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J Neurol Surg A Cent Eur Neurosurg 2013; 74(S 01): e70-e75
DOI: 10.1055/s-0032-1324803
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Solid Variant of Aneurysmal Bone Cyst of the Left Parietal Bone without Preceding Trauma

Ulf Nestler
1   Department of Neurosurgery, Justus Liebig University, Giessen, Germany
,
Hans-Joachim Wagner
2   Department of Pediatric Oncology, Justus Liebig University, Giessen, Germany
,
Anne Schaenzer
3   Department of Neuropathology, Justus Liebig University, Giessen, Germany
,
Matthias Preuss
1   Department of Neurosurgery, Justus Liebig University, Giessen, Germany
› Author Affiliations
Further Information

Publication History

12 September 2011

27 March 2012

Publication Date:
26 September 2012 (online)

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Abstract

Introduction We report the case of a 17-year-old girl with an indolent, smooth swelling of the left cranial vault that had been developing for 2 months. Complete surgical excision was performed and the defect was closed using artificial bone cement. The integrity of the dura mater was conserved and the patient recovered without neurological deficit. Magnetic resonance imaging (MRI) controls 6 and 18 months after the operation did not find signs of recurrence.

Results The lesion consisted of an elastic bone shell containing bony trabeculae with soft brown-greyish tissue and posthemorrhagic dark fluid. Histological assessment found CD68 positive multinucleated giant cells in a highly cellular fibroblastic matrix surrounding bony lamellar structures, without signs of inflammation or malignancy. Hyperparathyroidism was ruled out by normal serum values for parathyroid hormone, calcium, phosphate, and alkaline phosphatase. Histologically, first diagnosis was giant cell reparative granuloma and reference pathology disclosed aneurysmal bone cyst.

Conclusions The solid variant of aneurysmal bone cyst and the giant cell reparative granuloma can be histologically indistinguishable. Both lesions are only rarely encountered in cranial bones and most published cases affected the cranial base or the jaw, mainly in children or young adults. From a clinical point of view, classification into “outward” lesions (osteolysis of external parts of the vault with preservation of internal tabula) and “inward” lesions (intracranial multicystic lesions with raise of intracranial pressure) has been proposed. Three phases of development can be identified, and spontaneous involution has been described. Both entities are benign, but because in several cases an underlying malignant disease has been found, complete resection and regular follow-up by MRI are recommended.

Keywords

aneurysmal bone cyst - cranial vault - giant cell reparative granuloma - juvenile skull tumor
 

