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Year : 2004  |  Volume : 14  |  Issue : 2  |  Page : 179-180
Aneurysmal bone cyst of clavicle


Sheth K.M. School of P.G. Medicine and Research, Smt. N.H.L. Medical College, Sheth V.S. Hospital, Ahmedabad-380006, India

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Keywords: Aneurysmal Bone Cyst, Clavicle

How to cite this article:
Pamecha C, Patel J G, Patel L N, Patel P R. Aneurysmal bone cyst of clavicle. Indian J Radiol Imaging 2004;14:179-80

How to cite this URL:
Pamecha C, Patel J G, Patel L N, Patel P R. Aneurysmal bone cyst of clavicle. Indian J Radiol Imaging [serial online] 2004 [cited 2019 Dec 9];14:179-80. Available from: http://www.ijri.org/text.asp?2004/14/2/179/28581

   Introduction Top


Primary tumors of flat bones are not commonly. Among all flat bones, clavicle is an unusual bone for tumor or tumor like lesions. True benign neoplasm of clavicle are less common than malignant. Metastatic tumors are more common than primary tumors in clavicle. The incidence of tumor in clavicle to whole body is less than 1%. The following tumors are commonly seen in clavicle: Ewing's sarcoma (4%). Aneurysmal bone cyst (3%) and Hemangiopericytoma (2%) in decreasing order of occurrence[1]. Aneurysmal bone cyst is an uncommon benign tumor in clavicle. It usually involves long bones of the extremities. Clavicle involves nearly 3% of all cases of aneurysmal bone cyst[1].


   Case Study Top


A six year old male, son of a Muslim laborer, presented with complaint of slowly progressive hard swelling in left clavicular region since last 6 months. There was no history of trauma, fall, constitutional symptoms and any other similar swelling in the body.

A 5 x 2.5 cm solid swelling was palpable in midclavicular region on left side. The overlying skin was normal. The swelling was round to oval, well circumscribed, free from underlying skin, hard in consistency, smooth, non pulsatile, transillumination test was negative [Figure - 1]. There is no associated neurological and vascular deficit. Movement of left shoulder was normal.

The plain radiograph showed well defined radiolucent, expansile lesion with thin cortical margins in mid clavicle region. The margins of the swelling were continuous with adjacent normal bone. The central part of the swelling was homogenous with no visible septa [Figure - 2]. The CT scan showed a well circumscribed homogenous radio lucent swelling with continuous cortical margin and was concluded as Aneurysmal bone cyst or Hematoma

[Figure - 3] FNAC was done but it was inconclusive.

The tumor was operated with wide excision and part of adjacent normal bone was removed leaving 2 cm, at either end of clavicle. Histopathological examination revealed the diagnosis as solid variety of Aneurysmal bone cyst.

On follow up of 16 weeks, the patient had no complaints with non tender, smooth, healed scar at the tumor site with no abnormal swelling [Figure - 4]. The post operative plain x-x-ray showed a new regenerated clavicle [Figure - 5].


   Discussion Top


Aneurysmal bone cyst is a benign tumor commonly involving metaphyseal region of long bones (60-70% cases). The specific site of involvement include Tibia (15%), Vertebra (14%), Femur (13%), Humerus (9%), Pelvis (8%), Ulna (4%), Clavicle (3%), Ribs, Scapula & Skull (2%). They are usually observed in first, second or third decade of life. They commonly present as painful swelling of weeks to years in duration. Histologically, aneurysmal bone cyst are characterized by cavernous blood - filled cysts. Although Aneurysmal bone cyst is a non-neoplastic condition with no propensity to metastasize its potential for rapid growth, considerable destruction of bone and extension into soft tissue has generally led to aggressive therapy. Aneurysmal bone cyst is an uncommon benign tumor for clavicle. Clavicle accounts for 3% of all aneurysmal bone cyst in series of 465 cases[1].

It usually involves either ends of clavicle and commonly presents as an eccentrically placed mass. It occurs commonly in first and second decade of life. It usually presents as a slowly progressive painless bony swelling. Wide excision is the treatment of choice in contrast to curettage and grafting in case of long bones. Only curettage of the lesion is associated with a high recurrence rate of 42% on 5 yr followup[1]. Radiotherapy is given only in surgically inaccessible tumors.

In this case the histopathology was solid variety of Aneurysmal bone cyst; which is also known as Extragnathic giant cell reparative granuloma. They have a preference for axial involvement. The typical aneurysmal sinusoids and blood filled cysts of conventional aneurysmal bone cyst are absent. They have a favorable prognosis[6].

 
   References Top

1.Resnick D: Diagnosis of bone and Joint disorders 4th edition, W.B. Saunders com. 4037-4049  Back to cited text no. 1    
2.D. J. Ruiter et al: Aneurysmal bone cysts: J Bone Joint Surg Am, 39/A no.4, July 1957, pg. 875-878.  Back to cited text no. 2    
3.Rineter et al : A clinicopathologic study of 105 cases of aneurismal bone cyst, Cancer 39:2231;2239, 1977.  Back to cited text no. 3    
4.Senac Mo Jr. et al : A study of 465 cases of ABC, Radiology 160;491,1986.  Back to cited text no. 4    
5.Julius smith et al. 75th annual meeting of American roentgen ray society vol 124, pg 113 to 122.  Back to cited text no. 5    
6.Morrison MCT osteoclastoma of clavicle proc. Roy.soc. med.1965.  Back to cited text no. 6    

Top
Correspondence Address:
C Pamecha
Sheth K.M. School of P.G. Medicine and Research, Smt. N.H.L. Medical College, Sheth V.S. Hospital, Ahmedabad-380006
India
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Source of Support: None, Conflict of Interest: None


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    Figures

[Figure - 1], [Figure - 2], [Figure - 3], [Figure - 4], [Figure - 5]

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    Introduction
    Case Study
    Discussion
    References
    Article Figures

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