scholarly journals The Efficacy of Denosumab in the Management of a Tibial Paediatric Aneurysmal Bone Cyst Compromised by Rebound Hypercalcaemia

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Matthew Harcus ◽  
Samantha Aldridge ◽  
Adesegun Abudu ◽  
Lee Jeys ◽  
Senthil Senniappan ◽  
...  
Keyword(s):  
Aneurysmal Bone Cyst ◽  
Pathological Fracture ◽  
Proximal Tibia ◽  
Bone Cyst ◽  
Significant Risk ◽  
Paediatric Population ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Bisphosphonate Therapy ◽  
En Bloc

Surgery is the main treatment option for patients with aneurysmal bone cyst (ABC). We report our experience of using denosumab as an alternative treatment in a child with a multiply recurrent and unresectable tibial ABC. The efficacy and safety of denosumab in the paediatric population, and in the treatment of ABC, are still to be fully evaluated. We describe a 13-year-old boy with an extensive and aggressive ABC involving the proximal tibia, which had recurred following multiple previous surgeries. The patient had ongoing severe pain, was unable to weight-bear, and was at significant risk of pathological fracture. En bloc resection and embolization were not deemed viable, and a decision to use denosumab was made. He received 17 doses of subcutaneous denosumab (70 mg/m2) over a 27-month period, at increasing dose intervals. His symptoms significantly improved, and bony consolidation was observed within six months of treatment. He was able to walk without protection and fully weight-bear without any pain by 18 months. With an increase to a six-month dosing interval, the patient presented with a severe, symptomatic rebound hypercalcaemia requiring bisphosphonate therapy. This reoccurred on two further occasions. This case adds to the evidence that denosumab is effective in the treatment of ABC in paediatric patients, but there is a risk of rebound hypercalcaemia. Therefore, patient awareness and biochemical monitoring for rebound hypercalcaemia are essential.

scholarly journals Primary Aneurysmal Bone Cyst and Its Recent Treatment Options: A Comparative Review of 74 Cases

Cancers ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 2362
Author(s):  
Nils Deventer ◽  
Martin Schulze ◽  
Georg Gosheger ◽  
Marieke de Vaal ◽  
Niklas Deventer
Keyword(s):  
Aneurysmal Bone Cyst ◽  
Bone Cyst ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Treatment Modalities ◽  
En Bloc ◽  
Intralesional Curettage ◽  
Cyst Volume ◽  
Comparative Review ◽  
The Mean

(1) Background: An aneurysmal bone cyst (ABC) is a benign, locally aggressive tumor. Different treatment modalities are described in the literature i.e., en bloc resection, intralesional curettage and percutaneous sclerotherapy. (2) Methods: This single-center study is a review of 74 patients with primary ABCs who underwent a surgical treatment or polidocanol instillation. Cyst volume measurements using MRI and conventional radiographs are compared. (3) Results: The mean pre-interventional MRI-based cyst volume was 44.07 cm3 and the mean radiographic volume was 27.27 cm3. The recurrence rate after intralesional curettage with the need for further treatment was 38.2% (13/34). The instillation of polidocanol showed a significant reduction of the initial cyst volume (p < 0.001) but a persistent disease occurred in 29/32 cases (90.6%). In 10 of these 29 cases (34.5%) further treatment was necessary. After en bloc resection (eight cases) a local recurrence occurred in two cases (25%), in one case with the need for further treatment. (4) Conclusions: MRI scans are superior to biplanar radiographs in the examination of ABCs. Sequential percutaneous instillations of polidocanol are equally effective in the therapy of primary ABCs compared to intralesional curettage. However, several instillations have to be expected. In a considerable number of cases, a conversion to intralesional curettage or en bloc resection may be necessary.

