Large occipital aneurysmal bone cyst causing obstructive hydrocephalus in a pediatric patient

Case report

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Aneurysmal bone cyst (ABC) is an uncommon benign, tumorlike lesion of bone that is usually located in the long bones and spine. On rare occasions, ABCs are found in the bones of the cranial vault and skull base, occasionally causing mass effect and cranial nerve findings. In this report the authors detail the case of a patient who presented with incidentally discovered hydrocephalus due to a large ABC of the occipital bone that produced mass effect and obstruction of CSF. The diagnosis, imaging findings, and surgical management of this interesting and rare case are discussed.

Abbreviation used in this paper:ABC = aneurysmal bone cyst.

Article Information

Address correspondence to: Suresh N. Magge, M.D., Division of Neurosurgery, Children's National Medical Center, George Washington University Medical Center, 111 Michigan Avenue NW, Washington, DC 20010. email: smagge@cnmc.org.

Please include this information when citing this paper: published online October 12, 2012; DOI: 10.3171/2012.9.PEDS1295.

© AANS, except where prohibited by US copyright law.

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Figures

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    Axial noncontrast head CT scans demonstrating heterogeneous lytic lesion within the occipital bone (left) with sclerotic rim (right). Obstructive hydrocephalus is also present (left).

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    Sagittal (left) T2-weighted MR image showing heterogeneous lesion in the occipital bone with multiple fluid-filled cystic components. Axial (right) T1-weighted contrast-enhanced MR image showing avid contrast enhancement with heterogeneous uptake.

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    Hematoxylin and eosin–stained pathological specimens showing (A) blood-filled vascular spaces and (B) spindle cell proliferation with multinucleated giant cells consistent with aneurysmal bone cyst. Photograph of gross specimens (C) showing multiple cystic structures.

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    Postoperative images. Axial T1-weighted contrast-enhanced MR images (A and D), sagittal T2-weighted MR image (B), and axial CT (C) showing removal of tumor and improvement of hydrocephalus (D).

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