Simple Bone Cysts with Pathological Fracture in the Left Distal Femur: A Case Report

Simple Bone Cysts (SBCs), also known as unicameral bone cysts are the most common lytic benign lesions occurring in children and adolescents. These lesions can be incidentally found but commonly present to us with pathological fractures, necessitating individualised treatment plans. A 15-year-old adolescent female presented with a history of a minor fall at home, resulting in an injury to the left lower limb. The fall caused left thigh pain and difficulty bearing weight on her affected limb. The pain had an abrupt onset, was non progressive and non radiating, and worsened with movement of the left lower limb. The patient also reported a one-year history of swelling in her left thigh, which had a gradual onset and progression but was not associated with pain. An open biopsy performed at an external hospital confirmed the presence of SBC occupying the distal 3rd of the left femur. The management of SBCs requires a patient-specific approach that considers both the clinical and radiological features. In the present case, surgery was indicated because the Mirels’ score was 11. Surgical intervention is the preferred treatment option for symptomatic benign tumors, such as SBCs, as it generally leads to favourable postoperative outcomes.