Aneurysmal bone cyst

Case contributed by Dr Abdulmajid Bawazeer

Presentation

The patient complains of new unset of abnormal gait and weakness of lower limb muscles.

Patient Data

Age: 30 years
Gender: Male

Thoracic spine

CT

Well-defined expansile osteolytic lesion involving the right posterior element of T7 vertebra involving right pedicle, lamina, transverse process and to a lesser extent to the right side of the posterior vertebral body.

Thoracic spine

MRI

Expansile mass lesion containing fluid-fluid levels with blood products which shows septated enhancement after contrast administration with no soft tissue component, involving the right posterior element of T7 vertebra involving right pedicle, lamina, transverse process and to a lesser extent to the right side of posterior vertebral body extending to the vertebral foramen resulting in severe compression to the spinal cord and right nerve root.

Case Discussion

Pathology report:

  1. Gross:  Specimen consists of multiple gray-brown soft and bony tissue.
  2. Microscopic: Sections reveal blood-filled cystic spaces without endothelial lining surrounded by fibro-myxoid stroma containing many osteoclasts and chondroid areas formed of fibrillary elastic type of cartilage with bland cytologic features.

Diagnosis is Aneurysmal bone cyst.  

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