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Aneurysmal bone cyst in thoracolumbar spine
Alex Kiu1, Tiffany Fung1, Pranav Chowdhary1
1Department of Diagnostic Radiology, McGill University Health Center, MontrealQC, Canada.
BJR Case Reports
|September 14, 2020
Summary
Aneurysmal bone cysts (ABC) are rare bone tumors that can aggressively erode bone. This case shows a patient with a thoracic spine ABC causing severe spinal stenosis without neurological symptoms, highlighting the need for early diagnosis.
Area of Science:
- Orthopedics
- Neurosurgery
- Pathology
Background:
- Aneurysmal bone cysts (ABC) are uncommon, benign primary bone tumors known for local aggressiveness.
- While benign, ABCs can cause significant bone erosion and damage to surrounding tissues.
Observation:
- A 32-year-old female presented with progressive low back pain, but no neurological deficits.
- Radiological imaging identified a large, destructive mass in the thoracic spine encroaching on the central canal, leading to critical stenosis and cord compression.
- Histopathological examination confirmed the diagnosis of an Aneurysmal Bone Cyst (ABC).
Findings:
- The case demonstrates that Aneurysmal Bone Cysts can present insidiously with significant spinal canal stenosis and cord compression without causing neurological deficits.
- This suggests that slow-growing lesions may allow for neurological adaptation, even with critical stenosis.
Implications:
- It is crucial to include Aneurysmal Bone Cysts (ABCs) in the differential diagnosis for patients presenting with chronic, unexplained musculoskeletal pain.
- Recognizing that patients can be neurologically asymptomatic despite severe spinal stenosis is vital for appropriate and timely management planning.
- This case underscores the importance of considering 'benign' but locally aggressive lesions in the evaluation of spinal pathologies.
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