Simple Bone Cyst Research Articles

Osteosclerotic disease and bone cyst in a prehispanic burial from Las Cañadas del Teide (Tenerife, Canary Islands).

Skeletal remains of two prehispanic male adult individuals (antiquity ≈ 550 BP) recovered from a burial cave located in Montaña Blanca (Las Cañadas del Teide) at an altitude of 2450 m above sea level, in the highlands of Tenerife (Canary Islands) showed some unusual features. Femora and tibiae of both individuals showed increased bone density, with irregular thickening of the midshaft diaphyses. One individual showed a cystic lesion in the distal third of the left femoral diaphysis, surrounded by a subtle sclerotic reaction of the spongiosa and a thin cortex that was partially fractured. Periosteal thickening was present, but not around the cystic lesion. A thoracic vertebra with rachischisis was also recovered. The bone density of vertebrae and iliac bones were normal, and one recovered jaw was also normal. The tibiae of one individual showed an abnormal location of the foramen nutritium. Hypoplasia of the lesser trochanter and an abnormally thin left femoral neck were also observed. It is possible that both individuals were affected by diaphyseal dysplasia (possibly Camurati Engelmann or Ribbing disease). One of them also showed a lesion compatible with a unicameral bone cyst. The alternative possibility of a Klippel-Trenaunay-Weber disease, with a bone aneurysmal cyst, also exists.

Percutaneous calcium sulfate injection versus localized scrape bone grafting: clinical effect comparison in titanium elastic nail treatment of pathological fracture of proximal humerus caused by unicameral bone cysts in children.

A retrospective study was conducted to compare the mid-term clinical efficacy between percutaneous calcium sulfate injection (PCSI) and localized scrape bone grafting (LSBG) in using titanium elastic nails treat humerus pathologic fractures caused by unicameral bone cysts in children. Humerus pathologic fracture patients with unicameral bone cysts in our pediatric orthopedic department from January 2015 to January 2020 were retrospectively analyzed. Patients were divided into two groups, namely the PCSI group and the LSBG group, based on the type of bone grafting material they received. Preoperative assessments were made in both groups using the Cyst Index and Cyst activity. During the perioperative phase, assessments were made regarding operative time, bleeding, postoperative VAS scores, and the frequency of reoperation within 2 years. Clinical outcomes were evaluated using the Capanna scale at the last follow-up, and the occurrence of re-fractures during the follow-up period. A total of 22 patients were included, with a mean follow-up duration of 33.5 ± 5.8 months. No significant differences were found between the two groups in terms of Cyst Index and Cyst activity before the operation. The operative time, bleeding, and postoperative VAS scores in the PCSI group were found to be lower than those in the LSBG group (P < 0.05). The PCSI group also showed a higher frequency of reoperation within 2 years compared to the LSBG group (P < 0.05). However, no significant differences were observed between the two groups in terms of Capanna scale scores at the last follow-up and the incidence of re-fractures during follow-up. Both titanium elastic nails (TEN) combined with PCSI or LSBG were found to be safe and effective treatments for humerus pathologic fractures caused by unicameral bone cysts in children. PCSI is considered as a less invasive option with shorter operative times, less bleeding, and reduced postoperative pain, although it comes with the risk of multiple injections. On the other hand, LSBG is considered as a more invasive option for the treatment of active bone cysts but is associated with a lower recurrence rate.

Insights into the Distribution Patterns of Foot and Ankle Tumours: Update on the Perspective of a University Tumour Institute.

