavity of uncertain origin without lining epithelium commonly located in the mandibular marrow space. A 14-year-old White boy presented with an asymptomatic lesion in the right mandible that extended from the root of the canine to the first premolar. Radiographic examination revealed a radiolucent and unilocular lesion affecting the right mandible. Cone beam computed tomography showed slight expansion and thinning of the cortical margin with well-defined borders and scalloping contour among roots of involved teeth. No root resorption or tooth displacement was detected. After exploratory surgery, a nonpurulent fluid was aspirated, and curettage was performed. Microscopic examination revealed the presence of fibrous connective tissue, fibrinous exudate, and hemorrhagic foci neighboring fragments of dystrophic calcification. The final diagnosis of SBC was confirmed. The patient remains in follow-up without evidence of recurrence.

Risk factors for pathological fractures of simple bone cysts of the humerus in children: a retrospective cohort study.

BackgroundSimple bone cysts (SBCs) are common osteolytic lesions in children, which often lead to pathological fractures of the non-weight-bearing bone (humerus) in patients. Cyst index is a classic index to evaluate the risk of pathological fracture, but the reliability of this index is reduced due to the deviation of cyst area in the frontal and lateral position and the subjectivity of the determination of cyst area. MRI can clearly show the cyst boundary, the appointment cycle is long, and children need to be examined under sedation, which cannot be judged by clinicians in time. Therefore, it is necessary to find a basic and simple imaging evaluation index in clinic. The purpose of this study is to retrospectively analyze the risk factors of pathological fracture of simple bone cyst of humerus in children.MethodsThe medical records and plain films of patients with SBCs from January 2014 to December 2021 were retrospectively analyzed. Patients were divided into a fracture group (35 cases) and a non-fracture group (10 cases). The relationship between pathological fractures and the children’s age, gender, and cyst index was analyzed. The presence of the pectoralis major and the link to the tendon insertion site of ectopectoralis and anconeus lateralis (TEAL) of the lesion were also examined. Perform binary logistic regression analysis.ResultsBinary logistic regression analysis was performed on the age, gender, and cyst index, and whether the lesion was located in the TEAL. The results demonstrated that the TEAL was an independent risk factor for fractures [odds ratio (OR) =21.423, 95% confidence interval (CI): 2.409–190.539; P=0.006].ConclusionsSBCs of humerus in children is often accompanied by pathological fracture. The lesion is located at TEAL, so we should be alert to the risk of pathological fracture.