Aneurysmal bone cyst: Scarce existence in 60 years old mandible

Introduction: Aneurysmal bone cyst (ABC) is a trivial benign bony lesions springing predominantly in the pediatric population, as a congenital
occurrence. If seen in adult then mostly cases are reported up to age of 30 years. It has a propensity for the metaphysis of long bones and is
infrequent in craniofacial skeleton. Its craniofacial occurrence in adult may be attributed to history of trauma.
Case report: Here we report a very rare existence of aneurysmal bone cyst in a 60 year old female who reported to us with pain and swelling in the
right lower front jaw region since 6 months along with difficulty in chewing. As standard protocol first Orthopantomograph was advised which
showed expansile, eccentric and lytic lesion with bony septae. CT scan was advised showed expansile lytic/ cystic mass. Incisional biopsy done
disclosed reparative giant cell lesion. Standard treatment for large cystic/ lytic lesions are curettage and grafting to fill the bone void, but seeing the
size of mass and involvement of inferior border of mandible, segmental mandibulectomy was done under general anaesthesia and proximal and
distal segment were stabilized with reconstruction plate. At most instances such large masses are addressed via extra oral approach but this rare
ABC was resected and reconstructed via intraoral approach. Final histopathological investigation confirmed the diagnosis of aneurysmal bone cyst.
Conclusion: ABC is common tumor of long bones but its existence has not kept craniofacial skeleton untouched. This early age lesion has spread
its leg to advanced age group too, but extremely rare. Considering the fickle clinical and radiological appearance of ABC histopathological analysis
becomes must for the diagnosis. There are standard procedures and approaches for specific lesions but when it comes to maxillofacial region
aesthetics is a big concern, so one must always keep options open to keep it intact.