151 results on '"Bone Cysts, Aneurysmal therapy"'
Search Results
2. Denosumab and sclerotherapy for recurrent spinal aneurysmal bone cyst in a child.
- Author
-
Singh R, Madasswery S, Colman M, and Kent PM
- Subjects
- Child, Female, Humans, Sclerotherapy, Sacrum pathology, Administration, Intravenous, Denosumab therapeutic use, Bone Cysts, Aneurysmal diagnostic imaging, Bone Cysts, Aneurysmal therapy
- Abstract
Aneurysmal bone cyst (ABC) is a non-malignant, locally destructive, blood-filled lesion in the bone that tends to grow aggressively. A young girl presented with a rapid recurrence after aggressive surgery of a large symptomatic sacral-spinal ABC. After a multidisciplinary tumour board, she was successfully treated with sclerotherapy and monthly intravenous denosumab. The patient has maintained asymptomatic for over 36 months now and has returned to full activity and strength. She never required surgery and has had radiologic resolution of the lesions. Treatment of recurrent ABC requires a multidisciplinary team approach. We believe this to be the first report to use this combined therapy to provide an alternative to morbid surgery for children with ABCs., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2024. No commercial re-use. See rights and permissions. Published by BMJ.)
- Published
- 2024
- Full Text
- View/download PDF
3. Treatment of Spinal Aneurysmal Bone Cyst with Percutaneous Injection of Hydroxyapatite Osteoconductive Cement.
- Author
-
Gragnano E, Opancina V, Muto G, Giordano F, Guarnieri G, Hirsch J, Della Gata L, Piovan E, and Muto M
- Subjects
- Adult, Child, Humans, Retrospective Studies, Hydroxyapatites therapeutic use, Treatment Outcome, Pain drug therapy, Bone Cements therapeutic use, Bone Cysts, Aneurysmal diagnostic imaging, Bone Cysts, Aneurysmal therapy, Bone Cysts, Aneurysmal complications
- Abstract
Purpose: The aim of this study was to evaluate treatment efficacy of percutaneous injection of hydroxyapatite-osteoconductive-cement in patients with spinal aneurysmal bone cysts., Materials and Methods: The study was designed as a retrospective observational clinical study. We included patients who were diagnosed with of spinal aneurysmal bone cyst, at our institution between 2013 and 2020, and treated with percutaneous injection of osteoconductive cement: "Cerament"
® (BONESUPPORT AB, Lund, Sweden). Typical clinical and radiological features of the ABCs treatment and follow-up were investigated., Results: Our study included nine patients, two children and seven adults. Three different types of approaches were applied: (single pedicle approach in 3 patients; double pedicle approach in 2 patients; while in the remaining cases, a multiple access approach was used. VAS score decreased from 8.5 ± 0.5 before treatment to 4.1 ± 0.9 at 6-months-follow up. All of the patients reacted well to treatment, with none neurological complications, complete loss of pain and achieved osteosclerosis as radiological marker of treatment success., Conclusion: Treatment of symptomatic spinal ABC's with hydroxyapatite cement is effective to achieve complete pain reduction and sclerosis., (© 2023. Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE).)- Published
- 2023
- Full Text
- View/download PDF
4. Minimally Invasive Treatment of a Cervical Aneurysmal Bone Cyst Through Percutaneous Doxycycline-Albumin Foam Injection.
- Author
-
Bueno Neves F, Jansen O, Trentmann J, Mostafa K, and Madjidyar J
- Subjects
- Humans, Treatment Outcome, Tomography, X-Ray Computed, Albumins, Doxycycline, Bone Cysts, Aneurysmal diagnostic imaging, Bone Cysts, Aneurysmal therapy
- Published
- 2023
- Full Text
- View/download PDF
5. The treatment of aneurysmal bone cysts.
- Author
-
van Geloven TPG, van de Sande MAJ, and van der Heijden L
- Subjects
- Humans, Child, Denosumab therapeutic use, Neoplasm Recurrence, Local, Polidocanol, Treatment Outcome, Bone Cysts, Aneurysmal diagnosis, Bone Cysts, Aneurysmal therapy, Bone Cysts, Aneurysmal pathology, Hypercalcemia
- Abstract
Purpose of Review: Aneurysmal bone cysts are rare, locally aggressive bone tumors. Optimal treatment of ABCs is still matter of debate as therapies including sclerotherapy, selective arterial embolization and systemic treatment with denosumab are increasingly utilized, in addition to or instead of traditional curettage. The purpose of this review is to discuss current concepts and difficulties in diagnosing and treating primary ABCs, based on latest available literature., Recent Findings: In diagnostics, multiple new fusion partners of USP-6 have been described on next-generation sequencing specifically for primary ABCs. In a recent systematic review, failure rates of percutaneous injections and surgery were comparable. In a literature review, the use of denosumab seemed effective but resulted in multiple cases of severe hypercalcemia in children., Summary: Accurately diagnosing primary ABC is crucial for treatment decisions. Curettage remains a valid treatment option, especially with adjuvant burring, autogenous bone grafting and phenolization. Percutaneous sclerotherapy represents a solid alternative to surgery, with polidocanol showing good results in larger studies. Systematic therapy with denosumab exhibits favorable results but should be reserved in the pediatric population for unresectable lesions, as it may result in severe hypercalcemia in children. When selecting a treatment option, localization, stability and safety should be considered., (Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc.)
- Published
- 2023
- Full Text
- View/download PDF
6. Update on aneurysmal bone cyst: pathophysiology, histology, imaging and treatment.
- Author
-
Restrepo R, Zahrah D, Pelaez L, Temple HT, and Murakami JW
- Subjects
- Child, Humans, Tomography, X-Ray Computed, Young Adult, Bone Cysts diagnostic imaging, Bone Cysts therapy, Bone Cysts, Aneurysmal diagnostic imaging, Bone Cysts, Aneurysmal therapy, Bone Neoplasms diagnostic imaging, Bone Neoplasms pathology, Bone Neoplasms therapy, Osteosarcoma pathology
- Abstract
Aneurysmal bone cyst (ABC) is a benign but locally aggressive lesion that predominantly affects children and young adults. ABC, which accounts for approximately 70% of the cases, is now recognized to be a true neoplasm, whereas ABC-like changes associated to other bone neoplasms (also referred in the literature as secondary ABC) accounts for the remaining 30%. The solid variant of ABC is also considered a true neoplasm but is rare. ABC can involve any bone in the body, and although it has a metaphyseal preference, it can involve any part of a bone and soft tissues. As with any bone tumor, the initial evaluation of ABCs should be done with radiographs followed by magnetic resonance imaging or less frequently computed tomography for further characterization. The imaging appearance of ABC is variable; however, a lytic and expansile lesion with fluid-fluid levels is the most common presentation. The main differential diagnosis of an ABC in the pediatric population is unicameral bone cyst (UBC) and telangiectatic osteosarcoma, therefore a biopsy is recommended before treatment. The therapeutic options of ABC range from curettage with or without adjuncts such as phenol, liquid nitrogen, argon laser and bone grafting or bone substitutes to more recently employed alternatives such as image-guided sclerotherapy with various sclerosing agents and monoclonal antibodies (e.g., Denosumab)., (© 2022. The Author(s).)
- Published
- 2022
- Full Text
- View/download PDF
7. Doxycycline sclerotherapy of cervical spine aneurysmal bone cysts: single-institution 13-year experience.
- Author
-
Wong MN, Braswell LE, and Murakami JW
- Subjects
- Adolescent, Cervical Vertebrae diagnostic imaging, Child, Humans, Retrospective Studies, Sclerotherapy methods, Treatment Outcome, Young Adult, Bone Cysts, Aneurysmal diagnostic imaging, Bone Cysts, Aneurysmal therapy, Doxycycline therapeutic use
- Abstract
Background: Aneurysmal bone cysts (ABCs) are benign, locally aggressive neoplasms that typically affect patients during their first two decades of life. Curettage with or without bone grafting or adjuvants is the current standard treatment; however, other surgical and medical treatments, such as sclerotherapy, have been reported. Treatment options for cervical spine ABCs are more limited because the proximity of ABCs to critical structures leads to greater risk of spontaneous or treatment-related adverse events, including death., Objective: To retrospectively review all children and young adults with cervical spine ABCs treated with doxycycline sclerotherapy at one referral center to assess its viability as a standalone treatment., Materials and Methods: We retrospectively reviewed the clinical notes and imaging of 16 patients treated with doxycycline sclerotherapy for pathologically proven cervical spine ABCs at our institution between May 2008 and March 2021. All patients underwent image-guided percutaneous doxycycline sclerotherapy to ablate the ABC and stimulate bone formation. We assessed clinical outcomes through chart review and described post-treatment imaging outcomes using modified Neer scoring., Results: Of the 16 total children and young adults treated, 2 were lost to follow-up, leaving 14 patients with a median age of 14.5 years. Twelve of these 14 patients were successfully treated with doxycycline sclerotherapy for a success rate of 86%. One patient experienced one treatment-related complication (Society of Interventional Radiology [SIR] adverse event classification D), before ultimately being successfully treated. Doxycycline treatment failed in two patients, who then underwent surgical management. Post-treatment imaging of successfully treated cases had a mean modified Neer score of 1.3, whereas post-treatment imaging in failed cases had a mean score of 3.5., Conclusion: Doxycycline sclerotherapy is a viable standalone treatment for cervical spine ABCs because it is safe and effective while avoiding the morbidity associated with open surgical treatments., (© 2022. The Author(s).)
- Published
- 2022
- Full Text
- View/download PDF
8. [Andean children with aneurysmal bone cyst treated with polidocanol (use off-label)].
- Author
-
Ríos-Méndez RE, Espin-Villamarin LG, Rovalino-Troya CJ, Rosero-Lema VF, Barona-Freire EB, and Reinoso-Recalde DI
- Subjects
- Adolescent, Child, Child, Preschool, Cross-Sectional Studies, Female, Humans, Male, Off-Label Use, Polidocanol therapeutic use, Retrospective Studies, Bone Cysts, Aneurysmal diagnosis, Bone Cysts, Aneurysmal therapy
- Abstract
Introduction: The aneurysmal bone cyst is a rare benign but aggressive osteolytic tumor for which there is still no ideal treatment, the reports on treatment by sclerotherapy in the pediatric population are scarce and in our region even less. The objective is to communicate the experience of the treatment of aneurysmal bone cyst with polydocanol 3%., Material Y Methods: Retrospective, descriptive and cross-sectional study. Period: June/2017 to June/2021. Inclusion: patients with histological diagnosis of aneurysmal bone cyst; Under general anesthesia and fluoroscopic guidance, intralesional puncture with 16G needle was performed through which 3% polydocanol was slowly administered. Data: medical history. Quantitative variables shall be expressed in measures of central tendency and dispersion; qualitative variables shall be expressed as frequencies or percentages., Results: Nine consecutive patients were included, all of whom had pain and tumor in one of the extremities. Gender: 3 female and 6 male. Age: median 10.5 years (range: 2-15.1). Weight: median 32.8 kg (range: 11-44.5). Total procedures: 44; procedures per patient: mean 4.9 (SD: ± 2.0). Procedure time: mean 33.9 minutes (SD: ± 18.3); radiation: mean 1.34 mGy (SD: ± 1.55). Hospitalization: one day, except one patient. Complications: skin damage in one case, no recurrences follow-up: 12 to 50 months., Conclusion: In this pediatric series, polydocanol 3% was useful and effective for the treatment of aneurysmal bone cyst, with few complications. One disadvantage is that it requires several sessions and in addition, no significant difference has been demonstrated between other forms of treatment in terms of the recurrence rate.
