case_images: PMC10629290_01
case_images: (a) Computed tomography (CT) axial view, (b) sagittal view, and (c) 3D reconstruction showing an extensive sacral lytic lesion extending to the iliac bones. (d) T2 magnetic resonance imaging(MRI) sagittal view showing multiple cystic cavities with fluid levels extending into the sacral canal and peritoneal cavity.
case_images: SNI-14-373-g001.jpg
case_images: PMC10629290_01_SNI-14-373-g001.jpg
case_images: F1
case_images: The lesion extended anteriorly to the sacrum into the pelvic cavity (i.e., with ill-defined borders), laterally into the iliac bones, superiorly into the L5 vertebral body, and inferiorly into S4 [Figures 1a-c]. On MR imaging (MRI), the inhomogeneous cysts were filled with moderate/high signal intensities (i.e., fluid levels on T1/T2 images), separated by multiple septae [Figure 1d].
case_images: (a) Intra-Arterial computerized tomography (CT) with 3D reconstruction identifying culprit arterial branches. (b) Digital subtraction angiography (DSA) showing catheter and microcatheter tip with stasis in one of the arterial branches. Gross calcification of the aneurysmal bone cysts (ABC) is seen on the left. (c) DSA showing a branch from the right internal iliac artery which was super selectively catheterized and embolized with polyvinyl alcohol particles ( PVA) particles.
case_images: SNI-14-373-g002.jpg
case_images: PMC10629290_01_SNI-14-373-g002.jpg
case_images: F2
case_images: Digital subtraction angiography of the infrarenal aorta identified feeders from the posterior rami of both internal iliac arteries, (i.e., mainly from the left) [Figure 2].
case_images: (a) Non-contrast computerized tomography (CT) axial view, (b) sagittal view and, (c) 3D reconstruction at 24 months post treatment showing signs of healing (ie bone formation within the aneurysmal bone cysts (ABC) and peripheral sclerotic bony changes).
case_images: SNI-14-373-g003.jpg
case_images: PMC10629290_01_SNI-14-373-g003.jpg
case_images: F3
case_images: Multiple follow-up CT exams obtained up to 2 years later showed progressive healing, (i.e., bone formation within the ABC and peripheral sclerotic bony changes) [Figure 3].