Aneurysmal bone cysts of the head and neck in pediatric patients: a case series
Lorne Segall1, Raanan Cohen-Kerem, Bo-Yee Ngan
1Department of Otolaryngology, Head and Neck Surgery, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
Insights
Aneurysmal bone cysts (ABCs) in the head and neck present diversely. Surgical excision is the preferred treatment for these pediatric bone lesions, though some may be secondary to other pathologies.
Area of Science:
- Pediatric Orthopedics
- Head and Neck Surgery
- Radiology
Background:
- Aneurysmal bone cysts (ABCs) are benign, expansile, osteolytic bone lesions.
- Head and neck ABCs are rare, particularly in pediatric populations.
- Characterization of these lesions is crucial for appropriate management.
Purpose of the Study:
- To describe the clinical characteristics, treatment, and outcomes of pediatric head and neck aneurysmal bone cysts.
- To evaluate the efficacy of surgical management for these lesions.
- To identify potential challenges and associated pathologies.
Main Methods:
- Retrospective case series.
- Review of pediatric patients treated for head and neck ABCs between 1994 and 2006.
- Analysis of clinical presentation, imaging, treatment, and follow-up data.
Main Results:
- Nine pediatric patients with head and neck ABCs were identified.
- Common locations included paranasal sinuses, mandible, and temporal bone.
- Surgical excision was successful in seven cases; one required conservative management, and another was secondary to osteoblastoma.
Conclusions:
- Head and neck ABCs exhibit variable presentations and severity.
- Surgical removal is the primary treatment modality, often yielding favorable outcomes.
- Underlying bone pathologies, such as osteoblastoma, can complicate treatment and prognosis.
Objectives:
To characterize aneurysmal bone cysts (ABCs) of the head and neck as seen at a tertiary care center.
Design:
A case series.
Methods:
A retrospective chart review of pediatric patients with aneurysmal bone cyst of the head and neck treated at the Hospital for Sick Children during the years 1994-2006 was carried out.
Results:
Nine patients with ABC were treated. The average age at diagnosis was 9.3 years (range: 5 months-15 years), six males and three females. Four cysts originated in the paranasal sinuses, two in the mandible, one in the zygoma, one in the mastoid and one in the parietal bone. Two cases were associated with a previous localized trauma (mandible, zygoma). 5/9 presented with pain, 4/9 presented as an asymptomatic mass, 2/9 were associated with proptosis and nasal obstruction, 2/9 with nasal obstruction and 1/9 presented with an aural polyp. Seven cysts were successfully excised while one (in the pterygomaxillary fossa) is being followed conservatively. In one case the ABC was found to be secondary to an extensive osteoblastoma and this child continuous to be problematic. Follow-up time ranged from 2 years and 6 months to 10 years.
Conclusions:
ABC of the head and neck may vary in presentation and severity. Surgical removal is the treatment of choice at our institution and may provide a satisfying outcome. ABC may be secondary to an underlying bone pathology (e.g., osteoblastoma) which may make it refractory to treatment.
