Differential diagnosis includes conditions such as telangiectatic osteosarcoma and giant cell tumor. It is mainly located in the metaphysis of the long bones and in the spine. While it is referred to a cyst, it is a true benign bone tumor surrounded by a thin wall of bone. Spread the love an aneurysmal bone cyst is a benign, blood filled lesion in the bone that tends to expand or grow. Aneurysmal bone cysts can occur in any bone, but are most commonly. Many authors consider diagnostic biopsy indispensable. Various treatment approaches, such as en bloc resection, open curettage. Aneurysmal bone cyst, luque rods, magnetic resonance imaging. Selective embolization is used as a primary treatment of aneurysmal bone cysts in surgically difficult anatomical locations and as an adjuvant to surgical treatment to. Bright t2weighted signal intensity secondary to central bloodfluid within the lesion also occurs in telangiectatic osteosarcoma and other benign tumors where there. On the basis of clinical, radiographic, and histologic examinations, a diagnosis of aneurysmal bone cyst was made.
Pdf bone cement treatment for aneurysmal bone cyst in a dog. The cyst may be present for a few weeks to a few years before diagnosis. Since their first description in 1942, a variety of treatment methods has been proposed. The patient was then followed up with serial ct examinations, which showed stabilization and. Percutaneous treatment of symptomatic aneurysmal bone cyst. Aneurysmal bone cyst after femoral derotational osteotomy. The standard treatment is to remove the lesion by curettage, followed by local adjuvant treatment and bone grafting. The cause of an aneurysmal bone cyst may be a traumatic lesion, vascular malformation, or a neoplasm that disrupts the vasculature of the bone and results in a rapidly enlarging, bloodfilled, anomalous vascular condition. Current management of aneurysmal bone cysts ncbi nih. Large aneurysmal bone cyst of iliac bone in a female child. Treatment of an aneurysmal bone cyst of the spine by radionuclide ablation charles h. Aneurysmal bone cysts abcs of spine are conventionally treated with enbloc resection or intralesional excisioncurettage and reconstruction or filling of defects with bone cement. Typically ubcs appear in the bones of the upper arm near the shoulder or leg near the hip. The patient was surgically treated by curettage and bone grafting along with reconstruction.
Aneurysmal bone cyst of the mandible with conservative. Aneurysmal bone cyst an overview sciencedirect topics. Aneurysmal bone cyst in proximal phalanx treated without. Pdf selective arterial embolization of aneurysmal bone. Aneurysmal bone cyst abc shows onset in the first decades of life, with incidence of 1. Although an effective spinal decompression and stabilization can be achieved by partial or subtotal excisions, recurrence rate is significantly lower in. Increasing awareness sinceon the part of physicians, radiologists, and surgeonshas led to an increase in the reported incidence of this lesion so that at present it is not too uncommon a clinical or pathologic entity. Aneurysmal bone cyst involving the hand are a rare occurrence especially in the proximal phalanx. Selective arterial embolization of aneurysmal bone cyst of the skeleton with n2 butil cyanoacrylate. Ubc can involve all bones, but usually the long bone metaphysis and otherwise primarily the proximal humerus and proximal femur. Although benign, the abc can be locally aggressive and can cause extensive weakening of the bony structure and impinge on the surrounding tissues.
Aneurysmal bone cyst, abbreviated abc, is an osteolytic bone neoplasm characterized by several spongelike blood or serum filled, generally nonendothelialized spaces of various diameters the term is a misnomer, as the lesion is neither an aneurysm nor a cyst. Additionally, soft tissue bulges into the outer part of the bone, where new bone is formed. A case of an aneurysmal bone cyst that involved the distal tibia and medial malleolus with erosion of the medial cortex in a 22yearold woman is presented. Secondary forms associated with benign or malignant.
