Aneurysmal Bone Cyst of the Navicular: A Case Report and Review of the Literature

Abstract

An aneurysmal bone cyst is neither a cyst nor a neoplasm. The current theory is that the lesion is an intraosseous arteriovenous rnattorrnatlon.?" Thus, it is a benign blood-filled lesion with a cyst-like wall predominantly of fibrous tissue and surrounded by a thin layer of periosteal new bone. 14,15,19,21 The foot is a relatively uncommon location for an aneurysmal bone cyst. To our knowledge, no previous cases have been reported in the navicular. In the case reported here, an extensive lesion in the navicular was treated with an en bloc resection and intercalary bone grafting to maintain medial column length. CASE REPORTA 25-year-old woman in otherwise good health presented complaining of left midfoot pain and swelling for 3 years, worsening over the preceding 3 months. She stated that she could walk approximately two blocks, after which she needed to stop because of pain. A 3 x 3 cm firm, moderately tender mass was palpated on the medial aspect of her left midfoot. She had full range of motion at her ankle and limited inversion and eversion secondary to pain.A roentgenogram and computed tomographic image showed an expansile, lytic lesion in the navicular bone (Fig. 1). No other associated lesions were seen.Intraoperatively, a specimen was sent for frozen section yielding a preliminary diagnosis of giant cell tumor. The tourniquet was deflated while awaiting the pathology results, which resulted in brisk bleeding from the biopsy site. Because the tumor represented either an aneurysmal bone cyst (our preoperative diagnosis) or a giant cell tumor, both of which have significant recurrence rates, we elected to resect the

Endoscopically and Fluoroscopically Assisted Curettage and Bone Grafting of the Navicular Bone Cyst

“…Aggressive cystic lesions, for example, aneurysmal bone cyst is a relative contraindication for endoscopic procedure as en bloc resection is usually indicated ( Table 1). [7][8][9][10]…”