The rarity of foot and ankle tumours, together with the numerous histological entities, presents a challenge in accumulating sufficient patients to draw reliable conclusions. Therefore, we decided to present an update of a retrospective analysis of their distribution patterns, comprising 536 cases of foot and ankle tumours presented to our tumour board between June 1997 and June 2023. Our aim was to provide a comprehensive overview of the prevalence and distribution patterns of benign and malignant bone and soft tissue tumours of the foot and ankle. A total of 277 tumours involved bone (51.7%). Of these, 242 (87.4%) were benign and 35 (12.6%) were malignant. In addition, 259 soft tissue tumours (48.3%) were found, of which 191 (73.7%) were benign and 68 (26.3%) were malignant. The most common benign bone tumours were simple bone cysts, enchondromas, osteochondromas, aneurysmal bone cysts, and lipomas of bone. Common benign soft tissue tumours included a tenosynovial giant cell tumour, haemangioma, plantar fibromatosis, schwannoma, and lipoma. The most common malignant soft tissue tumours were synovial sarcoma, malignant melanoma, and myxofibrosarcoma. In terms of anatomical location, the hindfoot was the most common site (28.7%), followed by the midfoot (25.9%), ankle (25.4%), and forefoot (20.0%). The distribution of benign entities often follows typical patterns, which may facilitate an early diagnosis even without biopsy (e.g., simple bone cyst, plantar fibromatosis). On the other hand, the distribution patterns of many rare or malignant entities are inconsistent. Individual soft tissue malignancies occur very sporadically, even over long periods of time and in specialized tumour centres. It is therefore important to recognise that any suspicious mass in the foot and ankle must be considered a possible malignancy until proven otherwise.

As simple as it sounds? The treatment of simple bone cysts in the proximal femur in children and adolescents: Retrospective multicenter EPOS study of 74 patients.

Simple bone cysts are among the most prevalent benign cystic tumor-like lesions in children. Proximal femoral simple bone cysts may require specific treatment because of increased fracture risk. With limited literature available on this specific localization, consensus regarding optimal treatment is lacking. We present a large international multicenter retrospective cohort study on proximal femoral simple bone cysts. All consecutive pediatric patients with proximal femoral simple bone cyst from 10 tertiary referral centers for musculoskeletal oncology were included (2000-2021). Demographics, primary treatment, complications, and re-operations were evaluated. Primary outcomes were time until full weight-bearing and failure-free survival. Overall, 74 simple bone cyst patients were included (median age 9 years (range = 2-16), 56 (76%) male). Median follow-up was 2.9 years (range = 0.5-21). Index procedure was watchful waiting (n = 6), percutaneous procedure (n = 12), open procedure (n = 50), or osteosynthesis alone (n = 6). Median time until full weight-bearing was 8 weeks (95% confidence interval = 0.1-15.9) for watchful waiting, 9.5 (95% confidence interval = 3.7-15.3) for percutaneous procedure, 11 (95% confidence interval = -0.7 to 13.7) for open procedure, and 6.5 (95% confidence interval = 5.9-16.1) for osteosynthesis alone (p = 0.58). Failure rates were 33%, 58%, 29%, and 0%, respectively (p = 0.069). Overall failure-free survival at 1, 2, and 5 years was 77.8% (95% confidence interval = 68.2-87.4), 69.5% (95% confidence interval = 58.5-80.5), and 62.0% (95% confidence interval = 47.9-76.1), respectively. A preferred treatment for proximal femoral simple bone cysts remains unclear, with comparable failure rates and times until full weight-bearing. Watchful waiting may be successful in certain cases. If not feasible, osteosynthesis alone can be considered. Treatment goals should be cyst control, minimizing complications and swift return to normal activities. Therefore, an individualized balance should be made between undertreatment, with potentially higher complication risks versus overtreatment, resulting in possible larger interventions and accompanying complications. Level IV, retrospective multicentre study.

Treatment and Outcomes of 4,973 Unicameral Bone Cysts: A Systematic Review and Meta-Analysis.

» Unicameral bone cysts (UBCs) can increase the risk of pathologic fractures of both long and short bones. Although multiple treatments exist, data are conflicting regarding optimal management.» We sought to analyze treatment strategies for UBCs and their rates of successful treatment.» Success rates were analyzed according to treatment modality, with emphasis on filling techniques and/or decompression associated with curettage, and injection compounds.» Curettage with bone substitute and cyst decompression was identified as a highly successful technique for UBC treatment.» Decompressing the cyst wall after injection, regardless of the specific compound used, had a greater potential to enhance healing rates.» The management decision should be individually guided within the patient's context. Level of Evidence: Level III. See Instructions for Authors for a complete description of levels of evidence.

