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[Sacral metastasis simulating aneurysmal bone cyst].

Pablo Sanromán-Álvarez¹, Juan Antonio Simal-Julián¹, Pablo Miranda-Lloret¹

¹Departamento de Neurocirugía, Hospital Universitario y Politécnico La Fe, Valencia, España.

Neurocirugia (Asturias, Spain)

|June 5, 2013

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Cystic spinal lesions with haematic fluid-fluid levels (H-FFL) can mimic aneurysmal bone cysts but may represent metastasis. This case highlights a rare spinal metastasis presenting with H-FFL, successfully treated with surgery.

Area of Science:

Oncology
Radiology
Orthopedic Surgery

Background:

Cystic spinal lesions with haematic fluid-fluid levels (H-FFL) are often associated with aneurysmal bone cysts (ABC).
Metastatic disease presenting as cystic bone lesions with H-FFL is exceptionally rare.

Observation:

A 60-year-old male presented with a sacral cystic bone lesion exhibiting H-FFL.
Initial suspicion favored ABC, but the diagnosis was confirmed as metastasis.

Findings:

This is the second reported case of spinal cystic bone metastasis with an H-FFL pattern and an unknown primary tumor at diagnosis.
The patient underwent resective surgery, achieving pulmonary and metastatic disease control.

Implications:

Keywords:

3D fluoroscopy Aneurysmal bone cyst Bone metastasis Fluid-fluid levels Fluoroscopio 3D Imagen en resonancia magnética Magnetic resonance imaging Metástasis ósea Niveles serohemáticos Quiste óseo aneurismático Resultado quirúrgico Surgical outcome

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This case expands the differential diagnosis for cystic spinal lesions with H-FFL.

Surgical resection can be an effective treatment for spinal metastases with this pattern, improving quality of life.