ANEURYSMAL BONE CYST (ABC) IN FIFTH METACARPAL RIGHT HAND OF A MALE CHILD WITH HEMOPHILIA TREATED BY STEROID INJECTION: A CASE REPORT

Agus Wahyudi(1*), Mujaddid Idulhaq(2), Rhyan Darma Saputra(3), Pamudji Utomo(4)

(1) Resident of Orthopaedic & Traumatology, Faculty of Medicine Universitas Sebelas Maret
(2) Staff of Orthopaedic & Traumatology, Sub Musculoskeletal Tumor, Faculty of Medicine Universitas Sebelas Maret Surakarta, Dr. Moewardi General Hospital, and Prof. DR.R Soeharso Orthopaedic
(3) Staff of Orthopaedic & Traumatology, Sub Musculoskeletal Tumor, Faculty of Medicine Universitas Sebelas Maret Surakarta, Dr. Moewardi General Hospital, and Prof. DR.R Soeharso Orthopaedic
(4) Staff of Orthopaedic & Traumatology, Sub Musculoskeletal Tumor, Faculty of Medicine Universitas Sebelas Maret Surakarta, Dr. Moewardi General Hospital, and Prof. DR.R Soeharso Orthopaedic
(*) Corresponding Author

Abstract

ABSTRACT

Aneurysma bone cyst (ABC) is a rare case, rapidly growing, and destructive benign bone tumor that rarely involves the bones of the hand. Pathogenesis of these tumors remains controversial and may be vascular, traumatic, or genetic disorders.  This study aimed to evaluate patient’s out come after steroid injection. A male child presented with a history of pain and local swelling over his fifth metacarpal right hand of two months duration with hemofilia condition. Physical and radiographic examination of the hand was consistent with aneurysmal bone cyst. The patient the VIII factor 2 hours before doing steroid injection on his lump over fifth metacarpal right hand. A month evaluation after injection for this patient, we had a good result clinically and radiologically. Radiological evaluation obtained appearance of cortex thickening on the bone affected. We concluded that steroid injection should be considered as one of ABC’s treatment with hemophilia, but the outcome still needed more evaluation.  

Keywords: Aneurysmal Bone Cyst, Hemophilia, Steroid Injection

 

ABSTRAK 

Kista tulang aneurisma adalah kasus yang jarang terjadi, tumbuh dengan cepat, dan tumor tulang jinak destruktif yang jarang melibatkan tulang-tulang tangan. Patogenesis tumor ini masih kontroversial dan mungkin bersifat kelainan vaskular, traumatis, atau genetik. Penelitian ini bertujuan untuk mengevaluasi pasien setelah injeksi steroid. Seorang anak laki-laki dengan riwayat nyeri dan pembengkakan lokal pada metacarpal kelima tangan kanannya selama dua bulan dengan kondisi hemofilia. Pemeriksaan fisik dan radiografi tangan menegakkan adanya kista tulang aneurisma. Pasien diberi faktor VIII 2 jam sebelum injeksi steroid pada benjolan di atas metacarpal kelima tangan kanannya. Evaluasi sebulan setelah injeksi untuk pasien ini, kami memiliki hasil yang baik secara klinis dan radiologis. Evaluasi radiologis diperoleh penampilan penebalan korteks pada tulang yang terkena. Kami menyimpulkan bahwa injeksi steroid harus dipertimbangkan sebagai salah satu pengobatan kista tulang aneurisma dengan hemofilia, namun hasilnya masih perlu evaluasi lebih lanjut.

Kata kunci: Kista Tulang Aneurisma, Hemofilia, Injeksi steroid

Full Text:

PDF

References

Brosjö, O., Pechon, P., Hesla, A., Tsagozis P., and Bauer, H. 2013. Sclerotherapy with polidocanol for treatment of aneurysmal bone cysts. Acta Orthop. 84: 502-5

Connie ,Y.C., Susan, V.K., Ambrose, J.H., Joseph, F.S., Martin, T., and Miriam, A. B. 2016. Treatment of aneurysmal bone cyst by percutaneous CT-guided injection of calcitonin and steroid. Skeletal Radiol.

Docquier, P.L. and Delloye, C. 2011. Kyste osseux anévrysmal. In: EMC. Elsevier. Masson SAS.

Louahem, D., Kouyoumdjian, P., Ghanem, I., Mazeau, P., Perrochia, H., L’Kaissi, M., and Cottalorda, J. 2012. Active aneurysmal bone cysts in children: possible evolution after biopsy. J Child Orthop. 6:333-8.

Mascard, E., Gomex-Brouchet, A., and Lambot, K. 2015. Bone cysts : Unicameral and aneurysmal bone cysts. Orthop Traumatol Surg Res.101:S119-127

Nielsen, G.P., Fletcher, J.A., and Oliveira, A.M. 2013. Aneurysmal bone cyst. In: Fletcher BJA, Hogendoorn PCW, Mertens F, editors. WHO classification of tumours of soft tissue and bone. Lyon. IARC. p. 348–9.

Rapp, T.B., Ward, J.P., and Alaia, M.J. 2012. Aneurysmal bone cyst. J Am Acad Orthop Surg. 20(4):233e241.

Varshney, M.K., Rastogi, S., Khan, S.A., and Trikha, V. 2010. Is sclerotherapy better than intralesional excision for treating aneurysmal bone cysts? Clin Orthop Relat Res. 468(6). Pp: 1649–59

DOI: 10.23917/biomedika.v12i2.10541

Article Metrics

Abstract view(s): 1985 time(s)
PDF: 840 time(s)

Refbacks

  • There are currently no refbacks.