- Published
- 2021
9. [Aneurysmal bone cyst in the sacrum: Case report and literature review].
- Author
-
Elía Martínez JM, Puerta de Diego R, Gallart Úbeda V, Elía Martínez I, and Losar Sogues Colom A
- Subjects
- Aged, Curettage, Humans, Male, Radiography, Sacrococcygeal Region, Sacrum diagnostic imaging, Bone Cysts, Aneurysmal diagnostic imaging, Bone Cysts, Aneurysmal therapy
- Abstract
Aneurysmal bone cysts are rare benign bone lesions. Location in the sacrum is unusual. Symptoms are nonspecific. After an injury, pain develops and complications of adjacent structures can be triggered by the associated oedema. Radiological presentation is usually characteristic but must be confirmed by biopsy and a differential diagnosis must be made with other tumours. Treatment in long bones is based in curettage and refill with bone replacement material. In the sacrum, neurological complications can develop with selective arterial embolisation being an alternative in their management. We describe the case of a 71-year-old male patient with sacral aneurysmal bone cysts and a history of chronic lymphoid leukaemia and benign prostatic hyperplasia. The report includes the clinical presentation, imaging findings and outcome after treatment with selective arterial embolisation. This case highlights the therapeutic options and difficulties encountered in the management of these lesions when located in the sacrum, which complicates their usual treatment. Selective arterial embolisation is a therapeutic option in patients with sacral aneurysmal bone cysts, allowing less aggressive treatments and favourable results., (Copyright © 2020 Sociedad Española de Rehabilitación y Medicina Física. Publicado por Elsevier España, S.L.U. All rights reserved.)
- Published
- 2021
- Full Text
- View/download PDF
10. The role of percutaneous transarterial embolization in the management of spinal bone tumors: a literature review.
- Author
-
Facchini G, Parmeggiani A, Peta G, Martella C, Gasbarrini A, Evangelisti G, Miceli M, and Rossi G
- Subjects
- Humans, Spine, Bone Cysts, Aneurysmal therapy, Embolization, Therapeutic, Fractures, Spontaneous, Spinal Neoplasms diagnostic imaging, Spinal Neoplasms therapy
- Abstract
Purpose: Spinal bone tumors include a heterogeneous broad of primary or metastatic lesions that may present as incidental findings or manifest with painful symptoms and pathological fractures. Optimal management of spine bone lesions is often difficult and treatment algorithms are usually solidly based on surgery. We aimed to evaluate the contribution of trans-arterial embolization in this field, with particular attention to the procedure efficacy, technical difficulties and complications., Methods: We present a literature review on the role of trans-arterial embolization in the management of spinal bone tumors, both primary and metastatic, evaluating its contribution as preoperative treatment, palliative procedure and standalone curative strategy., Results: Trans-arterial embolization provides an important contribution to reducing surgery hemorrhagic risks, offering a better visualization of the operating field, and possibly increasing tumor susceptibility to chemotherapy or radiation therapy. Nonetheless, it plays an important part in pain palliation, with the unquestionable advantage of being easily repeatable in case of necessity. Its curative role as a standalone therapy is still subject of debate, and at the present time, satisfactory results have been recorded only in the treatment of aneurysmal bone cysts., Conclusion: Percutaneous trans-arterial embolization has established as a highly useful minimally invasive procedure in the management of spinal bone lesions, particularly as adjuvant preoperative therapy and palliative treatment., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
- Published
- 2021
- Full Text
- View/download PDF
11. Combined Transarterial Embolization and Percutaneous Sclerotherapy as Treatment for Refractory and Nonresectable Aneurysmal Bone Cysts.
- Author
-
Masthoff M, Gerwing M, Schneider KN, Köhler M, Deventer N, Schindler P, Heindel W, Hardes J, Seidensticker M, Gosheger G, and Wildgruber M
- Subjects
- Adolescent, Female, Humans, Male, Polidocanol, Quality of Life, Retrospective Studies, Sclerosing Solutions therapeutic use, Treatment Outcome, Bone Cysts, Aneurysmal drug therapy, Bone Cysts, Aneurysmal therapy, Sclerotherapy adverse effects
- Abstract
Purpose: To evaluate the safety and effectiveness of combined transarterial embolization and percutaneous sclerotherapy in the treatment of refractory and nonresectable aneurysmal bone cysts (ABCs) as assessed by imaging and clinical outcomes., Materials and Methods: This retrospective, single-center study included 16 consecutive patients (9 women and 7 men; median age, 17 years [range, 6-25 years]) who underwent combined transarterial embolization (using ethylene vinyl alcohol) and percutaneous sclerotherapy (using ethanol gel and polidocanol) for refractory and nonresectable ABCs. The median follow-up was 27.3 months (range, 6.7-47.5 months). Grade of mineralization (5-point Likert scale), grade of fluid-fluid levels (FFLs; 4-point Likert scale), and contrast-enhancing lesion volume were evaluated before and after treatment. The quality of life was determined before and after treatment using the Musculoskeletal Tumor Society (MSTS) score and the 36-Item Short Form Survey (SF-36) health questionnaire., Results: A mean of 1.6 ± 0.7 transarterial embolizations and 3.2 ± 1.7 percutaneous sclerotherapies were performed. No adverse events were observed. All patients showed either partial or complete response; no patient showed ABC recurrence. The grade of mineralization (3.7 ± 0.7 after therapy vs 1.4 ± 0.5 at baseline; P < .0001) and grade of FFL (3.5 ± 0.8 after therapy vs 1.9 ± 0.6 at baseline; P < .0001) significantly improved after therapy compared with baseline. The mean contrast-enhancing lesion volume significantly decreased after treatment compared with baseline (45.9 mm³ ± 96.1 vs 156.0 mm³ ± 115.3, respectively; P = .0003). The MSTS scores (28.8 ± 1.8 after treatment vs 14.1 ± 8.6 at baseline; P < .0001) and SF-36 findings revealed a significant improvement in the quality of life after treatment compared with baseline, leaving most patients without relevant constraints., Conclusions: Combined transarterial embolization and percutaneous sclerotherapy is a minimally invasive, safe, and effective treatment option for refractory and nonresectable ABCs. Treatment fostered bone mineralization and significantly improved patients' quality of life., (Copyright © 2021 SIR. Published by Elsevier Inc. All rights reserved.)
- Published
- 2021
- Full Text
- View/download PDF
12. Percutaneous treatments of primary aneurysmal bone cysts: systematic review and meta-analysis.
- Author
-
Cruz GS, Cuevas-Suárez CE, Saavedra JPA, Giorgis R, Teixeira MRK, and Muniz FWMG
- Subjects
- Humans, Neoplasm Recurrence, Local, Sclerotherapy, Treatment Outcome, Bone Cysts, Aneurysmal diagnostic imaging, Bone Cysts, Aneurysmal therapy, Embolization, Therapeutic
- Abstract
Purpose: To systematically review the literature to determine recurrence rates of percutaneous treatments for primary aneurysmal bone cysts (ABC)., Methods: Search strategies were performed in the following databases: PubMed, SCIELO, LILACS and BVS, using terms in English, Spanish and Portuguese (PROSPERO Registration Number: CRD42020170340). Longitudinal studies, either observational or clinical trials, with at least five patients and with a mean of 18 months of follow-up were included. Studies had to use any type of percutaneous treatments and report the recurrence rates of primary ABC treatment. Studies selection, data extraction and risk of bias assessment were performed independently by two researchers. A global meta-analysis was carried out to assess the proportion of recurrence. Studies were categorized into two subgroups: selective arterial embolization and sclerotherapy., Results: Thirteen studies were included in the present study. The average success rate of percutaneous treatments for ABC was 91.11%, with a total of 37 lesions recurrences in the 416 patients. The sex ratio was 1:1. The subgroup of sclerotherapies presented a lower proportion of recurrence. The proportion of recurrence in the subgroup of selective arterial embolization was 19% (95%IC 12.11-27.54) and that of sclerotherapies was 6% (95%IC 3.65-9.19)., Conclusions: Both percutaneous treatments for ABC are effective, showing a lower rate of recurrence. Sclerotherapy treatments seem to be promising, but further clinical trials must be conducted with a longer follow-up., (© 2021. The Author(s), under exclusive licence to Springer-Verlag France SAS part of Springer Nature.)
- Published
- 2021
- Full Text
- View/download PDF
13. Aneurysmal Bone Cysts of the Paranasal Sinuses: The Mayo Clinic Experience and Review of the Literature.
- Author
-
Smith AJ, Choby G, Van Gompel JJ, Link MJ, and Van Abel KM
- Subjects
- Disease Progression, Humans, Prognosis, Recurrence, Retrospective Studies, Bone Cysts, Aneurysmal diagnosis, Bone Cysts, Aneurysmal therapy, Paranasal Sinus Diseases diagnosis, Paranasal Sinus Diseases therapy
- Abstract
Objective/hypothesis: Aneurysmal bone cysts (ABCs) are benign, lytic bone lesions, which rarely present in the paranasal sinuses. There is no published consensus on the appropriate diagnostic or treatment approach. Our objective was to elucidate the clinical behavior, treatment, and outcomes for patients with ABCs of the paranasal sinuses (psABCs)., Study Design: Retrospective case series and system review of the literature., Methods: A retrospective chart review was performed to identify patients evaluated at the authors' institution with psABC and consolidated with literature reports of psABC., Results: Eighty-nine patients met inclusion criteria. The most common presenting symptom was painless facial swelling (n = 35, 39%). The ethmoid sinuses were the most common site involved (n = 55, 62%). Surgical approach was reported in 74 cases including 20 endoscopic and 54 with an open or combined approach. Fifty-nine patients (71%) underwent gross total resection. Follow up data was reported for 67 patients. Fifteen patients (22%) were found to have recurrence or progression at follow up; 10/15 (66%) patients within the first 12 months, 14/15 (93%) within the first 24 months, and 1/15 (7%) greater than 24 months after treatment. Patients were more likely to have recurrence/progression if they presented with nasal discharge (P = .05), proptosis (P = .01), or orbital involvement (P = .03)., Conclusions: psABCs typically present with painless swelling or nasal obstruction. Orbital involvement is a negative prognostic indicator with these patients more likely to have recurrence after treatment. Recurrence or progression of disease is most likely to occur within 2 years after treatment. Therefore, patients should be monitored closely during this time., Level of Evidence: 4 Laryngoscope, 131:E2525-E2533, 2021., (© 2021 The American Laryngological, Rhinological and Otological Society, Inc..)
