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Case Reports
. 2015 May 7;6(Suppl 4):S182-5.
doi: 10.4103/2152-7806.156570. eCollection 2015.

Solid variant of aneurysmal bone cyst presenting as a giant cervical mass: A clinical, radiological, histopathological dilemma

Amey R Savardekar  1 , Deviprasad Patra  1 , Debajyoti Chatterjee  2 , Chirag K Ahuja  3 , Pravin Salunke  1
Affiliations
Case Reports

Solid variant of aneurysmal bone cyst presenting as a giant cervical mass: A clinical, radiological, histopathological dilemma

Amey R Savardekar et al. Surg Neurol Int. .

Abstract

Background: Typical aneurysmal bone cysts (ABCs) are osteolytic, multicystic lesions with parietal sclerosis and blood-filled cysts. In rare instances, the cystic components may be completely absent. Such solid variants in ABC (s-ABC) exhibit a solid architecture; making the clinical, radiological, and histological differentiation from other solid bone tumors like osteosarcoma (especially giant cell rich osteosarcoma) and giant cell tumor, a difficult task.

Case report: We report the case of a 45-year-old male presenting with a giant solid cervical spine lesion. Histopathology revealed solid variant of ABC, even though the radiological and fine needle aspiration cytology studies pointed toward a giant cell tumor.

Conclusion: We aim to discuss the clinical, radiological, and histological findings of solid ABC (a rare benign entity) vis-à-vis the common neoplastic entities of osteosarcoma and giant cell tumor. The histopathological nuisances in making the diagnosis of s-ABC are put forth, along with its impact on management of such giant bony spinal lesions.

Keywords: Bony tumors of the cervical spine; pathology of solid variant of aneurysmal bone cyst; solid variant of aneurysmal bone cyst; spinal aneurysmal bone cysts.

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Figures

Figure 1
Figure 1
Computed tomography axial bone window (a) and soft-tissue mediastinal window (b) sections show an expansile, osteolytic lesion arising from the left lateral arch elements of C4 vertebra having an enhancing soft tissue component. The cranio-caudal extent and displacement of vascular and soft tissue structures is appreciated on sagittal CT reconstruction (c) image. Axial T1-weighted precontrast (d), T2-weighted (e) and T1-weighted postcontrast (f) images better demonstrate the extent of the soft tissue component
Figure 2
Figure 2
(a) Photomicrograph showing scattered multinucleated osteoclastic giant cells and focal osteoid production (arrow) in a background of fibroblastic proliferation (H and E ×10). (b) A few dilated blood filled spaces are seen lined by multinucleated osteoclastic giant cells (H and E ×10). The absence of atypia is key to diagnosis of s-ABC
Figure 3
Figure 3
Follow-up MR imaging (at 10 months postsurgery): Sagittal T1-weighted (a), T2-weighted (b) and T1-weighted postcontrast (c) images depict spinal fixation with decompressed spinal cord. The T1-weighted (d), T2-weighted (e) and T1-weighted postcontrast (f) axial sections confirm the residual lesion along the left lateral arch of the vertebra with associated small soft tissue component
See this image and copyright information in PMC

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