Aneurysmal Bone Cyst and Other Cystic Lesions

Aneurysmal bone cyst (ABC) is a benign tumor that can be locally aggressive with a risk of recurrence after treatment. It mainly affects children and young adults and generally occurs in long bones. The spine is involved in 8.7–19% of cases with a predilection for the posterior arch. ABC presents typically as a lytic and expansile lesion with internal bony septa. MRI is the modality of choice to show the blood-filled cavities with fluid-fluid levels and to evaluate paravertebral and spinal canal extension. Some tumors can present with similar imaging features (ABC-area changes), and histologic study is mandatory to confirm the diagnosis. Many treatment modalities are available but there is a lack of consensus regarding the management of spinal ABC.