Aneurysmal bone cysts of the pelvis

Capanna, Rodolfo; Bertoni, Franco; Bettelli, G.; Present, David; Biaginil, R.; Ruggieri, Pietro; Mancini, Ilaria; Campanacci, Mario

doi:10.1007/bf00449926

Cited by 37 publications

(39 citation statements)

References 11 publications

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“…The void in the bone can be filled with bone graft (allogenic or autogenic), bone cement, or calcium phosphate bone substitutes. The reported recurrence rate of ABCs located in the pelvis after surgical treatment is around 14 % [8, 15, 16]. Treatment of pelvic ABCs in children may be challenging because of the relative inaccessibility of the lesions, associated intraoperative bleeding, and the proximity of the lesions to neurovascular structures [16].…”

Section: Introductionmentioning

confidence: 99%

Functional outcomes and quality of life following surgical treatment of aneurysmal bone cysts of the pelvis in children

Novais

Zimmerman

Lewallen

et al. 2014

Journal of Children's Orthopaedics

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BackgroundAneurysmal bone cysts (ABCs) are a benign aggressive tumor that occurs rarely in the pelvis in the pediatric population. Pelvic ABCs may involve the triradiate cartilage and/or the acetabulum, which increases the technical difficulty of surgical treatment and has potential implications on the growth and development of the hip joint. This study examines the clinical presentation, rate of surgical complications, and recurrence rate, as well as, long-term clinical and functional outcomes of children with pelvic ABCs treated at a single institution by a single treatment modality.MethodsBetween 1988 and 2008, 142 children with histologically confirmed ABCs were treated at our institution. Seventeen (12 %) tumors were located in the pelvis. A total of 13 pelvic ABCs (5 ilium-periacetabular, 4 pubic, 3 ilium-iliac wing, and 1 ischium) were included in this study. There were eight male and five female patients with a mean age of 12.9 years (range 4.1–17.5 years) at the time of surgery. The Toronto Extremity Salvage Score (TESS), the Musculoskeletal Tumor Society 1993 (MSTS’93) score, and the Short Form Health Survey Sf-36 were obtained at a minimum 5-year follow-up in all patients (mean follow-up 11.5 years, range 5.5–19.8 years). The mean age at follow-up was 24.3 years (range 14.6–32.6 years).ResultsAll patients were treated surgically with intralesional curettage extended with a high-speed burr and bone grafting. Eight patients received adjunctive therapy with phenol. Five patients had preoperative selective arterial embolization. Of the 13 patients, 1 had a local recurrence diagnosed at 6 months after surgery. The only complication in the cohort was a superficial wound infection. At the latest follow-up, all patients were free of disease. The mean TESS score was 95 and the mean MSTS’93 score was 93 %. The mean self-rated general health score, according to the SF-36 was 87 % of total points possible.ConclusionsExtended curettage and bone grafting of pelvic ABCs in the pediatric population can yield high clinical and functional scores at an average of 11 years follow-up with a low rate of complications and recurrence.Level of evidenceIV, case series.

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Section: Introductionmentioning

confidence: 99%

Functional outcomes and quality of life following surgical treatment of aneurysmal bone cysts of the pelvis in children

Novais

Zimmerman

Lewallen

et al. 2014

Journal of Children's Orthopaedics

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“…Malghem et al [11] described in 1989 three cases but in young adults. In Capanna et al's study [23], two children with a pelvic ABC, aged 13 and 15 years, had only incisional biopsies, as their parents refused further treatment. Although both lesions were aggressive, with expansion into the soft tissues, the lesions became quiescent with reconstitution of a radiographic bony shell.…”

Section: Discussionmentioning

confidence: 99%

Active aneurysmal bone cysts in children: Possible evolution after biopsy

Louahem

Kouyoumdjïan

Ghanem³

et al. 2012

Journal of Children's Orthopaedics

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Purpose The active or aggressive character in certain localisations of aneurysmal bone cysts in children requires either curettage with a considerable recurrence rate or a radical segmental excision, raising complex reconstructive challenges. Cyst maturation with subsequent ossification may be observed either spontaneously or after incisional biopsy. Patients Five new cases of active aneurysmal bone cysts (ABCs) with healing of the cyst after biopsy alone are reported. All patients had no treatment of the cyst after the biopsy. Results In two cases, the lesion initially increases in size immediately after the biopsy, and it is only secondarily that the lesion decreases in size. Four out of five cases of the spontaneous healing occurred in pelvic bone. The cysts healed after, respectively, 36, 24, 12, 32 and 12 months. Conclusions The emergence of these new cases of spontaneous healing encourages promoting clinical and radiological supervision after biopsy in selected cases. Unfortunately, it is impossible to predict a possible aggressive behaviour in ABCs. Then, if the lesion is quickly aggressive with clinically and radiologically increasing size after biopsy, it would be illogical and dangerous to let this ABC evolve. It would be necessary to treat it without delay. On the other hand, if the lesion moderately increased after the biopsy, it is possible to wait and observe the patient during a period of 5 months for a possible healing, if the ABC localisation is not dangerous. Of course, if the lesion does not increase in size after biopsy, there is no delay to treat it.

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“…12,13 Adjuvant radiotherapy or radiotherapy alone has been advocated for recurrent lesions and those in regions difficult to safely reach surgically, with limited success. 10,[14][15][16][17] The use of radiation in this population (typically young) should be weighed carefully against the risk of postradiation sarcoma. 10,18 Cryotherapy has also been used with some success in these lesions (along with intralesional curettage and bone grafting), with results reported by some to be equivalent to those of wide resection.…”

Section: Benign Lesionsmentioning

confidence: 99%