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What is Expansile lytic lesion with fluid-fluid levels involing the proximal metaphysis of fibula in an early adolescent female is typical of? and explain in detail?
Ans. b (Aneurysmal bone cyst) (Ref: Bailey 26th/533; Grainger Diagnostic radiology 4th ed. 2463)Aneurysmal bone cyst is a benign cystic lesion of bone consisting of blood-filled spaces separated by fibrous septa. The lesion is much more aggressive than a simple bone cyst and often presents with pain and swelling. Plain x-rays show commonly aggressive features with eccentric expansion of the cortex and an open physis. MRI. often show multiple fluid levels.Few bone tumors AgeCommon site featuresRadiological SignSpecificAdditional commentsGCT (Osteoclastoma)20-40 yrs# Epiphysis# Around "knee# Lytic# Expansile# Eccentric# Subarticular" Soap-bubble" appearance# Benign bone tumor# Conservative surgery like curettage is associated with 40-60% recurrence rate.# Up to 4% metastasize to lung.ABC# peak age 16 years (range 10-30 years);# F>.M# Metaphysis# Diatal end of humerus is most common site# Purely lytic eccentric radiolucency# Expansile ballooning lesion with/ without Soap-bubble pattern# Rapid progression within 6 weeks to 3 months# Sclerotic inner portion# Tumor respects epiphyseal plate.Fluid-fluid/ Fluid-blood levels20--30% recurrence rateHEMAN- GIOMA# 4th--5th decade;# M:F = 2:1Vertebra (28% of all skeletal hemangiomas) in lower thoracic/ upper lumbar spine.Vertebra with vertical striations i.e. Corduroy/ Accordion vertebra"Polka-dot" appearance on CT# Mostly cavernous;# In spine Percutaneous Vertebroplasty is a good Rx option.FD# Usually early adolescence- M=F# Usually diaphyseal.# Ribs, femur, tibia, jawbones, calvaria, and humerus are most commonly affected, in descending order.# Well-defined mixed-density lesion"Ground-glass" appearance or smoky matrix# Benign tumor# Usually asymptomatic# Monostotic form does not evolve into polyostotic form.# Polyostotic form accounts for 27% of cases, Monostotic form 70% cases and 3% are seen as a part of McCune-Albright syndrome.# In polyostotic form rarely transformation into osteosarcoma/ malignant fibrous histiocytom may occur.