WordNet

remove the bones from; "bone the turkey before roasting it" (同)debone
the porous calcified substance from which bones are made (同)osseous_tissue
consisting of or made up of bone; "a bony substance"; "the bony framework of the body"
a shade of white the color of bleached bones (同)ivory, pearl, off-white
rigid connective tissue that makes up the skeleton of vertebrates (同)os
having bones as specified; "his lanky long-boned body"
having had the bones removed; "a boneless rib roast"; "a boned (or deboned) fish" (同)deboned
a percussion instrument consisting of a pair of hollow pieces of wood or bone (usually held between the thumb and fingers) that are made to click together (as by Spanish dancers) in rhythm with the dance (同)castanets, clappers, finger cymbals
a cardiovascular disease characterized by a saclike widening of an artery resulting from weakening of the artery wall (同)aneurism
relating to or affected by an aneurysm (同)aneurismal, aneurysmatic, aneurismatic

PrepTutorEJDIC

〈C〉骨 / 〈U〉骨を作っている物質,骨質 / 《複数形で》骨格;死骸(がい) / 〈魚など〉‘の'骨を取る
(魚など)骨を取り除いた / (衣服が)(コルセットなどで)骨で張りをつけた[ような]
動脈瘤(りゅう)

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/01/09 18:07:42」(JST)

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Aneurysmal bone cyst, abbreviated ABC, is an osteolytic bone neoplasm characterized by several sponge-like blood or serum filled, generally non-endothelialized spaces of various diameters.^[1]

Etymology

The term is a misnomer, as the lesion is neither an aneurysm nor a cyst.^[1]

Causes

Aneurysmal bone cyst has been widely regarded a reactive process of uncertain etiology since its initial description by Jaffe and Lichtenstein in 1942. Many hypotheses have been proposed to explain the etiology and pathogenesis of aneurysmal bone cyst, and until very recently the most commonly accepted idea was that aneurysmal bone cyst was the consequence of an increased venous pressure and resultant dilation and rupture of the local vascular network. However, studies by Panoutsakopoulus et al. and Oliveira et al. uncovered the clonal neoplastic nature of aneurysmal bone cyst. Primary etiology has been regarded arteriovenous fistula within bone.^[2]

The lesion may arise de novo or may arise secondarily within a pre-existing bone tumor, because the abnormal bone causes changes in hemodynamics. An aneurysmal bone cyst can arise from a pre-existing chondroblastoma, a chondromyxoid fibroma, an osteoblastoma, a giant cell tumor, or fibrous dysplasia. A giant cell tumor is the most common cause, occurring in 19% to 39% of cases. Less frequently, it results from some malignant tumors, such as osteosarcoma, chondrosarcoma, and hemangioendothelioma.

Pathology

Micrograph of an aneurysmal bone cyst. H&E stain.

Histologically, they are classified in two variants.

The classic (or standard) form (95%) has blood filled clefts among bony trabeculae. Osteoid tissue is found in stromal matrix.
The solid form (5%) shows fibroblastic proliferation, osteoid production and degenerated calcifying fibromyxoid elements.

According to Buraczewski and Dabska, the development of the aneurysmal bone cyst follows three stages.^[1]

Stage	Description
Initial phase (I)	Osteolysis without peculiar findings
Growth phase (II)	Rapid increase in size of osseous erosion Enlargement of involved bone Formation of shell around central part of lesion
Stabilization phase (III)	Fully developed radiological pattern

They can also be associated with a TRE17/USP6 translocation.^[3]

Aneurysmal bone cysts may be intraosseous, staying inside of the bone marrow. Or they may be extraosseous, developing on the surface of the bone, and extending into the marrow.

Clinical features

The afflicted may have relatively small amounts of pain that will quickly increase in severity over a time period of 6–12 weeks. The skin temperature around the bone may increase, a bony swelling may be evident, and movement may be restricted in adjacent joints.^[4]

Spinal lesions may cause quadriplegia and patients with skull lesions may have headaches.

