Almoguera-Martínez A, Fraga J, Pareja JA, García-López M

Language: Spanish
References: 10
Page: 46-49
PDF size: 196.69 Kb.

ABSTRACT

Introduction: Bone cystic angiomatosis is a disease with only 200 cases described, based on angiomatous nonmalignant proliferation, in bone tissue and viscera. It focuses on pelvis, long bones and scapular waist. Clinical evolution ranges from self-limiting forms to massive aggressive osteolysis (Gorham-Stout).Its diagnosis is of exclusion, with nonspecific clinical, radiological (lytic images) and histopathological findings. Clinical case: Our study is based on the clinical case of a 14-year-old man diagnosed with bone cystic angiomatosis, with disseminated bone involvement, who came to our center for pain and functional impotence in the right hip, diagnosing a pertrochanteric fracture. It was operated by open reduction and osteosynthesis with four-hole VERSA sliding plate screw. An allogeneic graft of cancellous bone was used from femoral head. The evolution was satisfactory, with ambulation at full load per month without requiring analgesic medication and control X-ray at eight months that showed signs of complete integration of the graft. The analgesic pain scale (visual analogue scale) showed a score of 2/10 per month. Discussion: There is controversy regarding the treatment of these fractures by osteosynthesis with bone graft. We are facing a case without serious clinical criteria, but with multiple foci of osteolysis. It was decided not to intervene prophylactically the contraleteral hip, since it is asymptomatic and there are different patterns of evolution described in the literature and risks in surgery.

REFERENCES

1. Ortiz EJ, Isler MH, Navia JE, Canosa R. Pathologic fractures in children. Clin Orthop Relat Res. 2005; (432): 116-26.

2. Marcucci G, Masi L, Carossino AM, Franchi A, Capanna R, Sinigaglia L, et al. Cystic bone angiomatosis: a case report treated with aminobisphosphonates and review of the literature. Calcif Tissue Int. 2013; 93(5): 462-71.

3. Jacobs JE, Kimmelstiel P. Cystic angiomatosis of the skeletal system. J Bone Joint Surg Am. 1953; 35-A(2): 409-20; passim.

4. Levey DS, MacCormack LM, Sartoris DJ, Haghighi P, Resnick D, Thorne R. Cystic angiomatosis: case report and review of the literature. Skeletal Radiol. 1996; 25(3): 287-93.

5. Najm A, Soltner-Neel E, Le Goff B, Guillot P, Maugars Y, Berthelot JM. Cystic angiomatosis, a heterogeneous condition: Four new cases and a literature review. Medicine (Baltimore). 2016; 95(43): e5213.

6. Erol B, Topkar MO, Aydemir AN, Okay E, Caliskan E, Sofulu O. A treatment strategy for proximal femoral benign bone lesions in children and recommended surgical procedures: retrospective analysis of 62 patients. Arch Orthop Trauma Surg. 2016; 136(8): 1051-61.

7. Canavese F, Samba A, Rousset M. Pathological fractures in children: diagnosis and treatment options. Orthop Traumatol Surg Res. 2016; 102(1 Suppl): S149-59.

8. Dormans JP, Pill SG. Fractures through bone cysts: unicameral bone cysts, aneurysmal bone cysts, fibrous cortical defects, and nonossifying fibromas. Instr Course Lect. 2002; 51: 457-67.

9. Park HY, Yang SK, Sheppard WL, Hegde V, Zoller SD, Nelson SD, et al. Current management of aneurysmal bone cysts. Curr Rev Musculoskelet Med. 2016; 9(4): 435-44.

10. Glancy GL, Brugioni DJ, Eilert RE, Chang FM. Autograft versus allograft for benign lesions in children. Clin Orthop Relat Res. 1991; (262): 28-33.