Abstract:Solid variant of aneurysmal bone cyst (sABC) is an extremely rare, reactive and non-neoplastic osseous lesion. On imaging it presents as a diaphyseal aggressive, eccentrically placed lytic and expansile lesion. However, differentiating this entity from the other possible malignant differentials is confounded by the histopathology mimicking several commoner lesions. We describe the distinctive MRI features of sABC of long bones from a series of four cases and briefly review the literature. We hope this review w… Show more
“…ABCs are diagnosed with imaging investigations such plain X-rays, CT scans, and MRI, but a histological evaluation of the lesion is required for a conclusive diagnosis. Giant cell tumours, telangiectatic osteosarcoma, fibrous dysplasia, simple bone cyst, osteoblastoma, and plasmacytoma are among other diagnoses (9) .…”
Background: Different treatment options for aneurysmal bone cysts (ABCs), which have a high risk of recurrence, are discussed. The choice of the treatment approach for patients with ABCs is based on the likelihood of recurrence and any potential side effects. Objective: This study aims to evaluate the outcome of extended curettage alone as a method of treatment for patients with ABCs of the upper extremity. Patients and Methods: From April 2013 to June 2021, 15 primary ABCs in the upper extremity (15 patients) were diagnosed and managed at the Orthopedic Oncology Unit, Zagazig University Hospital. The patients were 9 males and 6 females. The mean age was 13.2 ± 1.6 years (range, 7 years 5 months to 18 years 2 months). ABCs were present in the proximal humerus in 7 cases, distal humerus in 3 cases, radius in 3 cases, glenoid in one case, and distal phalanx of the thumb in one case. All patients were managed by extended curettage and followed up for at least one year. Results: All lesions healed after a mean period of 16 weeks (range 10-21 weeks). The time to healing was related to the age of patients, size, and behavior of the lesion. Superficial infection was seen in one patient and was managed conservatively. Recurrence developed in one patient at 9 months postoperatively and was managed by repeated extended curettage. There was only one patient who developed a shortening of the humerus of about 1.5 cm due to premature fusion of the proximal humeral epiphysis but without angular deformity. Conclusion: Extended curettage with high-speed burr is considered an effective technique in the management of ABCs in the upper extremity.
“…ABCs are diagnosed with imaging investigations such plain X-rays, CT scans, and MRI, but a histological evaluation of the lesion is required for a conclusive diagnosis. Giant cell tumours, telangiectatic osteosarcoma, fibrous dysplasia, simple bone cyst, osteoblastoma, and plasmacytoma are among other diagnoses (9) .…”
Background: Different treatment options for aneurysmal bone cysts (ABCs), which have a high risk of recurrence, are discussed. The choice of the treatment approach for patients with ABCs is based on the likelihood of recurrence and any potential side effects. Objective: This study aims to evaluate the outcome of extended curettage alone as a method of treatment for patients with ABCs of the upper extremity. Patients and Methods: From April 2013 to June 2021, 15 primary ABCs in the upper extremity (15 patients) were diagnosed and managed at the Orthopedic Oncology Unit, Zagazig University Hospital. The patients were 9 males and 6 females. The mean age was 13.2 ± 1.6 years (range, 7 years 5 months to 18 years 2 months). ABCs were present in the proximal humerus in 7 cases, distal humerus in 3 cases, radius in 3 cases, glenoid in one case, and distal phalanx of the thumb in one case. All patients were managed by extended curettage and followed up for at least one year. Results: All lesions healed after a mean period of 16 weeks (range 10-21 weeks). The time to healing was related to the age of patients, size, and behavior of the lesion. Superficial infection was seen in one patient and was managed conservatively. Recurrence developed in one patient at 9 months postoperatively and was managed by repeated extended curettage. There was only one patient who developed a shortening of the humerus of about 1.5 cm due to premature fusion of the proximal humeral epiphysis but without angular deformity. Conclusion: Extended curettage with high-speed burr is considered an effective technique in the management of ABCs in the upper extremity.
“…9 ) that can be intense. Surrounding soft-tissue and bone marrow edema can be significant in solid variant ABC, especially small tumors [ 44 , 45 ]. Fig.…”
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).
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