Primary aneurysmal bone cyst of hands and feet: A series of 14 cases

Aneurysmal bone cyst (ABC) is a relatively rare benign bone tumor first described by Jaffe and Lichtenstein in 1942 [1]. ABC can affect any bone but it is more common in the metaphysis of long tubular bones or posterior vertebrae elements [2,3]. To the best of our knowledge, only 85 cases have been reported in the hands [[4], [5], [6]] and 72 in the feet [2,3,[7], [8], [9], [10], [11], [12], [13], [14], [15], [16], [17], [18]].

The typical radiological appearance of ABC consists of multi-chambered areas with various septations that demarcate spaces displaying fluid-fluid levels on magnetic resonance image (MRI) [19]. Histologically, ABC is a well-circumscribed, multilocular tumor containing blood-filled cystic spaces without endothelial lining separated by septa with fibroblasts, scattered multinucleated osteoclast-type giant cells, and woven bone. Blue, reticulated chondroid-like material (“blue bone”) is characteristic [20]. Most primary ABCs present (16; 17)(q22; p13) translocation involving ubiquitin-specific protease 6 (USP6) [21]. Secondary cystic changes in benign and malignant tumors of bones resembling ABC are known as secondary ABC [22].

ABC in hands and feet have been classically treated by surgical procedures such as intralesional resection (curettage) or block excision [3,4]. The objective of this article is to present clinical, radiological, and histopathological features and management of cases of this bone tumor in these unusual locations.

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