Unusual bleeding of aneurysmal bone cyst in the upper thoracic spine

Aneurysmal bone cyst (ABC) is a benign bone lesion and commonly affects young adolescents. It usually grows rapidly with hypervascularity. In the spine, it can cause extensive bone destruction and compress neural structures with eventual vertebral collapse. Operative management of such a lesion may be complicated by profuse hemorrhage. Herein, we report a 15-year-old boy who had an acute exacerbation of spinal cord compression because of an ABC in the upper thoracic region. With a two-staged operation that complicating with profuse intraoperative bleeding, decompressive curettage and stabilization of the vertebral column were assured. However, abrupt neurologic deterioration occurred because of rebleeding with spinal cord compression 1 month postoperatively. Secondary decompressive curettage and following local radiotherapy were undertaken to cure the disease. Neurological recovery and healing of spinal ABC could be expected if the lining of a cyst had been totally removed. At the 18-month follow-up examination, he was neurologically intact and without any backache, leg pain or gait disturbance.