Aneurysmal bone cyst masquerading as unknown mandibular metastatic deposit causing pathological fracture

Area of Science:

• Oral and Maxillofacial Surgery
• Pathology
• Radiology

Background:

• Aneurysmal bone cysts (ABCs) are rare, benign bone lesions that can present with significant complications.
• This case involves an extensive, multilocular radiolucency in the mandible, initially raising concerns for a neoplastic process due to its non-pathognomonic appearance.
• The patient also presented with coincidental anemia of unknown cause, further complicating the diagnostic pathway.

Observation:

• The study details a case presentation of a mandibular aneurysmal bone cyst (ABC).
• The lesion was associated with a pathological fracture, a rare but significant complication.
• Diagnostic challenges were encountered due to the extensive and non-specific radiographic findings, coupled with unexplained anemia.

Findings:

• The aneurysmal bone cyst (ABC) presented as an extensive, multilocular radiolucency in the mandible.
• A pathological fracture occurred secondary to the bone cyst.
• Successful bone healing was achieved following treatment of the pathological fracture with good reduction, despite a fixation period shorter than one month.

Implications:

• This case underscores the importance of including aneurysmal bone cysts (ABCs) in the differential diagnosis of pathological mandibular fractures.
• Awareness of the varied clinical presentations of ABCs is crucial for timely and accurate diagnosis.
• Effective management of pathological fractures associated with ABCs can lead to favorable bone healing outcomes.