ObjectiveTo introduce the intralesional calcitonin and methylprednisolone percutaneous injection method, which results in the promotion of primary aneurysmal bone cyst (ABC) healing.MethodsA retrospective cohort study involving 76 patients diagnosed with ABC was performed between 2005 and 2014. Patients treated with calcitonin and methylprednisolone injection and who underwent more than 2 years of follow-up were considered eligible for the study (n=47). The Enneking staging and Capanna classification systems were used during the initial evaluation. Treatment response was assessed by Rastogi radiographic grading based on the degree of healing. X2 and Wilcoxon signed-rank tests and odds ratio calculations were used in the statistical analysis with a 5% significance level.ResultsThe proximal tibia extremity was the most commonly affected site (17.0%). Thirty-three (70.3%) ABC cases were staged as B3 and 28 (59.7%) were classified as type II. The average number of injections performed was 2.8 per patient, with an average reduction of the initial lytic area of 83.7% (p-value=0.00001). Satisfactory results for 91.4% (n=43; p-value=0.00001) were obtained and 5 recurrences occurred. No side effects were observed.ConclusionIntralesional calcitonin and methylprednisolone percutaneous injection is a minimally invasive, effective, and safe method for promoting primary ABC healing. Level of evidence IV, Type of study: case series.
Objective
Lung cancer is the leading cause of death by cancer, and the bones are one of the most common sites of metastasis from this condition. This study aimed to evaluate the influence of lung carcinoma histology on the frequency of bone metastases.
Methods
This retrospective study evaluated the medical records of 407 patients diagnosed with lung cancer between 2003 and 2012. The prevalence of bone metastases and their association with histological subtypes were evaluated using chi-squared tests, odds ratios (ORs) and 95% confidence intervals (CIs). The overall survival was evaluated using the Kaplan-Meier method.
Results
The prevalence of bone metastases was 28.2% (
n
= 115), and the spine was the most frequently affected site (98 metastases; 32.1%). Adenocarcinoma was the most common histological subtype of lung carcinoma (46.7%), and it was significantly more frequent among patients with bone metastases (58.3% versus 42.1%;
p
= 0.003; OR = 1.92; 95% CI: 1.29–2.97). Squamous cell carcinoma was significantly less frequent among patients with bone metastases (13.0% versus 29.8%;
p
= 0.0004; OR = 0.35; 95% CI: 0.19–0.64). The median survival time after the first bone metastasis diagnosis was 4 months.
Conclusion
Adenocarcinoma was the most common histological subtype of lung carcinoma, and it was significantly associated with a higher risk of developing bone metastases.
Aneurysmal bone cyst is a rare benign bone tumor usually treated by surgery, which may in turn result in poor functional outcome and recurrence. This study aims to report a series of cases of primary ABC treated with a single dose of calcitonin and methylprednisolone injection. Six patients treated with a single-dose combination of calcitonin (200 UI) and methylprednisolone (120 mg) at a single institution from January 2011 to December 2013 were clinically and radiologically evaluated. After the follow-up period, all patients presented cyst healing. The mean time to healing was 2.8 months. The final mean overall functional score rating was 89.0%. We conclude that intralesional calcitonin and methylprednisolone injection results in aneurysmal bone cyst healing with good functional outcomes and thus can be an effective treatment method.
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