  • References

  • 1 Alessio L, Iob I, Mottaran R, Salar G, Fiore D. [Aneurysmal cysts of the fronto-parietal bone]. Riv Neurol 1989; 59 (2) 53-57
    PubMedGoogle Scholar
  • 2 Amaral L, Chiurciu M, Almeida JR, Ferreira NF, Mendonça R, Lima SS. MR imaging for evaluation of lesions of the cranial vault: a pictorial essay. Arq Neuropsiquiatr 2003; 61 (3A) 521-532
    CrossrefPubMedGoogle Scholar
  • 3 Barbier O, Freude G, Blondet E, Goasgen O, de Soultrait F. [An unusual cranial vault tumor: the chondromyxoid fibroma]. Neurochirurgie 2011; 57: 34-38
    CrossrefPubMedGoogle Scholar
  • 4 Branch Jr CL, Challa VR, Kelly Jr DL. Aneurysmal bone cyst with fibrous dysplasia of the parietal bone. Report of two cases. J Neurosurg 1986; 64 (2) 331-335
    CrossrefPubMedGoogle Scholar
  • 5 Broc-Haro GG, Rodríguez-Valencia F, Manrique-Guzmán S. [Spontaneous regression of aneurysmal bone cyst of the skull. Case report]. Cir Cir 2007; 75 (1) 49-51
    PubMedGoogle Scholar
  • 6 Calliauw L, Roels H, Caemaert J. Aneurysmal bone cysts in the cranial vault and base of skull. Surg Neurol 1985; 23 (2) 193-198
    CrossrefPubMedGoogle Scholar
  • 7 Chang CS, Bergeron L, Liao CC , et al. Craniofacial reconstruction of primary osteogenic sarcoma of the skull. J Plast Reconstr Aesthet Surg 2010; 63 (8) 1265-1268
    CrossrefPubMedGoogle Scholar
  • 8 Chateil JF, Dousset V, Meyer P , et al. Cranial aneurysmal bone cysts presenting with raised intracranial pressure: report of two cases. Neuroradiology 1997; 39 (7) 490-494
    CrossrefPubMedGoogle Scholar
  • 9 Farrier SL, Farrier JN, Smart MK, Nash ES. A 10-year review of the occurrence and treatment of central giant cell granulomas, in a District General Hospital. J Oral Pathol Med 2006; 35 (6) 332-337
    CrossrefPubMedGoogle Scholar
  • 10 Forest M. Aneurysmal bone cyst (chapter 37); Giant cell reaction (chapter 46). In: Forest M, Tomeno B, Vanel D, , eds. Orthopedic Surgical Pathology. London: Churchill Livingstone (Elsevier); 1998
    Google Scholar
  • 11 Gan YC, Hockley AD. Aneurysmal bone cysts of the cranium in children. Report of three cases and brief review of the literature. J Neurosurg 2007; 106 (5, Suppl) 401-406
    PubMedGoogle Scholar
  • 12 Garza-Mercado R, Cavazos E, Hernández-Batres F. Giant cell reparative granuloma of the cranial vault: exceptional bone lesion. Neurosurgery 1984; 15 (2) 228-232
    CrossrefPubMedGoogle Scholar
  • 13 Genizi J, Srugo I, Attias D , et al. Giant pediatric aneurysmal bone cysts of the occipital bone: case report and review of the literature. Pediatr Neurol 2011; 45 (1) 42-44
    CrossrefPubMedGoogle Scholar
  • 14 Gopalakrishnan CV, Rao BRM, Nair S, Radhakrishnan VV, Kesavadas C. Intracranial intradural aneurysmal bone cyst: a unique case. Pediatr Neurosurg 2009; 45 (4) 317-320
    CrossrefPubMedGoogle Scholar
  • 15 Hadidy AM, Tamimi AF, Fayad LM, Al-Jadiry HA. Aneurysmal bone cyst concomitant with fibrous dysplasia in the frontal bone. Neurosciences (Riyadh) 2010; 15 (4) 280-283
    PubMedGoogle Scholar
  • 16 Hornig GW, Beatty RM. Osteolytic skull lesions secondary to trauma. Report of two cases. J Neurosurg 1990; 72 (3) 506-508
    CrossrefPubMedGoogle Scholar
  • 17 Ikeda H, Niizuma H, Suzuki J, Nagamine Y, Kameyama M. [Chemical embolization using estrogen for aneurysmal bone cyst of the skull: case report]. No Shinkei Geka 1985; 13 (2) 203-208
    PubMedGoogle Scholar
  • 18 Kumar R, Mukherjee KK. Aneurysmal bone cysts of the skull: report of three cases. Br J Neurosurg 1999; 13 (1) 82-84
    CrossrefPubMedGoogle Scholar