- Published
- 2021
- Full Text
- View/download PDF
14. Percutaneous Microwave Ablation and Osteoplasty of an Aneurysmal Bone Cyst.
- Author
-
Filippiadis D, Charalampopoulos G, Zampakidis X, Brountzos E, and Kelekis A
- Subjects
- Bone Cysts, Aneurysmal diagnostic imaging, Child, Preschool, Combined Modality Therapy, Humans, Male, Recurrence, Treatment Outcome, Ablation Techniques, Bone Cysts, Aneurysmal therapy, Cementoplasty, Microwaves therapeutic use
- Published
- 2021
- Full Text
- View/download PDF
15. Severe Acute Lung Injury After H2O2 Irrigation of an Aneurysmal Bone Cyst in an 8-Year-Old Girl: A Case Report.
- Author
-
Waldvogel S, Zutter A, Krieg AH, and Trachsel D
- Subjects
- Child, Female, Humans, Hydrogen Peroxide adverse effects, Prone Position, Pulmonary Gas Exchange, Supine Position, Acute Lung Injury etiology, Acute Lung Injury therapy, Bone Cysts, Aneurysmal therapy, Respiratory Distress Syndrome
- Abstract
An 8-year-old girl developed severe acute lung injury after irrigation of a pelvic aneurysmal bone cyst with H2O2 and filling with bone cement. Sudden profound oxygen desaturation occurred on the operating table when the patient was turned from the prone to the supine position. After a brief improvement in her oxygenation, the girl developed rapidly progressing severe respiratory failure necessitating reintubation and hour-long manual ventilation, while copious amounts of hemorrhagic frothy fluids were aspirated through the endotracheal tube. The patient started to improve after 24 hours and eventually made a full recovery. We hypothesize that the incident was caused by gas embolization and pulmonary endothelial damage by H2O2., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2021 International Anesthesia Research Society.)
- Published
- 2021
- Full Text
- View/download PDF
16. Qualitative evaluation of MRI features in aneurysmal bone cysts after percutaneous sclerotherapy.
- Author
-
Bih ES, Dao K, Padua H, and Shaikh R
- Subjects
- Humans, Magnetic Resonance Imaging, Sclerosing Solutions therapeutic use, Treatment Outcome, Bone Cysts, Aneurysmal drug therapy, Bone Cysts, Aneurysmal therapy, Sclerotherapy
- Abstract
Objective: To report MRI findings of changes seen in aneurysmal bone cysts after percutaneous sclerotherapy treatment., Materials and Methods: After applying exclusion criteria, a total of 36 patients who had aneurysmal bone cysts and undergone percutaneous sclerotherapy were included in this study. The pre-treatment and post-treatment MRIs were reviewed and multiple pre-determined MRI findings were evaluated. The presence of each post-treatment finding, as well as the time for each finding to develop, was recorded., Results: Early post-sclerotherapy changes include increased perilesional edema and enhancement, which appear on MRI on average 5.1 months after the initial sclerotherapy. This is followed by decreased cystic areas, which can be seen on average 5.9 months after the initial treatment. The presence of fibrosis, improved cortical integrity, and improving mass effect are later post-treatment changes and appear on MRI on average 9.7 months, 10.6 months, and 16.1 months after the initial sclerotherapy, respectively., Conclusion: The early and late post-sclerotherapy MR findings of aneurysmal bone cysts were reported in this study.
- Published
- 2021
- Full Text
- View/download PDF
17. Primary aneurysmal bone cyst of sacrum for adolescent: Eleven cases experience and literature review.
- Author
-
Wang J, Du Z, Yang R, Tang X, Yan T, and Guo W
- Subjects
- Adolescent, Child, Female, Humans, Male, Postoperative Complications epidemiology, Postoperative Complications etiology, Retrospective Studies, Treatment Outcome, Young Adult, Bone Cysts, Aneurysmal therapy, Embolization, Therapeutic methods, Sacrum pathology
- Abstract
The present study is aiming to describe clinical characteristics, surgical flowchart and treatment results of eleven adolescent patients with primary aneurysmal bone cyst (ABC) of sacrum and review in the literature. We retrospectively reviewed eleven young patients with sacral primary ABC, which had the intact clinical and follow-up information at our bone tumor center from 2001 to 2018. The literature review was based on Google Scholar, Medline, EMBASE and Pubmed databases. The search was performed using terms of "aneurysmal bone cyst", "sacral tumor", "sacrum tumor" "spine tumor" and "spinal tumor" for the literature review from 1998 to 2019. There were six male and five female with a mean age of 13 years old at the presentation. The mean follow-up duration was 6.5 years. No patient died of disease and had the pulmonary metastasis. Two patients had wound complications, including onesurgical site infection and one wound dehiscence. No patient had the local recurrence and neurologic deficit. In the literature review, 11 articles were reviewed and 45 cases with sacral primary ABC were included. The rate of local recurrence may be higher than that in our cohort. We proposed our flow chart for preparation of surgery for patients. Preoperative selective arterial embolization and intraoperative aortic balloon occlusion could provide the clear surgical vision and guarantee complete tumor excision by intralesional curettage. Preoperative selective arterial embolization, intraoperative aortic balloon occlusion and complete tumor excision by intralesional curettage can yield satisfactory results with a low rate of recurrence in adolescent patients with a sacral primary ABC., (Copyright © 2020 Elsevier Ltd. All rights reserved.)
- Published
- 2020
- Full Text
- View/download PDF
18. [Tumors affecting the temporomandibular joint - a literature review].
- Author
-
Schlund M, Roland-Billecart T, Aubert S, and Nicot R
- Subjects
- Bone Cysts, Aneurysmal etiology, Bone Cysts, Aneurysmal pathology, Bone Cysts, Aneurysmal therapy, Chondroblastoma complications, Chondroblastoma diagnostic imaging, Chondroblastoma surgery, Chondroma diagnostic imaging, Chondroma pathology, Chondroma surgery, Chondrosarcoma pathology, Chondrosarcoma therapy, Diagnosis, Differential, Fibrosarcoma diagnostic imaging, Fibrosarcoma pathology, Fibrosarcoma therapy, Giant Cell Tumor of Bone diagnostic imaging, Giant Cell Tumor of Bone therapy, Giant Cell Tumor of Tendon Sheath complications, Giant Cell Tumor of Tendon Sheath diagnostic imaging, Giant Cell Tumor of Tendon Sheath surgery, Hemangioma diagnostic imaging, Hemangioma therapy, Histiocytosis, Langerhans-Cell pathology, Histiocytosis, Langerhans-Cell surgery, Humans, Lipoma diagnostic imaging, Lipoma pathology, Lipoma surgery, Multiple Myeloma pathology, Osteoblastoma diagnostic imaging, Osteoblastoma pathology, Osteoblastoma surgery, Osteochondroma diagnostic imaging, Osteochondroma pathology, Osteochondroma surgery, Osteoma diagnostic imaging, Osteoma pathology, Osteoma, Osteoid complications, Osteoma, Osteoid diagnostic imaging, Osteoma, Osteoid pathology, Osteosarcoma diagnostic imaging, Osteosarcoma pathology, Osteosarcoma therapy, Sarcoma, Ewing diagnostic imaging, Sarcoma, Ewing pathology, Sarcoma, Synovial diagnostic imaging, Sarcoma, Synovial pathology, Sarcoma, Synovial therapy, Temporomandibular Joint Disorders diagnosis, Bone Neoplasms complications, Bone Neoplasms diagnostic imaging, Bone Neoplasms pathology, Bone Neoplasms surgery, Temporomandibular Joint diagnostic imaging, Temporomandibular Joint pathology
- Abstract
Benign and malign tumors can affect the temporomandibular joint (TMJ) as any other articulation. Nevertheless, TMJ tumors are rare and mostly benign. Their clinical expression is varied including symptomatology similar to TMJ dysfunctional disorders, otologic or neurologic pathologies. In some cases, they remain totally asymptomatic. Hence, diagnosis is difficult since the symptomatology can be misleading with TMJ dysfunctional disorders or otologic disorders wrongly diagnosed. There is thus frequently a long delay between symptoms onset and diagnosis. The great variety of TMJ lesions explains the wide range of possible treatment modalities, mostly based on surgery. We provide here a review of the lesions originating from the TMJ. Tumoral or cystic mandibular lesion affecting the TMJ through local extension will not be discussed. Osteoma, osteoid osteoma, osteoblastoma, chondroma, osteochondroma, chondroblastoma, tenosynovial giant cell tumors, giant cell lesions, non-ossifying fibroma, hemangioma, lipoma or Langerhans cell histiocytosis are all possible diagnosis among the benign tumors found in the TMJ. Pseudotumors include synovial chondromatosis and aneurysmal bone cyst. Finally, malign tumors of the TMJ include mainly sarcomas (osteosarcoma, chondrosarcoma, synovial sarcoma, Ewing sarcoma, and fibrosarcoma), but also multiple myeloma and secondary metastases. We will review the clinical, radiological and histological aspects of each of these lesions. The treatment and the recurrence risk will also be discussed., (Copyright © 2020 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.)
- Published
- 2020
- Full Text
- View/download PDF
19. Percutaneous alcohol-based sclerotherapy in aneurysmal bone cyst in children and adolescents.
- Author
-
Marie-Hardy L, El Sayed L, Alves A, Brunelle F, Ouchrif Y, Naggara O, Breton S, Mascard E, Glorion C, and Pannier S
- Subjects
- Adolescent, Child, Ethanol, Humans, Male, Retrospective Studies, Treatment Outcome, Bone Cysts, Aneurysmal diagnostic imaging, Bone Cysts, Aneurysmal therapy, Sclerotherapy
- Abstract
Introduction: Aneurysmal bone cyst (ABC) is a benign bone lesion of childhood and adolescence. It can be locally aggressive, with risk of fracture. Management is controversial. The aim of the present study was to assess the efficacy, simplicity and tolerance of percutaneous alcohol-bases sclerotherapy in ABC., Hypothesis: Alcohol-based sclerotherapy for ABC under radiographic control is safe and effective., Material and Methods: A single-center retrospective study for the period 2008-2016 included all of the 55 ABCs, in 54 patients, confirmed on pathology and treated by alcohol-based sclerotherapy under radiographic control. Mean age at diagnosis was 9.6 years. ABC involved the humerus in 30 cases (54%), tibia in 7 (13%) and femur in 5 (9%). Mean follow-up was 50.9 months (range, 16-117 months). Mean number of applications was 1.7 (range, 1-4). Results were assessed clinically (pain, return to sport, limb length and alignment, revision surgery) and radiologically. The main endpoint was lesion volume reduction. The secondary endpoint was failure, defined by open revision surgery or pain preventing return to a sports activity., Results: Clinical progression was favorable in 36 patients (67%), and radiological progression in 45 (85%). Only 1 cyst required secondary resection. One patient experienced spontaneously resolving intraoperative bradycardia. Male gender and young age emerged as factors for poorer response., Discussion: ABC management in children can be made difficult by lesion size, aggressiveness, location, proximity to the growth plate and small bone stock. Alcohol-based sclerotherapy is simple, reliable and effective in childhood ABC, and may be a first-line attitude, avoiding recourse to invasive surgery., Level of Evidence: IV, retrospective study., (Copyright © 2020 Elsevier Masson SAS. All rights reserved.)
