Aneurysmal Bone Cyst Of The Anterior Ethmoid: Management Of This Rare Entity

Abstract

Aneurysmal bone cysts (ABC) of the skull are rare osteolytic expansile lesions. There are few reports in the literature of ABC of the orbits and sinuses. We present computed tomography (CT), magnetic resonance (MRI) imaging and histopathologic findings of an aneurysmal bone cyst of the anterior ethmoids in an 8 year old boy, who presented to the department with a three month history of right epiphora and a right medial canthal mass. CT and MRI demonstrated a multiloculated expansile lesion arising from the right ethmoid air cells, displacing the right globe laterally. On biopsy bloody fluid was aspirated from the lesion. The histology was consistent with an aneurysmal bone cyst. The ABC was excised using a combined endoscopic and open approach. To date there have been 22 cases of ABC of the ethmoids reported in the English literature, the demographics, presenting features and management of these cases are discussed and a methodological approach is suggested.