ANEURYSMAL BONE-CYST - CONCEPT, CONTROVERSY, CLINICAL PRESENTATION, AND IMAGING

The origin of the term ''aneurysmal bone cyst'' stems from two cases reported by Jaffe and Lichtenstein [3] in their article on unicameral bone cysts in 1942, In that report, they noted two ''peculiar blood-containing cysts of large size,'' which they described as aneurysmal cysts, In a subsequent paper, Jaffe chose the name ''aneurysmal bone cyst'' as the descriptive term for this lesion, with the word ''aneurysmal'' to emphasize the ''blown-out,'' distended contour of the affected bone, and the words ''bone cyst'' to underscore that when the lesion is entered through a thin shell of bone, it appears largely as a blood-filled cavity [4] (Fig. 1), As originally described by Jaffe and Lichtenstein in 1942, and in following articles by each [3-6], aneurysmal bone cyst was sufficiently characteristic to identify it as a distinctive radiologic-pathologic entity. However, its nature has remained unclear. In both the original and an ensuing paper on the subject, Jaffe postulated that aneurysmal bone cyst may be a secondary phenomenon due to a hemorrhagic ''blow-out'' in a preexisting lesion, which may be destroyed in the process [3, 4]. Lichtenstein also suggested a vascular origin but postulated that the lesion was the result of a ''local circulatory disturbance,'' noting that although ''the precise basis for this vascular disturbance is not readily discernible, it could conceivably be thrombosis of a sizable vein, or perhaps an anomalous arteriovenous communication''