Clinical characteristics, anatomical distribution, and diagnostic patterns of simple bone cysts in Japan: an analysis of the Japanese Bone and Soft Tissue Tumor registry.
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BACKGROUND: Simple bone cysts are benign cystic bone lesions that occur predominantly in children and adolescents, although they might occur in all ages. Previous studies have described clinical features and treatment options; however, large-scale epidemiological data from Japan are limited. We aimed to investigate the clinical characteristics, anatomical distribution, diagnostic patterns, and initial treatment tendencies of simple bone cysts in Japan using data from the Japanese Bone and Soft Tissue Tumor (BSTT) registry and a nationwide institutional survey. METHODS: We performed a retrospective analysis using the BSTT registry maintained by the Musculoskeletal Tumor Committee of the Japanese Orthopedic Association. Patients diagnosed with simple bone cysts between 2006 and 2019 were included. Age at diagnosis, tumor location, method of diagnosis, presence of pathological fractures at presentation, and treatment patterns were analyzed. RESULTS: Overall, 3164 patients with simple bone cysts were identified in the registry. The mean age at diagnosis was 22.4 years (range, 0-89 years). Notably, 1663 (52.6%) patients were pathologically confirmed and 1501 (47.4%) were clinically diagnosed without histological confirmation. The humerus was the most common tumor location (910 cases, 28.8%), followed by calcaneus (803 cases, 25.4%), and femur (682 cases, 21.6%). Surgical treatment was performed in 1480 patients. CONCLUSION: This nationwide registry-based study provided an overview of the clinical characteristics, anatomical distribution, diagnostic patterns, and treatment strategies for simple bone cysts in Japan. Diagnostic methods and treatment strategies differed according to patient age, and surgeries were performed more frequently for long-bone lesions than for lesions at other anatomical sites.