Solitary cyst of innominate bone Bone cyst
KENNETH P. HEIST, 0.0. Columbus, Ohio
The case reported here is of interest Solitary unicameral bone cyst is an uncommon because of the unusual location of the benign cystic lesion of bone. It is still con- cyst, its size, and its treatment with sidered a disorder of unknown etiology al- though several theories have been proposed. heterogenous bone. The 15-year-old The cyst was first discovered in 1878 by Vir- male patient complained of hip pain chow, who reported on a case involving the after playing in a football game. humerus found at autopsy. It is a definite clini- He was admitted to the hospital after cal entity with well-defined features. x-rays showed a large lucent area in Unicameral bone cyst is a lesion of childhood and adolescence, usually occurring between the the left hip region. Examination ages of 4 and 21 years. The majority of the findings were within normal limits patients are between the ages of 10 and 15 except for slight tenderness on deep years. The male patient predominates two to palpation in the left gluteal region. one. Pelvic x-rays showed the lucent area The lesion is nearly always developed in the to measure about 12 by 10 cm. in the shaft of one of a few predilected long tubular bones. The proximal end of the humerus ac- left ilium, extending well into the counts for more than 50 per cent of the cases, sacroiliac articulating area. At surgery while over two thirds of them occur in the a large unicameral cavity was proximal humerus or femur. discovered with very thin connective Considering the fact that the skeleton makes tissue beneath a thin, distended up such a large percentage of the body and cortex. Ground cancellous bovine bone that the bone is so active a tissue, it seems peculiar that benign bone tumors are so un- was implanted in the cyst cavity. common. The pathologist s report indicated the Coley stated that in a 37-year period, he lesion to be a benign solitary bone saw only 142 cases of solitary bone cyst in an cyst. Although the patient suffered active bone tumor clinic. Over half of the postoperatively from fever and serous cases occurred in the proximal end of the humerus and femur, with only one case found drainage, he responded well to in the ilium. antibiotic therapy with no apparent Neer and associates2 reported a total of 175 delay in healing. The graft was well cases of unicameral bone cysts, more than 50 tolerated and clinical and radiologic per cent of which occurred in the proximal examinations demonstrated satisfactory end of the humerus. In their series, solitary osseous union. The advantages of bone cysts of the ilium were rare. In the 175 cases, only three iliac cysts were found. The using processed heterogenous bone in ages of these three patients ranged from 33 to view of the patient s age and the size 48. All three cysts were large and presented and location of the cyst are discussed. diagnostic problems. Biopsies were performed, but no treatment was administered, and, as the patients could not be followed up, the results