Knee intra-articular extraskeletal aneurysmal bone cyst: a case report and review of literature

Aneurysmal bone cyst (ABC) is a benign locally destructive lesion that usually developed in the bone cavity of bones, less commonly on the surface of cortical bones and very rarely develop outside the bone. There are only 35 reports of extraskeletal aneurysmal bone cyst (ESABC) in the English literature. We report a case of a 12-year-old female with no history of trauma who presented with knee pain. Imaging studies revealed an infrapatellar mass that was fast to calcify during a period of 3 months. MRI showed high T2 center, low T1 signal, and heterogenic enhancement with a rim of low intensity consistent with calcified boarders surrounded by severe soft tissue edema. The lesion was surgically excised, and a histological examination revealed an aneurysmal bone cyst possibly arising within myositis ossificans or heterotopic ossification. In her last follow-up 1.5 years after the surgical excision, the patient was symptom free and without signs of recurrence. To the best of our knowledge, this is the first reported case of an intra-articular ESABC located in the knee.