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BMC Musculoskeletal Disorders Apr 2022The aneurysmal bone cyst (ABC) is a benign, but locally aggressive cystic lesion of the bone. It usually occurs in the metaphysis of long bones of adolescents and young...
BACKGROUND
The aneurysmal bone cyst (ABC) is a benign, but locally aggressive cystic lesion of the bone. It usually occurs in the metaphysis of long bones of adolescents and young adults but can also affect the pelvis.
METHODS
This single-center study is a retrospective review of 17 patients with primary ABCs of the pelvis. It examines the importance of polidocanol instillations as minimally invasive treatment option for ABCs of the pelvis compared to intralesional curettage or marginal resection.
RESULTS
Seventeen patients with the diagnosis of a primary ABC of the pelvis were included in the study. Six patients were male (35%) and 11 patients female (65%); the mean age was 18 (9-49) years. The mean follow-up time was 50 months (12-136 months). The most common location of manifestation was the pubis (6; 35%), followed by the ilium (6; 35%), the sacrum (3; 18%) and the ischium (2; 12%). Eight patients were treated by intralesional curettage with the use of adjuvants, one patient by marginal resection, seven by sequential instillation of polidocanol and one patient by simple observation. Five patients received an additional transarterial embolization. After intralesional curettage local recurrence was detected in 4/8 cases (50%). After instillation therapy six patients (86%) had a stable disease without recurrence, only one patient (14%) had a persistent disease with need of additional treatment and was therefore converted to intralesional curettage without local recurrence in the follow-up.
CONCLUSIONS
Sequential instillations of polidocanol are a promising, minimally invasive treatment method for ABCs of the pelvis and can be well combined with transarterial embolization.
Topics: Adolescent; Bone Cysts, Aneurysmal; Curettage; Female; Humans; Male; Pelvis; Polidocanol; Sacrum; Young Adult
PubMed: 35490224
DOI: 10.1186/s12891-022-05362-1 -
Orthopaedics & Traumatology, Surgery &... Nov 2020Aneurysmal bone cyst (ABC) is a benign bone lesion of childhood and adolescence. It can be locally aggressive, with risk of fracture. Management is controversial. The...
INTRODUCTION
Aneurysmal bone cyst (ABC) is a benign bone lesion of childhood and adolescence. It can be locally aggressive, with risk of fracture. Management is controversial. The aim of the present study was to assess the efficacy, simplicity and tolerance of percutaneous alcohol-bases sclerotherapy in ABC.
HYPOTHESIS
Alcohol-based sclerotherapy for ABC under radiographic control is safe and effective.
MATERIAL AND METHODS
A single-center retrospective study for the period 2008-2016 included all of the 55 ABCs, in 54 patients, confirmed on pathology and treated by alcohol-based sclerotherapy under radiographic control. Mean age at diagnosis was 9.6 years. ABC involved the humerus in 30 cases (54%), tibia in 7 (13%) and femur in 5 (9%). Mean follow-up was 50.9 months (range, 16-117 months). Mean number of applications was 1.7 (range, 1-4). Results were assessed clinically (pain, return to sport, limb length and alignment, revision surgery) and radiologically. The main endpoint was lesion volume reduction. The secondary endpoint was failure, defined by open revision surgery or pain preventing return to a sports activity.
RESULTS
Clinical progression was favorable in 36 patients (67%), and radiological progression in 45 (85%). Only 1 cyst required secondary resection. One patient experienced spontaneously resolving intraoperative bradycardia. Male gender and young age emerged as factors for poorer response.
DISCUSSION
ABC management in children can be made difficult by lesion size, aggressiveness, location, proximity to the growth plate and small bone stock. Alcohol-based sclerotherapy is simple, reliable and effective in childhood ABC, and may be a first-line attitude, avoiding recourse to invasive surgery.
LEVEL OF EVIDENCE
IV, retrospective study.
Topics: Adolescent; Bone Cysts, Aneurysmal; Child; Ethanol; Humans; Male; Retrospective Studies; Sclerotherapy; Treatment Outcome
PubMed: 32359956
DOI: 10.1016/j.otsr.2019.12.024 -
Dento Maxillo Facial Radiology May 2020Stafne's bone cyst (SBC) is an asymptomatic, round or oval-shaped, well-defined, uniform radiolucent lesion, usually incidentally observed in the posterior aspects of...
