Selective arterial embolization of 36 aneurysmal bone cysts of the skeleton with N-2-butyl cyanoacrylate

Aneurysmal bone cysts are benign musculoskeletal tumours, which occur in young patients and, occasionally, with aggressive behaviour. Those tumours very often will need surgical treatment with curettage and bone grafting, but for aggressive lesions, in<br />bloc resection is more advisable. Aggressive tumours use to be large and sometimes with difficult surgical approach and demanding complex surgical reconstructions. In this scenario, selective arterial embolization is a possible primary or adjuvant treatment option. This paper presents a paradigmatic case, where selective arterial embolization allowed a successful treatment of a large aneurysmal bone cyst with difficult surgical resolution.

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Aneurysmal Bone Cyst of the Atlas: Successful Treatment through Selective Arterial Embolization: Case Report

Neurosurgery ◽

10.1227/01.neu.0000137279.58768.7e ◽

2004 ◽

Vol 55 (4) ◽

pp. E1001-E1005 ◽

Cited By ~ 42

Author(s):

A Alex Mohit ◽

Joseph Eskridge ◽

Richard Ellenbogen ◽

Christopher I. Shaffrey

Keyword(s):

Successful Treatment ◽

Bone Cyst ◽

Arterial Embolization ◽

Craniovertebral Junction ◽

Cystic Mass ◽

High Morbidity ◽

Surgical Morbidity ◽

Complete Excision ◽

Selective Arterial Embolization ◽

Aneurysmal Bone Cysts

Abstract OBJECTIVE AND IMPORTANCE: Aneurysmal bone cysts (ABCs) are benign and expansile osteolytic lesions that can occur in any location in the spine, including the craniovertebral junction. Aggressive resection followed by bone grafting has been the mainstay of treatment, with selective arterial embolization as a presurgical adjunct. Complete excision of these lesions at the craniovertebral junction is associated with high surgical morbidity. We report a case of successful treatment of an ABC of the atlas in a child with selective arterial embolization alone. CLINICAL PRESENTATION: A 10-year-old girl presented with persistent neck pain after a snowboarding accident. Computed tomography and magnetic resonance imaging of the cervical spine revealed an expansile cystic mass involving the right lateral mass of C1. Digital subtraction angiography revealed a tumor blush, which, along with the cystic appearance of the lesion, was consistent with an ABC. INTERVENTION: The arterial feeders to the lesion were selectively embolized with polyvinyl alcohol particles. Three sessions of embolization were required to eradicate the blood supply to the lesion completely. CONCLUSION: Complete surgical resection of ABCs at the craniovertebral junction can be associated with high morbidity secondary to the highly vascular and destructive nature of these lesions. The case discussed here demonstrates the viability of selective arterial embolization as a primary and stand-alone modality of treatment.

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A rare case of an expansile spinopelvic aneurysmal bone cyst managed with embolization, excision, and fusion

Surgical Neurology International ◽

10.25259/sni_1045_2021 ◽

2021 ◽

Vol 12 ◽

pp. 580

Author(s):

Rudra Mangesh Prabhu ◽

Tushar N. Rathod ◽

Akash Vasavda ◽

Shivaprasad S. Kolur ◽

Punit Tayade

Keyword(s):

Bone Cyst ◽

Arterial Embolization ◽

Surgical Excision ◽

Osteolytic Lesions ◽

Selective Arterial Embolization ◽

Lower Back ◽

Spinopelvic Fixation ◽

Aneurysmal Bone Cysts ◽

Vertebral Bodies ◽

Neurologically Intact

Background: Aneurysmal bone cysts (ABC) are benign osteolytic lesions of the metaphyseal regions of long bones that typically contribute to rapid bony expansion. Here, we present an ABC involving the spinopelvic region in a 15-year-old male that required embolization, surgical excision, and fusion. Case Description: A 15-year-old male, presented with gradually progressive painful lower back swelling of 4 months’ duration. Once the diagnosis of an ABC was established based on a combination of X-ray, MR, and CT studies, he underwent selective arterial embolization, extended surgical excision (i.e. curettage), with a posterior fusion. Two years postoperatively, the patient remained neurologically intact without radiographic evidence of lesion recurrence. Conclusion: Large expansile ABC involving the vertebral bodies should be managed with preoperative selective arterial embolization, surgical decompression/curettage, and spinopelvic fixation.

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Musculoskeletal Interventional Radiology in the Pediatric Population: State of the Art

Seminars in Musculoskeletal Radiology ◽

10.1055/s-0041-1730326 ◽

2021 ◽

Vol 25 (01) ◽

pp. 176-183

Author(s):

Francesco Arrigoni ◽

Antonio Izzo ◽

Federico Bruno ◽

Pierpaolo Palumbo ◽

Massimo De Filippo ◽

...

