A patient with a 2-week history of proptosis and vision changes in the right eye is transferred from an outside hospital. Neuroimaging revealed a large intraorbital and intracranial expansile lesion with multilobulated cystic spaces, surrounded by a thin cortical shell with peripheral calcification. Incisional biopsy through a superior orbitotomy via a sub-brow approach revealed a tissue diagnosis of aneurysmal bone cyst. With the assistance of the Neurosurgery service, a supraorbital craniotomy was performed, and the aneurysmal bone cyst was excised successfully. While surgical resection remains gold standard in management, denosumab, a monoclonal antibody used to treat osteoporosis and bony metastases via inhibition of RANK signaling, is emerging as a possible alternative in surgical unresectable ABCs.
Presentation Date: 09/07/2023
Issue Date: 09/22/2023