Acetabular Aneurysmal Bone Cyst During the Syrian Conflict: A Case Report of Surgical Treatment and Outcomes

Abstract

Aneurysmal bone cysts (ABCs) are uncommon benign bone lesions that consist of blood-filled vascular spaces surrounded by fibrous tissue septa. Their diagnosis and surgical management are challenging in a war-torn region. In this case report, we present a rare case of a giant aneurysmal bone cyst located around the acetabulum in a 10-year-old female child who presented with an antalgic limp and left hip pain. The lesion was successfully treated with curettage and mixed autologous and synthetic bone grafts, and the follow-up for two years revealed a complete resolution of symptoms and radiological evidence of bone regeneration. This case highlights the successful surgical treatment of a challenging case of ABC in a difficult setting during the Syrian conflict.

Keywords: acetabulum; aneurysmal bone cysts; benign bone lesions; chatgpt; syrian conflict.

Figure 1. Pre-surgical anteroposterior pelvic and hip X-ray

On the pre-operative anteroposterior pelvic X-ray, arrows indicate a periacetabular lobulated lesion that invades the roof of the acetabular cavity and extends below the ischium.

Figure 2. Displays the lesion that was observed via computerized tomography

On the computerized tomography, the lesion appeared with an arrow indicating its invasion into the posterior column of the acetabular cavity towards the ischium and extending anteriorly through the floor of the acetabular cavity to the anterior column. L: left; R: right; P: posterior

Figure 3. Shows a mixed auto and synthetic graft and the post-surgical X-ray

Figure A shows a mixed graft composed of both autograft and synthetic material. In the postoperative X-ray image (Figure B), the mixed graft is visible as it fills the cyst completely following the curettage procedure, as indicated by the arrows.

Figure 4. X-ray control after three (A), six (B), and 12 (C) months post-surgery

The X-ray follow-up at three, six, and 12 months (A, B, and C) respectively demonstrated satisfactory incorporation of the mixed auto- and synthetic graft, with restoration of the normal borders of the acetabular cavity, including the roof, floor, anterior column, and posterior column (indicated by arrows).