MERVE GÜRSOY BULUT, Fazıl GELAL, NURULLAH YÜCEER, Türkan ATASEVER REZANKO

Aneurysmal bone cyst of petrous bone associated with sixth cranial nerve palsy and fatal outcome

Anevrizmal kemik kistleri sıklıkla vertebra, uzun tübüler ve yassı kemiklerde yerleşen, benign fakat lokal agresif tümörlerdir. Anevrizmal kemik kistlerinin küçük bir yüzdesi kafa tabanından kaynaklanır. Biz burada, 13 yaşında bir erkek olguda, temporal kemiğin petröz kısmında yerleşmiş nadir bir anevrizmal kemik kisti olgusunu sunmayı amaçladık. Erken agresif rekürrens göstermesi ve ölümle sonuçlanması nedeniyle eşsiz bir olguydu, ayrıca tek başvuru yakınması 6. kraniyal sinir felci olan bu gruptaki tek hasta idi. Petröz apeks yerleşimli anevrizmal kemik kisti, nadir olmasına rağmen, özellikle tipik MR görüntüleme bulgularının varlığında, izole ya da eşlikçi 6. kraniyel sinir felcinin ve petröz apeks kitlelerinin ayırıcı tanısında düşünülmelidir.

Altıncı kraniya l sinir felci oluşturan ve ölümle sonuçlanan petröz kemik yerleşimli anevrizmal kemik kisti

Aneurysmal bone cysts are benign but locally aggressive bone tumors often located in vertebrae, long tubular bones and flat bones. A small percentage of aneurysmal bone cysts arise from the skull base. We aim ed to present a rare case of aneurysmal bone cyst located in the petrous portion of the temporal bone in a 13-year-old boy. It was unique because it was the only case with early aggressive recurrence and fatal outcome and also was the only patient in this entity who had sixth cranial nerve palsy as the only presenting symptom. Although rare, petrous apex aneurysmal bone cyst should be considered in the differential diagnosis of isolated or coexistent sixth nerve palsy or a petrous apex mass, especially in the presence of typic al MRI findings .

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1. Jaffe HL, Lichtenstein L. Solitary unicameral bone cyst: W ith emphasis on the roentgen picture, the pathologic appearance, and the pathogenesis. Arch Surg 1942;44(6):1004 -25.
2. De Silva MV, Raby N, Reid R. Fibromyxoid areas and immature osteoid are associated with recurrence of primary aneurysmal bone cysts. Histopathology 2003;43(2):180 -8.
3. Lackmann GM, Tollner U. Aneurysmal cyst of the petrosal bone. Arch Dis Child 1993;69(2):241 -2.
4. Buxi TB, Sud S, Vohra R, Sud A, Singh S. Aneurysmal bone cyst of the temporal bone. Australas Radiol 2004;48(2):251 -5.
5. Tuna H, Karatas A, Yilmaz ER, Yagmurlu Y, Erekul S. Aneurysmal bone cyst of the temporal bone: Case report. Surg Neurol 2003;60(6):571 -4.
6. 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.
7. Patel SV, Mutyala S, Leske DA, Hodge DO, Holmes JM. Incidence, associations and evaluation of sixth nerve palsy using a population -based method. Ophthalmology 2004;111(2):369 -75.
8. Connor SEJ, Leung R, Natas S. Imaging of the petrous apex: A pictorial review. Br J Radiol 2008;81(965):427 -35.
9. Tsai JC, Dal inka MK, Fallon MD, Zlatkin M, Kressel H. Fluid -fluid level: A nonspecific findings in tumors of bone and soft tissue. Radiology 1990;175(3):779 -82.
10. Sayama CM, MacDonald JD. Aneurysmal bone cyst of the petrous bone: Case presentation and review of the lite rature. Pediatr Neurosurg 2010;46(4):308 -12 .