Osteoblastoma and aneurysmal bone cyst (ABC) are rare bone tumors with individual prevalence of <1%. Their combined occurrence is a rare subclass of tumors in the spinal column with only a few cases reported in literature.
The present case is a rare combination of aggressive osteoblastoma with secondary aneurysmal bone cyst masquerading as neck pain, arising from cervical C4 vertebra in a 19-year-old male. The patient presented with complaints of neck pain for 7 months, gradual in onset, dull, aching, and progressively increasing in severity. Neurological examination was normal. Radiology showed an expansile lytic mass arising from the posterior elements of C4 vertebra involving the left lateral mass. Piecemeal total removal was done and a posterior fusion from C3 to C5 was performed for stability. Histopathology confirmed the osteoblastoma with a secondary aneurysmal bone cyst. Postoperatively the patient recovered well, and no recurrence was seen on a 2-year follow-up.
Simultaneous presence of an osteoblastoma with a secondary ABC arising from various bones, such as cranial fossa, ethmoid sinus, skull, and mandibular condyle, has rarely been reported. It is often diagnosed late due to nonspecific symptoms; but it has a good prognosis if early and complete resection is performed. Thorough surgical excision is always a challenge in spine cases due to surrounding important structures and meticulousness is required to prevent any recurrences. Hence, we recommend a surgical team comprising both spine and musculoskeletal oncologic surgeons to achieve best results.
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Weber KL, Heck RKJ. Cystic and benign bone lesions. Rosemont, IL: American Academy of Orthopaedic Surgeons; 2007.
Hu H, Wu J, Ren L, Sun X, Li F, Ye X. Destructive osteoblastoma with secondary aneurysmal bone cyst of cervical vertebra in an 11-year-old boy: case report. Int J Clin Exp Med. 2014;7:290–5.
Pavanello M, Melloni I, Fiaschi P, Consales A, Piatelli G, Ravegnani M, et al. A rare case of osteoblastoma associated to aneurysmal bone cyst of the spine. Case report. Br J Neurosurg. 2016;30:106–9.
Ramme AJ, Smucker JD. Balancing spinal stability and future mobility in the cervical spine: surgical treatment of a case of osteoblastoma with secondary aneurysmal bone cyst. The spine journal: official journal of the North American Spine. Society. 2011;11:e5–12.
Tarantino R, Piccirilli M, Anichini G, Delfini R. Benign osteoblastoma of the odontoid process of the axis with secondary aneurysmal bone cyst component: a case report. Neurosurgical Rev. 2008;31:111–5.
Coscina WF, Lee BC. Concurrent osteoblastoma and aneurysmal bone cyst of the ethmoid sinus: case report. J Comput Tomogr. 1985;9:347–50.
Han X, Dong Y, Sun K, Lu Y. A huge occipital osteoblastoma accompanied with aneurysmal bone cyst in the posterior cranial fossa. Clin Neurol Neurosurg. 2008;110:282–5.
Svensson B, Isacsson G. Benign osteoblastoma associated with an aneurysmal bone cyst of the mandibular ramus and condyle. Oral Surg Oral Med Oral Pathol. 1993;76:433–6.
Vade A, Wilbur A, Pudlowski R, Ghosh L. Case report 566: osteoblastoma of sacrum with secondary aneurysmal bone cyst. Skelet Radiol. 1989;18:475–80.
Wang YC, Huang JS, Wu CJ, Jeng CM, Fan JK, Resnick D. A huge osteoblastoma with aneurysmal bone cyst in skull base. Clin Imaging. 2001;25:247–50.
Jackson RP. Recurrent osteoblastoma: a review. Clin Orthop Relat Res. 1978;131:229–33.
Lucas DR, Unni KK, McLeod RA, O’Connor MI, Sim FH. Osteoblastoma: clinicopathologic study of 306 cases. Hum Pathol. 1994;25:117–34.
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Gahlot, N., Jalan, D. & Elhence, P. C4 cervical spine osteoblastoma associated with secondary aneurysmal bone cyst in an adolescent patient: 2-year follow-up. Spinal Cord Ser Cases 5, 89 (2019) doi:10.1038/s41394-019-0233-5