Pdf aneurysmal bone cysts are benign bone tumors that usually present in childhood and early adulthood. The patient was then followed up with serial ct examinations, which showed stabilization and progressive ossification within the lesion. Sclerotherapy treatment of an assumed aneurysmal bone cyst. Aneurysmal bone cyst is a benign neoplasm composed of bloodfilled spaces separated by connective tissue 235. Aneurysmal bone cyst of the mandible scielo espana. The treatment of aneurysmal bone cysts abcs has evolved and less invasive methods have been. It has been reported that occasionally these lesions heal spontaneously or after a pathologic fracture, and we observed that some abcs treated at our center healed after biopsy alone. Unicameral bone cyst childrens hospital of philadelphia. Aneurysmal bone cyst abc is a solitary, locally invasive, expansile, osteolytic lesion with multiple intralesional septa that contains freeflowing blood, primarily seen in immature patients. We report the nonoperative treatment of a recurrent, multilevel spinal aneurysmal bone cyst by injection of 32 p chromic phosphate colloid into the cyst. Even though they are not cancerous, aneurysmal bone cysts tend to grow quickly, and treatment is recommended. Patients and methods the lesions were principally located in the tibia, femur, pelvis, humerus, and spine and, in most cases, presented the imaging appearance originally described by jaffe and lichtenstein as a blowout with thin cortices. Most bone cysts are benign, are pain free, and resolve spontaneously. Current strategies for the treatment of aneurysmal bone cysts.
The aneurysmal bone cyst is a nonneoplastic, osteolytic and locally destructive lesion that mainly affects the metaphyseal area of long bones and only 2% of it is diagnosed in the maxillofacial skeleton. The peculiar bony lesion called aneurysmal bone cyst was first named and described as a distinct entity under this term by jaffe and lichtenstein 5 in 1942. Treatment by excision and segmental stabilization with luque rods. Treatment of an aneurysmal bone cyst of the spine by. Simple bone cyst is a cystic, fluidfilled lesion, which may be unicameral ubc or partially separated. Challenges in the diagnosis and treatment of aneurysmal. Traditionally, these tumors were treated with open. Learn about symptoms, treatment and when to seek medical advice here using content verified by certified doctors. Treatment of abc includes surgery, radiotherapy, selective arterial embolization sae, and a combination of these modalities. Early diagnosis and appropriate surgical treatment of aneurysmal bone cysts in the spine remain the key factors to successful management. Thoracolumbar mri and multidetector ct showed an aneurysmal bone cyst intersecting the body and pedicles of l5.
An aneurysmal bone cyst is similar to a simple bone cyst in that it is not a true cyst with an epithelial lining. Pdf treatment of aneurysmal bone cysts with percutaneous. Pdf treatment of aneurysmal bone cysts using endoscopic. We report on 6 patients treated with denosumab and compare our results to the cases already published. Curettage means that the cyst is opened, and the contents are scraped out with a scooped instrument called a curette. Successful treatment of aggressive aneurysmal bone cyst of. The most common bone cyst is unicameral 1chamber bone cyst, also known as simple bone cyst. The efficacy of combining radical excision with stabilization for treatment of aneurysmal bone cysts of the spine is emphasized. A unicameral bone cyst is a benign noncancerous, fluidfilled cavity in the bone, which does not spread. It has been shown to be effective in giant cell tumour of bone gct of bone and hence promises some effect also in abc. Aneurysmal bone cysts generally have been detected in 11 to yearold, medium.
Aneurysmal bone cyst abc is a benign but locally aggressive tumor. It has been reported that occasionally these lesions heal spontaneously or after a pathologic fracture. A case report of aneurysmal bone cyst of the thoracic. Aneurysmal bone cyst abc is an uncommon benign tumorlike lesion. Bioactive glass and childrens aneurysmal bone cysts 77 introduction primary aneurysmal bone cyst abc is a rare lesion with an incidence of 1. Primary aneurysmal bone cysts abcs are benign, expansile bone lesions commonly treated with aggressive curettage with or without adjuvants such as cryotherapy, methacrylate cement, or phenol.
Aneurysmal bone cysts are benign, expansile, lytic bone lesions that behave in a locally aggressive manner. A team of doctors at nationwide childrens has developed a minimally invasive alternative approach to treating abcs utilizing sclerotherapy techniques. Understanding unicameral and aneurysmal bone cysts. For the treatment of upper cervical abcs, enbloc resections are often not desirable considering the riskbenefit ratio while the risk of recurrence after intralesional excision is high. Challenges in the diagnosis and treatment of aneurysmal bone. Objective the purpose of this case series is to report on the effectiveness of a single percutaneous injection of doxycycline as a primary treatment for aneurysmal bone cyst abc. Treatment of aneurysmal bone cysts using endoscopic curettage. Treatment typically consists of open surgical curettage with the addition of local. Magnetic resonance imaging may show fluid filled spaces but definite diagnosis can only be obtained histologically. Because of the rarity of aggressive abc cases, diagnostic and treatment protocols remain controversial and problematic. Aneurysmal bone cyst abc is a benign, reactive, nonneoplastic, proliferative, highly vascular osseous lesion. Although benign, abc can be locally aggressive, cause extensive weakening of the bony structure and impinge on the surrounding tissues it is the third most common lesion arising in the patella after chondroblastoma and giant cell tumor and accounts for 10% of all patellar lesions.
