A Case Report of Giant Aneurysmal Bone Cyst of Distal Tibia with a Non-healing Fungating Mass and its Management in a 30-year-old Male.

Introduction: Aneurysmal bone cyst (ABC) is a benign, expansible, non-neoplastic tumor of usually long bones and is identified by blood vessels and spaces that are most often differentiated by fibrous septae. It is challenging to treat these rare, giant ABCs as they have a damaging effect on the bones and compress the nearby structures, especially in load-bearing bones of the body.

Case Report: We report a case of a giant ABC in the distal tibia one-third with soft tissue component of a 30-year-old male. The patient presented to our outpatient department with complaints of pain and swelling over left ankle for 1 year. The size of the swelling was 15 cm × 10 cm × 10 cm over medial aspect of ankle with 3 discharging sinuses which present over swelling. His blood parameters were suggestive of low hemoglobin count. X-rays showed cystic lesions over medial aspect of left ankle. Computed tomography scan and magnetic resonance imaging reports were suggestive of ABC.

Conclusion: Our case report is unique as it reminds us that when presented with a case of ABC, excision of fungating soft tissue with curettage followed by cementing can be a preferable and better treatment option. ABC was extensively curetted out, the formed cavity was packed with bone cement, and fixation with 3 cortico cancellous screws was carried out. At 4-month follow-up, the lesion had receded, and the patient was walking without pain and any deformity. We suggest that this method of treatment is beneficial for ABC at this site and at this age.