Presentation
Right knee pain.
Patient Data
Right lower femoral metaphyseal osteolytic lesion showing a narrow zone of transition. Small lateral cortical transverse pathological fracture. Posterior cortical smooth scalloping is noted with adjacent soft tissue swelling. No periosteal reaction.
Lower femoral metaphyseal intramedullary cystic lesion showing multiple fluid-fluid levels. Posterior cortical breaching with posterior extra-osseous component.
Small lateral cortical pathological fracture with surrounding bone marrow and soft tissue edema.
Radiological findings are impressive of lower femoral metaphyseal aneurysmal bone cyst (ABC).
Case Discussion
Aneurysmal bone cysts (ABC) are benign expansile osteoclastic giant cell-rich bony neoplasms, composed of numerous blood-filled channels and cystic spaces.
Typical radiological features include a multicystic bone lesion with fluid-fluid levels.
It is important to remember that the presence of fluid-fluid levels, although characteristic of aneurysmal bone cysts, is by no means pathognomonic, and is seen in other lesions as well, both benign and malignant (e.g. giant cell tumors (GCT), chondroblastoma, simple bone cysts and telangiectatic osteosarcomas).
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