Aneurysmal Bone Cyst: An Analysis of 38 Cases and Report of Four Unusual Surface Ones



1 Department of Pathology and Laboratory Medicine, Shafa Yahyaeyan Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran

2 Department of Pathology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran

3 Department of Radiology, Iran University of Medical Sciences, Tehran, Iran

4 Orthopedic Oncology Department, Shafa Yahyaean Hospital, Iran University of Medical Sciences, Tehran, Iran


 Aneurysmal bone cyst (ABC) is a benign expansile bone tumor, most commonly involving the medulla of long bones. ABC rarely arises within the cortex or in the subperiosteal region, radiographically mimicking other conditions, in particular surface osteosarcomathat is low-grade in nature and may go secondary ABC changes, and telangiectatic osteosarcoma. Both of these are sometimes mistaken microscopically for primary ABC. We review the characteristics of ABC cases in our center and report four unusualsurface ABCs arising in the subperiosteal or cortical region of long bones, identified among 38 histologically proven ABCs during a four-year period in our center. The surface ABCs occurred at an older agewith a predilection for diaphysis of femur, tibia, and humerus.


  1. Wheeless CR. Wheeless’ textbook of orthopaedics. Towson, US: Data Trace Internet Pub; 1996.
  2. Dorfman HD, Czerniak B. Bone tumors. New York: Mosby; 1998.
  3. Apaydin A, Ozkaynak C, Yilmaz S, Akyildiz F, Sindel T, Aydin AT, et al. Aneurysmal bone cyst of metacarpal. Skeletal Radiol. 1996; 25(1):76-8.
  4. Capote-Moreno A, Acero J, Garcia-Recuero I, Ruiz J, Serrano R, de Paz V. Giant aneurysmal bone cyst of the mandible with unusual presentation. Med Oral Patol Oral Cir Bucal. 2009; 14(3):E137-40.
  5. Dossing KV. Aneurysmal bone cyst of the hand. An unusual location in the first phalanges of the first finger. Case report. Scand J Plast Reconstr Surg Hand Surg. 1990; 24(2):173-5.
  6. Gold RH, Mirra JM. Case report 234. Aneurysmal bone cyst of left scapula with intramural calcified chondroid. Skeletal radiol. 1983; 10(1):57-60.
  7. Parashari UC, Khanduri S, Upadhyay D, Bhadury S, Singhal S. Radiologic and pathologic correlation of aneurysmal bone cysts at unusual sites. J Cancer Res Ther. 2012; 8(1):103-5.
  8. Theron S, Steyn F. Clinical image. An unusual cause of proptosis: aneurysmal bone cyst of the anterior skull base. Pediatr Radiol. 2006; 36(9):997.
  9. Sherman RS, Soong KY. Aneurysmal bone cyst: its roentgen diagnosis. Radiology. 1957; 68(1):54-64.
  10. Capanna R, Bettelli G, Biagini R, Ruggieri P, Bertoni F, Campanacci M. Aneurysmal cysts of long bones. Ital J orthop Traumatol. 1985; 11(4):409-17.
  11. Maiya S, Davies M, Evans N, Grimer J. Surface aneurysmal bone cysts: a pictorial review. Eur Radiol. 2002; 12(1):99-108.
  12. Vergel De Dios AM, Bond JR, Shives TC, McLeod RA, Unni KK. Aneurysmal bone cyst. A clinicopathologic study of 238 cases. Cancer. 1992; 69(12):2921-31.
  13. Oliveira AM, Chou MM. USP6-induced neoplasms: the biologic spectrum of aneurysmal bone cyst and nodular fasciitis. Hum Pathol. 2014; 45(1):1-11.
  14. Jacquot C, Szymanska J, Nemana LJ, Steinbach LS, Horvai AE. Soft-tissue aneurysmal bone cyst with translocation t(17;17)(p13;q21) corresponding to COL1A1 and USP6 loci. Skeletal Radiol. 2015; 44(11):1695-9.
  15. Unni KK, Inwards CY, Research MFME. Dahlin’s bone tumors: general aspects and data on 10,165 cases. Philadelphia: Wollters Kluwer Health/Lippincott Williams & Wilkins; 2010.
  16. Radulescu R, Badila A, Manolescu R, Sajin M, Japie I. Aneurysmal bone cyst--clinical and morphological aspects. Rom J Morphol Embryol. 2014; 55(3):977-81.
  17. Saito T, Oda Y, Kawaguchi K, Tanaka K, Matsuda S, Sakamoto A, et al. Five-year evolution of a telangiectatic osteosarcoma initially managed as an aneurysmal bone cyst. Skeletal Radiol. 2005; 34(5):290-4.
  18. Slavotinek JP, Wicks A, Spriggins AJ. Subperiosteal aneurysmal bone cyst with associated bone marrow oedema: an unusual appearance. Australas Radiol. 2003; 47(4):475-8.
  19. Malfair D, Munk PL, O’Connell JX. Subperiosteal aneurysmal bone cysts: 2 case reports. Cana Assoc Radiol J. 2003; 54(5):299-304.
  20. Burnstein MI, De Smet AA, Hafez GR, Heiner JP. Case report 611: Subperiosteal aneurysmal bone cyst of tibia. Skeletal Radiol. 1990; 19(4):294-7.
  21. Bloch C, Peck HM. Aneurysmal bone cyst with doculmented subperiosteal origin. J Mt Sinai Hosp N Y. 1968; 35(2):192-5.
  22. Schoedel K, Shankman S, Desai P. Intracortical and subperiosteal aneurysmal bone cysts: a report of three cases. Skeletal radiology. 1996; 25(5):455-9.
  23. Kobayashi S, Hayakawa K, Takeno K, Baba H, Meir A. Parosteal aneurysmal bone cyst of the humerus with birdcage-like ossification on three-dimensional CT scanning: a case report. Joint Bone Spine. 2009; 76(6):705-7.
  24. Woertler K, Brinkschmidt C. Imaging features of subperiosteal aneurysmal bone cyst. Acta Radiol. 2002; 43(3):336-9.
  25. Okada K, Masuda H, Shozawa T, Arai M. A small aneurysmal bone cyst restricted to the cortical bone of the femur resembling so-called subperiosteal giant cell tumor or subperiosteal osteoclasia. Acta Pathol Jpn. 1989; 39(8):539-44.