ANEURYSMAL BONE-CYSTS OF THE JAWS - CLINICOPATHOLOGICAL FEATURES, RADIOGRAPHIC EVALUATION AND TREATMENT ANALYSIS OF 17 CASES

This article re-evaluates the various clinicopathological presentation s and array of radiographic features displayed by aneurysmal bone cyst s (ABCs) of the jaws, In this retrospective clinical study, 17 cases o f ABCs of the jaws surgically treated during an Ii-par period from 198 6-1997 are evaluated, The age and sex distribution, diagnostic charact eristics, mode of treatment and long-term surgical results are present ed and compared with the international literature, Investigation inclu ded serial clinical examinations, appropriate radiographic evaluation, CT scans and angiograms when indicated, All the patients had mandibul ar lesions and were managed by complete surgical curettage of the lesi ons, Ten were in males (58.8%) and seven (41.2%) in females, The mean age of occurrence was 21.05 years, ranging from 7 to 58 years, Clinica l presentation in these patients ranged from an asymptomatic incidenta l radiographic finding tcr an expanding, rapidly progressive and destr uctive lesion resulting in a pathological fracture, Radiographic findi ngs varied from unicystic radiolucencies or moth-eaten radiolucencies to extensive multilocular lesions causing bilateral expansion and dest ruction of the mandibular cortices. Twelve of the patients (70.5%) cou ld recall a history of trauma, Needle aspiration with a 16 or 18 guage needle was positive, producing syringes full of blood in all but two of the cases (88.2%). Six cases (35.2%) were extremely vascular and ha d increased rapidly in size, and three required angiographic studies f or preoperative diagnosis and differentiation from other vascular enti ties, Nine of the cases (52.9%) were found in the mandibular angle-ram us area, Four cases (23.5%) required extraoral surgical access for cur ettage while the remainder were treated intraorally, During the follow -up period, which ranged from 2-11 years, no recurrences have occurred , Restoration of facial symmetry and bone formation has been favourabl e in all patients, despite the fact that grafts mere not used, This Ii -year study shows that ABCs present with varied clinicopathological an d radiographic features and thus may pose a diagnostic dilemma, iis we have not noted any recurrences following surgical curettage of mandib ular lesions, we feel that initial surgical resection or bone grafting is not necessary provided that adequate access and complete curettage can be obtained.