Intraosseous pneumatocysts of the cervical spine: a report of four cases and review of literature

Pneumatocysts are benign, gas-containing lesions, most commonly observed affecting the vertebrae, sacrum, and ileum. Most often, these lesions are asymptomatic and are detected incidentally during imaging examinations. Although once believed to be a rare lesion, recent studies suggest that it is more common than previously thought. We present four cases of pneumatocysts affecting the cervical vertebrae detected as incidental findings on cone beam computed tomography (CBCT). Given the increased use of CBCTin dentistry to evaluate the maxillofacial structures, it is likely that dentists will encounter this lesion on CBCT scans that encompass the superior cervical spine. Recognition of the pathognomonic features of this benign, innocuous lesion is important to avoid unnecessary investigations and causing alarm to the patient. We also present a comprehensive review of the literature on the demographic characteristics and clinical presentation of this relatively unknown lesion. (Oral Surg Oral Med Oral Pathol Oral Radiol 2015;119:e49-e54) Cone beam computed tomography (CBCT) is used to image the dentomaxillofacial region for a variety of diagnostic tasks. Often, a region of the cervical spine is encompassed within the image volume, especially in mediumefield-of-view (FOV) and large-FOV scans. Incidental findings noted on such CBCT scans affecting the cervical vertebrae include, but are not limited to, osteoarthritic changes, fusion and nonsegmentation of the vertebral bodies, and the presence of surgical hardware. 1 Thus, dentists should recognize the presence of abnormalities in the cervical spine and, where appropriate, seek consultation or refer the patient to an appropriate provider for further management. Intraosseous gas collection is considered an uncommon finding affecting the vertebral bodies. 2,3 It has been associated with various pathologic conditions that include gas-forming osteomyelitis, osteonecrosis, trauma, and surgery. 4 However, an innocuous and relatively more common cause of intraosseous gas collection in the vertebral bodies is the intraosseous pneumatocyst. 5 This is a relatively unknown cystic