- Published
- 2020
- Full Text
- View/download PDF
20. Primary aneurysmal bone cyst of the scapula in adult patient: two case reports and a review of the literature.
- Author
-
Atalay İB, Yapar A, and Öztürk R
- Subjects
- Adult, Female, Humans, Young Adult, Bone Cysts, Aneurysmal diagnosis, Bone Cysts, Aneurysmal pathology, Bone Cysts, Aneurysmal therapy, Scapula diagnostic imaging, Scapula pathology
- Abstract
Aneurysmal bone cyst (ABC) is a rare, benign but locally aggresive bone tumor of unknown origin tumor. It commonly affects children and usually occurs at the metaphysis of long bones. Scapula is a very rare location and ABCs of the scapula have been sparsely described in the literature. Differential diagnosis can be challenging as it shares common radiological and clinicopathological features with other benign and malignant bone tumors. The degree of diagnostic difficulty increases even more when an unusual tumor site has to be taken into account. Here, we describe rare and challenging cases of a primary ABC located at the scapula that was surgically treated. This is the first case report of ABC involving the scapula in adult patient.
- Published
- 2020
- Full Text
- View/download PDF
21. Cervical Spine Aneurysmal Bone Cyst in a Pediatric Patient: Embolization Considerations and Potential Pitfalls.
- Author
-
Ehlers LD, McMordie J, Lookian P, Surdell D, and Puccioni M
- Subjects
- Bone Cysts, Aneurysmal diagnostic imaging, Bone Cysts, Aneurysmal therapy, Cerebral Angiography, Cervical Vertebrae, Child, Preschool, Female, Humans, Imaging, Three-Dimensional, Magnetic Resonance Imaging, Spinal Diseases diagnostic imaging, Axis, Cervical Vertebra, Bone Cysts, Aneurysmal blood supply, Embolization, Therapeutic methods, Neurosurgical Procedures methods, Spinal Diseases therapy, Vertebral Artery diagnostic imaging
- Abstract
Background: Aneurysmal bone cysts (ABCs) comprise 1%-2% of all bone tumors. ABCs involving the upper cervical spine in pediatric patients complicate intervention because of an immature skeleton and nearby neurovascular elements. Treatment often consists of surgical intervention with preoperative embolization to mitigate blood loss. During selective arterial embolization, it is important to be aware of extracranial-intracranial anastomoses from tumor feeding vessels. We describe a C2 vertebrae ABC that had multiple tumor arteries anastomosing with bilateral vertebral arteries., Case Description: A 3-year-old healthy girl presented with 1 month of progressive neck pain and palpable posterior neck mass. Imaging was most consistent with an ABC of the C2 vertebra. Preoperative embolization was planned. Angiography demonstrated tumor arterial supply anastomosing with the left and right vertebral artery stemming from the ascending and deep cervical artery branches. Tumor embolization was therefore carried out using coils and larger embolization particles to decrease ischemic stroke risk. Follow-up angiography showed successful tumor embolization with no vertebrobasilar complications. Surgical excision was uncomplicated and the patient's cervical spine has remained stable without fusion., Conclusions: Preoperative embolization for ABC resection is common, but thorough angiography must be done to rule out dangerous extracranial-intracranial anastomoses. This case demonstrated 2 key anastomoses with the vertebral artery that if not recognized, could lead to disastrous consequences. Comprehensive angiographic evaluation is necessary because previous reports have described ischemic complications from embolization because of unrecognized vertebrobasilar anastomoses. If any angiographic evidence is seen, then larger particle size, coil embolization, or abandoning the case should be considered., (Copyright © 2020 Elsevier Inc. All rights reserved.)
- Published
- 2020
- Full Text
- View/download PDF
22. Primary aneurysmal bone cysts.
- Author
-
Puri A, Hegde P, Gulia A, and Parikh M
- Subjects
- Adolescent, Adult, Child, Child, Preschool, Female, Humans, Infant, Injections, Intralesional, Male, Middle Aged, Treatment Outcome, Young Adult, Bone Cysts, Aneurysmal therapy, Polidocanol administration & dosage, Sclerosing Solutions administration & dosage, Sclerotherapy
- Abstract
Aims: The aim of this study was to analyze the complications and outcomes of treatment in a series of previously untreated patients with a primary aneurysmal bone cyst (ABC) who had been treated by percutaneous sclerosant therapy using polidocanol., Methods: Between January 2010 and December 2016, 56 patients were treated primarily with serial intralesional sclerosant injections. Their mean age was 20 years (1 to 54). The sites involved were clavicle (n = 3), humeri (n = 11), radius (n = 1), ulna (n = 3), hand (n = 2), pelvis (n = 12), femur (n = 7), tibia (n = 13), fibula (n = 3), and foot (n = 1). After histopathological confirmation of the diagnosis, 3% polidocanol (hydroxypolyaethoxydodecan) was injected into the lesion under image intensifier guidance. Patients were evaluated clinically and radiologically every six to eight weeks. In the absence of clinical and/or radiological response, a repeat sclerosant injection was given after eight to 12 weeks and repeated at similar intervals if necessary., Results: There were no complications of treatment. One patient was lost to follow-up. Overall, 46/55 (84%) of lesions healed after one or more injections of polidocanol: 24/55 (44%) patients healed with a single injection, and 43/55 (78%) within two injections. Of these 46, four (9%) patients developed local recurrence, two of whom healed with a repeat sclerosant injection. Thus, 44/55 (80%) patients of primary ABC healed with sclerotherapy. The mean follow-up was 62 months (20 to 111). The local recurrence free survival (LRFS) with percutaneous sclerosant therapy with polidocanol was 100%, 98% (95% confidence interval (CI) 85 to 100) and 93% (95% CI 78 to 98) at two, three, and five years, respectively., Conclusion: Percutaneous sclerotherapy using polidocanol is a safe, effective, minimally invasive and inexpensive method of treating a primary ABC of the limbs or pelvis. Cite this article: Bone Joint J 2020;102-B(2):186-190.
- Published
- 2020
- Full Text
- View/download PDF
23. Combined Preoperative Embolization and Surgical Treatment of a Giant Aneurysmal Bone Cyst in the Lumbar Spine: A Case Study.
- Author
-
Sertbas I and Karatay M
- Subjects
- Adolescent, Female, Humans, Lumbar Vertebrae, Bone Cysts, Aneurysmal therapy, Embolization, Therapeutic methods, Neurosurgical Procedures methods, Spinal Diseases therapy
- Abstract
An aneurysmal bone cyst (ABC) is a vascular locally proliferative, non-neoplastic, benign lesion observed in children and young adults. 75% of ABCs occur before the age of twenty. The cyst frequently develops in the long bones and comprises 1.4% of primary bone tumors. Spinal ABC is rare and is typically observed in the thoracic and cervical regions. In the spinal region, the posterior elements of a single vertebra are usually involved. The lamina, pedicle, facet joints are more commonly affected. The lesion may also expand toward the corpus. We present a case involving successful total excision of a lumbar spinal giant ABC by combining surgery with preoperative coil embolization. Preoperative arterial embolization contributes to decreased morbidity and mortality rates by reducing the duration of surgery and occurrence of intraoperative hemorrhage.
- Published
- 2020
- Full Text
- View/download PDF
24. Pediatric Cervical Aneurysmal Bone Cyst Treated by Endovascular Approach.
- Author
-
Demartini Z Jr, Koppe GL, Guimarães RMDR, da Rocha LEM, Francisco AN, and Gatto LAM
- Subjects
- Adolescent, Humans, Male, Treatment Outcome, Bone Cysts, Aneurysmal diagnostic imaging, Bone Cysts, Aneurysmal therapy, Cervical Vertebrae diagnostic imaging, Embolization, Therapeutic methods, Endovascular Procedures methods
- Abstract
Introduction: Aneurysmal bone cyst (ABC) is a rare, benign, and expansible bone lesion, occurring mainly in childhood. Although most lesions are located at the metaphysis of long bones, they can also be found in flat bones and spine., Case Presentation: We report a case of a 16-year-old boy with cervical ABC treated by endovascular embolization. The afferents were occluded as a preoperative preparation for surgery; however, as the patient became asymptomatic after the procedure, the family refused surgery. Image at 1-year follow-up showed reduction and ossification of the lesion., Conclusion: Endovascular treatment decreases surgical morbidity by reducing blood loss, which is particularly important in the pediatric population. This therapeutic option may also halt ABC growth in selected cases., (© 2020 S. Karger AG, Basel.)
- Published
- 2020
- Full Text
- View/download PDF
25. Aneurysmal Bone Cyst: A Review of Management.
- Author
-
Muratori F, Mondanelli N, Rizzo AR, Beltrami G, Giannotti S, Capanna R, and Campanacci DA
- Subjects
- Bone Transplantation, Child, Curettage, Humans, Spine pathology, Treatment Outcome, Young Adult, Bone Cysts, Aneurysmal therapy, Catheter Ablation, Embolization, Therapeutic
- Abstract
Aneurysmal bone cyst is a rare lesion that is most often found in young adults and children. It can have an unpredictable behavior, with a high recurrence rate after treatment. Treatment is based on personal and institutional experience and preferences. Standard treatment consists of curettage (manual + motorized high-speed burr) plus local adjuvants and bone grafting to fill the void. In anatomical locations that are difficult to reach surgically, percutaneous procedures (injection of sclerosant agents, radiofrequency thermal ablation (RFTA)) or selective arterial embolization (SAE) are used. Medical management with bisphosphonates (BPs) or denosumab has also been advocated. Minimally invasive surgical procedures such as "curopsy" and percutaneous demineralized bone matrix (DBM) and/or autologous bone marrow concentrate (BMC) grafting have also been proposed. SAE is used as a pre-operative procedure to reduce intra-operative bleeding in the case of large lesions and as primary treatment for spinal lesions. The purpose of this review is to present currently available options for the management of aneurysmal bone cyst.
- Published
- 2019
26. Giant Cervical Aneurysmal Bone Cyst and Its Multimodal Management.
- Author
-
Lu VM and Daniels DJ
- Subjects
- Child, Disease Management, Female, Humans, Bone Cysts, Aneurysmal diagnostic imaging, Bone Cysts, Aneurysmal therapy, Cervical Vertebrae diagnostic imaging, Spinal Diseases diagnostic imaging, Spinal Diseases therapy
- Abstract
Giant aneurysmal bone cysts of the spine are rare lesions and, correspondingly, the optimal treatment sequence is unclear if gross total resection cannot be achieved. We present a remarkable clinical image of a giant cervical aneurysmal bone cyst diagnosed in a 12-year-old female, which was refractory to gross total resection due to vertebral artery encasement and involvement of the carotid artery and jugular vein. We then summarize our planned multimodal management., (Copyright © 2019 Elsevier Inc. All rights reserved.)