Management of unicameral bone cysts by intramedullary flexible nails: a series of 18 children

Abstract Introduction The intracystic injection of methylprednisolone acetate, curettage with bone grafting, osteoinductive treatments employing demineralized bone matrix, and intramedullary fixation with flexible nails are being used to treat unicameral bone cysts (UBC) in children. The purpose of this study was to assess the functional results of elastic stable intramedullary nails for symptomatic UBC with or without a fracture. Methods From March 2012 to March 2022, 18 patients with UBC were treated with intramedullary flexible nails. Pathological fractures were present at the cyst site in 6 individuals. 12 patients had discomfort and swelling in the afflicted extremity. Cysts were found in the humerus in 13 (72%) patients and the femur in 5 (28%) cases. The average age of the patient at the time of surgery was 7.8 (6–12 years), and the average follow-up period was 16 months. The Capanna et al. criteria were used to do the radiographic evaluation. Results According to radiological evaluation by Capanna et al., 5 cysts healed completely (Stage I), 5 cysts healed with residual radiolucent areas visible on radiographs that were less than 3 cm in size (Stage II), and 7 cysts healed with residual radiolucent areas that were visible on radiographs that were larger than 3 cm in size (Stage III). An infection at the surgery site affected one patient. A 12 (60%) patients had their implants removed. Conclusion Elastic stable intramedullary nailing promotes early stabilization, enables early mobilization, eliminates the need for a plaster cast, and reduces the occurrence of a pathological fracture with early return to functional activity.

Primary Benign Neoplasms of Spine

Abstract Majority of primary vertebral tumours are benign and are often diagnosed incidentally on imaging. It is crucial to have an accurate diagnosis to avoid missing more threatening malignant lesions or infection. Many of these primary benign lesions can be locally aggressive and cause neural compromise or pain requiring active management. The most common benign tumours are osteomas and haemangiomas. Other benign tumours are similar to those observed in the appendicular skeleton, for example, osteoid osteoma, osteoblastoma, fibrous dysplasia, osteochondroma, chondroblastoma, haemangioma, simple bone cysts, aneurysmal bone cysts, giant cell tumours, eosinophilic granuloma and notochordal rests. Most of these tumours are asymptomatic; however, locally aggressive lesions, for example, aneurysmal bone cysts or giant cell tumours, are characterized by back pain, neurological deficits and spinal instability. Sometimes, it is difficult to distinguish from more commonly encountered pain due to degenerative disc disease or malignant lesions and metastatic spine tumours, thus necessitating imaging techniques such as radiography, computed tomography and magnetic resonance imaging, which help in diagnosis. Generally, most incidental or asymptomatic lesions are managed conservatively, while symptomatic or locally aggressive lesions warrant active interventions. Some of these tumours require surgical resection or percutaneous techniques such as radiofrequency ablation, sclerotherapy or cryotherapy with favourable outcomes. This review elaborates different types of primary benign vertebral tumours, supported by characteristic imaging features.

How successful is synthetic graft treatment for children with pathological hip fractures?

To determine whether synthetic grafts are a satisfactory treatment option for pathological proximal femoral fractures in children. Paediatric patients treated for pathological fractures of the proximal femur between 2013 and 2020 were evaluated retrospectively. 17 patients with a mean age of 10.7 years (range 6-16 years) were assessed. The definitive histopathological diagnoses were SBC (simple bone cyst) (12) and ABC (aneurysmal bone cyst) (5). The median duration of follow-up was 37 months (range 12-70 months). All patients returned to their normal daily routine within 3-8 months following surgery. The mean post-op recovery time was 3.2 months (range 3-6 months). Graft was incorporated at approximately 12 months. No significant radiographic healing was observed in 2 patients. In the remaining 15 patients, the mean duration of healing was 14 months (range 8-24 months). Synthetic grafts are a satisfactory treatment option for pathological proximal femoral fractures in children.

