Aneurysmatic bone cyst of the craniocervical region: Surgical technique
An 11-year-old girl presented in our outpatient clinic with history of an expansible mass and local pain at the dorsal portion of her neck for the last 4 months. A CT scan was compatible with an intrinsic bone lesion, with multiple cysts, in the posterior aspect of the atlas []. No neurological compromise was noticed. A CT angiogram demonstrated that the tumor was highly vascularized. The child was taken to surgery. No prior embolization was performed. The patient was positioned prone using a head holder. With a midline incision, the lesion was completely dissected from the superficial layers of skin. A subperiostal dissection was then performed, exposing all the tumor limits []. The arterial supply of the tumor came from both occipital arteries that were occluded at the beginning of the dissection []. The tumor was then removed in small portions. After total removal, we could clearly see both C1 lateral masses and the dura mater exposed []. The total surgical bleeding estimated was 200 mL.\nThe patient was discharged at the second day after surgery without complaints. No radiological evidence of recurrence after 9 months of follow-up.