Intralesional Ethibloc injections in primary aneurysmal bone cysts: an efficient and safe treatment (original) (raw)
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Percutaneous Ethibloc injection in aneurysmal bone cysts
Skeletal Radiology, 2000
Objective. To investigate whether the injection of Ethibloc into aneurysmal bone cysts can be an effective treatment modality. Design and patients.Ethibloc is an alcoholic solution of zein (corn protein) which has thrombogenic and fibrogenic properties. Ten patients with aneurysmal bone cysts were treated with CT-guided percutaneous injection of Ethibloc into the cyst cavity. Ethibloc injection was the primary treatment in five patients. Four patients had recurrence following previous curettage and bone grafting and one patient had not responded to injection into the lesion of autologous iliac crest bone marrow aspirate. Three patients needed a second injection. The median follow-up was 27 (6–60) months. Results and conclusion.Symptoms were relieved in all patients. At imaging, seven patients had resolution of the lesion and three had partial response at the most recent follow-up. Complications consisted of a local transitory inflammatory reaction in two patients and an aseptic abscess in one patient. This relatively simple, minimally invasive procedure makes an operation unnecessary by stopping the expansion of the cyst and inducing endosteal new bone formation. This technique may be used as the primary management of aneurysmal bone cysts excluding spinal lesions.
Aneurysmal Bone Cysts: Treatment with Direct Percutaneous Ethibloc Injection. Long-Term Results
CardioVascular and Interventional Radiology, 2002
Purpose: To assess the efficacy and long-term results of Ethibloc treatment in aneurysmal bone cysts (ABC). Methods: Thirteen patients with ABC were treated with direct percutaneous Ethibloc injection. Four patients had only one injection and the other nine patients from two to four injections. No severe complications were observed; in two patients a local leakage of Ethibloc from the cyst into the soft tissues occurred but it was temporary and the consequent inflammation self-healed without residua and sequelae. Imaging follow-up lasted from 6 to 67 months and included conventional radiology (CR) and magnetic resonance imaging (MRI), both used in the presurgical phase. Results and Conclusions: All images demonstrated a remarkable shrinkage of the cystic lesion and bone cortex thickening. In all patients, circumscribed areas of lucency persisted at radiography, corresponding to residual cystic areas without fluid-fluid levels at MRI. Pain, which was present in all the patients before treatment, was relieved within a month. According to our experience, direct percutaneous Ethibloc injection is effective in the treatment of ABC and can be recommended as the first-choice treatment. Due to its higher sensitivity MRI must be included either in the pretreatment phase to study the multilocular structure or in the imaging follow-up to evaluate the efficacy of Ethibloc in persistently non-responsive areas.
Efficacy of treatment interventions for primary aneurysmal bone cysts: a systematic review
Bone & Joint Open
Aims Aneurysmal bone cysts (ABCs) are locally aggressive lesions typically found in the long bones of children and adolescents. A variety of management strategies have been reported to be effective in the treatment of these lesions. The purpose of this review was to assess the effectiveness of current strategies for the management of primary ABCs of the long bones. Methods A systematic review of the published literature was performed to identify all articles relating to the management of primary ABCs. Studies required a minimum 12-month follow-up and case series reporting on under ten participants were not included. Results A total of 28 articles meeting the eligibility criteria were included in this review, and all but one were retrospective in design. Due to heterogeneity in study design, treatment, and outcome reporting, data synthesis and group comparison was not possible. The most common treatment option reported on was surgical curettage with or without a form of adjuvant ther...
Therapeutic embolization of aneurysmal bone cyst
Cardiovascular and Interventional Radiology, 1989
Results of therapeutic embolization of aneurysmal bone cysts in five patients are described. Transcatheter arterial embolization was performed with Ivalon and Gelfoam particles and Gianturco coils. The postembolization period was characterized by complete relief of pain and decrease in size of the aneurysmal bone cyst in all patients. In patients whose follow-up was longer than 12 months, sclerosis and recalcification of bone were present. There were no complications.
Aneurysmal bone cyst of the ischium
International Orthopaedics, 1985
The treatment of a patient with an aneurysmal bone cyst involving the pelvis by selective arterial embolism is described. After one year pain relief is complete and radiologically the lesion is healing with increased density of the cyst wall and intracystic trabecular bone formation.
