Korean J Sports Med.  2021 Dec;39(4):188-192. 10.5763/kjsm.2021.39.4.188.

Osseous Erosion by Spinoglenoid Ganglion Cyst in Adolescent Baseball Player: A Case Report

• Jin HK
• Cho HL
• Kim JH

• KMID: 2523234
• DOI: http://doi.org/10.5763/kjsm.2021.39.4.188

Abstract

Spinoglenoid notch cysts, a certain expansion form of paralabral ganglion cyst, are often associated with superior labrum anterior to posterior (SLAP) lesions in overhead athletes. We report a unique case of spinoglenoid notch cyst that extended to posterosuperior bony glenoid in a 16-year-old high school male baseball fielder. Magnetic resonance imaging showed multilobulated spinoglenoid notch ganglion cyst associated with posterosuperior SLAP lesion, and computed tomography (CT) revealed distinct osseous erosion of posterosuperior glenoid. The cyst was enlarged on serial follow-up imaging, and his symptoms were continued, arthroscopic decompression was performed via posterosuperior capsulotomy. The concomitant SLAP lesion was not repaired, but only marginal debridement was performed. At 6 months after surgery, he returned to game without symptoms, and the bony glenoid lesion was almost remodeled on follow-up CT. In adolescent athletes, significant osseous erosion by spinoglenoid notch cyst may be accentuated due to the skeletal immaturity of posterosuperior glenoid.

Keyword

Ganglion cysts; Spinoglenoid notch; Superior labrum anterior to posterior lesion; Glenoid; Erosion

Figure

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  Fig. 1 Anteroposterior radiographs in (A) neutral and (B) internal rotation show oval radiolucent cystic lesion (arrows) in posterosuperior glenoid. (C) T2-weighted coronal magnetic resonance (MR) image demonstrates multi-lobulated homogenous high signal intensity paralabral cyst (arrow). (D) Fat-suppressed coronal MR arthrography shows superior labrum anterior to posterior lesion (arrow) communicated with paralabral cyst.

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  Fig. 2 Preoperative magnetic resonance images 8 months after initial presentation. (A) T2-weighted coronal image demonstrates enlargement of previous cyst (arrow) and (B) axial and (C) oblique sagittal images show anteroinferior osseous erosion (arrows) by adjacent extension of spinoglenoid ganglion cyst. (D) T1-weighted image shows significant scalloping of posterosuperior glenoid maintaining low-signal cortical continuity (arrow).

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  Fig. 3 Preoperative (A) axial and (B) coronal computed tomography images show punched-out osseous erosion (arrows) of posterosuperior glenoid in lateral portion of the spinoglenoid notch.

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  Fig. 4 Intraoperative arthroscopic images during spinoglenoid cyst decompression show (A) posterosuperior labral tear from anterior viewing portal and (B) characteristic amber-colored, gelatinous content within the cyst after posterosuperior capsulotomy. During cyst decompression, (C) posterosuperior glenoid cortex was maintained intact (arrows) and (D) stable posterosuperior labrum was established after debridement.

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  Fig. 5 Six months after cyst decompression, anteroposterior radiographs in (A) neutral and (B) internal rotation show significant resolution of preoperative radiolucent lesion (arrows) and (C) axial and (D) coronal computed tomography images demonstrate remodeling of eroded posterosuperior glenoid (arrows).

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