Sites

Commonly affected sites are metaphyses of vertebra, flat bones, femur and tibia.^[5] Approximate percentages by sites are as shown:

Skull and mandible (4%)
Spine (16%)
Clavicle and ribs (5%)
Upper extremity (21%)
Pelvis and sacrum (12%)
Femur (13%)
Lower leg (24%)
Foot (3%)

Diagnosis

On a radiograph, well-defined, expansile, lytic lesion is observed. Expansion of cortex gives the lesion a balloon-like appearance. Larger lesions may appear septated^[6]

Differential diagnosis

Following conditions are excluded before diagnosis can be confirmed:^[7]

Unicameral bone cyst
Giant cell tumor

Telangiectatic osteosarcoma
Secondary aneurysmal bone cyst

Treatment

Curettage is performed on some patients,^[8] and is sufficient for inactive lesions. The recurrence rate with curettage is significant in active lesions, and marginal resection has been advised. Liquid nitrogen, phenol, methyl methacrylate are considered for use to kill cells at margins of resected cyst.^[2]

Prognosis

Recurrence rate of solid form of tumour is lower than classic form.^[2]

Epidemiology

It is common in age group of 10-30 years.^[6] It is second most common tumor of spine and commonest benign tumor of pelvis in pediatric population.^[2] Incidence is slightly more in males than females (1.3:1).^[7]

Additional images

High magnification micrograph of an aneurysmal bone cyst
Intermediate magnification micrograph of an aneurysmal bone cyst

References

^ ^a ^b ^c Maroldi, Roberto (2005). Imaging in Treatment Planning for Sinonasal Diseases. Springer. p. 114. ISBN 9783540266310.
^ ^a ^b ^c ^d Pediatric Orthopedics in Practice. Springer. 2007. pp. 151–155. ISBN 9783540699644.
^ Ye Y, Pringle LM, Lau AW; et al. (June 2010). "TRE17/USP6 oncogene translocated in aneurysmal bone cyst induces matrix metalloproteinase production via activation of NF-kappaB". Oncogene 29 (25): 3619–29. doi:10.1038/onc.2010.116. PMC 2892027. PMID 20418905.
^ Zadik, Yehuda; Aktaş Alper; Drucker Scott; Nitzan W Dorrit (2012). "Aneurysmal bone cyst of mandibular condyle: A case report and review of the literature". J Craniomaxillofac Surg 40 (8): e243–8. doi:10.1016/j.jcms.2011.10.026. PMID 22118925.
^ Rosai and Ackerman's surgical pathology, Volume 2, 9th ed. Mosby. 2004. p. 148. ISBN 9780323013420.
^ ^a ^b Davies, Arthur (2002). Who Manual Of Diagnostic Imaging: Radiographic Anatomy And Interpretation Of The Muskuloskeletal System, VOlume. World Health Organization. pp. 168–186. ISBN 9241545550.
^ ^a ^b Differential Diagnosis in Surgical Pathology: Expert Consult - Online and Print, 2e. Elsevier Health Sciences. 2010. pp. 878–879. ISBN 9781416045809.
^ Mankin HJ, Hornicek FJ, Ortiz-Cruz E, Villafuerte J, Gebhardt MC (September 2005). "Aneurysmal bone cyst: a review of 150 patients". J. Clin. Oncol. 23 (27): 6756–62. doi:10.1200/JCO.2005.15.255. PMID 16170183.

Missing references

External links

Bonetumor.org

UpToDate Contents

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1. 小児および思春期における良性骨腫瘍：概要 benign bone tumors in children and adolescents an overview
2. 骨の巨大細胞腫瘍 giant cell tumor of bone
3. 骨肉腫：術前評価、組織学的分類、および外科的マネージメントの原則 bone sarcomas preoperative evaluation histologic classification and principles of surgical management
4. 骨肉腫：疫学、病因、臨床症状、診断、および組織学的検査 osteosarcoma epidemiology pathogenesis clinical presentation diagnosis and histology
5. 成人における膝関節腫瘍のX線評価 radiologic evaluation of knee tumors in adults

English Journal

Giant cell tumor of bone with secondary aneurysmal bone cyst-like change producing β-human chorionic gonadotropin.

