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Case Report Plastic and Aesthetic Research

Aneurysmal bone cyst of the maxilla

rare presentation with radiological and

pathological correlation

Bharat Bhushan Sharma , Priya Ramchandran , Sandeep Sharma , Shweta Sharma 4
3
1
2
1 Department of Radio Diagnosis, PGIMER and Dr. RML Hospital, New Delhi 110001, India.
2 Intensive Care Unit and Anesthesiology, Heartlands Hospital, B912AF, Brimingham, UK.
3 Pain Management and Anesthesiology SGT Medical College, Gurgaon 122505, Haryana, India.
4 ENT and Head and Neck Surgery, PGIMER and Dr. RML Hospital, New Delhi 110001, India.
Address for correspondence: Dr. Bharat Bhushan Sharma, Department of Radio Diagnosis, PGIMER and RML Hospital, B-32, Nivedita Kunj
Sector 10 R.K. Puram, New Delhi 110001, India. E-mail: bbhushan986@gmail.com

ABSTRACT
The incidence of aneurysmal bone cyst in the maxillofacial region is rare and may remain undiagnosed
for a long period prior to becoming symptomatic. This may cause associated issues secondary to
compression by extending to the surrounding vital anatomical areas. An aggressive course can lead to
bony destruction with intracranial extension. We present a case of a 23-year-old man who presented
with bilateral exorbitism with nasal obstruction.

Key words:
Aggressive course, aneurysmal bone cyst, bone destruction, intracranial extension

INTRODUCTION physical examination was remarkable for a brownish
bulge in the nasopharynx. The patient underwent
Aneurysmal bone cysts (ABC) are typically found in computerized tomography (CT) and magnetic resonance
long bones and the spine, but rarely can be seen in the imaging (MRI) examinations. Noncontrast computerized
craniofacial region. The incidence is 2% and 1.3% in the tomography (NCCT) of the nasopharynx region showed
craniofacial region and maxillary region, respectively. [1,2] an expansile cystic lesion in the maxillary region bulging
These benign, expansile bony tumors of unknown etiology into the nasopharynx [Figure 1]. There was no cortical
are often referred to as aneurysmal bone tumors rather break [Figures 2 and 3]. Multiple fluid levels were seen
than cysts because of their aggressive behavior. within the lesion [Figures 4 and 5]. Cytology following
fine‑needle aspiration was performed, and a cytological
CASE REPORT diagnosis of ABC of the maxilla was given. The patient
underwent enucleation of the mass. Histopathological
A 23‑year‑old man presented with a history of anosmia, examination further confirmed the diagnosis of a
the sensation of a blocked nose with mild pain that maxillary ABC, with cystic spaces filled with blood, and
had been increasing over 6 months, and a gradual without an endothelial lining along with osteoclast
increase in bilateral exorbitism. The patient denies any giant cells [Figure 6a and b]. There were no surgical
history of fever, trauma, epistaxis, or oral bleeding. His complications, and the patient was advised to follow‑up in
3 months. His recovery has been uneventful.
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Quick Response Code: DISCUSSION
Website:
www.parjournal.net
The maxilla is a rare site of ABC. It is neither an aneurysm
nor a cyst. The World Health Organization (WHO) defines
DOI: an ABC as an “expanding osteolytic lesion consisting of
10.4103/2347-9264.153203 blood‑filled spaces of variable size separated by connective
tissue septa containing trabeculae of osteoid tissue and

Plast Aesthet Res || Vol 2 || Issue 2 || Mar 13, 2015 73