  • 19 Lin SP, Fang YC, Chu DC, Chang YC, Hsu CI. Characteristics of cranial aneurysmal bone cyst on computed tomography and magnetic resonance imaging. J Formos Med Assoc 2007; 106 (3) 255-259
    CrossrefPubMedGoogle Scholar
  • 20 Menge M, Maier W, Feuerhake F, Kaminsky J, Pfeiffer J. Giant cell reparative granuloma of the temporal bone. Acta Neurochir (Wien) 2009; 151 (4) 397-399
    CrossrefPubMedGoogle Scholar
  • 21 Moser A, Hoffmann KM, Walch C , et al. Intracranial reparative giant cell granuloma secondary to cholesteatoma in a 15-year-old girl. J Pediatr Hematol Oncol 2008; 30 (12) 935-937
    CrossrefPubMedGoogle Scholar
  • 22 Mukerji N, Willmott H, Joy A, Sutter R, Wadley J. Giant cell reparative granuloma of the cranial vault-case report and review of literature. Surg Neurol 2009; 71 (4) 493-495
    CrossrefPubMedGoogle Scholar
  • 23 Oki S, Shima T, Uozumi T, Kodama T. [Aneurysmal bone cyst of the skull -a case report- (author's transl)]. No Shinkei Geka 1978; 6 (12) 1197-1201
    PubMedGoogle Scholar
  • 24 Patibandla MR, Uppin SG, Thotakura AK, Panigrahi MK, Challa S. Primary telangiectatic osteosarcoma of occipital bone: a case report and review of literature. Neurol India 2011; 59 (1) 117-119
    CrossrefPubMedGoogle Scholar
  • 25 Reis C, Lopes JM, Carneiro E , et al. Temporal giant cell reparative granuloma: a reappraisal of pathology and imaging features. AJNR Am J Neuroradiol 2006; 27 (8) 1660-1662
    PubMedGoogle Scholar
  • 26 Sabatini PR, Horenstein MG, Oliveri CV, Gacek RR. Aneurysmal bone cyst of the temporal bone associated with reversible hemifacial paralysis. Am J Otolaryngol 2005; 26 (4) 261-264
    CrossrefPubMedGoogle Scholar
  • 27 Salmasi V, Blitz AM, Ishii M, Gallia GL. Expanded endonasal endoscopic approach for resection of a large skull base aneurysmal bone cyst in a pediatric patient with extensive cranial fibrous dysplasia. Childs Nerv Syst 2011; 27 (4) 649-656
    CrossrefPubMedGoogle Scholar
  • 28 Santos-Briz A, Lobato RD, Ramos A, Millán JM, Ricoy JR, Martínez-Tello FJ. Giant cell reparative granuloma of the occipital bone. Skeletal Radiol 2003; 32 (3) 151-155
    CrossrefPubMedGoogle Scholar
  • 29 Saw S, Thomas N, Gleeson MJ, Bódi I, Connor S, Hortobágyi T. Giant cell tumour and central giant cell reparative granuloma of the skull: do these represent ends of a spectrum? A case report and literature review. Pathol Oncol Res 2009; 15 (2) 291-295
    CrossrefPubMedGoogle Scholar
  • 30 Segall L, Cohen-Kerem R, Ngan BY, Forte V. Aneurysmal bone cysts of the head and neck in pediatric patients: a case series. Int J Pediatr Otorhinolaryngol 2008; 72 (7) 977-983
    CrossrefPubMedGoogle Scholar
  • 31 Stapleton CJ, Walcott BP, Linskey KR, Kahle KT, Nahed BV, Asaad WF. Temporal bone chondroblastoma with secondary aneurysmal bone cyst presenting as an intracranial mass with clinical seizure activity. J Clin Neurosci 2011; 18 (6) 857-860
    CrossrefPubMedGoogle Scholar
  • 32 Tokarz F, Jankowski R, Zukiel R, Nowak S. [Aneurysmal bone cyst of the skull and vertebral column treated operatively]. Neurol Neurochir Pol 1993; 27 (4) 533-540
    PubMedGoogle Scholar
  • 33 Uchino A, Kato A, Yonemitsu N, Hirctsu T, Kudo S. Giant cell reparative granuloma of the cranial vault. AJNR Am J Neuroradiol 1996; 17 (9) 1791-1793
    PubMedGoogle Scholar
  • 34 Ulivieri S, Oliveri G, Miracco C. Aneurysmal bone cyst of the parietal bone. Case report. Pathologica 2008; 100 (1) 41-42
    PubMedGoogle Scholar
  • 35 Yoshimura J, Onda K, Tanaka R, Takahashi H. Giant cell reparative granuloma of the temporal bone: neuroradiological and immunohistochemical findings. Neurol Med Chir (Tokyo) 2002; 42 (11) 510-515
    CrossrefPubMedGoogle Scholar