Although radiography and computed tomography ct can detect the lesion, magnetic resonance imaging mri is ideal for the demonstration of characteristic fluidfluid levels, extent, and margins. An 11yearold girl presenting with neck pain was diagnosed as having an aneurysmal bone cyst involving the posterior arch of c1. Abcs dont spread but can be quite damaging to the bone and can come back after they are removed. Pdf distal tibial aneurysmal bone cyst treatment by. A benign and nonneoplastic reactive bone lesion filled with multiple bloodfilled cavities. Aneurysmal bone yst, c 141, 145 in chondroblastoma, 206 brous septa, 168, 169 in posterior skull, 167 solid component of, 168, 169 b botryoid odontogenic cyst, 21, 22 bullough s lesion, 125 osseous spheroids, 9 peripheral brocellular rim and radiating bers, 9, 10 c. Arthroscopic treatment of an aneurysmal bone cyst of the. The treatment of aneurysmal bone cysts abcs has evolved and less invasive methods have been tried. Two injections separated in time by 2 months were performed with complete sclerosis and ossification of the cyst over a period of 6 months. The appearance on xray often is characteristic because it has clear boundaries and is located away from the center of the bone. Bone cysts in the pediatric population are often found incidentally on radiographs or after a cyst has created cortical weakness leading to a pathologic fracture.
It usually affects children between ages 515, but can also affect older children. Minimally invasive treatment was performed with percutaneous injections of calcitonin and methylprednisolone. Although surgical treatment is the most common option, it is associated to high morbidity rates. Pdf current strategies for the treatment of aneurysmal bone cysts. The aim of this study is to identify challenges in the diagnosis and treatment of abc especially in patients with unusual features.
Aneurysmal bone cyst diagnosis and treatment almurshidi. A nonneoplastic, serous fluidfilled bone lesion thought to result from temporary failure of medullary bone formation near the physis. With surgery, these cysts are highly curable, although they do grow back in some cases. In our patient, the surgical excision allowed a complete removal of the lesion and a posterior bone healing which made possible a implantsupported rehabilitation. The mainstay of treatment is curettage and bone graft, with or. A bone cyst is a fluidfilled hole in a bone that usually occurs in children and young adults. The patient was then followed up with serial ct examinations. Traumatic bone cyst an overview sciencedirect topics. Aneurysmal bone cyst childrens hospital of philadelphia. Traditionally, these tumors were treated with open surgery. Results only one of the patients was believed to have an. We report the nonoperative treatment of a recurrent, multilevel spinal aneurysmal bone cyst by injection of 32p chromic phosphate colloid into the cyst.
Various treatment approaches, such as en bloc resection, open curettage, radiotherapy, sclerotherapy, and embolization have been proposed. Aneurysmal bone cysts are aggressive benign lesions with high rates of recurrence rendering its treatment uniquely challenging. They usually manifest as expansile osteolytic lesions with a varying potential to be locally aggressive. When necessary, the treatment of aneurysmal bone cysts generally includes surgery to remove the cyst and to repair the affected bone. The tumor is characterized by translocations resulting in fusion of the usp6 gene at 17p with a highly active promoter of. Simple and aneurysmal bone cysts are benign lytic bone lesions, usually encountered in children and adolescents. Aneurysmal bone cysts are benign bone tumors that usually present in childhood and early adulthood. We present a case report of a 33yearold woman with back pain for several months which was resistant to medical treatment. Although aneurysmal bone cysts abcs are benign tumours, they have the potential to be locally aggressive. Adjuvant mriguided percutaneous cryoablation treatment. An aneurysmal bone cyst abc is a highly destructive, bloodfilled benign noncancerous bone tumor.