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Case reports: malignant transformation of aneurysmal bone cysts
George W Brindley1, John F Greene, Lawrence S Frankel
1Scott & White Memorial Hospital and Clinic, Temple, TX 76508, USA. gwbrindley@swmail.sw.org
Clinical Orthopaedics and Related Research
|September 1, 2005
Summary
Aneurysmal bone cysts, though benign, may rarely transform into malignant osteosarcomas after surgical treatment. Long-term patient monitoring is crucial for early detection of such rare but serious complications.
Area of Science:
- Orthopedic Surgery
- Oncology
- Pathology
Background:
- Aneurysmal bone cysts (ABCs) are rare, benign primary bone tumors.
- Standard surgical treatment involves intralesional curettage, cauterization, and bone grafting/cementation.
- Adjuvant or primary radiation is rarely used due to potential malignant transformation risks.
Observation:
- This study documents two cases of primary ABCs treated with surgical curettage and allograft bone grafting without adjuvant radiation.
- Patients were monitored for 5.5 and 12 years post-treatment.
- Malignant transformation occurred in both cases.
Findings:
- A telangiectatic osteosarcoma developed 5.5 years after treatment in one patient.
- A fibroblastic osteosarcoma developed 12 years after treatment in the second patient.
- Both osteosarcomas arose at the original ABC sites.
Implications:
- Histologic evaluation of ABCs is critical at presentation.
- Patients require counseling on the possibility of recurrence and the necessity of long-term follow-up.
- Changes in symptoms post-treatment warrant thorough investigation for potential malignant transformation.