The treatment of aneurysmal bone cysts

Abstract

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.

Autogenous fibula head transplantation for aneurysmal bone cyst of distal radius: A case report followed up for 7 years

“…[5] There is no definite standard for the treatment of ABC, and the best treatment remains under discussion. [7] Different doctors describe different treatments, such as intratumoral curettage, embolization, local percutaneous drug injection, cryoablation, radiotherapy, and the systemic application of denosumab or bisphosphate. [8,9] ABC grows rapidly and is destructive to local tissues; therefore, routine treatment is accompanied by possible complications and easily leads to recurrence.…”

Restoration of Limb Length Discrepancy and Alignment With the Ilizarov Device After Management of an Aneurysmal Bone Cyst Crossing the Distal Femoral Physis

“…The damage of the open growth plate, mainly in children younger than 12-14 years, may severely affect limb alignment and create leg length discrepancy (LLD). Various treatment methods have been reported for managing ABCs related to the incidence of cyst recurrence [ 6 - 8 ]. There are no previous reports on managing the late sequelae of the growth plate lesion.…”

Diagnostic Accuracy of Aneurysmal Bone Cyst (ABC): Immunohistochemical Aspects

“…There are many and variable lytic and expansive "fluid-filled cavities" in pediatric population, needing differential diagnosis of an ABC [2][3][4][5], to find leading trigger mechanisms of a preexisting processes, initiation intraosseous hemodynamic, inflammatory and reactive changes resulting by formation in well-defined "bloodfilled" cavities and fibrous trabeculation. According the data [6][7][8][9] and our experiences, ABC termed as locally aggressive tumor. Different treatment tools are described in literature [2,3,6,10].…”

“…According the data [6][7][8][9] and our experiences, ABC termed as locally aggressive tumor. Different treatment tools are described in literature [2,3,6,10]. Therefore, this area presents an opportunity risk aggression (metastasis), risk of recidives (relapses).…”

“…Under high-power microscopical and immunohistochemical evaluation: characteristic appearance is the degenerative cystic part of the lesion [6,15,18].…”