Surgical Procedure for a Rare Case of Skull Bone Cysts

Introduction: Bone cysts are inclusive of but not limited to the unicameral bone cyst (UBC) and aneurysmal bone cyst (ABC). UBC have a predilection for males (3:1). UBC make up 3% of primary bone lesions. Most UBCs are found in long bones, most common sites are proximal humerus and femurs, rarely found in flat bones (Skull). Cases of UBC observed following trauma are thought to occur due to intraosseous bleeding when bone organization or repair mechanisms fail. Case Report: Twenty-one-year-old male complained of headache, a history of traumatic brain injury. Motoric examinations show diminished motor function on the left side. CT Scan shows an expansile sclerotic lytic lesion on the right parietal bone. We diagnosed this case with a suggested Bone Cyst on the right parietal, and craniotomy tumor removal with a direct approach was performed. Thickened dura mater was identified, cleansed using NaCL and povidone-iodine, and drilled using a high-speed drill until flattened. The yellowish-colored bony lesion was discovered to contain a semi-translucent substance, the lesion was found to be a unicameral bone cyst. Discussion: UBCs are generally asymptomatic, and usually appear as lesions with lucent characteristics and small zones of transition. As a benign bone tumor, treatments are not required unless the lesion is large and symptomatic, due to the patient's symptomatic condition, craniotomy tumor removal was performed. Conclusion:UBC is a rare condition, that’s scarcely located in the skull. Post-operatively, the patient shows normal motor function and no complaint of pain. Craniectomy tumor removal and flattening of the dura mater using a high-speed drill is sufficient in treating this rare disease.

Long-Term Outcomes of Decompression and Grafting in Acute Pathological Proximal Femur Fractures in Children with Unicameral Bone Cysts: A Retrospective Study Utilizing a 120° Fixed-Angle Low-Contact Locking Pediatric Hip Plate

Long-Term Outcomes of Decompression and Grafting in Acute Pathological Proximal Femur Fractures in Children with Unicameral Bone Cysts: A Retrospective Study Utilizing a 120° Fixed-Angle Low-Contact Locking Pediatric Hip Plate

Toronto extremity salvage score-patient reported outcome measures in upper extremity bone tumors treated with limb salvage surgery

Bone and soft tissue tumors of upper extremity are relatively uncommon than those of lower limb. Treating these patients while retaining a functional limb is quite a challenge. Along with musculoskeletal tumor society score, Toronto extremity salvage score (TESS) is most widely used patient-reported outcome measure for sarcomas of upper extremity. Retrospective analysis of patients with upper extremity bone tumors (24) treated with limb salvage surgery (20) from 2014 to 2022 was undertaken. Mean follow-up period was 26 months and mean age was 30.2 years. Out of 20, 11 humerus cases were of tumors arising from humerus, 5 in radius and 3 in ulna. 9 patients were treated with custom mega prosthesis reconstruction, 6 with fibular free flap, 6 radius underwent simple resection and 1 curettage. Majority of the cases were giant cell tumors (8) followed by osteosarcoma (3), fibromatosis (3), aneurysmal bone cyst (2), simple bone cyst (2), 1 Ewing sarcoma and 1 metastatic bone disease. The mean TESS score of the sample population was 69.7 Most of the patients (11) rated their disability to be of moderate degree and considered themselves to be moderately disabled. The mean TESS score for CMP group was 71.1, while that of autograft reconstruction was 68.3. Despite only half the population having received CMP as a reconstructive option, nearly 40% patients with disease of forearm where the results are not so great, our study population reported a reasonably good patient reported outcome score. A dedicated physiotherapy team with tailor made exercise protocol for each patient depending on their needs can help in improving the quality of life.

Coexistence of Ipsilateral Sacroiliitis and Simple Cyst in the Iliac Bone: A Case Report

Here, a 36-year-old female patient with inflammatory sacroiliitis and simple bone cyst of the ipsilateral iliac bone is presented. Simple bone cysts occur in the developing skeleton, usually asymptomatic; however, they are benign lytic bone lesions that can cause pathological fractures. The prevalence of simple bone cysts in the whole body has been reported as 0.30/100000. Only 2% of these rare cysts are found in the pelvis, and according to our knowledge, it is the first case in which iliac simple bone cyst is seen together with sacroiliitis on the same side.