OBJECTIVE
Stafne's bone cyst (SBC) is an asymptomatic, round or oval-shaped, well-defined, uniform radiolucent lesion, usually incidentally observed in the posterior aspects of the mandible. Radiographical appearance may be confusing though. This study aimed to review the literature on SBCs and to map the SBC as shown in their respective papers.
METHODS
A Pubmed® search (1/9/2018 till 31/5/2019), mentioning SBC, was carried out. Included papers had to contain: patient's age, gender and radiographs.
RESULTS
In total, 114 papers were found, but only 64 papers were retained, which contained 109 cases (95 males, 14 females). The patients' ages ranged between 14 and 89 years old (mean age being 52 years). Male patients' ages ( = 95) ranged from 14 to 89 years (mean age 52.3 years), whereas the females ( = 14) ages ranged between 22 and 68 (mean age 50.2 years). 28 combinations of locations of SBC were recorded. Only three lesions were located at the symphysis, six were bilateral, 55 appeared on the left hand side and 45 on the right hand side of the mandible.The literature mentioned that these cavities could contain salivary gland tissue, muscular tissue, lymphoid tissue, blood vessels, fat tissue or connective tissue.
DISCUSSION/CONCLUSION
This study illustrates the wide variation of SBC locations across the mandible and leads us to conclude that the differential diagnosis of every asymptomatic, oval or round, well-defined, uniform radiolucent lesion on two-dimensional radiographs of the mandible should include "a benign mandibular concavity", formerly known as SBC.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Bone Cysts; Female; Humans; Jaw Cysts; Male; Mandible; Mandibular Diseases; Middle Aged; Radiography, Panoramic; Young Adult
PubMed: 31944858
DOI: 10.1259/dmfr.20190475 -
Dental and Medical Problems 2020Simple bone cyst (SBC), also known as unicameral bone cyst, is a benign, fluid-filled cystic lesion that mainly appears in the long bones of young patients. Simple bone...
Simple bone cyst (SBC), also known as unicameral bone cyst, is a benign, fluid-filled cystic lesion that mainly appears in the long bones of young patients. Simple bone cysts are considered dysplastic or reactive lesions of bone. The most common locations for SBCs are the proximal humerus and femur. Lesions may occasionally be found in the jawbones. Simple bone cysts often have no clinical impact and are usually detected during routine radiographic examinations unless a gross pathologic fracture occurs. When symptoms develop, they may include mild pain, local tenderness and swelling. Computed tomography (CT) scans demonstrate a central, well-defined, mildly expansile or non-expansile, thin-walled lytic lesion, with little or no marginal sclerosis. Magnetic resonance imaging (MRI) usually confirms the cystic nature of the lesion by showing its fluid content. Cystic masses in the hyoid bone are very rare. Here we report an asymptomatic SBC in the hyoid bone, incidentally discovered in a cone-beam computed tomography (CBCT) examination, which appears to be the 2nd reported case.
Topics: Bone Cysts; Follow-Up Studies; Humans; Hyoid Bone; Magnetic Resonance Imaging; Radiography
PubMed: 33113293
DOI: 10.17219/dmp/120079 -
BioMed Research International 2020To study the efficacy of arthroscopy for treating symptomatic bone cysts of the foot and ankle through the follow-up of patients and to further explore the application...
OBJECTIVE
To study the efficacy of arthroscopy for treating symptomatic bone cysts of the foot and ankle through the follow-up of patients and to further explore the application value of 3D printing technology in this treatment.
METHODS
Twenty-one patients with symptomatic bone cysts in the foot and ankle who underwent arthroscopic surgery in our Center from March 2010 to December 2018 were enrolled, including 11 in the experimental group and 10 in the control group. For the control group, C-arm fluoroscopy was used intraoperatively to confirm the positioning of the cysts; for the experimental group, a 3D model of the lesion tissue and the 3D-printed individualized guides were prepared to assist the positioning of the cysts. Debridement of the lesion tissues was conducted under an arthroscope. Regular follow-ups were conducted. The time of establishing arthroscopic approaches and the times of intraoperative fluoroscopy between the two groups were compared. Significance was determined as < 0.05.
