Knee intra-articular extraskeletal aneurysmal bone cyst: a case report and review of literature

Abstract

Aneurysmal bone cyst (ABC) is a benign locally destructive lesion that usually developed in the bone cavity of bones, less commonly on the surface of cortical bones and very rarely develop outside the bone. There are only 35 reports of extraskeletal aneurysmal bone cyst (ESABC) in the English literature. We report a case of a 12-year-old female with no history of trauma who presented with knee pain. Imaging studies revealed an infrapatellar mass that was fast to calcify during a period of 3 months. MRI showed high T2 center, low T1 signal, and heterogenic enhancement with a rim of low intensity consistent with calcified boarders surrounded by severe soft tissue edema. The lesion was surgically excised, and a histological examination revealed an aneurysmal bone cyst possibly arising within myositis ossificans or heterotopic ossification. In her last follow-up 1.5 years after the surgical excision, the patient was symptom free and without signs of recurrence. To the best of our knowledge, this is the first reported case of an intra-articular ESABC located in the knee.

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References

  1. 1.

    Fletcher CDM, Unni KK, Mertens F, Weltgesundheitsorganisation, International Agency for Research on Cancer, editors. Pathology and genetics of tumours of soft tissue and bone ; [the WHO classification of tumours of soft tissue and bone presented in this book reflects the views of a working group that convened for an editorial and consensus conference in Lyon, France, April 24–28, 2002]. Lyon: IARC Press; 2002. 427. (World Health Organization Classification of tumours).

  2. 2.

    Shooshtarizadeh T, Movahedinia S, Mostafavi H, Jamshidi K, Sami SH. Aneurysmal bone cyst: an analysis of 38 cases and report of four unusual surface ones. Arch Bone Jt Surg. 2016;4(2):7.

    Google Scholar 

  3. 3.

    Meohas W, de Sá Lopes AC, da Silveira Möller JV, Barbosa LD, Oliveira MB dos R. Parosteal aneurysmal bone cyst. Rev Bras Ortop Engl Ed. 2015;50(5):601–6.

    Article  Google Scholar 

  4. 4.

    Lopez LV, Rodriguez MG, Siegal GP, Wei S. Extraskeletal aneurysmal bone cyst: report of a case and review of the literature. Pathol Res Pract. 2017;213(11):1445–9.

    Article  Google Scholar 

  5. 5.

    Salm R, Sissons HA. Giant-cell tumours of soft tissues. J Pathol. 1972;107(1):27–39.

    CAS  Article  Google Scholar 

  6. 6.

    Song W, Suurmeijer AJH, Bollen SM, Cleton-Jansen A-M, Bovée JVMG, Kroon HM. Soft tissue aneurysmal bone cyst: six new cases with imaging details, molecular pathology, and review of the literature. Skelet Radiol. 2019;48(7):1059–67.

    Article  Google Scholar 

  7. 7.

    Petrik PK, Findlay JM, Sherlock RA. Aneurysmal cyst, bone type, primary in an artery. Am J Surg Pathol. 1993;17(10):1062–6.

    CAS  Article  Google Scholar 

  8. 8.

    Shannon P, Bedard Y, Bell R, Kandel R. Aneurysmal cyst of soft tissue: report of a case with serial magnetic resonance imaging and biopsy. Hum Pathol. 1997;28(2):255–7.

    CAS  Article  Google Scholar 

  9. 9.

    Samura H, Shiraishi M, Tokashiki H, Nosato E, Miyazato H, Muto Y. An extraosseous aneurysmal cyst in the pelvic cavity: report of a case. Clin Imaging. 2000;24(2):68–71.

    CAS  Article  Google Scholar 

  10. 10.

    D’Costa GF, Hastak MS, Patil YV. Primary aneurysmal cyst: bone type in the breast. Indian J Surg. 2007;69(6):248–50.

    Article  Google Scholar 

  11. 11.

    Chung IA, Petelin K, Pižem J, Luzar B. Cutaneous aneurysmal bone cyst—first report of a case and literature review. J Cutan Pathol. 2019;46(11):858–63.

    Article  Google Scholar 

  12. 12.

    Park HY, Yang SK, Sheppard WL, Hegde V, Zoller SD, Nelson SD, et al. Current management of aneurysmal bone cysts. Curr Rev Musculoskelet Med. 2016;9(4):435–44.

    Article  Google Scholar 

  13. 13.

    Baker KS, Gould ES, Patel HB, Hwang SJ. Soft tissue aneurysmal bone cyst: a rare case in a middle aged patient. J Radiol Case Rep. 2015;9(1):26–35.

    PubMed  PubMed Central  Google Scholar 

  14. 14.

    Kransdorf MJ, Sweet DE. Aneurysmal bone cyst: concept, controversy, clinical presentation, and imaging. Am J Roentgenol. 1995;164(3):573–80.

    CAS  Article  Google Scholar 

  15. 15.