Tailored treatment of aneurysmal bone cyst of the scapula: en bloc resection for the body and extended curettage for the neck and acromion

2020 ◽  
Vol 29 (5) ◽  
pp. 961-967 ◽  
Author(s):  
Khodamorad Jamshidi ◽  
Milad Haji Agha Bozorgi ◽  
Mikaiel Hajializade ◽  
Abolfazl Bagherifard ◽  
Alireza Mirzaei
Keyword(s):  
Aneurysmal Bone Cyst ◽  
Bone Cyst ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
The Body ◽  
En Bloc ◽  
Tailored Treatment ◽  
Extended Curettage

scholarly journals Aneurysmal bone cyst of rib in middle age: An uncommon case with a recent review

2021 ◽  
Vol 7 (1) ◽  
pp. 25-26
Author(s):  
Sunder Goyal ◽  
◽  
Snigdha ◽  
Keyword(s):  
Aneurysmal Bone Cyst ◽  
Middle Age ◽  
Bone Cyst ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Long Bones ◽  
Age Group ◽  
En Bloc ◽  
Uncommon Case ◽  
Rare Benign Tumour

Aneurysmal cyst of bone is a rare benign tumour that is slowing growing and expansile in nature. Generally, occurs in the long bones but can also involve the vertebrae. An aneurysmal bone cyst from the rib, especially in the middle age group, is extremely uncommon. Hereby, we report a 40-year-old woman with an aneurysmal bone cyst of the left 6th rib. She was treated with en bloc rib excision with the cyst. FNAC of lesion proved the diagnosis of the aneurysmal bone cyst. Curative treatment is en bloc resection of the affected rib, leaving no chance of recurrence.

Metacarpal Aneurysmal Bone Cyst En Bloc Resection Reconstructed With Osteoarticular Allograft

2019 ◽  
Vol 44 (5) ◽  
pp. 425.e1-425.e5 ◽  
Author(s):  
Ezequiel Ernesto Zaidenberg ◽  
Efrain Farias Cisneros ◽  
Ryan Miller ◽  
Carlos Rodolfo Zaidenberg
Keyword(s):  
Aneurysmal Bone Cyst ◽  
Bone Cyst ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
En Bloc ◽  
Osteoarticular Allograft

scholarly journals Preoperative endoscopic predictors of severe submucosal fibrosis in colorectal tumors undergoing endoscopic submucosal dissection

2019 ◽  
Vol 07 (04) ◽  
pp. E421-E430 ◽  
Author(s):  
Uayporn Kaosombatwattana ◽  
Takeshi Yamamura ◽  
Julajak Limsrivilai ◽  
Masanao Nakamura ◽  
Somchai Leelakusolvong ◽  
...  
Keyword(s):  
Endoscopic Submucosal Dissection ◽  
Curative Resection ◽  
Significant Risk ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Resection Rate ◽  
En Bloc ◽  
Submucosal Dissection ◽  
Submucosal Fibrosis ◽  
Severe Fibrosis

Abstract Background and study aims Endoscopic submucosal dissection (ESD) enables en bloc removal of colorectal neoplasms regardless of size. Submucosal fibrosis is a significant factor for technical difficulty and poor outcomes. We assessed the predictive factors for severe submucosal fibrosis and the ESD outcomes. Patients and methods Patients undergoing ESD from January 2006 to September 2017 were retrospectively reviewed. The degree of submucosal fibrosis was classified into three types: no fibrosis (F0), mild fibrosis (F1), and severe fibrosis (F2). F0 and F1 cases were grouped as non-severe fibrosis for comparison with the severe fibrosis group. Predictors of severe submucosal fibrosis and ESD outcomes were evaluated. Results ESD was performed in 524 lesions (60 % male; mean age, 67.8 years). Eighty lesions with severe fibrosis (15.3 %) were observed. The overall en bloc resection rate and curative resection rate were 94.3 % and 77.7 %, respectively. Rates of en bloc resection (91.2 % vs. 94.8 %, P = 0.2) and perforation (7.5 % vs. 5.6 %, P = 0.45) were no different between severe fibrosis and non-severe fibrosis groups. However, incidences of non-curative resection and low resection speed were significantly higher in the severe fibrosis group. Among protruding lesions, tumor height and volume were significantly greater in the severe counterparts. A diameter ≥ 40 mm, endoscopic finding of the tumor beyond fold, and fold convergence were independent risk factors for severe fibrosis. Conclusions Severe submucosal fibrosis is a significant risk factor for non-curative resection and a long procedural time. Tumor size and morphology might help to predict the severity of fibrosis.

