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Osteoblastoma is a rare bone tumour. It is occasionally associated with an aneurysmal bone cyst (ABC). Several treatment strategies can be adopted. We report a challenging case of an osteoblastoma associated with ABC of the lumbar spine in a 2-year-old boy. The pathogenesis and the critical management of the disease are discussed.

Background: Osteoblastomas and aneurysmal bone cysts each comprise 1% of primary bone tumours. As both osteoblastomas and aneurysmal bone cysts are not common, osteoblastomas with secondary aneurysmal bone cysts of calvaria are extremely rare. Only three cases describing a secondary aneurysmal bone cyst in the setting of a calvarial osteoblastoma can be found in the literature. We report the case of the surgical resection of the fronto-parietal osteoblastoma accompanying a secondary aneurysmal bone cyst., Case Description: The case is a 24-year-old male with a 2-year history of a painless lump in the hair-bearing region of the left fronto-parietal area without neurologic symptoms. Computed tomography showed an intradiploic tumour with maintained inner and outer cortex of the left front-parietal bones. 3.0-T magnetic resonance imaging showed a well-circumscribed, intradiploic, multilocular cystic tumour. A gadolinium-enhanced sequence showed strong peripheral and septal enhancement. These findings were consistent with an osteoblastoma associated with secondary aneurysmal bone cyst. An en bloc tumour resection with a 10-mm horizontal margin was completed without complications. The calvarial defect was covered by calvarial bone graft harvested from the contralateral fronto-parietal bone. The postoperative course was uneventful. Pathological diagnosis was consistent with the osteoblastoma with secondary aneurysmal bone cyst. After a follow-up period of 2 years, there was no evidence of recurrence., Conclusion: The combination of osteoblastoma and aneurysmal bone cyst of the calvaria is a rare clinical entity. Careful preoperative examination and complete resection of the tumour are essential., (Copyright © 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.)

Background Context: The combination of osteoblastoma and aneurysmal bone cyst (ABC) in the cervical spine is a relatively rare occurrence in the general population. The diagnosis and surgical management of osteoblastoma and ABCs have been previously described in a small number of case reports/series and orthopedic texts. Lesions of the cervical spine pose challenges to surgeons that require preoperative planning and intraoperative decisions to ensure an appropriate patient outcome. Complete resection has been shown to be the most effective method for preventing recurrence; however, balancing spinal stability, future mobility, and complete resection is especially important in active young patients., Purpose: We describe a modern approach to the surgical management of osteoblastoma with secondary ABC of the cervical spine with 4-year clinical and radiographic follow-up. Included in this report is a comprehensive review of the literature related to osteoblastoma, ABCs, and surgical issues pertinent to them., Study Design: An independent retrospective case review combined with a review of current literature was performed., Patient Sample: A single patient with a combination of osteoblastoma and secondary ABC is presented., Outcome Measures: During 4 years of follow-up, the patient has been evaluated with plain radiographs for subluxation or rotation of the cervical spine. Postoperative assessments for pain and range of motion were also collected., Methods: The medical, pathologic, and radiographic records of a case of osteoblastoma with secondary aneursymal bone cyst of the cervical spine were reviewed. A computer-based literature search of the PubMed database was used to compile a comprehensive review of the topic., Results: The diagnosis and surgical treatment of osteoblastoma with secondary ABC in the cervical spine are discussed in the context of a literature review. The surgical management of this lesion was dictated by the size and location of the mass as well as the impact of the surgical resection on surrounding structures in terms of spinal stability and future mobility., Conclusions: The combination of osteoblastoma and ABC in the cervical spine is an uncommon occurrence in the general population. In the cervical spine, careful surgical planning and a case-by-case evaluation must be implemented to minimize morbidity and recurrence for every patient., (Copyright © 2011 Elsevier Inc. All rights reserved.)

The authors report their experience on one patient with osteoblatoma of the odontoid process of the axis with secondary aneurysmal bone cyst. According to their knowledge, this is the first case, reported in the literature, of this kind of lesion in that particular anatomical region. Because of the rarity of this lesion, it was difficult to have a certain preoperative diagnosis. Therefore, the patient underwent a biopsy via a transoral route. The biopsy was performed over the noncalcified component of the lesion. The intraoperative histological examination showed the benign nature of the lesion. Thereafter, the lesion was totally removed, succeeding in preserving the remaining part of the odontoid process and the anterior arch of C1. In the follow-up, there was no evidence of cranio-vertebral instability. The histological examination revealed an osteoblastoma of the odontoid process of the axis with a secondary aneurysmal bone cyst. To the best of our knowledge, this is the first case reported in the literature.

One case of malignant schwannoma of the sacrum and another of occipital osteoblastoma were evaluated by MR imaging. Both tumors showed fluid-fluid levels with different signal intensities in the sequences performed. Pathologic examination revealed hemorrhagic fluid in both tumors. Malignant schwannoma and osteoblastoma should be included in the list of bone and soft-tissue with fluid-fluid levels. Our data confirm the non-specificity of this finding, which only suggests the presence of previous intratumoral hemorrhage.

This article reviews the clinical behavior, the histologic conditions, and the treatment of a benign osteoblastoma associated with an aneurysmal bone cyst of the mandibular condyle and ramus. A 14-year-old boy, otherwise healthy, was referred for pain and enlargement in his right temporomandibular joint-cheek region. The swelling was firm and tender, a slight facial asymmetry was present, and the mouth-opening capacity was reduced. During a 6-weeks period from the primary examination to surgery the lesion expanded extensively, anesthesia appeared in the right inferior alveolar nerve and a lateral open bite developed on the affected side. Computed tomography displayed a total destruction of the right mandibular condyle and ramus to the level of the mandibular foramen. The lesion was radiolucent without distinct borders to adjacent bone. Surgery revealed a bluish, well-vascularized predominantly cystic tumor. The lesion included the temporomandibular joint disk but without overgrowth to the temporal component. After resection of the lesion, the condyle and the mandibular ramus was reconstructed with the use of an autogenous costochondral graft. The postoperative healing was uncomplicated. At follow-up 2 years after surgery the boy was free of recurrence with normal motor and sensory nerve function.