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Aneurysmal bone cysts in children: Absolute alcohol sclerotherapy as first-line treatment

Published in N°268 - Book 1 - November 2017
Article viewed 185 times

Aneurysmal bone cysts in children: Absolute alcohol sclerotherapy as first-line treatment

By Stéphanie Pannier(1), Alexandra Alves(1), Francis Brunelle(2), Sylvain Breton(2), Eric Mascard(1), Christophe Glorion(1) in category FOLLOW-UP
1- Université Paris Descartes – Sorbonne Paris Cité – Service d’orthopédie infantile - Hôpital Necker Enfants Malades - Paris - France / 2- Université Paris Descartes – Sorbonne Paris Cité – Service d’imagerie médicale - Hôpital Necker Enfants Malades - Paris - France

We believe that surgery can no longer be considered as first-line treatment for aneurysmal bone cysts (ABCs) in children and adolescents.
We have been using absolute alcohol sclerotherapy to treat ABCs in children and adolescents for nearly 10 years, with around 100 patients treated with remarkable results.

Introduction

We believe that surgery can no longer be considered as first-line treatment for aneurysmal bone cysts (ABCs) in children and adolescents.

We have been using absolute alcohol sclerotherapy to treat ABCs in children and adolescents for nearly 10 years, with around 100 patients treated with remarkable results. It is a simple and effective technique that can be repeated should the lesion remain insufficiently filled. It avoids the problems related to reconstruction, bone stock and the risk of post-surgical recurrence. The technique is simple and follows a precise protocol that reduces the complication rate to a minimum. Even though the diagnosis may be suggested by the clinical presentation and imaging, a biopsy is essential to confirm the diagnosis and prepare a treatment plan.

 

What is an aneurysmal bone cyst?

An ABC is a benign bone lesion most commonly found in children and adolescents (75–90% of cases occur before the age of 20 years). The lesion is osteolytic, and the cysts may be uni- or multilocular, usually affecting the metaphysis of the long bones but also the spine and pelvis in 15% and 9% of cases, respectively.1 It may be isolated, in which case it is known as a primary cyst, or in about one-third of cases, it can be secondary to another type of bone...

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