Giant Cell Tumor and Aneurysmal Bone Cyst of the Talus: Clinicopathological Review and Two Case Reports

Foot & Ankle ◽  
1981 ◽  
Vol 1 (4) ◽  
pp. 235-244 ◽  
Author(s):  
Martin M. Malawer ◽  
Raymond Vance
Keyword(s):  
Giant Cell Tumor ◽  
Giant Cell ◽  
Aneurysmal Bone Cyst ◽  
Case Reports ◽  
Bone Cyst ◽  
En Bloc Resection ◽  
Cell Tumor ◽  
Biological Behavior ◽  
En Bloc ◽  
Proximal Lesion

Two cases of giant cell tumor and aneurysmal bone cyst of the talus were analyzed with a review of eight cases from the literature. This anatomic setting represents a distinct clinical and roentgenographic entity with a less aggressive natural history than the more common sites. All lesions presented a characteristic radiographic involvement of the head and neck of the talus. Eight of ten lesions were treated by curettage, with or without bone grafting, and healed. Two underwent partial en bloc resection. None developed late fracture, recurrence, avascular necrosis, or metastases. We concluded that a giant cell tumor or aneurysmal bone cyst when located in the talus may be difficult to differentiate but tends to exhibit a less aggressive biological behavior and a more favorable prognosis than the more classical proximal lesion. Talectomy is not indicated in the primary treatment. Curettage with or without bone graft has a high success rate. Cryosurgery should be reserved for a recurrent lesion.

scholarly journals Aneurysmal bone cyst of proximal fibula treated with en-bloc excision: a rare case report

2019 ◽  
Vol 5 (4) ◽  
pp. 736
Author(s):  
Piyush Wadhawan ◽  
Atul Agrawal ◽  
Ruchit Khera
Keyword(s):  
Bone Cyst ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
En Bloc ◽  
Radiographic Findings ◽  
Proximal Fibula ◽  
Rare Case Report ◽  
Aneurysmal Bone Cysts ◽  
En Bloc Excision ◽  
Bloc Excision

Aneurysmal bone cysts (ABCs) are benign but locally destructive, blood filled reactive lesions of the bone. Although a wider age group may be affected, most commonly they are seen in patients younger than 20 years of age, with a slight female preponderance. Most common sites include metaphysis of femur followed by tibia and then humerus. Vertebral lesions involving the posterior elements are common.Aneurysmal bone cyst of proximal fibula is a rare and uncommon. Here, we report a case of 13 year old female with classic histologic, clinical, and radiographic findings that was treated by en bloc resection. <p class="Default"> </p>

scholarly journals Mediastinal herniation of the biliary tract leading to bile duct obstruction following oesophagectomy

2018 ◽  
Vol 100 (8) ◽  
pp. e211-e213
Author(s):  
A Laliotis ◽  
T Hettiarachchi ◽  
F Rashid ◽  
A Hindmarsh ◽  
V Sujendran
Keyword(s):  
Bile Duct ◽  
Surgical Management ◽  
Standard Treatment ◽  
Locally Advanced ◽  
Significant Risk ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
En Bloc ◽  
Abdominal Organs ◽  
Increased Risk

Surgical management of oesophageal and gastro-oesophageal junction malignancies is one of the most challenging situations confronting the surgeon. Attaining a complete circumferential resection margin of lower-third oesophageal and gastro-oesophageal junction locally advanced carcinomas requires en-bloc resection of the hiatus and all the peri-oesophageal tissue and pleura. This results in an increased risk of herniation of the abdominal organs through the enlarged hiatus, which carries significant risk of morbidity and mortality. The incidence of this complication is higher than has been reported. Surgical management of symptomatic hernias is the standard treatment while criteria for managing asymptomatic hernias are less clear. We report a rare case of a late mediastinal herniation of the pancreas and bile duct, leading to obstructive jaundice following oesophagectomy which was treated successfully in our unit.

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