DOI QR코드

DOI QR Code

Aneurysmal bone cyst arising from the surgically removed craniofacial fibrous dysplasia in the long-term follow-up: a case report

  • Seungchul Baek (Department of Plastic and Reconstructive Surgery, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Byung Jun Kim (Department of Plastic and Reconstructive Surgery, Seoul National University Hospital, Seoul National University College of Medicine)
  • Received : 2023.05.29
  • Accepted : 2023.10.09
  • Published : 2023.10.20

Abstract

Fibrous dysplasia (FD) is a rare skeletal disorder characterized by abnormal fibro-osseous connective tissue replacing normal bone. Despite its benign behavior, craniofacial FD can cause morphological disfigurement, headache, and even blindness as a result of the produced mass effect. Surgical resection is recommended when the patient shows apparent clinical symptoms or aggravating facial asymmetry. Postoperative complications have been reported, such as hematoma, surgical site infection, abscess formation, resorption of the bone graft used for reconstruction, and recurrence. An aneurysmal bone cyst (ABC) is a rare benign bony lesion that can occur secondary to preexisting bone tumor. Secondary ABCs in craniofacial FD are extremely rare in the literature, accounting for less than 30, all of which are either case reports or series. We report an extremely rare case of symptomatic secondary ABC arising from craniofacial FD that had been misdiagnosed with abscess formation or recurrence and was surgically removed. Notably, 17 years elapsed between the primary surgery and the complication of secondary ABC. The patient underwent total removal of secondary ABC. After surgery, symptoms were relieved, with no recurrence observed during a 6-month follow-up.

Keywords

References

  1. DiCaprio MR, Enneking WF. Fibrous dysplasia: pathophysiology, evaluation, and treatment. J Bone Joint Surg Am 2005;87:1848-64.  https://doi.org/10.2106/00004623-200508000-00028
  2. Adetayo OA, Salcedo SE, Borad V, Richards SS, Workman AD, Ray AO. Fibrous dysplasia: an overview of disease process, indications for surgical management, and a case report. Eplasty 2015;15:e6. 
  3. Lee JS, FitzGibbon EJ, Chen YR, Kim HJ, Lustig LR, Akintoye SO, et al. Clinical guidelines for the management of craniofacial fibrous dysplasia. Orphanet J Rare Dis 2012;7 Suppl 1:S2. 
  4. Kim DY. Current concepts of craniofacial fibrous dysplasia: pathophysiology and treatment. Arch Craniofac Surg 2023;24:41-51.  https://doi.org/10.7181/acfs.2023.00101
  5. Park JK, Lee SY, Kim JH, Kim BK. Long-term outcomes after core extirpation of fibrous dysplasia of the zygomaticomaxillary region. Arch Craniofac Surg 2023;24:59-65.  https://doi.org/10.7181/acfs.2023.00038
  6. Kim GH, Yoon YS, Kim EK, Min KH. Frontal peripheral osteomas: a retrospective study. Arch Craniofac Surg 2023;24:24-7.  https://doi.org/10.7181/acfs.2022.01004
  7. Panda NK, Parida PK, Sharma R, Jain A, Bapuraj JR. A clinicoradiologic analysis of symptomatic craniofacial fibro-osseous lesions. Otolaryngol Head Neck Surg 2007;136:928-33.  https://doi.org/10.1016/j.otohns.2007.01.031
  8. Denadai R, Raposo-Amaral CA, Marques FF, Ghizoni E, Buzzo CL, Raposo-Amaral CE. Strategies for the optimal individualized surgical management of craniofacial fibrous dysplasia. Ann Plast Surg 2016;77:195-200.  https://doi.org/10.1097/SAP.0000000000000640
  9. Feingold RS, Argamaso RV, Strauch B. Free fibula flap mandible reconstruction for oral obstruction secondary to giant fibrous dysplasia. Plast Reconstr Surg 1996;97:196-201.  https://doi.org/10.1097/00006534-199601000-00032
  10. Chen YR, Noordhoff MS. Treatment of craniomaxillofacial fibrous dysplasia: how early and how extensive? Plast Reconstr Surg 1990;86:835-44.  https://doi.org/10.1097/00006534-199011000-00002
  11. Valentini V, Cassoni A, Marianetti TM, Terenzi V, Fadda MT, Iannetti G. Craniomaxillofacial fibrous dysplasia: conservative treatment or radical surgery? A retrospective study on 68 patients. Plast Reconstr Surg 2009;123:653-60.  https://doi.org/10.1097/PRS.0b013e318196bbbe
  12. Pruksapong C, Lohwongwatana B. Orbitocranial fibrous dysplasia: immediate reconstruction with titanium 3-dimensional printing. Plast Reconstr Surg Glob Open 2020;8:e3114. 
  13. Ahn SJ, Hong JW, Kim YO, Lew DH, Lee WJ. Treatment of fibrous dysplasia of the zygomaticomaxillary complex with radical resection and three-dimensional reconstruction with autologous calvarial bone graft. Arch Craniofac Surg 2018;19:200-4.  https://doi.org/10.7181/acfs.2018.00052
  14. Wu H, Li J, Xu J, You C, Huang S. Recurring craniofacial fibrous dysplasia with extensive titanium mesh invasion. J Craniofac Surg 2014;25:697-9.  https://doi.org/10.1097/SCS.0000000000000612
  15. Lin WC, Wu HT, Wei CJ, Chang CY. Aneurysmal bone cyst arising from fibrous dysplasia of the frontal bone (2004:2b). Eur Radiol 2004;14:930-2.  https://doi.org/10.1007/s00330-003-2181-4
  16. Restrepo R, Zahrah D, Pelaez L, Temple HT, Murakami JW. Update on aneurysmal bone cyst: pathophysiology, histology, imaging and treatment. Pediatr Radiol 2022;52:1601-14.  https://doi.org/10.1007/s00247-022-05396-6
  17. Kushchayeva YS, Kushchayev SV, Glushko TY, Tella SH, Teytelboym OM, Collins MT, et al. Fibrous dysplasia for radiologists: beyond ground glass bone matrix. Insights Imaging 2018;9:1035-56.  https://doi.org/10.1007/s13244-018-0666-6
  18. Davies AM, Evans N, Mangham DC, Grimer RJ. MR imaging of brown tumour with fluid-fluid levels: a report of three cases. Eur Radiol 2001;11:1445-9.  https://doi.org/10.1007/s003300100860
  19. Gan YC, Mathew B, Salvage D, Crooks D. Aneurysmal bone cyst of the sphenoid sinus. Br J Neurosurg 2001;15:51-4.  https://doi.org/10.1080/026886901300004102
  20. Rehman R, Dekhou A, Osto M, Agemy J, Chaaban A, Yuhan B, et al. Aneurysmal bone cysts of the craniofacial origin: a systematic review. OTO Open 2021;5:2473974X211052950.