Aneurysmal Bone Cyst of the Jaws: Clinicopathological Study

Abstract

Aim: The aim of the present study was to analyze clinical, radiological and histopathological features of aneurysmal bone cysts (ABCs) of jaws.

Materials and methods: Archival data from 2009 to 2012 present in the Oral Pathology Department was retrieved and clinicopathological features of all the cases which had been previously diagnosed as ABC were analyzed in detail.

Results: Seven cases ranging in age from 10 to 50 years were included, in which maximum (5/7) cases were below 20 years. Ratio of presentation of lesion in male to female and in maxilla to mandible was 3:6 and 1:6 respectively. Swelling and pain were the most common presenting features. Variable presentation of the lesion was observed radiographically; although multilocular, well defined, bone expansion and perforation were the most common observations. Histopathological analysis revealed association of one case with ossifying fibroma and two cases with trabecular variety of juvenile ossifying fibroma. Predominance of solid variety was noted and other features like stroma, giant cells, nature of blood vessels, bone destruction and perforation and presence of any osteoid or calcified material was also accounted for. The current study showed association of two cases with trabecular variety of juvenile ossifying fibroma, which is a rare finding.

Conclusion: ABCs of jaws, thus have varying patterns of presentation which are diagnostically challenging. A thorough examination of the incisional/excisional tissue is thus required to confirm the association with any other lesion which will affect the treatment plan for the patient.

Keywords: Aneurysmal bone cyst; Juvenile ossifying fibroma; Trabecular juvenile ossifying fibroma.

Fig. 1

a Extraoral view showing swelling over right ramus of mandible (case #6), b intraoral view showing buccal expansion (case #5)

Fig. 2

a Computed tomography scan showing radiolucent, multilocular lesion (case #6), b panoramic view showing well defined, unilocular, radiolucent lesion with ballooning expansion of the inferior border of mandible (case #7)

Fig. 3

a Photomicrograph of solid type ABC showing dense stroma with few small vascular spaces (black arrows), H&E ×100, b photomicrograph of mixed type ABC showing cellular stroma with moderate amount of blood filled spaced and associated giant cells H&E ×100; inset showing multinucleated giant cells X400, c photomicrograph of vascular type ABC showing loose connective tissue stroma with abundant large blood filled spaces, H&E ×100, d photomicrograph of solid ABC with TJOF: highly cellular stroma with abundant immature bone formation (yellow arrows) associated with large blood filled areas (black arrows), H&E ×100, e photomicrograph of vascular ABC with OF: abundant blood filled spaces (black arrows) with ossifying fibroma (yellow arrows), H&E ×100