International Orthopaedics, 2018
Introduction Aneurysmal bone cyst (ABC) is a benign intraosseous lesion filled with blood that can determine a blowout distension of the bone. The purpose of this study is to evaluate the efficacy of sclerotherapy by percutaneous intralesional administration of ethanol 96% for the treatment of this pathology in paediatric patients. Method The retrospective study includes 17 paediatric patients with ABC who were treated by repeated intracystic injection with ethanol 96%, 1 ml/kg, in our clinic between December 2015 and July 2017. Fluoroscopic guidance was used to inject the cyst with contrast agent. The mean follow-up period was 11 months. Results and discussion All cysts are healed or are in the healing process. The mean age was 11 years old. Seven patients needed three repeated injections and ten patients needed two injections until healing. We observed a mean reduction in the size of the lesions, measured on plain X-rays, of 68%. The complications that were observed included the following: dizziness after injection, skin pigmentation at the injection site, local inflammatory reaction, and pain after injection. The current study approves the importance of this minimally invasive treatment with no recurrence after a follow-up of 19 months. The healing rate was 100%. A limitation of this study consists in the small number of patients. Conclusion Sclerotherapy with ethanol 96% is a useful method for the treatment of ABC. It is a minimally invasive method, with no major complications, which lowers the risks of open surgical intervention and has a good rate of success.
Sclerotherapy in aneurysmal bone cysts in children: a review of 17 cases
Pediatric Radiology, 2003
In 1970, in a classic review article, Biesecker et al. [1] wrote ''the lack of understanding about the origin and growth of aneurysmal bone cysts has led to an empirical approach to their treatment''. Thirty years later, despite the persistent uncertainty of their origin, treatments have improved, mostly owing to sclerotherapy and
Treatment of Aneurysmal Bone Cysts with Bioactive Glass in Children
Scandinavian Journal of Surgery, 2017
Background and Aims:Aneurysmal bone cysts represent about 1% of primary bone tumors. The standard treatment is curettage, followed by local adjuvant treatments and bone grafting. The problem is the high recurrence rate. The purpose of this study was to evaluate retrospectively the use of bioactive glass as a filling material in the treatment of aneurysmatic bone cysts in children.Material and Methods:A total of 18 consecutive children (mean 11.3 years at surgery; 10 males; 11 lower, 6 upper limb, 1 pelvis; 15 with primary surgery) with histologically proven primary aneurysmal bone cysts operated with curettage and bioactive glass filling between 2008 and 2013 were evaluated after a mean follow-up of 2.0 years (range, 0.7–5.1 years).Results:Two (11%) patients showed evidence of aneurysmal bone cyst recurrence and both have been re-operated for recurrence. Bone remodeling was noted in all patients with remaining growth and no growth plate disturbances were recorded. Two patients neede...
Challenges in the Diagnosis and Treatment of Aneurysmal Bone Cyst in Patients with Unusual Features
Advances in Orthopedics, 2019
Objectives. Aneurysmal bone cyst (ABC) is a benign but locally aggressive tumor. It has several challenging features. The aim of this study is to identify challenges in the diagnosis and treatment of ABC especially in patients with unusual features. Methods. This retrospective study involved medical record review of primary ABC patients with one or more of the following features: unusual clinical presentation with a mass or a pathological fracture especially at an unusual age, rare locations, radiological findings suggesting other diagnoses especially sarcoma, and a nondiagnostic histopathology of biopsy samples. Results. 25 patients (17 males and 8 females) were included. Most patients were either younger than 10 or older than 20 years. 10 patients presented with a mass or a pathological fracture. Unusual locations include the scapula, the olecranon, the hamate, the calcaneus, and the first metatarsal bone. Extension into the epiphysis occurred in 2 patients with proximal fibula an...
Aneurysmal bone cyst--clinical and morphological aspects
Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie, 2014
To assess the results of surgical treatment in aneurysmal bone cysts. 31 patients with aneurysmal bone cysts underwent surgical treatment in our department. In almost half of cases, the lesion was located in the femur. In 12 cases, a pathological bone fracture was the first clinical sign. The treatment consisted in curettage, abrasion of the cavity inner walls using a motorized burr and filling with morsellized bone grafts (autografts ± allografts) or bone substitutes (four cases). Microscopically, the diagnosis relies on cystic spaces filled with blood, divided by fibrous septae consisting in immature bone trabeculae, hemosiderin filled macrophages and fibroblasts. We performed multiple bioptic probes from different levels of the lesion. Macroscopically, the osseous lesion appeared as a multi-loculated blood-filled cavity (cavities separated by septa) in 30 (96.77%) cases and as a solid tumor in one (3.23%) case. At 12 months after surgery, grafts osteointegration was present in 24...