- Published
- 2019
- Full Text
- View/download PDF
27. Multidisciplinary management of spinal aneurysmal bone cysts: A single-center experience.
- Author
-
Desai SB, O'Brien C, Shaikh R, Hedequist D, Proctor M, Orbach DB, and Padua H
- Subjects
- Adolescent, Anti-Bacterial Agents therapeutic use, Bone Cysts, Aneurysmal complications, Child, Cohort Studies, Doxycycline therapeutic use, Female, Follow-Up Studies, Humans, Joint Instability etiology, Joint Instability surgery, Joint Instability therapy, Lumbar Vertebrae, Magnetic Resonance Imaging, Male, Pain etiology, Pain Management, Retrospective Studies, Sclerotherapy, Treatment Outcome, Bone Cysts, Aneurysmal surgery, Bone Cysts, Aneurysmal therapy, Spinal Diseases surgery, Spinal Diseases therapy
- Abstract
Objective: The management of spinal aneurysmal bone cysts (ABCs) is complex and often requires multimodality therapy, including surgical intervention to stabilize the axial skeleton, and avoid neurologic injury or death. With en bloc resection, ABCs have a recurrence rate of 12%, which increases to >50% with subtotal resection. The use of doxycycline sclerotherapy has been reported to reduce the recurrence rate of non-spinal ABCs to 5% at >24 month follow-up. We retrospectively reviewed our institutional results for sodium tetradecyl sulfate (STS)/doxycycline sclerotherapy and surgical intervention for spinal ABCs, to assess our treatment paradigm for these tumors and inform our future approach to these lesions., Methods: Three cervical, two thoracic and two lumbar spine ABCs were treated in seven patients with spine-exclusive disease at our institution from 2011 to the present. The most common presenting complaint was pain. Each patient was retrospectively reviewed for clinical symptomology, number of treatments, technique and clinical follow-up. Qualitative assessment of improvement was based on the most recent clinical evaluation., Results: The cohort underwent a mean of three treatment sessions (range 2-15). All were treated with STS and/or doxycycline. Five patients underwent surgical intervention at some point, either before or following sclerotherapy. After the last sclerotherapy session, four patients reported stable or improved pain symptoms, while two reported progressive pain that required surgical intervention for that indication. One patient, who underwent both multiple rounds of sclerotherapy and surgical resection, died due to acute on chronic cervical spine collapse with cord compression and inability to control disease., Conclusion: We report our experience in the treatment of spinal column ABCs. Stabilization or improvement in pain was seen in four patients, while the remainder had progressive disease. Our multidisciplinary approach allows patients to receive the most appropriate treatment at presentation and thereafter, for symptom amelioration or spinal stability. Important future goals are to quantitatively assess changes in symptoms over time and to incorporate a reproducible radiographic endpoint for the assessment of treatment efficacy.
- Published
- 2019
- Full Text
- View/download PDF
28. Adjuvant MRI-guided percutaneous cryoablation treatment for aneurysmal bone cyst.
- Author
-
Fritz J, Sonnow L, and Morris CD
- Subjects
- Bone Cysts, Aneurysmal diagnostic imaging, Child, Preschool, Embolization, Therapeutic, Humans, Male, Pain Measurement, Recurrence, Tomography, X-Ray Computed, Bone Cysts, Aneurysmal therapy, Cryosurgery, Magnetic Resonance Imaging, Interventional, Scapula diagnostic imaging
- Abstract
Aneurysmal bone cysts are benign, expansile, lytic bone lesions that behave in a locally aggressive manner. Although radiography and computed tomography (CT) can detect the lesion, magnetic resonance imaging (MRI) is ideal for the demonstration of characteristic fluid-fluid levels, extent, and margins. Treatment typically consists of open surgical curettage with the addition of local adjuvants and bone grafting. Residual or recurring lesions may be treated using percutaneous cryoablation. Although CT guidance is often employed for image guidance, visualization and targeting of smaller clusters can be challenging in young children, secondary to the partially mineralized bone matrix in the immature skeleton. In such cases, the higher contrast resolution of interventional MRI affords direct visualization and targeting of small aneurysmal bone cysts, accurate monitoring of the extent of the growing ice ball beyond the lesion's margin, and avoidance of exposure to ionizing radiation. We report a case of a 5-year-old boy with recurrent or remaining aneurysmal bone cysts of the scapula after surgical excision and embolization, which were successfully treated using MRI-guided cryoablation.
- Published
- 2019
- Full Text
- View/download PDF
29. Advantages of a transradial vascular access for embolization of a sacral tumor in a child.
- Author
-
Chua YX, Yang C, Lau LL, and Loh SEK
- Subjects
- Bone Cysts, Aneurysmal diagnostic imaging, Child, Female, Humans, Spinal Diseases diagnostic imaging, Treatment Outcome, Bone Cysts, Aneurysmal therapy, Embolization, Therapeutic methods, Radial Artery diagnostic imaging, Sacrum diagnostic imaging, Spinal Diseases therapy
- Published
- 2019
- Full Text
- View/download PDF
30. Multimodal Management of Aggressive Recurrent Aneurysmal Bone Cyst of Spine: Case Report and Review of Literature.
- Author
-
Frassanito P, D'Onofrio GF, Pennisi G, Massimi L, Tamburrini G, Muto M, and Caldarelli M
- Subjects
- Adolescent, Bone Cysts, Aneurysmal complications, Humans, Hydroxyapatites, Male, Recurrence, Sclerotherapy instrumentation, Secondary Prevention methods, Treatment Outcome, Bone Cysts, Aneurysmal therapy, Sclerotherapy methods, Spinal Cord Compression etiology
- Abstract
Background: Different treatment options have been proposed for aneurysmal bone cysts (ABCs) with sclerotherapy favored as primary treatment and surgery remaining the mainstay of treatment in case of compression of neural structures. Recurrent spinal ABCs are burdened by increased risk of spinal deformity and instability, further complicating the management of these cases., Case Description: A 15-year-old boy presented with acute symptoms and signs of spinal cord compression due to a large thoracic ABC. Subtotal resection of the lesion achieved optimal decompression of neural structures with good neurologic recovery, but the remnant of the lesion rapidly grew with recurrent spinal cord compression after 40 days. The patient underwent total surgical resection with full neurologic recovery. Unfortunately, recurrence of the lesion was documented at 3-months' follow-up. This was successfully treated with percutaneous injection of hydroxyapatite cement. Two years' follow-up ruled out any further recurrence of the lesion. Furthermore, spinal deformity and instability were also excluded., Conclusions: Percutaneous sclerotherapy with hydroxyapatite cement proved to be highly effective and safe in the treatment of spinal ABC, though surgery remains mandatory in case of spinal cord compression. The main advantage of sclerotherapy with hydroxyapatite cement seems to be the capacity to regenerate bone with normal radiologic features., (Copyright © 2019 Elsevier Inc. All rights reserved.)
- Published
- 2019
- Full Text
- View/download PDF
31. Percutaneous albumin/doxycycline injection versus open surgery for aneurysmal bone cysts in the mobile spine.
- Author
-
Liu X, Han SB, Si G, Yang SM, Wang CM, Jiang L, Wei F, Wu FL, Liu XG, and Liu ZJ
- Subjects
- Adolescent, Adult, Bone Cysts, Aneurysmal diagnostic imaging, Child, Female, Humans, Injections, Intralesional, Injections, Spinal, Male, Neck Pain etiology, Neck Pain therapy, Radiography, Interventional, Retrospective Studies, Spinal Diseases diagnostic imaging, Tomography, X-Ray Computed, Visual Analog Scale, Young Adult, Angiogenesis Inhibitors therapeutic use, Bone Cysts, Aneurysmal therapy, Doxycycline therapeutic use, Serum Albumin therapeutic use, Spinal Diseases therapy
- Abstract
Purpose: This study aimed to validate the safety and effectiveness of percutaneous doxycycline/albumin injection for spinal aneurysmal bone cysts (ABCs) as an alternative to open surgery., Methods: From January 2000 to December 2016, 25 patients who had no/minor neurological deficits (modified Frankel scale D or E) and acceptable local stability (spinal instability neoplastic score < 12) were included in the study, of whom 14 were treated with percutaneous doxycycline/albumin injection (injection group) and 11 were treated with open surgery (surgery group). The demographic and clinical information of the injection and surgery groups were recorded and compared., Results: In the injection group, lesion size was significantly reduced in all 14 patients, all patients showed complete neurological recovery, and 13 patients had complete relief of neck pain; their mean visual analogue scale (VAS) decreased from 3.4 to 0.5. No complication or recurrence was observed during the mean 30.7-month follow-up (range, 24-50 months). In the surgery group, 9 patients had complete neurological recovery and 2 patients had residual slight paresthesia; their mean VAS decreased from 3.4 to 0.5. Two had local recurrence during their follow-up at 66.5 months (range, 50-96 months). Compared with the surgery group, the injection group showed no significant difference in the rate of recurrence (P = 0.14) and complication (P = 0.36)., Conclusions: Percutaneous doxycycline/albumin injection for spinal ABCs can be safely and effectively performed in well-selected cases. It could serve as an alternative treatment, especially for spinal ABCs lesions with acceptable local stability and in patients without severe neurological deficits. These slides can be retrieved under Electronic Supplementary Material.
- Published
- 2019
- Full Text
- View/download PDF
32. An aneurysmal bone cyst at T1 treated with bone grafts containing calcitonin and methylprednisolone.
- Author
-
Okuda A, Shigematsu H, Iwata E, Tanaka M, Morimoto Y, Masuda K, Ohbayashi C, and Tanaka Y
- Subjects
- Adolescent, Bone Cysts, Aneurysmal complications, Bone Cysts, Aneurysmal diagnostic imaging, Bone Transplantation, Curettage, Female, Fractures, Spontaneous etiology, Fractures, Spontaneous surgery, Humans, Magnetic Resonance Imaging, Neoplasm Recurrence, Local surgery, Bone Cysts, Aneurysmal therapy, Bone Density Conservation Agents administration & dosage, Calcitonin administration & dosage, Glucocorticoids administration & dosage, Methylprednisolone administration & dosage, Thoracic Vertebrae
- Abstract
Aneurysmal bone cysts (ABCs) rarely trigger pathological fractures. Various surgical and nonsurgical treatments have been reported for this condition. Herein, we present the examination findings and treatment for a 15-year-old girl who initially presented with adolescent idiopathic scoliosis and mild back pain, but subsequently experienced severe back pain. Magnetic resonance imaging revealed an ABC at T1, with an associated pathological fracture. We successfully treated the patient using posterior fixation with instrumentation, curettage, and bone grafts combined with calcitonin and methylprednisolone (mPSL). At 3 years post-surgery, there was no ABC recurrence and only mild back pain persisted. To our knowledge, this is the first report of open surgery (curettage and fixation) with local intralesional administration of calcitonin and mPSL for an ABC-induced pathological spinal fracture. We believe that this treatment is an effective option for ABCs associated with a pathological spinal fracture.
- Published
- 2019
- Full Text
- View/download PDF
33. Percutaneous Doxycycline Foam Injections: Novel Treatment Method for Vertebral Aneurysmal Bone Cysts.
- Author
-
Lyons KW, Borsinger TM, and Pearson AM
- Subjects
- Adult, Humans, Injections, Spinal, Magnetic Resonance Imaging, Male, Multimodal Imaging, Tomography, X-Ray Computed, Anti-Bacterial Agents administration & dosage, Bone Cysts, Aneurysmal therapy, Doxycycline administration & dosage, Spinal Diseases therapy
- Abstract
Aneurysmal bone cysts (ABCs) are among the most aggressive benign bone tumors, often occurring in both long bones and the spine. Treatment remains controversial as recurrence rates continue to be high. Treatment options include curettage with or without bone grafting, arterial embolization, en block resection with or without instrumentation or arthrodesis, radiation, and intralesional drug injections (steroids, calcitonin, doxycycline). We present the case of a patient with a thoracic vertebral ABC who underwent 2 rounds of doxycycline foam percutaneous injections. At the 1-year follow up appointment, all symptoms had been resolved. Repeat computed tomography and magnetic resonance imaging demonstrated that the ABC had nearly filled in completely with new bone. Our case demonstrates successful use of this percutaneous, less invasive method in the management of vertebral ABCs., (Copyright © 2019 Elsevier Inc. All rights reserved.)
