Journal article

Publication year: 2013

Pages: E70-E75

Journal: Journal of neurological surgery. Part A, Central European neurosurgery

Volume number: 74

ISSN: 2193-6315

eISSN: 2193-6323

DOI Link: https://doi.org/10.1055/s-0032-1324803

Publisher: Thieme

Abstract: 

IntroductionWe report the case of a 17-year-old girl with an indolent, smooth swelling of the left cranial vault that had been developing for 2 months. Complete surgical excision was performed and the defect was closed using artificial bone cement. The integrity of the dura mater was conserved and the patient recovered without neurological deficit. Magnetic resonance imaging (MRI) controls 6 and 18 months after the operation did not find signs of recurrence.

ResultsThe lesion consisted of an elastic bone shell containing bony trabeculae with soft brown-greyish tissue and posthemorrhagic dark fluid. Histological assessment found CD68 positive multinucleated giant cells in a highly cellular fibroblastic matrix surrounding bony lamellar structures, without signs of inflammation or malignancy. Hyperparathyroidism was ruled out by normal serum values for parathyroid hormone, calcium, phosphate, and alkaline phosphatase. Histologically, first diagnosis was giant cell reparative granuloma and reference pathology disclosed aneurysmal bone cyst.

ConclusionsThe solid variant of aneurysmal bone cyst and the giant cell reparative granuloma can be histologically indistinguishable. Both lesions are only rarely encountered in cranial bones and most published cases affected the cranial base or the jaw, mainly in children or young adults. From a clinical point of view, classification into outward lesions (osteolysis of external parts of the vault with preservation of internal tabula) and inward lesions (intracranial multicystic lesions with raise of intracranial pressure) has been proposed. Three phases of development can be identified, and spontaneous involution has been described. Both entities are benign, but because in several cases an underlying malignant disease has been found, complete resection and regular follow-up by MRI are recommended.

Harvard Citation style: Nestler, U., Wagner, H., Schaenzer, A. and Preuss, M. (2013) Solid Variant of Aneurysmal Bone Cyst of the Left Parietal Bone without Preceding Trauma, Journal of neurological surgery. Part A, Central European neurosurgery, 74, pp. E70-E75. https://doi.org/10.1055/s-0032-1324803

APA Citation style: Nestler, U., Wagner, H., Schaenzer, A., & Preuss, M. (2013). Solid Variant of Aneurysmal Bone Cyst of the Left Parietal Bone without Preceding Trauma. Journal of neurological surgery. Part A, Central European neurosurgery. 74, E70-E75. https://doi.org/10.1055/s-0032-1324803