Fitzhugh VA1, Katava G, Wenokor C, Roche N, Beebe KS.Author information 1Department of Pathology and Laboratory Medicine, Rutgers, the State University of New Jersey-New Jersey Medical School, Newark, NJ, 07103, USA, fitzhuva@njms.rutgers.edu.AbstractGiant cell tumor of bone is a benign, locally aggressive neoplasm that is composed of sheets of neoplastic mononuclear cells interspersed amongst non-neoplastic, uniformly distributed, osteoclast-like giant cells. They represent approximately 4-5 % of primary bone tumors. Rarely, bone tumors have been noted to produce human chorionic gonadotropin, a finding most often reported in osteosarcoma. We present the case of a young woman who presented with a low-level human chorionic gonadotropin level which, after resection of her recurrent giant cell tumor of bone with secondary aneurysmal bone cyst-like change, became undetectable in her blood. Furthermore, cells within the aneurysmal bone cyst component were immunohistochemically positive for β-human chorionic gonadotropin. This is the first report of such a finding in the literature.
Skeletal radiology.Skeletal Radiol.2014 Jun;43(6):831-4. doi: 10.1007/s00256-013-1785-2. Epub 2013 Dec 21.
Giant cell tumor of bone is a benign, locally aggressive neoplasm that is composed of sheets of neoplastic mononuclear cells interspersed amongst non-neoplastic, uniformly distributed, osteoclast-like giant cells. They represent approximately 4-5 % of primary bone tumors. Rarely, bone tumors have b
PMID 24362936

Primary aneurysmal bone cyst of the distal tibial epiphysis: a case report.

Kerimoğlu S1, Citlak A, Kerimoğlu G, Turgutalp H.Author information 1Departments of aOrthopaedics and Traumatology bHistology and Embryology cPathology, School of Medicine, Karadeniz Technical University, Trabzon dDepartment of Orthopaedics and Traumatology, School of Medicine, Giresun University, Giresun, Turkey.AbstractAneurysmal bone cyst (ABC) is a benign lesion that commonly involves the metaphysis or metadiaphyseal region of long bones in children. The WHO defined ABC as an expansile osteolytic lesion consisting of blood-filled spaces and channels that are divided by connective tissue septa that may contain osteoid tissue and osteoclast-like giant cells. ABCs are usually treated with intralesional procedures, and variables including surgeon technique, young patient, juxtaphyseal tumors, and tumor location have been associated with recurrence. Juxtaphyseal lesions breaching the physis have been described. There is only one case of primary ABC of the epiphysis in the literature. We present a second case in a 13-year-old boy who presented with a primary ABC of the distal tibial epiphysis, including diagnostic evaluation and treatment.
Journal of pediatric orthopedics. Part B.J Pediatr Orthop B.2014 May;23(3):266-9. doi: 10.1097/BPB.0000000000000014.
Aneurysmal bone cyst (ABC) is a benign lesion that commonly involves the metaphysis or metadiaphyseal region of long bones in children. The WHO defined ABC as an expansile osteolytic lesion consisting of blood-filled spaces and channels that are divided by connective tissue septa that may contain os
PMID 24217294

Japanese Journal

オトガイ神経領域の知覚異常を初発症状とした下顎骨脈瘤性骨囊胞の1例

岩城太,大西正信
日本口腔科学会雑誌 63(3), 275-278, 2014-07
NAID 40020171052

オトガイ神経領域の知覚異常を初発症状とした下顎骨脈瘤性骨囊胞の1例

岩城太,大西正信
日本口腔科学会雑誌 63(3), 275-278, 2014
… A case of aneurysmal bone cyst of the mandible with mental neuropathy is reported. … Histopathological examination of the biopsy specimen suggested that the lesion was an aneurysmal bone cyst. … Surgical excision of the aneurysmal bone cyst was performed immediately after the embolization. …
NAID 130004679832

Related Pictures

★リンクテーブル★

リンク元	「動脈瘤様骨嚢腫」「動脈瘤様骨嚢胞」
関連記事	「bone cyst」「aneurysmal」「bone」

「動脈瘤様骨嚢腫」

Aneurysmal bone cyst
Classification and external resources
Specialty	rheumatology
ICD-10	M85.5
ICD-9-CM	733.22
OMIM	606179
eMedicine	radio/26 article/1254784
MeSH	D017824