- Published
- 2019
- Full Text
- View/download PDF
34. Aneurysmal bone cyst of C2 treated with novel anterior reconstruction and stabilization.
- Author
-
Rajasekaran S, Aiyer SN, Shetty AP, Kanna R, and Maheswaran A
- Subjects
- Bone Cysts, Aneurysmal diagnostic imaging, Cervical Vertebrae diagnostic imaging, Child, Combined Modality Therapy, Diagnosis, Differential, Embolization, Therapeutic methods, Female, Humans, Magnetic Resonance Imaging, Radiography, Spinal Fusion methods, Tomography, X-Ray Computed, Bone Cysts, Aneurysmal therapy, Cervical Vertebrae surgery
- Abstract
Purpose: Aneurysmal bone cysts (ABC) form 1 % of primary bone tumors. Reported incidence rates are no more than 1.4 to 1,00,000. ABC of spine frequently involves posterior elements and commonly affects the lumbar spine (45 %). We present a case of C2 ABC for the challenges it poses due to the rarity of the lesion, tedious to access location, dilemmas relating to the suitable approach for tumor resection and technically demanding stabilization and reconstruction strategy post resection., Methods: Clinical data analysis was performed to discuss a method of novel anterior column reconstruction following resection of a C2 aneurysmal bone cyst in a 8 year old child with anterior and posterior elements being involved., Results: An 8-year-old girl with an aneurysmal bone cyst of the C2 vertebra underwent staged surgery following pre-operative embolisation. First a posterior approach tumor excision with posterior instrumented fusion was performed. Following which, using a modified anterior retropharyngeal approach anterior tumor excision and fibular graft reconstruction between the C1 lateral mass and C2 body was performed. Complete tumor clearance and stable reconstruction was successfully achieved in our patient. Patient showed excellent clinical outcome with radiological fusion., Conclusions: Preoperative embolisation in the treatment of ABC has supplemental advantage by reducing blood loss. Modified anterior retropharyngeal approach allows satisfactory clearance for C1-2 lesion and fibular strut graft between the C1 lateral mass and C2 body can provide a stable graft placement with good chance of fusion. Instability and spinal deformity, whether preexisting or post-excision, should be corrected with reconstruction and stabilization to offer best chance of cure in such cases.
- Published
- 2019
- Full Text
- View/download PDF
35. Primary malignancy in giant cell tumor of thoracic vertebrae: A case report.
- Author
-
Yu H, Shi R, Peng ZG, Yu BH, and Cui JL
- Subjects
- Bone Cysts, Aneurysmal etiology, Bone Cysts, Aneurysmal therapy, Bone Neoplasms complications, Bone Neoplasms therapy, Giant Cell Tumor of Bone complications, Giant Cell Tumor of Bone therapy, Humans, Magnetic Resonance Imaging, Male, Spinal Neoplasms complications, Spinal Neoplasms therapy, Thoracic Vertebrae surgery, Tomography, X-Ray Computed, Young Adult, Bone Neoplasms pathology, Giant Cell Tumor of Bone pathology, Spinal Neoplasms pathology, Thoracic Vertebrae pathology
- Abstract
Rationale: Primary malignancy in giant cell tumor of bone (PMGCTB) is extremely unusual. PMGCTB in the thoracic vertebrae is particularly rare., Patients Concerns: A 23-year-old man was admitted with a chief complaint of chest pain associated with cough for approximately 3 days. Physical examination revealed a palpable, immobile, tender, 7 cm mass in the right paravertebral area of the thoracolumbar spine., Diagnosis: Computed tomography images revealed an osteolytic, expansive, and eccentric lesion on the vertebral bodies and right accessory processes with spinal cord compression in the thoracic vertebra, with right rib also having bone destruction. Magnetic resonance imaging revealed multiple fluid-fluid levels occupying more than one-third of the lesions. On the basis of the imaging and pathological findings, the final pathological diagnosis was PMGCTB with aneurysmal bone cyst., Interventions: The patient underwent successful wide spondylectomy of T9/10 to remove the tumor, and adjuvant chemotherapy based on the protocol used for osteosarcoma., Outcomes: After 4 years of follow-up, there is no clinical or radiological evidence of recurrence., Lessons: PMGCTB is difficult to distinguish from giant cell tumor of bone. PMGCTB should be considered when lesions appear with multiple fluid-fluid levels and soft tissue mass.
- Published
- 2018
- Full Text
- View/download PDF
36. [Bone cysts-differential diagnosis and therapeutic approach].
- Author
-
Weber M and Hillmann A
- Subjects
- Adolescent, Bone Cysts pathology, Bone Cysts, Aneurysmal pathology, Diagnosis, Differential, Humans, Neoplasm Recurrence, Local, Treatment Outcome, Bone Cements therapeutic use, Bone Cysts therapy, Bone Cysts, Aneurysmal therapy, Bone Substitutes therapeutic use, Curettage methods
- Abstract
The differential diagnosis of cystic lesions of the skeleton is multifarious. Besides patient age, the localization and radiologic morphology provide important information for a closer differentiation. Juvenile and aneurysmal bone cysts represent two frequent entities in growing patients. The fluid content of the cysts helps in distinguishing between juvenile and aneurysmal bone cysts. Whereas juvenile bone cysts contain clear fluid, the content of aneurysmal bone cysts consists of blood combined with solid tissue. With respect to progression, aneurysmal bone cysts show a higher activity than solitary bone cysts. The treatment of juvenile bone cysts usually consists of curettage including filling with bone replacement material. For aneurysmal bone cysts the additional use of adjuvants is recommended. Bone cement is preferably used for filling. It shows favorable properties for prophylaxis of recurrence and facilitates the recognition of relapses. Both juvenile and aneurysmal bone cysts often show recurrences.
- Published
- 2018
- Full Text
- View/download PDF
37. USP6 gene rearrangement differentiates primary paranasal sinus solid aneurysmal bone cyst from other giant cell-rich lesions: report of a rare case.
- Author
-
Li HR, Tai CF, Huang HY, Jin YT, Chen YT, and Yang SF
- Subjects
- Adult, Bone Cysts, Aneurysmal diagnostic imaging, Bone Cysts, Aneurysmal pathology, Bone Cysts, Aneurysmal therapy, Diagnosis, Differential, Female, Genetic Markers, Genetic Predisposition to Disease, Giant Cell Tumor of Bone pathology, Granuloma, Giant Cell pathology, Humans, Immunohistochemistry, In Situ Hybridization, Fluorescence, Nasal Surgical Procedures, Paranasal Sinus Diseases diagnostic imaging, Paranasal Sinus Diseases pathology, Paranasal Sinus Diseases therapy, Paranasal Sinus Neoplasms diagnostic imaging, Paranasal Sinus Neoplasms pathology, Paranasal Sinus Neoplasms therapy, Phenotype, Predictive Value of Tests, Radiotherapy, Adjuvant, Tomography, X-Ray Computed, Treatment Outcome, Bone Cysts, Aneurysmal genetics, Gene Rearrangement, Giant Cell Tumor of Bone genetics, Granuloma, Giant Cell genetics, Paranasal Sinus Diseases genetics, Paranasal Sinus Neoplasms genetics, Proto-Oncogene Proteins genetics, Ubiquitin Thiolesterase genetics
- Abstract
Aneurysmal bone cysts (ABCs) mostly occur in the metaphysis of long bones. Primary paranasal ABCs are extremely rare, and most reported cases reveal typical histopathological features including cystic space with fibrous septa and hemorrhage. Solid-variant ABCs or solid ABCs lacking cyst formation may be histologically indistinguishable from giant cell reparative granulomas, giant cell tumor of bone, and brown tumor. Here we report the case of a 24-year-old woman with a paranasal mass diagnosed as USP6-rearranged solid ABC, mimicking giant cell reparative granuloma, giant cell tumor of bone, and brown tumor. For paranasal sinus bone or soft tissue tumors containing numerous giant cells, molecular analysis including the USP6 gene may serve as a useful diagnostic tool to distinguish solid ABCs from other giant cell-rich lesions., (Copyright © 2017 Elsevier Inc. All rights reserved.)
- Published
- 2018
- Full Text
- View/download PDF
38. Cystic bone tumors of the foot and ankle.
- Author
-
Reda B
- Subjects
- Bone Cysts diagnosis, Bone Cysts therapy, Bone Cysts, Aneurysmal diagnosis, Bone Cysts, Aneurysmal therapy, Chondroblastoma diagnosis, Chondroblastoma therapy, Chondroma diagnosis, Chondroma therapy, Fibroma diagnosis, Fibroma therapy, Fibrous Dysplasia of Bone diagnosis, Fibrous Dysplasia of Bone therapy, Foot diagnostic imaging, Foot surgery, Giant Cell Tumor of Bone diagnosis, Giant Cell Tumor of Bone therapy, Humans, Lipoma diagnosis, Lipoma therapy, Osteoblastoma diagnosis, Osteoblastoma therapy, Osteoma, Osteoid diagnosis, Osteoma, Osteoid therapy, Synovitis, Pigmented Villonodular diagnosis, Synovitis, Pigmented Villonodular therapy, Bone Neoplasms diagnosis, Bone Neoplasms therapy, Foot pathology
- Abstract
Bone tumors are relatively rare in the foot and ankle region. Many of them present as cystic lesions on plain films. Due to the relative rarity of these lesions and the complex anatomy of the foot and ankle region, identification of such lesions is often delayed or they get misdiagnosed and mismanaged. This review discusses the most common cystic tumors of the foot and ankle including their radiographic features and principles of management., (© 2018 Wiley Periodicals, Inc.)
- Published
- 2018
- Full Text
- View/download PDF
39. Treatment of the aneurysmal bone cyst by percutaneous intracystic sclerotherapy using ethanol ninety five percent in children.
- Author
-
Ulici A, Florea DC, Carp M, Ladaru A, and Tevanov I
- Subjects
- Adolescent, Child, Contrast Media, Female, Fluoroscopy methods, Humans, Injections, Intralesional, Male, Retrospective Studies, Sclerosing Solutions adverse effects, Sclerotherapy adverse effects, Treatment Outcome, Bone Cysts, Aneurysmal therapy, Bone and Bones pathology, Ethanol administration & dosage, Sclerosing Solutions administration & dosage, Sclerotherapy methods
- Abstract
Introduction: Aneurysmal bone cyst (ABC) is a benign intraosseous lesion filled with blood that can determine a blowout distension of the bone. The purpose of this study is to evaluate the efficacy of sclerotherapy by percutaneous intralesional administration of ethanol 96% for the treatment of this pathology in paediatric patients., Method: The retrospective study includes 17 paediatric patients with ABC who were treated by repeated intracystic injection with ethanol 96%, 1 ml/kg, in our clinic between December 2015 and July 2017. Fluoroscopic guidance was used to inject the cyst with contrast agent. The mean follow-up period was 11 months., Results and Discussion: All cysts are healed or are in the healing process. The mean age was 11 years old. Seven patients needed three repeated injections and ten patients needed two injections until healing. We observed a mean reduction in the size of the lesions, measured on plain X-rays, of 68%. The complications that were observed included the following: dizziness after injection, skin pigmentation at the injection site, local inflammatory reaction, and pain after injection. The current study approves the importance of this minimally invasive treatment with no recurrence after a follow-up of 19 months. The healing rate was 100%. A limitation of this study consists in the small number of patients., Conclusion: Sclerotherapy with ethanol 96% is a useful method for the treatment of ABC. It is a minimally invasive method, with no major complications, which lowers the risks of open surgical intervention and has a good rate of success.