Tension Side Femoral Neck Fracture due to Simple Bone Cyst in a Low Resource Area; A Report of Case

Tension Side Femoral Neck Fracture due to Simple Bone Cyst in a Low Resource Area; A Report of Case

Pathological fracture increases the risk of unsatisfactory functional results and avascular necrosis in children with proximal femur simple bone cysts

IntroductionProximal femur simple bone cysts (SBCs) are rare in children, but with a risk of pathological fractures and the associated poor outcomes. This study aimed to evaluate the functional and radiographic outcomes of children with proximal femur SBCs. Patients and Methods38 children with proximal femur SBCs treated surgically at our department, West China hospital, were enrolled in the study. Patients were divided into two groups according to whether pathological fractures presented before treatment. The non-fracture group received treatment of open curettage, cavity electrocauterization, bone grafting, and fixation (proximal femoral plate, intramedullary nail or Kirschner wire). The pathological fracture group received the same procedures of curettage, electrocauterization, grafting, and fixation. Autogenous iliac bone grafting was done in all cases, and the artificial bone was used as a supplementary based on the size of the cavity. Postoperatively, all patients underwent hip spica or similar orthosis immobilization for six weeks and received the same rehabilitation program after the removal of hip spica. Patients were evaluated by two independent observers, including the functional results based on the Ratliff's criteria, avascular necrosis, healing rate based on the Neer scoring system, coxa vara, and premature physeal arrest. We described the good outcome in Ratliff's criteria as “Satisfactory results”, and fair and poor outcomes as “Unsatisfactory results.” Grade 1 and grade 2 Neer results were termed as failures in treatment, and grades 3 and 4 were considered successes and healing. Results38 patients with 38 hips (18 on the left side and 20 on the right side) were evaluated, including 9 females and 29 males, with a mean age of 9.0±2.6 years old (range, 5 to 14 years). There was no significant difference between these two groups in the baseline data of gender, age, side, grafting, staging, and fixation methods. The rate of unsatisfactory functional results in the pathological fractures group was 56.3% (9/16), significantly higher than that in patients without fracture (22.7%, 5/22. p= 0.047). There was also a significant difference in avascular necrosis of the femoral head between the pathological fractures group (7/16) and the group without fracture (2/22, p=0.021). Thirty cases presented with healing, including 13 in the fractures group and 17 in the non-fracture group (p=1.000), and eight cases were graded as failures (2 cases of grade 1 and 6 cases of grade 2). There were also no significant differences between these two groups in premature physeal arrest (2 in fracture group and 1 in non-fracture group, P=0.562), and Coxa vara (3 in the fracture group and 0 in non-fracture group, P=0.066). ConclusionsPathological fracture significantly increases the risk of unsatisfactory functional results and avascular necrosis of the femoral head in patients with femoral neck SBCs. Prophylactic treatment and fixation of SBCs in weight bearing proximal femur region is better to manage without complications than managing with pathological fractures.

Open surgical treatment of unicameral bone cysts : Aretrospective data analysis.

Avariety of treatment options for unicameral bone cysts (UBC) exist. The controversy of open management of UBC is discussed. The aim of this study was to analyze asingle institution's experience in the open surgical treatment of UBC. By retrospective analysis of the Vienna Bone and Soft Tissue Tumor Registry, 119 patients with open surgery and histologically verified UBC with amean follow up of 4.8 years (range 1-30 years) were included. Lesion treatment failure was defined as surgically addressed UBC undergoing revision surgery due to persistence or recurrence. Local revision-free survival for lesion treatment failure was 93% after 1 year, 80% after 2 years, 60% after 5 years and 57% after 10 years. Of the patients 34 (29%) had at least 1 revision surgery due to lesion treatment failure. We found that patients with lesion treatment failure were younger (p = 0.03), had UBC with less minimal distance to the growth plate (p = 0.02) and more septation chambers in radiologic imaging (p = 0.02). Patients with open revision surgery were less likely to require a second revision due to lesion treatment failure than patients with percutaneous revision surgery (p = 0.03). Open surgery for UBC can only be recommended as reserve treatment in younger children with actively growing lesions. Open UBC surgery carries arelatively high risk of almost 30% of lesion treatment failure and therefore the indications should be limited to extensive osteolysis with high risk of pathological fractures, lesions with displaced pathological fractures, and lesions with an ambiguous radiological presentation that require tissue collection.