RESULTS
The postoperative pathology of the patients confirmed the diagnosis. No significant perioperative complications were observed in either group, and no recurrence of bone cysts was seen at the last follow-up. The VAS scores and AOFAS scores of the two groups at the last follow-up were significantly improved compared with the preoperative data, but there was no statistical difference between the two groups. All surgeries were performed by the same senior surgeon. The time taken to establish the arthroscopic approaches between the two groups was statistically significant ( < 0.001), and the times of intraoperative fluoroscopy required to establish the approach were also statistically significant ( < 0.001). The intraoperative bleeding between the two groups was statistically significant ( < 0.01). There was 1 case in each group whose postoperative CT showed insufficient bone grafting, but no increase in cavity volume was observed during the follow-up.
CONCLUSION
With the assistance of the 3D printing technology for treating symptomatic bone cysts of the ankle and foot, the surgeon can design the operation preoperatively and perform the rehearsal, which would make it easier to establish the arthroscopic approach, better understand the anatomy, and make the operation smoother. This trial is registered with http://www.clinicaltrials.govNCT03152916.
Topics: Adult; Ankle Joint; Arthroscopy; Bone Cysts; Female; Fluoroscopy; Follow-Up Studies; Foot Bones; Humans; Male; Middle Aged; Postoperative Complications; Printing, Three-Dimensional
PubMed: 33426066
DOI: 10.1155/2020/8323658 -
Journal of Radiology Case Reports Jul 2018We present a case of 27-year-old female who presented for a progressive frontal swelling with ipsilateral headache. Subsequent CT scan revealed an extradural and... (Review)
Review
We present a case of 27-year-old female who presented for a progressive frontal swelling with ipsilateral headache. Subsequent CT scan revealed an extradural and expansile multiloculated mass with thin and strongly enhanced septations and MRI evaluation showed internal hyperintensity on T2 with no restriction of diffusion and confirmed the multiple cystic spaces with enhancing septations and rare hemorrhagic fluid-fluid levels. Surgery was performed and diagnosis of aneurysmal bone cyst was made on frozen section. Identification of USP6 fusion gene by in situ hybridization technique permitted to confirm the diagnosis of primary ABC. Although aneurysmal bone cyst (ABC) of the skull is a very rare entity and accounts for 2-6% of all ABCs, we should think about it in front of osteolytic and cystic skull changes even with very few fluid-fluid levels. Following description of our case and differential diagnoses, we conduct a literature review of skull ABCs imaging characteristics and discuss the interest of USP6 rearrangement identification.
Topics: Adult; Bone Cysts, Aneurysmal; Diagnosis, Differential; Diffusion Magnetic Resonance Imaging; Female; Frontal Bone; Headache; Humans; Positron Emission Tomography Computed Tomography; Prognosis; Tomography, X-Ray Computed
PubMed: 30651914
DOI: 10.3941/jrcr.v12i7.3344 -
Monaldi Archives For Chest Disease =... Sep 2017Thoracic cage is the site of development of various primary or metastatic tumors. An aneurysmal rib cyst is a benign tumor arising from the chest wall. Aneurysmal rib...
Thoracic cage is the site of development of various primary or metastatic tumors. An aneurysmal rib cyst is a benign tumor arising from the chest wall. Aneurysmal rib cyst is considered a rare surgical entity and its presence must be followed by removal for histology examination. We present here the case of an aneurysmal rib cyst to a young 33-year-old female. The tumor was presented as an expanding left anterior second rib mass during a self-breast examination. Chest x-ray showed a shadow on the left upper lung area and CT scan revealed a large multicystic mass in the anterolateral left 2nd rib protruding underneath the thoracic major muscle. We discuss the clinicopathological characteristics of this tumor and its surgical management along with a short literature review.
Topics: Adult; Aftercare; Bone Cysts, Aneurysmal; Female; Humans; Ribs; Thoracic Wall; Thoracotomy; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 29424198
DOI: 10.4081/monaldi.2017.860 -
Journal of the American Academy of... Mar 2023Cysts of the bone are a common pathology that, although benign, are frequently treated because of their tendency to compromise the integrity of affected bone. Two common... (Review)
Review
Cysts of the bone are a common pathology that, although benign, are frequently treated because of their tendency to compromise the integrity of affected bone. Two common entities are unicameral bone cysts and aneurysmal bone cysts. Although these are two distinct pathologies, they are treated similarly and thus will be discussed in tandem. The optimal treatment of calcaneal bone cysts in pediatric patients has long been debated among orthopaedic surgeons because of the relatively small number of cases and varied results within the literature. Currently, there are three lines of thought regarding treatment: observation, injection, and surgical intervention. When considering which course of treatment is best for an individual patient, the surgeon must consider the fracture risk without treatment, the risk of complications with treatment, and the recurrence rate with each treatment approach. There are limited data on pediatric calcaneal cysts specifically. Still, there are much data concerning simple bone cysts of long bones in the pediatric population and calcaneal cysts in the adult population. Because of the lack of literature on the subject, there is a need for a review of the available literature and a consensus on the approach to treating calcaneal cysts in the pediatric population.