- Published
- 2018
- Full Text
- View/download PDF
40. Aggressive development of an aneurysmal bone cyst of the proximal femur in a paediatric patient: a case report.
- Author
-
Ulici A, Sterian AG, Tevanov I, Carp M, Dusca A, and Cosma D
- Subjects
- Arthroplasty, Replacement, Hip rehabilitation, Biopsy, Bone Cysts, Aneurysmal diagnostic imaging, Bone Cysts, Aneurysmal pathology, Bone Cysts, Aneurysmal surgery, Child, Disease Progression, Female, Femur, Humans, Tomography, X-Ray Computed, Arthroplasty, Replacement, Hip methods, Bone Cysts, Aneurysmal therapy, Embolization, Therapeutic, Prostheses and Implants, Recovery of Function physiology
- Abstract
We report development of an aneurysmal bone cyst (ABC) that was located in the proximal region of the femur in an 11-year-old girl. Over a period of 30 weeks, the ABC showed fulminant local progression, with destruction of the bone, which led to an abrupt loss of function of the left hip. The standard tumour treatment protocol was followed. We performed embolisation of the tumour followed by a biopsy, which confirmed the diagnosis of ABC. The outcome was negative with total destruction of the proximal third of the femur, despite repeating the embolisation. Because of the unfavourable local progression, a second biopsy was performed and we reconfirmed the initial diagnosis. The final decision regarding the therapeutic approach was total hip arthroplasty with femoral reconstruction with a prosthesis. Following this treatment, the patient's outcome was favourable, with complete recovery of function and no local relapse.
- Published
- 2018
- Full Text
- View/download PDF
41. Diagnostic value of histone 3 mutations in osteoclast-rich bone tumors.
- Author
-
Nohr E, Lee LH, Cates JM, Perizzolo M, and Itani D
- Subjects
- Adolescent, Adult, Aged, Alberta, Bone Cysts, Aneurysmal mortality, Bone Cysts, Aneurysmal pathology, Bone Cysts, Aneurysmal therapy, Bone Neoplasms mortality, Bone Neoplasms pathology, Bone Neoplasms therapy, Child, Chondroblastoma mortality, Chondroblastoma pathology, Chondroblastoma therapy, Diagnosis, Differential, Disease-Free Survival, Female, Genetic Predisposition to Disease, Giant Cell Tumor of Bone mortality, Giant Cell Tumor of Bone pathology, Giant Cell Tumor of Bone therapy, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Phenotype, Predictive Value of Tests, Tennessee, Time Factors, Young Adult, Biomarkers, Tumor genetics, Bone Cysts, Aneurysmal genetics, Bone Neoplasms genetics, Chondroblastoma genetics, DNA Mutational Analysis, Giant Cell Tumor of Bone genetics, Histones genetics, Mutation, Osteoclasts pathology
- Abstract
Differentiating osteoclast-rich lesions of bone (giant cell tumor of bone [GCTB], chondroblastoma [CBA], and aneurysmal bone cyst [ABC]) can be challenging, especially in small biopsies or fine-needle aspirations. Mutations affecting codons 34 and 36 of either H3 Histone Family Member 3A (H3F3A) and/or 3B (H3F3B) are characteristically seen in GCTB and CBAs. We devised a simple assay to identify these mutations and evaluated its applicability for routine clinical diagnosis. One hundred twenty-four tissue specimens from 108 patients (43 GCTBs, 38 CBAs and 27 ABCs) were collected from the archives of the Calgary Laboratory Services/University of Calgary and Vanderbilt University Medical Center. Histology was reviewed by an expert orthopedic pathologist. A single base extension assay (SNaPshot) is used to interrogate each nucleotide in codons 34 and 36 of H3F3A and codon 36 of H3F3B. Final diagnoses were generated after re-reviewing cases and incorporating molecular findings. Of 43 GCTBs, 38 (88%) had an H3F3A G34W mutation; 35 of 38 CBAs (92%) had a K36M mutation in either H3F3B (N = 31; 82%) or H3F3A (N = 4; 11%); none of 27 ABCs had a tested mutation. Molecular findings changed the histomorphologic diagnosis in 5 cases (3 GCTB changed to ABC, and 2 ABC changed to GCTB). These findings support the diagnostic utility of mutational analysis for this differential diagnosis in certain challenging cases when clinicoradiologic and histomorphologic features are not definitive, particularly for distinguishing cellular ABC versus GCTB with secondary ABC., (Copyright © 2017 Elsevier Inc. All rights reserved.)
- Published
- 2017
- Full Text
- View/download PDF
42. Image-Guided Injection of Bone Allograft and Autologous Bone Marrow for the Treatment of Aneurysmal Bone Cyst of the Jaw.
- Author
-
Costa de Freitas RM, Fonseca KC, Procópio RJ, and Cardoso Lehman LF
- Subjects
- Allografts, Bone Cysts, Aneurysmal drug therapy, Child, Contrast Media administration & dosage, Diagnosis, Differential, Humans, Male, Mandibular Diseases diagnostic imaging, Multimodal Imaging, Pain Measurement, Radiography, Interventional, Transplantation, Autologous, Triiodobenzoic Acids administration & dosage, Bone Cysts, Aneurysmal therapy, Bone Marrow Transplantation, Bone Transplantation methods, Mandibular Diseases therapy
- Published
- 2017
- Full Text
- View/download PDF
43. How effective is embolization with N-2-butyl-cyanoacrylate for aneurysmal bone cysts?
- Author
-
Rossi G, Mavrogenis AF, Facchini G, Bartalena T, Rimondi E, Renzulli M, Andreone A, Durante S, Angelini A, and Errani C
- Subjects
- Adolescent, Adult, Child, Child, Preschool, Female, Humans, Male, Middle Aged, Retrospective Studies, Tissue Adhesives administration & dosage, Treatment Outcome, Young Adult, Bone Cysts, Aneurysmal therapy, Embolization, Therapeutic methods, Enbucrilate administration & dosage
- Abstract
Purpose: To evaluate the outcome of selective arterial embolization with N-2-butyl-cyanoacrylate for aneurysmal bone cysts., Methods: We retrospectively studied 102 patients (72 male, 30 female; mean age, 16 years; range, 3-60 years) with aneurysmal bone cysts treated with embolization with N-2-butyl-cyanoacrylate. Mean follow-up was seven years (range, 3-13 years); no patient was lost to follow-up. We evaluated healing and recurrences of the lesions, complications and cost of the procedures, and recurrences with respect to age and gender of the patients, and size and location of the lesions., Results: Embolization was feasible in 88 patients (86.3%), and not feasible in 14 patients (13.6%) because feeding arteries were not identified or the spinal artery of Adamkiewicz was recognized at the embolization field. Seventy two patients (81.8%) experienced complete healing of their lesions after a single (50 patients, 56.8%), a second (17 patients, 19.3%) or a third embolization (5 patients, 5.7%). Sixteen patients (18.2%) experienced recurrence within four months (range, 3-9 months) after embolization; these patients underwent surgical treatment. Recurrences were more common in patients younger than 15 years of age and cysts larger than 6 cm, without any difference with respect to gender and location. Four patients (4.5%) experienced a complication including skin necrosis, sciatic nerve paresthesias, and femoral artery pseudoaneurysm. The cost estimate was 3000 euro per procedure., Conclusion: Embolization of aneurysmal bone cysts with N-2-butyl-cyanoacrylate is associated with good results and low complication rates, however, experience, technical skills, and knowledge of the vascular anatomy of the area is necessary.
- Published
- 2017
- Full Text
- View/download PDF
44. Efficacy and Safety of Selective Arterial Embolization in the Treatment of Aneurysmal Bone Cyst of the Mobile Spine: A Retrospective Observational Study.
- Author
-
Terzi S, Gasbarrini A, Fuiano M, Barbanti Brodano G, Ghermandi R, Bandiera S, and Boriani S
- Subjects
- Adolescent, Adult, Child, Embolization, Therapeutic adverse effects, Female, Follow-Up Studies, Humans, Male, Prospective Studies, Retrospective Studies, Treatment Outcome, Vascular Surgical Procedures adverse effects, Young Adult, Bone Cysts, Aneurysmal diagnostic imaging, Bone Cysts, Aneurysmal therapy, Embolization, Therapeutic methods, Vascular Surgical Procedures methods
- Abstract
Study Design: A retrospective observational study., Objective: Our aim is to define the efficacy and safety of serial selective arterial embolization (SAE) in the treatment of aneurysmal bone cysts (ABCs), to explore potential treatment alternatives, and to define a therapeutic algorithm., Summary of Background Data: ABC is a benign lesion with an unpredictable behavior. Its treatment is challenging especially in poorly accessible surgical areas, such as spine and pelvis. Currently, the first-line treatment of ABC is repeated SAE until healing. Other options have been used with variable success rates., Methods: From January 2004 to September 2015, 23 patients affected by ABC of the mobile spine have been treated with SAE and prospectively followed up by computed tomographic scan and magnetic resonance imaging. Signs of neurological deficit, complications, healing of the lesion, and clinical outcomes were registered.Signs of healing are defined as peripheral sclerotic bone rim formation, decrease of the ABC mass, disappearance of the double content image, and bone formation inside the ABC mass, associated with remission of pain., Results: Twenty-three patients underwent SAE according to the protocol. Seventeen patients have healed. The number of procedures necessary to obtain healing (clinical and radiographic) varied from 1 to 10. No complication occurred during the procedure. Follow-up time ranged from 5 to 120 months after the last angiographic procedure. All 17 patients had complete relief of pain symptoms. Six patients did not respond to SAE, presenting a progressive clinical and radiographic worsening, and underwent other medical or minimally invasive treatments., Conclusion: Our study confirms the safety of SAE. The efficacy of the treatment was however lower than expected. SAE is indicated when pathological fracture or signs of cord damage are not detected. Infiltration with autologous bone marrow concentrate or administration of Denosumab is under investigation as alternative choices of treatment., Level of Evidence: 4.
