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Intracranial intradural aneurysmal bone cyst: a unique case.
C V Gopalakrishnan1, B R M Rao, S Nair
1Department of Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India. drgopal@sctimst.ac.in
Pediatric Neurosurgery
|August 29, 2009
Summary
A rare intradural aneurysmal bone cyst (ABC) in a 14-year-old boy presented without bone involvement, causing increased intracranial pressure. This unique case highlights an unusual presentation of ABC in the skull.
Area of Science:
- Neurosurgery
- Pediatric Oncology
- Pathology
Background:
- Aneurysmal bone cysts (ABC) are rare, typically benign bone tumors. Skull ABCs are exceptionally uncommon, with most cases involving bone destruction.
- Intradural presentations of ABCs without bone involvement are virtually unheard of in medical literature.
Observation:
- A 14-year-old male presented with symptoms of elevated intracranial pressure, including headache, vomiting, and focal seizures.
- Neuroimaging revealed a large, multicystic lesion in the left frontal lobe, notably lacking any bone erosion or involvement.
- The lesion was intimately associated with the dura mater of an intact sphenoid wing.
Findings:
- Surgical excision of the intradural lesion was performed completely.
- Histopathological analysis confirmed the diagnosis of an aneurysmal bone cyst.
- This represents the first documented instance of an intradural ABC occurring without any associated bone pathology or dural erosion.
Implications:
- This case expands the known spectrum of aneurysmal bone cyst presentations.
- It suggests that intradural lesions, even without apparent bone involvement, should be considered in the differential diagnosis of intracranial masses.
- Further research into the potential origins and pathomechanisms of such rare intradural ABCs is warranted.
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