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March 16, 1957


JAMA. 1957;163(11):914-918. doi:10.1001/jama.1957.02970460004002

• Bony lesions occurring at various levels of the vertebral column in seven young people between the ages of 13 and 28 years were originally diagnosed roentgenologically as benign giant-cell tumor (three cases), benign bone cyst, extramedullary neoplasm, granulomatous lesion, and epidural abscess. The case histories are given in some detail to illustrate the severe pain and disability caused by these lesions and their treatment by surgery and roentgen irradiation. Five of the patients have become asymptomatic. One required a second irradiation because of return of symptoms but continued to improve thereafter; another was improving but had not yet recovered completely when last observed. The lesions in these seven cases were all found, on critical review, to be aneurysmal bone cysts. Diagnosis depends on finding by x-ray a characteristic thin rim of cortical bone about the expanding cyst. The fact that six of these seven lesions had been originally misdiagnosed by pathologists as giant-cell tumors is significant. Exact diagnosis is important because for aneurysmal bone cysts the prognosis is excellent.