CYSTIC AND FIBROCYSTIC DISEASE OF THE LONG BONES

¹ Mayo Clinic, Rochester, Minnesota.

1. Cysts and osteitis fibrosa cystica may arise from either local or general processes.

2. Cysts, osteitis fibrosa cystica and giant cells may occur in the same bone.

3. Giant cells in moderate numbers, especially the atypical forms, are not prognostic of malignancy.

4. Before diagnosis of a local osteitis fibrosa cystica is made, it is necessary to rule out the general form; this is most practical by means of the roentgenograph.

5. Curetting and crushing in of the diseased wall is usually sufficient surgery.

6. The microscopic picture is clear and should not be confounded with malignancy.

7 The roentgenograph is of the greatest value and it is fairly diagnostic, but it cannot accurately determine the contents of the cyst; the localization in the diaphysis and the tendency to remain inside the cortex and periosteum are valuable signs in the differentiation from malignancy, the epiphysis being free from involvement.

8. The history, clinical findings, examination of the patient, and laboratory and roentgenographic reports should be included in making the diagnosis.

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