Rare case of metachronous and synchronous polyostotic aneurysmal bone cysts with atypical features; in a known case of mucopolysaccharidosis- II (Hunter syndrome)

Aneurysmal bone cyst (ABC) occurs most commonly in the second decade of life. It has a female preponderance with a male-to-female ratio of 1:1.16. (1) It usually presents with pain, slow-onset localized swelling, or mass. Depending upon the site of the lesion, it can have varied presentations, such as neurological symptoms or severe pain due to pathological fracture. ABC can occur as a primary bone tumor ; or in 30% of cases it is seen to complicate a preexisting bone lesion. (2). Mucopolysaccharidosis type II (Hunter’s syndrome) is an X-linked disorder. It can present with a number of musculoskeletal features such as arthropathies and contractures. Others may have claw hands, carpal tunnel syndrome, or deformities in the bones of the spine, chest, and limbs. However, no case of associated bone tumors or specifically aneurysmal bone cysts has been reported.