Evaluation of EWSR1/FUS rearrangements by FISH and NKX2.2 immunoexpression in simple bone cysts of the jaw

Recent studies have identified recurrent rearrangements of EWSR1 or FUS with NFATC2 in extragnathic simple bone cysts (SBCs). We investigated the presence of EWSR1 or FUS rearrangements and the immunophenotypic expression of NKX2.2 and CD99 in a series of SBCs of the jaw. We retrieved 10 cases of SBC of the jaw from the University of Pittsburgh archives. Of the 10 cases, we were able to evaluate 8 by immunohistochemistry for CD99 and NKX2.2 and 7 by fluorescence in situ hybridization (FISH) for EWSR1 and FUS rearrangement using EWSR1 and FUS break-apart probes. All 8 cases evaluated by immunohistochemistry expressed CD99 but were negative for NKX2.2, and all 7 cases assayed using FISH were negative for EWSR1 and FUS rearrangements. In contrast to the SBC of extragnathic sites, we found no presence of EWSR1 and FUS rearrangements by FISH in the SBC of the jaw, suggesting that this entity may be etiologically/molecularly distinct and reflects a non-neoplastic reactive process. However, as these lesions tend to be paucicellular, FISH may not be the appropriate technique for identifying EWSR1/FUS fusions. Other techniques should be used to evaluate them in future studies.

Intralesional extended curettage with fibular strut for the treatment of large peritrochanteric cyst: a case report and review of literature

Simple bone cysts are benign bone lesions commonly found in children and adolescents. They are usually asymptomatic and are incidentally detected on imaging studies. However, in rare cases, simple bone cysts can grow to a large size and cause symptoms such as pain and functional limitations. We present a case report of a large peritrochanteric simple bone cyst in an adolescent male who presented with hip pain and difficulty in walking. The diagnosis was confirmed by radiographic findings and histopathological examination of the cyst. The patient was managed with curettage and auto allo bone grafting with fibular strut and supplementary plate fixation. Patient had a favourable outcome with complete resolution of symptoms at 18-month follow-up. Our case report highlights the need of fixation for large simple bone cyst in proximal femur region along with curettage and bone grafting.

Allogenic Cancellous Bone versus Injectable Bone Substitute for Endoscopic Treatment of Simple Bone Cyst and Intraosseous Lipoma of the Calcaneus and Is Intraosseous Lipoma a Developmental Stage of a Simple Bone Cyst?

