Occipital aneurysmal bone cyst rupture following head trauma: case report

Abstract

<jats:p>Aneurysmal bone cysts (ABCs) are benign, expansile, osteolytic lesions that represent 1%–2% of primary bone tumors. Cranial ABCs are even more rare and represent 3%–6% of these unique lesions. The authors describe the case of a 3-year-old girl who presented with an acute posterior fossa epidural hematoma after minor trauma. Imaging workup revealed a previously undiagnosed suboccipital ABC that appeared to have ruptured as a result of her trauma, leading to a life-threatening hemorrhage. To the authors' knowledge, a ruptured ABC has never before been presented in the pediatric literature. In this case report, the authors review the imaging findings, natural history, clinical course, and treatment of these rare lesions.</jats:p>

Isolated calvarial aneurysmal bone cyst in a pediatric patient: illustrative case

“…Approximately 30% of calvarial ABCs have been reported to occur in conjunction with associated pathology (secondary ABC), including osteoblastoma, chondroblastoma, giant cell tumors, osteogenic sarcoma, chondromyxoid fibroma, Langerhans cell histiocytosis, or fibrous dysplasia. 3,4,[9][10][11][12][13][14][15] Although primary ABCs are benign tumors of the bone, they can destroy surrounding bone tissue and enlarge rapidly, as in our illustrative case. ABCs of the skull present with varying symptoms depending on their anatomical location; an enlarging palpable mass, focal tenderness, headache, 3 cranial nerve palsy, 16 seizure, 17 otitis media, 18 vision changes, 19 ptosis or exophthalmos, 18 cerebellar signs, 20 bacterial meningitis, 21 or increased intracranial pressure and hydrocephalus [22][23][24] have all been reported in the literature.…”

“…This process yielded five articles reporting on six patients (age range 17 months to 27 years). [4][5][6][7][8] Patients commonly presented with progressive painless swelling of the area, headaches, or mass effect from a hemorrhage after blunt trauma. Diagnostic workup generally consisted of computed tomography (CT) or MRI of the brain.…”

Hemorrhagic Giant Cell Tumor of the Occipital Skull Base: A Case Report and Literature Review

“…Hemorrhagic skull lesions are rare in the pediatric population [ 15 ]. The differential for benign hemorrhagic skull lesions includes aneurysmal bone cysts, intraosseous hemangiomas, and osteoid osteomas.…”

“…Aneurysmal bone cysts typically present during the first or second decade of life and are painful to the touch, allowing for clinical examination to aid in their diagnosis. Osteoid osteomas, which account for 10% to 12% of osseous tumors in pediatric patients, are typically smaller in size (<1.5 cm, distinguishing them from osteoblastomas) and are more commonly found in the posterior elements of the cervical spine [ 15 ]. In contrast, intraosseous hemangiomas are painless and can present as enlarging skull masses, thus requiring biopsy specimens for differentiation.…”

Frontal skull osteoblastoma with aneurysmal bone cyst-like changes associated with trauma during pregnancy: a case report

“…The trophic effects of oestrogen on bone are well-established [14]. This steroid hormone acts by direct and indirect binding to the oestrogen receptor; both alpha and beta subtypes have been found to be expressed in osteoblasts, but are notably absent from ABCs [4]. Circulating oestrogen levels rise during pregnancy, therefore the gravid state certainly has the potential to precipitate progression of bone tumour.…”