- Published
- 2017
- Full Text
- View/download PDF
45. Primary Tumors of the Osseous Chest Wall and Their Management.
- Author
-
Thomas M and Shen KR
- Subjects
- Bone Cysts, Aneurysmal diagnosis, Bone Cysts, Aneurysmal surgery, Bone Cysts, Aneurysmal therapy, Bone Neoplasms diagnosis, Bone Neoplasms therapy, Chemoradiotherapy, Adjuvant, Chondroma diagnosis, Chondroma surgery, Chondroma therapy, Histiocytosis, Langerhans-Cell diagnosis, Histiocytosis, Langerhans-Cell surgery, Histiocytosis, Langerhans-Cell therapy, Humans, Osteochondrodysplasias diagnosis, Osteochondrodysplasias surgery, Osteochondrodysplasias therapy, Prognosis, Sarcoma diagnosis, Sarcoma surgery, Sarcoma therapy, Thoracic Neoplasms diagnosis, Thoracic Neoplasms therapy, Bone Neoplasms surgery, Plastic Surgery Procedures, Rib Cage surgery, Thoracic Neoplasms surgery, Thoracic Surgical Procedures, Thoracic Wall surgery
- Abstract
Primary osseous tumors of the chest wall are uncommon neoplasms. They occur in a wide variety of pathologic forms, most of which can be distinguished by unique radiologic appearance. Management of these tumors depends on the diagnosis and stage. Adequate surgical resection is critical in achieving the best outcomes for most of these tumors. Chemotherapy and radiation may have an adjuvant role. Surgeons considering resection of any chest wall tumor should have a sound knowledge of the principles of resection and reconstruction., (Copyright © 2017 Elsevier Inc. All rights reserved.)
- Published
- 2017
- Full Text
- View/download PDF
46. Aneurysmal bone cyst of the spine treated by concentrated bone marrow: clinical cases and review of the literature.
- Author
-
Barbanti-Brodano G, Girolami M, Ghermandi R, Terzi S, Gasbarrini A, Bandiera S, and Boriani S
- Subjects
- Adolescent, Angiography, Bone Cysts, Aneurysmal diagnostic imaging, Female, Humans, Injections, Intralesional, Magnetic Resonance Imaging, Male, Retrospective Studies, Tomography, X-Ray Computed, Transplantation, Autologous, Treatment Outcome, Axis, Cervical Vertebra diagnostic imaging, Bone Cysts, Aneurysmal therapy, Bone Marrow Transplantation methods, Embolization, Therapeutic methods
- Abstract
Purpose: ABC is a benign lesion with unpredictable behavior. Its treatment is challenging, especially in poorly accessible surgical areas, such as spine and pelvis. Currently, the first-line treatment of ABC is repeated selective arterial embolization (SAE) until healing. Other options have been used with variable success rates. We propose an alternative treatment for spine aneurysmal bone cyst (sABC) based on the injection of concentrated autologous bone marrow., Methods: We retrospectively report and analyze here two cases of patients, a 14-year-old girl and a 16-year-old boy, both affected by ABC in C2 vertebra which were impossible to treat by SAE. They were treated with single or repeated injection of concentrated autologous bone marrow into the lesion. Their follow-up period is 27 months for both patients., Results: In the two cases reported here we observed a progressive ossification of the lesion, which was slow in one case, requiring three subsequent injections of concentrated bone marrow, and fast in the other case, beginning 1 month after the procedure. In both cases, the healing of the lesion was associated with symptom relief and the clinical status of the patients remains stable after 2 years., Conclusions: Although SAE can still be considered the first line in the treatment of ABC in the axial skeleton, new promising therapeutic procedures involving the use of mesenchymal stem cells are developing.
- Published
- 2017
- Full Text
- View/download PDF
47. Treatment outcome in 60 children with pathological fractures of the humerus caused by juvenile or aneurysmal bone cysts.
- Author
-
Rapp M, Grauel F, Wessel LM, Illing P, and Kaiser MM
- Subjects
- Adolescent, Bone Cysts complications, Bone Cysts diagnostic imaging, Bone Cysts therapy, Bone Cysts, Aneurysmal complications, Bone Cysts, Aneurysmal diagnostic imaging, Bone Nails, Child, Child, Preschool, Conservative Treatment, Female, Fracture Healing, Fractures, Spontaneous diagnostic imaging, Fractures, Spontaneous etiology, Humans, Humeral Fractures diagnostic imaging, Humeral Fractures etiology, Injections, Intralesional, Male, Radiography, Retrospective Studies, Treatment Outcome, Anti-Inflammatory Agents therapeutic use, Bone Cysts, Aneurysmal therapy, Bone Substitutes therapeutic use, Cortisone therapeutic use, Fracture Fixation, Intramedullary methods, Fractures, Spontaneous therapy, Humeral Fractures therapy
- Abstract
The treatment of pathological fractures of the humerus caused by juvenile or aneurysmal bone cysts (JBC/ABC) should be a single approach with a high success rate and low complication rate. This study evaluates how day by day treatment concepts fulfil these aims. Children below 15 years of age with a pathological fracture of the humerus caused by a JBC or ABC between 01.01.2001 and 31.12.2010, were investigated by chart review in four major paediatric trauma centres. Age, gender, fracture localisation, X-ray findings, treatment and outcome - assessed by the Capanna classification (I to IV), were analysed. 60 children [41male, 19 female; mean age: 9 years (4-14 years)] with 43 JBC and 12 ABC were included as well as five cysts, who could not be classified definitively. First treatment was non-operatively in 33 children. Of these 27 cysts did not improve; likewise the supportive installation of cortisone in six patients did not change the outcome. The first treatment consisted of elastic stable intramedullary in 13 children; up to three nail exchanges included. But only six of these reached (nearly) complete resolution (I/II). Overall the combined mechanical and biological treatment with curettage, elastic stable intramedullary nailing, (artificial) bone substitute and in some cases growth factors was performed as the 1st-line treatment in nine patients and further in 2nd or 3rd-line treatments in 13 humeral cysts. More than half of these reached a complete or nearly complete resolution of the cyst (12x I, 5x II, 1x III, 4x IV). Major complications in all operated patients were six nails not removable and two children with upper extremities length differences. Healing rates are low for non-operative treatment, elastic stable intramedullary nailing alone and by using cortisone for cysts resolution in pathological fractures of the humerus. Data support a combined mechanical and biological treatment with curettage, elastic stable intramedullary nailing, (artificial) bone substitute and the use of growth factors.
- Published
- 2016
48. Benign Tumors of the Spine: Has New Chemotherapy and Interventional Radiology Changed the Treatment Paradigm?
- Author
-
Charest-Morin R, Boriani S, Fisher CG, Patel SR, Kawahara N, Mendel E, Bettegowda C, and Rhines LD
- Subjects
- Antineoplastic Agents therapeutic use, Bone Cysts, Aneurysmal drug therapy, Bone Cysts, Aneurysmal radiotherapy, Combined Modality Therapy, Diphosphonates therapeutic use, Doxycycline therapeutic use, Embolization, Therapeutic, Giant Cell Tumor of Bone drug therapy, Giant Cell Tumor of Bone radiotherapy, Humans, Osteoma, Osteoid drug therapy, Osteoma, Osteoid radiotherapy, Radiology, Interventional, Spinal Neoplasms drug therapy, Spinal Neoplasms radiotherapy, Treatment Outcome, Bone Cysts, Aneurysmal therapy, Giant Cell Tumor of Bone therapy, Osteoma, Osteoid therapy, Spinal Neoplasms therapy
- Abstract
Study Design: Clinically based systematic review., Objective: To determine the role of (A) medical treatment and (B) interventional radiology as either adjuvant or stand-alone treatment in primary benign bone tumors of the spine., Methods: A multidisciplinary panel of spine surgeons, radiation oncologists, and medical oncologists elaborated specific focused questions regarding aneurysmal bone cyst, giant cell tumor, and osteoid osteoma. Denosumab, bisphosphonate, interferon, bone marrow aspirate, doxycycline, thermal ablation, and selective arterial embolization were identified as areas of interest for the article. A systematic review was performed through MEDLINE and EMBASE. Recommendations based on the literature review and clinical expertise were issued using the GRADE system., Results: The overall quality of the literature is very low with few multicenter prospective studies. For giant cell tumor, combination with Denosumab identified 14 pertinent articles with four multicenter prospective studies. Nine studies were found on bisphosphonates and six for selective arterial embolization. The search on aneurysmal bone cyst and selective arterial embolization revealed 12 articles. Combination with Denosumab, Doxycycline, and bone marrow aspirate identified four, two, and three relevant articles respectively. Eleven focused articles were selected on the role of thermal ablation in osteoid osteoma., Conclusion: Alternative and adjuvant therapy for primary benign bone tumors have emerged. Their ability to complement or replace surgery is now being scrutinized and they may impact significantly the algorithm of treatment of these tumors. Most of the data are still emerging and further research is desirable. Close collaboration between the different specialists managing these pathologies is crucial., Level of Evidence: N/A.
- Published
- 2016
- Full Text
- View/download PDF
49. Aneurysmal bone cyst (ABC) : treatment options and proposal of a follow-up regime.
- Author
-
Hauschild O, Lüdemann M, Engelhardt M, Baumhoer D, Baumann T, Elger T, Südkamp NP, and Herget GW
- Subjects
- Adolescent, Adult, Bone Cysts, Aneurysmal complications, Bone Cysts, Aneurysmal diagnostic imaging, Bone Cysts, Aneurysmal pathology, Child, Female, Fractures, Spontaneous etiology, Humans, Injections, Intralesional, Magnetic Resonance Imaging, Male, Middle Aged, Retrospective Studies, Transplantation, Autologous, Young Adult, Aftercare, Bone Cysts, Aneurysmal therapy, Bone Transplantation, Curettage, Glucocorticoids therapeutic use
- Abstract
The aim of this study was to describe treatment -options and develop a follow-up regime for the -aneurysmal bone cyst, a neoplastic bone lesion with a noticeable recurrence rate. Reports of 28 patients and a mean follow-up of 42.2 months treated multidisciplinary were analysed. Data were complemented by a literature review including 790 patients. Patient age was from seven to 57 years, in line with the literature (1-69 years). Lesions most frequently affect long bones, spine and pelvis ; pain is the most common symptom. Treatment modalities vary, recurrences -occurred in 26.1% in our series, rates ranged from 0-60% in the literature, with the vast majority within 2 years. With regard to the findings we propose, irrespective of treatment, a follow-up regime including clinical survey and imaging, best with MRI, at 3 months, 6 months and at half-yearly intervals within the first two and yearly within the third to fifth year.
- Published
- 2016
50. Background acetabular aneurysmal bone cyst in a 7 year-old: Presentation of a case.
- Author
-
Saus Milán N, Pino Almero L, and Mínguez Rey MF
- Subjects
- Acetabulum pathology, Biopsy, Bone Cysts, Aneurysmal pathology, Bone Cysts, Aneurysmal therapy, Child, Embolization, Therapeutic, Humans, Magnetic Resonance Imaging, Male, Tomography, X-Ray Computed, Acetabulum diagnostic imaging, Bone Cysts, Aneurysmal diagnostic imaging
- Abstract
The bone cyst is a rare benign tumor that usually develops in childhood. There are several treatment options, however when it is located within the pelvis treatment is complex. A 7 year-old patient who presented with 3 months of right hip pain and limping. The initial radiograph showed a discrete periostic reaction and acetabulum effacement. The MRI and CT scans suggested the diagnosis of aneurysmal bone cyst and was confirmed by open biopsy. Two serial embolizations were performed with good results, the patient was asymptomatic one year after., (Copyright © 2014 SECOT. Published by Elsevier Espana. All rights reserved.)
- Published
- 2016
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.