An Uncommon Presentation of an Uncommon Bone Tumor: A Case Study of a Pathologic Fracture of an Intertrochanteric Aneurysmal Bone Cyst

Weber, Matthew G; Fan, Juston; Jenkins, Ryne

doi:10.7759/cureus.6461

Cited by 4 publications

(4 citation statements)

References 19 publications

(29 reference statements)

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“…Weber et al, in trochanteric fractures, suggest considering not only the lesion's location but also its size and bone stock. Large lesions and inadequate bone stock should be treated using modular tumor prostheses, while good bone stock allows for the use of intramedullary nails [29]. In none of our studies was treatment with prostheses considered, likely due to the average age of 19.7 years and, thus, the tendency to opt for a less aggressive approach.…”

Section: Discussionmentioning

confidence: 85%

“…As of today, in the literature, there is still an open debate regarding the most appropriate treatment for ABCs, particularly when they are associated with pathological fractures and many different strategies are applied, as the data that we collected show, in the absence of a guideline to follow. Curettage is considered the standard treatment for ABCs and it is, in fact, the most used strategy among all patients considered in our review [28,29,60,62]. Some authors reserve en bloc excision only for recurrent cases or for lesions that can be removed surgically without bone reconstruction [7,63].…”

Section: Discussionmentioning

confidence: 99%

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Pathological Fractures in Aneurysmal Bone Cysts: A Systematic Review

Costa,

Gabrielli,

Cerrone

et al. 2024

JCM

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Background: Aneurysmal bone cysts (ABCs) are osteolytic, non-malignant, vascular lesions of the bone. Pathological fractures can be a manifestation of the ABCs, which occur in about 8% of ABCs. Different treatments have been described in the literature, but, nowadays, an optimal management of the pathological fractures in patients with ABCs is still a matter of debate and there are no standard guidelines for treatment nor any shared indication about the best surgical intervention. The aim of our study is to review the current literature available on this matter exploring and confronting different surgical treatments for pathological fractures in ABC in order to clarify the surgical approach to these patients. Methods: A systematic review of the literature indexed in PubMed, MEDLINE, and Cochrane Library databases was carried out. The Preferred Reporting Items for Systematically Reviews and Meta-Analyses (PRISMA) were followed. Results: A total of 37 articles were relevant and were finally included in the study. In total, we reached a population of 140 patients. Of the 140 patients included in the review, 124 patients (88.6%) underwent curettage surgery, 15 patients (10.7%) underwent en bloc resection surgery. A total of 47% of patients (70) underwent synthesis surgery with a plate, screw, nail, or external fixator. Adjuvant treatments were used in 8.6% of patients (12). Complications involved 20.7% of the patients (29). Conclusions: In conclusion, the treatment of pathological fractures in aneurysmal bone cysts requires careful patient assessment, considering factors such as age, the presence of open growth plates, the location of the lesion, and the surgeon’s expertise.

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Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Pathological Fractures in Aneurysmal Bone Cysts: A Systematic Review

Costa,

Gabrielli,

Cerrone

et al. 2024

JCM

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“…Aneurysmal bone cysts (ABCs) are benign single bone tumors characterized by a uniform foam-like translucent area within the tumor. Weber MG founded that one patient had a pathologic fracture when the lesion area occurred at intertrochanteric and calcar femorale [55]. The accepted treatment is curettage and bone grafting when pathologic fractures occur [56].…”

Section: Tumor-like Lesionsmentioning

confidence: 99%

Strategies for managing the destruction of calcar femorale

Jin

Pang

Jiang

2021

BMC Musculoskelet Disord

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Background The calcar femorale was identified long ago. However, our current understanding of the calcar is insufficient, and its related concepts are sometimes confused. The calcar femoral is an important anatomical structure of the proximal femur, and its function can be overlooked. In trauma, tumors, or other diseases, the calcar femorale can be destroyed or changed pathologically. As a result, the mechanical structure of the proximal femur becomes destroyed, causing pathological fractures. How to address the destruction of the calcar femorale or the damage to the calcar femorale is discussed in this article. Main text Destruction of the calcar femorale is accompanied by many conditions, including trauma, tumors, and other diseases. The types of hip fractures caused by trauma include femoral neck fractures and intertrochanteric fractures. Dynamic hip screws, proximal femoral nail anti-rotation, and multiple parallel cannulate pins can be used in different conditions. When metastatic and primary bone tumors involve the calcar femorale, endoprostheses are widely used. Other diseases, such as fibrous dysplasia and aneurysmal bone cyst are treated differently. Conclusions The calcar femorale can redistribute stresses and the destruction of the calcar femorale can lead to an increase in posterior medial stress. Many factors need to be considered when deciding whether to reconstruct the calcar femorale. Effective treatment strategies for managing the destruction of calcar femorale will need first establishing the precise mechanism of the destruction of the calcar and then designing therapies towards these mechanisms. Further investigation to the calcar needs to be carried out.

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“…Patients usually present with pain and swelling of variable duration at the site of involvement. Rarely, the initial presentation is pathologic fracture specifically in the major long tubular bones of the extremities [ 10 ]. In the vertebral lesions, symptoms of compression of the spinal cord or nerve roots may be the initial presentation [ 11 , 12 ].…”

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confidence: 99%

Aneurysmal bone cyst: a review

Nasri¹,

Reith

2023

JPTM

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Aneurysmal bone cyst (ABC) is a benign locally destructive bone neoplasm composed of multi-loculated blood-filled cystic spaces. The most common sites of involvement are the meta-diaphysis of the long bones and posterior elements of the vertebrae. Secondary, ABC-like changes can complicate a variety of other benign and malignant primary bone neoplasms, including giant cell tumor, fibrous dysplasia, and osteosarcoma. About two-third of primary ABCs have a rearrangement of the <i>USP6</i> gene, which is not present in the ABC-like changes that occur secondary to other primary bone tumors (i.e., secondary ABC). Primary ABC of bone carries a variable but generally high rate of local recurrence. This paper provides an overview of the pathophysiology, clinical presentation, radiographic and pathologic findings, treatment, and prognosis of ABC.

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An Uncommon Presentation of an Uncommon Bone Tumor: A Case Study of a Pathologic Fracture of an Intertrochanteric Aneurysmal Bone Cyst

Cited by 4 publications

References 19 publications

Pathological Fractures in Aneurysmal Bone Cysts: A Systematic Review

Pathological Fractures in Aneurysmal Bone Cysts: A Systematic Review

Strategies for managing the destruction of calcar femorale

Aneurysmal bone cyst: a review

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