Cristian Cazac is a 5th year medical student enrolled at the University of Medicine and Pharmacy “Carol Davila” in Bucharest, Romania. He has been the class president for two years. He has presented at two medical congresses and has attended a total of 5. He has published 4 medical articles and has been the consultant student editor for the medical journal titled Journal of Medicine and Life. During the summer months, he participates in electives, observerships, volunteerships, and medical research at Mercy Medical Center in Baltimore, Sinai Hospital of Baltimore, and Medstar Franklin Square Medical Center.
Objective: To highlight the differences and similarities in the diagnosis and treatment of aneurismal bone cysts in Romania and U.S.A.\r\nCase Presentation: A 19 year old male Romanian resident presented to Sinai Hospital of Baltimore for the treatment of an aneurismal bone cyst located in the proximal left tibia. The patient previously consulted 3 orthopaedic surgeons in Romania. After evaluation of x-ray films, ultrasound, and blood tests the Romanian physicians concluded the absence of disease. After a 4th office visit, an MRI was performed which revealed an osteolitic tumor in the proximal left tibia suggestive of a giant cell tumor with dimensions of 61/43 mm. The Romanian orthopaedic surgeons recommended partial join replacement. The patient refused treatment and went to the U.S.A. for consultation at John’s Hopkins Hospital and Sinai Hospital. After performing an MRI, bone scan, x-ray films, and blood panel the lesion was suggested to be an aneurismal bone cyst. The recommended treatment was curettage, bone allotransplantation, phenol irrigation, and insertion of a fibula segment. The patient remained at Sinai Hospital for treatment. The histopathological findings were difficult to differentiate between a giant cell tumor and an aneurismal bone cyst. The samples were sent for re-evaluation to an outside center which confirmed that the lesion was an aneurismal bone cyst. At three years follow up, the patient’s repeat x-ray films show no sign of recurrent disease. \r\nConclusion: The diagnosis and treatment of aneurismal bone cysts in Romania and U.S.A. differ due to the different availability of medical resources. \r\n