Surgical Treatment of an Aneurysmal Bone Cyst with Avascular Bone Graft (original) (raw)
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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...
Orthopaedic Surgery
ObjectiveRecurrence is the main hinderance in treatment of aneurysmal bone cysts (ABCs). Therefore, several treatment modalities and adjuvant therapies have been proposed. In this study, we aim to evaluate the long‐term effectiveness of percutaneous curettage and allogenic bone grafting as a new, minimally invasive modality in treating ABCs.MethodsWe performed a retrospective review of the medical records of patients diagnosed with primary ABCs at a university hospital over a 10‐year period (2000–2010). We selected all patients who were diagnosed with primary ABC in the extremities and pelvis, treated with the same surgical procedure, and were followed for at least 2 years postoperatively. All patients underwent the same procedure of percutaneous curettage and impaction of allogenic pulverized fine bone fragments (harvested from locally stored femoral heads) mixed with autologous bone marrow aspirate from the iliac bone. We reported patient's characteristics (age and gender), si...
International journal of scientific research, 2020
Aneurysmal Bone Cyst (ABC) is a Benign tumor, Also known as Giant Cell Repetative Granuloma, They are locally destructive hemorrhagic benign cystic legion. According to the definition of the WHO Aneurismal Bone Cyst is expanding osteolytic lesion consisting of blood-filled spaces of variable size and that are separated by connective tissue septae containing trabecula of bone or osteoid tissue and osteoclast giant cells. We report a case of a giant aneurysmal bone cyst in the Middle one-third of Right humerus of a 16 -year-old boy, which was treated with Allograft, Autograft and ender's nail fixation. At 6 Years of follow up Patient regain a pain-free complete Range of motion with radiographically subside of legion.
Shaped graft for aneurysmal bone cyst of upper limb bones
Strategies in trauma and limb reconstruction (Online), 2017
The optimal treatment of aneurysmal bone cyst remains challenging. The aim of this prospective study was to evaluate the results of using bone grafts shaped to the defects caused by aneurysmal bone cysts of upper limb bones. Fifteen patients (12 males and 3 females) with an average age of 12 years (range 6-16 years) were treated for aneurysmal bone cysts of upper limb bones by intralesional resection, argon beam coagulation and shaped bone graft. The grafts were harvested from 14 patients (11 fibulas and 3 iliac bones) and from the mother of one patient (proximal fibula). Osteosynthesis was required to stabilize the graft in four cases. The modified Enneking's scoring system was used for functional evaluation. One patient developed partial recurrence at 6 months and required reoperation. Superficial wound infection was encountered in one patient. Shortening of the humeral segment was seen in two patients (1 and 1.5 cm) but without angular deformity. After a mean follow-up of 45 ...
Aneurysmal bone cyst of the pelvis and extremities: Contemporary management
International Journal of Surgery Oncology, 2019
Aneurysmal bone cysts are tumors of bone occurring predominantly in the metaphyses of long bones and posterior elements of spine in adolescents and young adults. Radiographically, on x-rays they appear as eccentric metaphyseal expansile lytic lesions containing “fluid-fluid” levels. Computed tomographic scan and magnetic resonance imaging clearly define the cysts and fluid-fluid levels; the former delineates cortical expansion and the latter the fibrovascular component clearly. Magnetic resonance imaging is particularly useful in differentiating aneurysmal bone cysts from malignant lesions. Histologically, these cysts are characterized by fibrovascular tissue, multinucleated giant cells, inflammatory cells, fiber-osteoid, “blue bone,” and blood filled lacunae. Chromosomal translocation has been found, implying a neoplastic basis for the development of aneurysmal bone cysts. Malignant transformation has been reported where radiation therapy was used, and in cysts associated with sarc...
Aneurysmal Bone Cyst: A Review of 150 Patients
Journal of Clinical Oncology, 2005
Purpose We have reviewed a series of 150 aneurysmal bone cysts treated over the last 20 years. Patients and Methods The lesions were principally located in the tibia, femur, pelvis, humerus, and spine and, in most cases, presented the imaging appearance originally described by Jaffe and Lichtenstein as a blowout with thin cortices. Results Only one of the patients was believed to have an osteoblastoma of the spine with secondary development of an aneurysmal bone cyst, and none of the patients developed additional lesions. The patients were treated primarily with curettage and implantation of allograft chips or polymethylmethacrylate, but some patients were treated with insertion of autografts or allografts. The local recurrence rate was 20%, which is consistent with that reported by other centers. Conclusion Aneurysmal bone cysts are enigmatic lesions of unknown cause and presentation and are difficult to distinguish from other lesions. Overall, the treatment is satisfactory, but it...
CASE REPORTS: Malignant Transformation of Aneurysmal Bone Cysts
Clinical Orthopaedics and Related Research, 2005
An aneurysmal bone cyst is an uncommon benign primary bone tumor. Careful intralesional curettage through a wide cortical window in addition to cauterization with or without adjuvant therapy (phenol or hydrogen peroxide) and bone grafting or cementation is the preferred surgical treatment. Adjuvant or primary radiation of an aneurysmal bone cyst rarely is used because of its association with malignant transformation of the lesion. Several cases of late malignant transformation of primary aneurysmal bone cysts without adjuvant radiation have been reported. We provide additional documentation of two primary aneurysmal bone cysts treated surgically with careful intralesional curettage through a wide cortical window and allograft bone grafting without adjuvant radiation. At 5.5 years and 12 years after treatment, a telangiectatic osteosarcoma and a fibroblastic osteosarcoma, respectively, were identified in the site of the original lesions. Not only should aneurysmal bone cysts be evaluated carefully through histologic examination at presentation, patients also should be counseled regarding possible recurrence and the need for routine followups, especially if symptoms change.
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...
Aneurysmal bone cyst in the proximal femur: Combined approach of management: a case report
2021
Purpose of Study: To study the effectiveness of combined extended curettage and sclerosant therapy in the management of aneurysmal bone cyst of proximal femur. Materials and Methods: A 22 years old male presented with complaints of left hip pain since 20 days, was examined clinically and radiologically. On MRI, he was diagnosed to have a non-expansile lytic lesion in the left proximal femur with features suggestive of aneurysmal bone cyst or an unicameral bone cyst. Patient was planned and taken up for aspiration and curettage followed by a single sitting sclerosant therapy with 3% polidocanol, bone cementing combined with plating. Curetted sample was sent for histo-pathological examination. Patient was advised restricted weight bearing for a period of 4 weeks. Regular follow-ups of the patient was done at 1, 3, 12 and 18 months post-operatively to assess for recurrence. Results: Histo-pathological examination confirmed the diagnosis of aneurysmal bone cyst. With regular follow-ups,...