Aneurysmal bone cyst of zygoma with rupture

Case contributed by Shailaja Muniraj
Diagnosis almost certain


Swelling over the left cheek since childhood. Pain since 1 week. Low grade fever since 1 week.

Patient Data

Age: 23 years
Gender: Female

Pre operative study


There is a well defined expansile cystic lesion with fluid fluid level noted to involve superolateral maxillary bone and zygoma. Features favor aneurysmal bone cyst.

There is secondary breach of the outer table of zygoma with resultant subtle hypodensities within the proximal zygomaticus and distal temporalis muscle. 

Also seen is breach of the left sided bony orbital floor with extension of hypodensities into the inferolateral extraconal space. Resultant indentation of the globe inferiorly with loss of fat planes between inferior and lateral rectus muscle noted.

Right orbit shows normal imaging features.

Post operative study


There is complete resolution of the previously seen soft tissue attenuation focus involving the inferolateral extraconal space and zygomaticus and distal temporalis muscle.

The bony orbital floor and lateral zygoma shows changes of remodeling.

Residual aneurysmal bone cyst persists. 

N.B. intraoperatively, only blood was aspirated.

Post operative study


MRI confirms the above findings. No adjacent edema or inflammatory changes.

Case Discussion

Aneurysmal bone cyst of left zygoma with cortical breach and rupture.

Post operative imaging shows significant regression.

Special thanks: Dr H K Anand and Dr Nanda Kumar.

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