Topics: Adult; Humans; Child; Bone Cysts; Fractures, Bone; Injections; Bone Cysts, Aneurysmal; Calcaneus
PubMed: 36913318
DOI: 10.5435/JAAOSGlobal-D-22-00248 -
Brazilian Journal of Otorhinolaryngology Apr 2012The traumatic bone cyst is characterized by the presence of an asymptomatic sinus devoid of epithelial lining, which is rarely found in the jaws. (Review)
Review
UNLABELLED
The traumatic bone cyst is characterized by the presence of an asymptomatic sinus devoid of epithelial lining, which is rarely found in the jaws.
OBJECTIVE
To describe the clinical, surgical and radiographic findings of traumatic bone cysts.
MATERIAL AND METHOD
A retrospective study was made of patients diagnosed with traumatic bone cysts at an oral pathology department from 1992 to 2007. Data on the clinical, radiographic and surgical complications were gathered.
RESULTS
Twenty-six cases of traumatic bone cyst were diagnosed in 15 years; 17 were male and 09 were female. Most patients were within first two decades of life and had no pain or history of trauma in the affected area. The multilocular pattern was observed in only seven cases, its radiographic appearance suggests a tumor. Air was found inside the lesion in about 70% of cases; serous fluid with blood and blood only were uncommon within the lesions.
CONCLUSION
A higher prevalence in young patients, absence of a history of trauma, and a small number of lesions containing serous fluid with blood reflects the need to discuss the true pathogenesis of traumatic bone cysts.
Topics: Adolescent; Adult; Aged; Child; Female; Humans; Jaw Cysts; Male; Mandibular Diseases; Middle Aged; Retrospective Studies; Young Adult
PubMed: 22499365
DOI: 10.1590/S1808-86942012000200004 -
Orthopaedics & Traumatology, Surgery &... Jun 2022The optimal treatment of aneurysmal bone cysts (ABC) remains controversial. Surgery has long been considered as the treatment that yields the best outcomes. Some authors... (Review)
Review
INTRODUCTION
The optimal treatment of aneurysmal bone cysts (ABC) remains controversial. Surgery has long been considered as the treatment that yields the best outcomes. Some authors now prefer using less invasive options as the primary treatment. The primary objective of this systematic literature review was to determine if treatments that are less invasive than surgery are also effective in curing the ABC. The secondary objective was to determine the respective role of each treatment in the therapeutic arsenal.
HYPOTHESIS
Less invasive treatments can replace surgery as the base treatment for ABC.
PATIENTS AND METHODS
A PubMed® search was carried out for this review. The inclusion criteria were ABC treatment without cyst removal, case series, clinical case reports, reviews, publication in French or English. Excluded were articles that described the results of surgical treatment only, cranial or maxillofacial cysts, secondary ABC, duplicates, no abstract available. Based on the first six items of the "MINOR criteria", we selected 42 studies. For each selected study, we analyzed the number of cases, clinical response to treatment, radiological healing, recurrence or failure rate, complications and side effects of the treatment.
RESULTS
This review found that less invasive treatments generate results that are at least as good as surgery, often with fewer complications. Thus, in certain cases, these treatments can be recommended as first-line therapy. This category includes selective arterial embolization, sclerotherapy (alcohol, polidocanol) and injection of demineralized bone matrix.
DISCUSSION
Selective arterial embolization yields good results. While this is a difficult, operator-dependent technique that is not suitable for all ABCs (no identifiable feeding vessel), we recommend it as the primary treatment for spinal ABCs. For ABCs in other locations, sclerotherapy can be used as the primary treatment. However, this treatment becomes inconvenient if the number of injections is too high. Radiation therapy is not a first-line treatment because of its side effects. Bisphosphonates and denosumab can be used when the other treatments are contraindicated.
Topics: Bone Cysts, Aneurysmal; Embolization, Therapeutic; Humans; Radiography; Sclerotherapy; Treatment Outcome
PubMed: 35331923
DOI: 10.1016/j.otsr.2022.103272