Keyword(s):

Interventional Radiology ◽

Vascular Malformations ◽

Pediatric Population ◽

Arterial Embolization ◽

Bone Cysts ◽

Sclerosing Agents ◽

Aneurysmal Bone Cysts ◽

Intracystic Injection ◽

Interventional Radiology Procedures ◽

Lower Morbidity

AbstractInterventional radiology procedures have been proven to be as effective as traditional surgery but usually are characterized by lower morbidity rates. In this article, the most diffuse IR treatments for pediatric lesions are reviewed with the aim of describing main advantages and drawbacks. Ablation procedures (in particular RFA and MRgFUS) are widely used for the management of osteoid osteoma and osteoblastoma whereas intracystic injection of methylprednisolone acetate is performed for simple bone cysts. Sclerosing agents and where possible, selective arterial embolization are used for treatment of aneurysmal bone cysts and other vascular malformations. In the management of malignant muscoloskeletal tumors, the role interventional radiology is mainly represented by percutaneous biopsies, and by adiuvant selective embolizations in presence of hypervascular lesions to be submitted to surgery.

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THE EFFICACY OF SELECTIVE ARTERIAL EMBOLIZATION IN THE MANAGEMENT OF DIVERTICULAR BLEEDING

10.26226/morressier.59a6b34cd462b80290b55b03 ◽

2017 ◽

Author(s):

Yuichi Fukami

Keyword(s):

Arterial Embolization ◽

Diverticular Bleeding ◽

Selective Arterial Embolization

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Percutaneous sclerotherapy of spinal aneurysmal bone cysts causing neurological compromise: preliminary experience with a novel technique

10.26226/morressier.5ee7788d8ba89b7c87c300b1 ◽

2020 ◽

Author(s):

Danoob Dalili

Keyword(s):

Bone Cysts ◽

Novel Technique ◽

Percutaneous Sclerotherapy ◽

Aneurysmal Bone Cysts

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Cervical Spine Aneurysmal Bone Cysts: A Meta-Analysis of 114 Cases and Comparison of Clinical Features between Pediatric and Adult Patients

The Spine Scholar ◽

10.26632/ss.4.2017.1.1 ◽

2017 ◽

Vol 1 (1) ◽

pp. 21-29

Author(s):

Matthew Protas ◽

Henry Wingfield ◽

Basem Ishak ◽

Rong Li ◽

Rod J. Oskouian ◽

...

Keyword(s):

Cervical Spine ◽

Clinical Features ◽

Meta Analysis ◽

Adult Patients ◽

Bone Cysts ◽

Aneurysmal Bone Cysts

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Two cases of paralysis secondary to aneurysmal bone cysts with complete neurologic recovery

Spine Deformity ◽

10.1007/s43390-019-00023-1 ◽

2020 ◽

Vol 8 (2) ◽

pp. 339-344

Author(s):

Aaron Beck ◽

David L. Skaggs ◽

Tracy Kovach ◽

Erin Kiehna ◽

Lindsay M. Andras

Keyword(s):

Bone Cysts ◽

Neurologic Recovery ◽

Aneurysmal Bone Cysts

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Aneurysmal Bone Cysts Recur at Juxtaphyseal Locations in Skeletally Immature Patients

Clinical Orthopaedics and Related Research ◽

10.1007/s11999-007-0080-8 ◽

2008 ◽

Vol 466 (3) ◽

pp. 722-728 ◽

Cited By ~ 40

Author(s):

Patrick P. Lin ◽

Christopher Brown ◽

A. Kevin Raymond ◽

Michael T. Deavers ◽

Alan W. Yasko

Keyword(s):

Bone Cysts ◽

Skeletally Immature ◽

Aneurysmal Bone Cysts

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Aneurysmal Bone Cyst: A Review of 150 Patients

Journal of Clinical Oncology ◽

10.1200/jco.2005.15.255 ◽

2005 ◽

Vol 23 (27) ◽

pp. 6756-6762 ◽

Cited By ~ 222

Author(s):

Henry J. Mankin ◽

Francis J. Hornicek ◽

Eduardo Ortiz-Cruz ◽

Jorge Villafuerte ◽

Mark C. Gebhardt

Keyword(s):

Aneurysmal Bone Cyst ◽

Local Recurrence Rate ◽

Bone Cyst ◽

Secondary Development ◽

Bone Cysts ◽

Resonance Imaging ◽

Imaging Studies ◽

Treatment Protocols ◽

Imaging Appearance ◽

Aneurysmal Bone Cysts

PurposeWe have reviewed a series of 150 aneurysmal bone cysts treated over the last 20 years.Patients and MethodsThe 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.ResultsOnly 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.ConclusionAneurysmal 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 is possible that newer approaches, such as improved magnetic resonance imaging studies, may help diagnose the lesions and allow the physicians to plan for more effective treatment protocols.

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