Treatment of an aggressive aneurysmal bone cyst with percutaneous injection of polidocanol: a case report

Brosjö, Otte; Tsagozis, Panagiotis

doi:10.1186/1752-1947-8-450

Cited by 9 publications

(7 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Recent literature supports the use of Polidocanol in ABC because of high healing rate and minimal complications compared to other modalities. 7 , 8 , 10 It has been used and recommended to be used in an out-patient setting in view of its safety 9 . To our knowledge, not even a single study has reported such a severe life-threatening hypersensitivity reaction to the use of polidocanol in ABCs till date.…”

Section: Discussionmentioning

confidence: 99%

Severe life-threatening hypersensitivity reaction to polidocanol in a case of recurrent aneurysmal bone cyst

Gupta

Pandit

Jerath

et al. 2019

Journal of Clinical Orthopaedics and Trauma

View full text Add to dashboard Cite

Aneurysmal bone cysts (ABC) are expansile lytic lesions constituting around 1% of all benign bone tumors with an annual incidence of 1.4/100000. A variety of treatments are available ranging from curettage with or without bone grafting (autologous or allogeneic), curettage with use of adjuvants [Polymethylmethacrylate (PMMA) bone cement, high speed burr, phenol, liquid nitrogen], wide en-block excision with or without reconstruction, selective arterial embolization of the feeding vessels, radiation therapy, high precision megavoltage radiotherapy and percutaneous radio-nuclide ablation, sclerotherapy (ethibloc, aetoxisclerol, alcohol gel, polidocanol). The optimal treatment is debatable due to various indications and contraindications of different modalities of treatment. Recent data suggest that percutaneous sclerotherapy with polidocanol is safe and effective alternative to surgery for treatment of ABCs as it has minimal side effects. We are reporting the first case of life-threatening adverse reaction to intralesional polidocanol in a three-year-old boy with a proximal femoral aneurysmal bone cyst. The importance of reporting this case is to make people aware regarding the adverse reaction of polidocanol and to highlight the precautions one should follow while using polidocanol for aneurysmal bone cysts.

show abstract

Section: Discussionmentioning

confidence: 99%

Severe life-threatening hypersensitivity reaction to polidocanol in a case of recurrent aneurysmal bone cyst

Gupta

Pandit

Jerath

et al. 2019

Journal of Clinical Orthopaedics and Trauma

View full text Add to dashboard Cite

show abstract

“…Even aggressive lesions can be treated in this manner. 41 The major drawback is multiple treatments are required. We resort to curettage, and fill the cavity with bone cement when sclerotherapy fails.…”

Section: Discussionmentioning

confidence: 99%

“… 1 Even aggressive ABCs can be cured by sclerotherapy. 41 It should be noted that other agents have been injected in ABCs and shown to have effect. Doxycycline, which probably has an analogous mode of action to sclerosants, has been effectively used for percutaneous treatment of ABCs.…”

Section: Sclerotherapy and Injection Of Other Drugsmentioning

confidence: 99%

Current strategies for the treatment of aneurysmal bone cysts

2015

Orthop Rev

Self Cite

111

View full text Add to dashboard Cite

Aneurysmal bone cysts are benign bone tumors that usually present in childhood and early adulthood. They usually manifest as expansile osteolytic lesions with a varying potential to be locally aggressive. Since their first description in 1942, a variety of treatment methods has been proposed. Traditionally, these tumors were treated with open surgery. Either intralesional surgical procedures or en bloc excisions have been described. Furthermore, a variety of chemical or physical adjuvants has been utilized in order to reduce the risk for local recurrence after excision. Currently, there is a shift to more minimally invasive procedures in order to avoid the complications of open surgical excision. Good results have been reported during percutaneous surgery, or the use of embolization. Recently, sclerotherapy has emerged as a promising treatment, showing effective consolidation of the lesions and functional results that appear to be superior to the ones of open surgery. Lastly, non-invasive treatment, such as pharmaceutical intervention with denosumab or bisphosphonates has been reported to be effective in the management of the disease. Radiotherapy has also been shown to confer good local control, either alone or in conjunction to other treatment modalities, but is associated with serious adverse effects. Here, we review the current literature on the methods of treatment of aneurysmal bone cysts. The indication for each type of treatment along reported outcome of the intervention, as well as potential complications are systematically presented. Our review aims to increase awareness of the different treatment modalities and facilitate decision-making regarding each individual patient.

show abstract

“…Among vascular and traumatic factors, recent studies describe genetic alterations as well [ 3 , 6 , 7 ]. Treatment options for aneurysmal bone cysts comprise surgical resection or curettage followed by bone grafting or cement insertion as well as arterial embolization or direct injection of the cyst with sclerosing agents such as polidocanol or local injection of doxycycline [ 8 – 10 ]. Focusing on the pelvis, optimal treatment is challenging since the lesions are usually very large, highly vascularized and the anatomical relation to the acetabulum and neurovascular structures reduces the chance of adequate resection [ 2 , 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

Therapeutic Management of a Substantial Pelvic Aneurysmatic Bone Cyst Including the Off-Label Use of Denosumab in a 35-Year-Old Female Patient

Ntalos

Priemel

Schlickewei

et al. 2017

Case Reports in Orthopedics

View full text Add to dashboard Cite

Aneurysmal bone cysts (ABC) are benign bone tumors, which are highly vascularized. The main course of treatment is curettage followed by bone grafting or cement insertion. Still recurrence remains a main problem for patients. Denosumab is a monoclonal antibody, which acts as an inhibitor of the RANK/RANKL pathway, diminishing bone turnover. Recent case reports have shown that Denosumab can be a promising therapeutic agent for people suffering from therapy-resistant ABC. We report the case of a 35-year-old female patient presenting with a pronounced ABC of the pelvis. Since the tumor was inoperable, Denosumab was administered, leading to a significant shrinkage of the lesion, which allowed surgical intervention. Upon recurrence, Denosumab was restarted putting the patient once more into remission. Follow-up was four years overall with a clinical and radiological stable disease for fifteen months after final discontinuation of the monoclonal antibody. Therefore, our case further underlines the potential of Denosumab in the treatment of ABC.

show abstract

Treatment of an aggressive aneurysmal bone cyst with percutaneous injection of polidocanol: a case report

Cited by 9 publications

References 11 publications

Severe life-threatening hypersensitivity reaction to polidocanol in a case of recurrent aneurysmal bone cyst

Severe life-threatening hypersensitivity reaction to polidocanol in a case of recurrent aneurysmal bone cyst

Current strategies for the treatment of aneurysmal bone cysts

Therapeutic Management of a Substantial Pelvic Aneurysmatic Bone Cyst Including the Off-Label Use of Denosumab in a 35-Year-Old Female Patient

Contact Info

Product

Resources

About