    Hao Y, Wang L, Yan M, Jin F, Ge S, Dai K. Soft tissue aneurysmal bone cyst in a 10-year-old girl. Oncol Lett. 2012;3(3):545–8.

    Article  Google Scholar 

  16. 16.

    López-Barea F, Rodríguez-Peralto JL, Burgos-Lizaldez E, Alvarez-Linera J, Sánchez-Herrera S. Primary aneurysmal cyst of soft tissue. Report of a case with ultrastructural and MRI studies. Virchows Arch Int J Pathol. 1996;428(2):125–9.

    Article  Google Scholar 

  17. 17.

    Ajilogba KA, Kaur H, Duncan R, McFarlane JH, Watt AJ. Extraosseous aneurysmal bone cyst in a 12-year-old girl. Pediatr Radiol. 2005;35(12):1240–2.

    Article  Google Scholar 

  18. 18.

    Mulcahy H, Hoch B. An extraskeletal para-articular osteochondroma of Hoffa’s fat pad. Radiol Case Rep. 2010;5(4):420.

    Article  Google Scholar 

  19. 19.

    Nielsen GP, Smith MA, Rosenberg AE. Soft tissue aneurysmal bone cyst. Am J Surg Pathol. 2002;26(1):6.

    Article  Google Scholar 

  20. 20.

    Bahk W-J, Mirra JM. Differential diagnostic value of “blue reticulated chondroid-like material” in aneurysmal bone cysts. Am J Clin Pathol. 2015;143(6):823–9.

    Article  Google Scholar 

  21. 21.

    Amir G, Mogle P, Sucher E. Case report 729. Myositis ossificans and aneurysmal bone cyst. Skelet Radiol. 1992;21(4):257–9.

    CAS  Article  Google Scholar 

  22. 22.

    Sukov WR, Franco MF, Erickson-Johnson M, Chou MM, Unni KK, Wenger DE, et al. Frequency of USP6 rearrangements in myositis ossificans, brown tumor, and cherubism: molecular cytogenetic evidence that a subset of “myositis ossificans-like lesions” are the early phases in the formation of soft-tissue aneurysmal bone cyst. Skelet Radiol. 2008;37(4):321–7.

    Article  Google Scholar 

  23. 23.

    Rodríguez-Peralto JL, López-Barea F, Sánchez-Herrera S, Atienza M. Primary aneurysmal cyst of soft tissues (extraosseous aneurysmal cyst). Am J Surg Pathol. 1994;18(6):632–6.

    Article  Google Scholar 

  24. 24.

    Wang XL, Gielen JL, Salgado R, Delrue F, De Schepper AMA. Soft tissue aneurysmal bone cyst. Skelet Radiol. 2004;33(8):477–80.

    CAS  Article  Google Scholar 

  25. 25.

    Ellison DA, Sawyer JR, Parham DM, Nicholas R. Soft-tissue aneurysmal bone cyst: report of a case with t(5;17)(q33;p13). Pediatr Dev Pathol. 2007;10(1):46–9.

    Article  Google Scholar 

  26. 26.

    Karkuzhali P, Bhattacharyya M, Sumitha P. Multiple soft tissue aneurysmal cysts: an occurrence after resection of primary aneurysmal bone cyst of fibula. Indian J Orthop. 2007;41(3):246.

    CAS  Article  Google Scholar 

  27. 27.

    An SB, Choi J-A, Chung J-H, Oh JH, Kang HS. Giant cell tumor of soft tissue: a case with atypical US and MRI findings. Korean J Radiol. 2008;9(5):462.

    Article  Google Scholar 

  28. 28.

    Sahu A, Gujral SS, Gaur S. Extraosseous aneurysmal cyst in hand: a case report. Cases J. 2008;1(1):268.

    Article  Google Scholar 

  29. 29.

    Pietschmann MF, Oliveira AM, Chou MM, Ihrler S, Niederhagen M, Baur-Melnyk A, et al. Aneurysmal bone cysts of soft tissue represent true neoplasms: a report of two cases. J Bone Jt Surg Am. 2011;93(9):e45 -1–8.

    Article  Google Scholar 

  30. 30.

    Jacquot C, Szymanska J, Nemana LJ, Steinbach LS, Horvai AE. Soft-tissue aneurysmal bone cyst with translocation t(17;17)(p13;q21) corresponding to COL1A1 and USP6 loci. Skelet Radiol. 2015;44(11):1695–9.

    Article  Google Scholar 

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Correspondence to Noam Olshinka.

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Olshinka, N., Azraq, Y., Benshushan, S. et al. Knee intra-articular extraskeletal aneurysmal bone cyst: a case report and review of literature. Skeletal Radiol 49, 1499–1503 (2020). https://doi.org/10.1007/s00256-020-03464-2

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Keywords

  • Aneurysmal bone cyst
  • Extraskeletal aneurysmal bone cyst
  • Myositis ossificans
  • Knee
  • Soft tissue
  • Radiograph
  • MRI