Simple bone cysts (SBCs) and intraosseous lipoma (IOL) of the calcaneus are rare tumor entities that are primarily diagnosed due to unspecific heel pain, incidental findings, or rarely due to pathological fractures. Compared to traditional open tumor resections, endoscopic resection of these benign tumors aims to minimize surgical morbidity and maximize surgical efficiency without compromising safety. Grafting is regularly performed to reduce the risk of recurrence and stimulate osseous consolidation of the lytic lesion. As the incidence is low and treatment strategies are heterogeneous, there is no clear consensus for the treatment of simple cysts or intraosseous lipomas of the calcaneus. The objectives of this study are (a) to present medium to long-term results after endoscopic resection and grafting with allogenic cancellous bone or bioresorbable hydroxyapatite and calcium sulfate cement, and (b) to add further evidence to the discussion of whether calcaneal SBC and IOL are the same entity at different developmental stages. Between 2012 and 2019, a total of 25 benign bone tumors consisting of 17 SBCs and 8 IOLs were treated by A.T. with endoscopic resection and grafting, comprising the largest cohort to date. For grafting, 12 patients received allogenic cancellous bone (group A) and 13 patients received injectable bone substitute (group B). Pre- and postoperative imaging using plain X-rays and MRI was retrospectively analyzed with a mean follow-up time of 24.5 months to assess tumor size, osseous consolidation (modified Neer classification), and tumor recurrence. A retrospective chart analysis focusing on adverse intra- and perioperative events and other complications associated with the surgical procedure was performed using the modified Clavien-Dindo classification (CD1-3). A total of 12/13 cases with allogenic bone grafting showed a Neer Type 1 osseous healing of the tumorous lesion after endoscopic resection, whereas only 5/11 cases with injectable bone substitute showed sufficient healing (types 1 and 2). There were three recurrent cysts (Neer 4) and two persistent cysts (Neer 3) after using injectable bone substitute. Two CD1 complications were observed in group A (prolonged wound drainage, sural neuritis) and eight complications were observed in group B (6× CD1, 2× CD3). At least two IOLs diagnosed preoperatively using MRI were ultimately identified as SBCs upon histopathologic examination. Allogenic cancellous bone grafting after endoscopic resection of calcaneal SBC or IOL showed a very low rate of complications and no tumor recurrence in our series. On the other hand, depending on the material used, injectable bone substitute showed a high rate of "white-out" (excessive drainage), resulting in multiple complications such as prolonged wound healing, insufficient permanent defect filling, recurrence, and revision surgery. Over time, calcaneal SBC may transform into IOL, exhibiting distinct features of both entities simultaneously during ossoscopy and histopathological analysis.

MULTIPLE SIMPLE BONE CYSTS: A RARE MANIFESTATION

A 45-year-old female sought out care due to a radiolucent area in the right mandibular body, observed during routine dental treatment. Computed tomography showed a hypodense area extending to the midline, with displacement of the right mandibular canal. During the anamnesis, she reported previous treatment of a lesion in the body of the left mandible with surgical exploration and intralesional injection of dexamethasone. In intraoral physical examination, expansion of the cortical bone and vital teeth were observed in the mandible on the right side. Under diagnostic hypothesis of Simple Bone Cyst (SBC), puncture and exploratory surgery were performed, which revealed an empty cavity. Microscopically, vital mature mineralized tissue confirmed the diagnosis of SBC. Currently, the patient is undergoing follow-up. A 45-year-old female sought out care due to a radiolucent area in the right mandibular body, observed during routine dental treatment. Computed tomography showed a hypodense area extending to the midline, with displacement of the right mandibular canal. During the anamnesis, she reported previous treatment of a lesion in the body of the left mandible with surgical exploration and intralesional injection of dexamethasone. In intraoral physical examination, expansion of the cortical bone and vital teeth were observed in the mandible on the right side. Under diagnostic hypothesis of Simple Bone Cyst (SBC), puncture and exploratory surgery were performed, which revealed an empty cavity. Microscopically, vital mature mineralized tissue confirmed the diagnosis of SBC. Currently, the patient is undergoing follow-up.

Treatment of Pathological Fracture Following Unicameral Bone Cyst in Unusual Location of Proximal Radius: Rare Case Report

Unicameral bone cysts (UBCs) are benign bone lesions predominantly affecting children and teenagers. This case report highlights the rare occurrence of a simple bone cyst in the proximal radius in a 29-year-old woman with a pathological fracture. Although the proximal radius is an uncommon site for UBC occurrence, the surgical approach required special care due to the complex anatomical structures near the fracture site. The surgical management of UBCs aims to prevent or manage pathological fractures, facilitate cyst healing, prevent recurrence, and reduce the risk of refracture. Understanding the treatment options and involving patients in the decision-making process are crucial for achieving the best possible results in managing UBCs with pathological fractures. The decision to pursue nonoperative or operative treatment should be made in consultation with healthcare professionals, considering factors such as clinical presentation, radiological features, and symptoms.