Percutaneous image-guided treatment of aneurysmal bone cysts: is there a superior treatment option?

Arleo, Timothy; Hawkins, C. Matthew; Fabregas, Jorge; Gill, Anne E.

doi:10.1007/s00247-022-05326-6

Cited by 6 publications

(10 citation statements)

References 25 publications

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“…This agent is not widely adapted but two articles appeared recently. Arleo et al [ 32 ▪ ] reported treatment with doxycycline alone or combining cryotherapy with recurrence free healing in 13/15 cases [ 30 ]. Wong et al [ 33 ▪ ] reported 14 patients who received doxycyline in cervical spine ABCs, achieving a success rate of 86% [ 31 ].…”

Section: Percutaneous Proceduresmentioning

confidence: 99%

“…Lower leg involvement had a three-fold increased risk for failure compared with other localizations. Kumar et al [ 32 ▪ ] described significant and swift pain relief and cyst healing with repeated polidocanol injections.…”

Section: Percutaneous Proceduresmentioning

confidence: 99%

“…Deventer et al [ 49 ] had disease persistence in 90.6% of 32 cases, after first injection, eventually requiring a mean of 5.7 injections, whereas Rai et al reported all 43 patients to have fully resolved lesions after 2 years with 3–4 injections [ 33 ▪ , 34 ]. Multiple injections are common, with a mean number of injections varying between 1.8 and 5.7 [ 5 ▪▪ , 32 ▪ , 33 ▪ , 34 ]. Complications observed are: skin induration at injection site, skin hypopigmentation [ 32 ▪ , 34 ] and rarely anaphylactic shock [ 5 ▪▪ ].…”

Section: Percutaneous Proceduresmentioning

confidence: 99%

“…Multiple injections are common, with a mean number of injections varying between 1.8 and 5.7 [ 5 ▪▪ , 32 ▪ , 33 ▪ , 34 ]. Complications observed are: skin induration at injection site, skin hypopigmentation [ 32 ▪ , 34 ] and rarely anaphylactic shock [ 5 ▪▪ ].…”

Section: Percutaneous Proceduresmentioning

confidence: 99%

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The treatment of aneurysmal bone cysts

Geloven

Sande²,

Heijden³

2022

Current Opinion in Pediatrics

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Purpose of reviewAneurysmal 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 findingsIn 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.SummaryAccurately 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.

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Section: Percutaneous Proceduresmentioning

confidence: 99%

Section: Percutaneous Proceduresmentioning

confidence: 99%

Section: Percutaneous Proceduresmentioning

confidence: 99%

Section: Percutaneous Proceduresmentioning

confidence: 99%

See 2 more Smart Citations

The treatment of aneurysmal bone cysts

Geloven

Sande²,

Heijden³

2022

Current Opinion in Pediatrics

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“…However, it poses a particularly challenging task in the cervical spine due to its potential impact on the structural stability of the neck and proximity to crucial neurovascular structures. Minimally invasive procedures, including transarterial embolization (TAE), image-guided percutaneous cryoablation (CYOA) and image-guided percutaneous doxycycline sclerotherapy (DS), have shown to be viable options in the treatment of ABCs when surgery is not possible ( 3 , 4 ). This case report describes a successful treatment with combined CYOA and DS of a symptomatic cervical spinal C5 ABC encompassing the right vertebral artery (RVA) and in close contact with critical nervous structures in a 4-year-old patient not amenable to surgery or TAE.…”

Section: Introductionmentioning

confidence: 99%

Minimizing neurovascular complications during image-guided percutaneous cryoablation of a cervical spinal aneurysmal bone cyst using protective doxycycline sclerotherapy: a case report

Radalov,

Páez-Carpio,

Macías Rodríguez

et al. 2024

J Spine Surg

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Background Aneurysmal bone cysts (ABC) are rare, locally aggressive bone tumors primarily observed in pediatric patients. Surgical curettage is the treatment of choice. Image-guided percutaneous cryoablation (CYOA) is a recently implemented alternative technique in cases not amenable to surgery. CYOA may be limited if the lesion is close to critical neurovascular structures. In this case report, a cervical spinal ABC was successfully treated using CYOA in combination with complementary and protective image-guided percutaneous doxycycline sclerotherapy (DS) to dissect and treat the portion of the lesion in contact with critical structures. Case Description A 4-year-old male presented with a symptomatic ABC within the C5 vertebral body, which encompassed the right vertebral artery and contacted the right C5–C6 spinal cord and nerve roots. After ruling out surgery due to the proximity of critical neurovascular structures, treatment with CYOA was performed. However, subsequent follow-up showed recurrence in the part of the lesion contacting critical structures. A second approach was then decided, using DS to dissect and treat the most vulnerable portion and CYOA to treat the remaining tumor. Follow-up showed almost complete sclerosis of the lesion and total resolution of symptoms 3 years after treatment. Conclusions Using DS to dissect and treat the portion of the lesion in contact with critical neurovascular structures during CYOA treatment of a cervical spinal ABC allowed for a safe and effective approach in our case.

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