Aneurysmal bone cyst: а case report

Abstract

The study objective is to describe a clinical case of intracranial aneurysmal bone cyst in a 9-year-old patient with peripheral facial nerve paresis on the left.Materials and methods. In a 9-year-old patient with facial asymmetry and pain syndrome on the results of magnetic resonance imaging of the brain with contrast in the upper edge of the left temporal bone pyramid revealed inhomogeneous encapsulated lesion with the level of media separation in the structure, high-intensity zones on T1and T2-weighted images, additional intracranial lesion in the left temporal region. Multispiral computer tomography of the brain revealed a cystic-solid lesion with clear contours, causing destruction of the pyramid of the left temporal bone. Lesion spreads to the middle cranial fossa with compression of the basal parts of the left temporal lobe. The diagnosis was made: neoplasm of the left temporal bone (possibly primary cholesteatoma) with destruction of the pyramid and petrosal part of the temporal bone and clivus with suppuration and formation of abscess of the left temporal lobe. Left facial nerve paresis. Osteo-plastic trepanation of the skull in the left temporal region, microsurgical removal of the tumor of the base of the middle cranial fossa on the left and plastic of the skull base defect with abdominal fat were performed.Results. The postoperative period was uneventful. The patient complained of moderate headaches in the area of operative access. The wound healed by primary tension. Positive dynamics in neurological status in the form of regression of left facial nerve paresis was noted. Based on the data of morphological and immunohistochemical studies, an aneurysmal bone cyst was diagnosed.Conclusion. The method of choice in the treatment of an aneurysmal bone cyst of the skull base is the en block removal. In case of impossibility of carrying out radical operation radiotherapy and embolization of the vessels feeding a cyst can be used, however convincing researches about their efficiency in such cases are not published. Aneurysmal bone cyst is uncommon, and to differentiate it from chondroblastoma, teleangiectatic osteosarcoma and giant cell tumors is rather difficult, therefore, it is necessary to increase the level of knowledge about this nosology.