Introduction: Spinal aneurysmal bone cysts are very infrequent benign osteolytic lesions consisting of blood-filled cavities that are separated by osteo-connective septa and osteoclast-type giant cells. Clinically they manifest with local pain, neurological symptoms secondary to spinal cord compression, and fractures, deformities and vertebral instability. We report a case of an aneurysmal bone cyst in the thoracic spine with neurological signs and symptoms treated by means of a full microsurgical resection, with no associated neurological sequelae.
Case report: A 47-year-old woman, with no previous history of traumatic injuries, who was examined following several weeks with clinical signs and symptoms of paraesthesia in the lower limbs. Thoracic magnetic resonance imaging revealed the existence of a lytic lesion with clearly defined edges and marginal sclerosis in T4, in addition to involvement of the posterior vertebral elements and compression of the underlying spinal cord. The whole lesion was removed surgically, and the sensitive clinical symptoms disappeared after the procedure. The definite pathological diagnosis was spinal aneurysmal bone cyst.
Conclusion: Despite their low incidence, aneurysmal bone cysts of the spine must be taken into account in the differential diagnosis of spinal bone tumours as a possible cause of subacute or chronic compressive myelopathy. Full surgical removal of the tumour is considered the preferred treatment, which is often curative and is associated with a good prognosis of the patient in the long term.
Title: Mielopatia secundaria a un quiste oseo aneurismatico espinal dorsal.
Introduccion. Los quistes oseos aneurismaticos espinales son lesiones osteoliticas benignas muy infrecuentes constituidas por cavidades hematicas limitadas por septos osteoconectivos y celulas gigantes tipo osteoclastos. Clinicamente se manifiestan con dolor local, sintomas neurologicos secundarios a compresion medular, asi como fracturas, deformidades e inestabilidad vertebral. Presentamos un caso de quiste oseo aneurismatico espinal dorsal con sintomatologia neurologica, tratado mediante una reseccion microquirurgica completa, sin secuelas neurologicas asociadas. Caso clinico. Mujer de 47 años, sin antecedentes traumaticos previos, valorada por presentar un cuadro de parestesias de los miembros inferiores de semanas de evolucion. El estudio radiologico de resonancia magnetica dorsal demostro la existencia de una lesion litica de bordes bien delimitados y esclerosis marginal en D4, con afectacion de los elementos posteriores vertebrales y compresion del cordon medular subyacente. La lesion fue extirpada en su totalidad, con desaparicion de la clinica sensitiva tras la intervencion. El diagnostico anatomopatologico definitivo fue quiste oseo aneurismatico espinal. Conclusion. A pesar de su baja incidencia, los quistes oseos aneurismaticos espinales deben considerarse, en el diagnostico diferencial de los tumores oseos espinales, como una posible causa de mielopatia compresiva subaguda o cronica. La reseccion tumoral completa se considera el tratamiento de eleccion, el cual con frecuencia es curativo y asocia un buen pronostico del paciente a largo plazo.