case_images: PMC10823826_01
case_images: X-ray shows a lytic lesion involving the left pelvis (A), which is ballooning with peripheral thinned cortex appreciated on the CT scan (B and C), MRI showing the classical multiple fluid levels (D).
case_images: JOCR-14-109-g001.jpg
case_images: PMC10823826_01_JOCR-14-109-g001.jpg
case_images: F1
case_images: An anteroposterior radiograph of the pelvis showed expansile osteolytic lesions throughout the left iliac bone right up to the roof of the acetabulum (Fig. 1). A computed tomography (CT) confirmed the lesion to be expansile and with global ballooning of the ileac bone (Fig. 1). ABC (Fig. 1).
case_images: Intraoperative clinical picture showing the bony window (A), curettage (B) and final extent of the window (C), the fluoroscopic images showing the full reach of lesion by curette (D), the lesion after complete curettage (E), and after bone grafting (F).
case_images: JOCR-14-109-g002.jpg
case_images: PMC10823826_01_JOCR-14-109-g002.jpg
case_images: F2
case_images: A window (1.5 x 5 cm) was made on the left iliac crest, and it was seen to be filled up with blood (Fig 2). A long curettage was used to palpate the inner side, which was hollow with few intervening septa but easily reached the hard bone of the roof of the acetabulum (Fig 2). India). It was packed and confirmed on the fluoroscopic views (Fig 2).
case_images: Histopathological examination shows- (A) fragments of bony trabeculae showed multiple cystic lesions (black arrow) and thin fibrous walls (H&E, 40X); (B) cystic spaces contain blood, and cyst wall showed thin fibrous tissue (H&E, 100X); (C) the cyst wall showed fibroblasts and osteoclast-type giant cells (H&E, 40X); (D) higher magnification of the cyst wall contained fibroblasts, osteoclast-type giant cells (black arrow), and hemosiderin laden macrophages (H&E, 400X)
case_images: JOCR-14-109-g003.jpg
case_images: PMC10823826_01_JOCR-14-109-g003.jpg
case_images: F3
case_images: Histological examinations revealed fibrous walls and septa containing blood components, inflammatory cells, and osteoclasts sparsely scattered around cystic spaces filled with blood suggestive of ABC (Fig. 3).
case_images: X-ray showing immediate post-operative (A), at 2 weeks (B), at 6 months (C), and final follow-up at 12 months (D-F) which is showing integration of the graft and substitute to the host bone.
case_images: JOCR-14-109-g004.jpg
case_images: PMC10823826_01_JOCR-14-109-g004.jpg
case_images: F4
case_images: Her serial X-ray at follow-up showed gradual integration of bone grafts and substitutes (Fig. 4).