Jaw Osteonecrosis Preceded by Dengue Fever - Possible Pathogenetic Mechanism.

INTRODUCTION

Aneurysmal bone cysts of the hand are rare, and only few cases are reported in scientific literature. We report a case of aneurysmal bone cyst of 3rd metacarpal treated at our tertiary care hospital, Mumbai.

CASE REPORT: A 13-year-old young female presented with pain and progressive increase in swelling over the dorsum of the right hand for 7-months. There was pain and tenderness over 3rd metacarpal. There was painful restriction of movement at the metacarpophalangeal joints. Serial radiographic evaluation of the hand from May 2009 to October 2010 showed multilocular expansile lytic lesion with ballooning of 3rd metacarpal with increasing size. The patient was managed surgically with bone grafting. Histopathology section suggested fibrous septa enclosing hemorrhagic cystic space. Septa contained bony chips, spindle cell, inflammatory cell, and few scattered osteoclast. Diagnosis of aneurysmal bone cyst of 3rd metacarpal was made. The patient was followed up after 5 years with good radiological healing with pain-free and good range of motion, good grip strength without any recurrence.

CONCLUSION

Aneurysmal bone cyst is a rare, rapidly growing, and destructive benign bone tumor. Many treatment modalities have been reported in literature including radiation, curettage and bone grafting, cryotherapy, and excision. However, controversy exists in the literature regarding optimal treatment. Due to its rarity in the hand, no evidence-based treatment regimen has been established. The patient can be managed surgically with bone grafting with good radiological healing with pain-free and good range of motion, good grip strength without any recurrence.