Rare Aneurysmal Bone Cyst Presentation in the Orbit: A Systematic Review of the Literature with an Illustrative Case Report

Objective: Aneurysmal bone cysts (ABCs) are benign but aggressive vascular lesions within bone. Orbital ABCs, though rare, are clinically significant due to the risk of debilitating symptoms such as vision loss.

Methods: Our systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines using PubMed, Google Scholar, Embase, and SCOPUS databases to identify and assess primary articles exploring orbital ABC cases. Additionally, we present an illustrative case report.

Results: Among the 54 cases from the 51 studies included, the mean age was 16.87 years, with 23 males, 29 females, and 2 unspecified. The most prevalent symptoms were exophthalmos (N = 36) and diplopia (N = 21). Regarding laterality, the right orbit was most commonly affected (N = 27), followed by the left orbit (N = 21), with 4 cases of bilateral involvement. Within the orbit, the medial wall most frequently impacted location (N = 14), followed by the orbital roof (N = 13), posterior wall (N = 7), lateral wall (N = 3), and orbital floor (N = 2), with 15 cases involving multiple locations. Surgical resection was the primary treatment, resulting in complete resolution in 44 cases. In our case, a 30-year-old male with an orbital ABC was managed surgically through bifrontal craniotomy with superior orbitotomy for lesion excision and orbital roof reconstruction.

Conclusions: ABCs in the orbit can be challenging, and complete removal of the lesion is essential for achieving optimal patient outcomes.