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Erschienen in: Pediatric Radiology 5/2012

01.05.2012 | Original Article

Primary aneurysmal bone cysts in children: percutaneous sclerotherapy with absolute alcohol and proposal of a vascular classification

verfasst von: K. Lambot-Juhan, S. Pannier, D. Grévent, Z. Péjin, S. Breton, L. Berteloot, S. Emond-Gonsard, N. Boddaert, C. Glorion, F. Brunelle

Erschienen in: Pediatric Radiology | Ausgabe 5/2012

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Abstract

Background

Percutaneous sclerotherapy is an effective treatment for aneurysmal bone cysts (ABCs).

Objective

The purpose of this study was to demonstrate the safety and efficacy of sclerotherapy with absolute alcohol and to propose a vascular classification of ABCs based on a retrospective review.

Materials and methods

This was a review of children treated with absolute alcohol sclerotherapy for ABC at a single institution from January 1995 until November 2009. Treatment response was evaluated radiographically and clinically. Cyst fluid was classified as clear, partially bloody, or bloody. Presence of any venous drainage of the cyst was assessed by injection of contrast medium into the cyst cavity.

Results

Twenty-nine children with ages ranging from 2 to 16 years were included. Treatment response was good in 17 (59%), partial in 9 (31%), and poor in 3 (10%) children. Venous drainage was absent in six out of seven clear-fluid cysts, which we classified as lymphatic. Drainage was present in all seven bloody-fluid cysts, which we classified as venous. In seven partially bloody-fluid cysts, venous drainage was seen in three.

Conclusion

Sclerotherapy with absolute alcohol is a safe and effective treatment of ABC. We propose classifying ABC as lymphatic or venous and suggest considering ABC intraosseous slow-flow vascular malformations.
Literatur
1.
Zurück zum Zitat Jaffe HL, Lichtenstein L (1942) Solitary unicameral bone cyst: with emphasis on the roentgen picture, the pathologic appearance and the pathogenesis. Arch Surg 44:1004–1025CrossRef Jaffe HL, Lichtenstein L (1942) Solitary unicameral bone cyst: with emphasis on the roentgen picture, the pathologic appearance and the pathogenesis. Arch Surg 44:1004–1025CrossRef
2.
Zurück zum Zitat Cottalorda J, Gouin F (2005) Kyste osseux anévrismal (Aneurysmal bone cyst). In: Chotel F, Gouin F (eds) Tumeurs osseuses bénignes (Benign osseous tumors). Elsevier, Paris, pp 188–200 Cottalorda J, Gouin F (2005) Kyste osseux anévrismal (Aneurysmal bone cyst). In: Chotel F, Gouin F (eds) Tumeurs osseuses bénignes (Benign osseous tumors). Elsevier, Paris, pp 188–200
3.
Zurück zum Zitat Cottalorda J, Bourelle S (2007) Aneurysmal bone cyst in 2006. Rev Chir Orthop Reparatrice Appar Mot 93:5–16PubMedCrossRef Cottalorda J, Bourelle S (2007) Aneurysmal bone cyst in 2006. Rev Chir Orthop Reparatrice Appar Mot 93:5–16PubMedCrossRef
4.
Zurück zum Zitat Bonakdarpour A, Levy WM, Aegerter E (1978) Primary and secondary aneurysmal bone cyst: a radiological study of 75 cases. Radiology 126:75–83PubMed Bonakdarpour A, Levy WM, Aegerter E (1978) Primary and secondary aneurysmal bone cyst: a radiological study of 75 cases. Radiology 126:75–83PubMed
5.
Zurück zum Zitat Kransdorf MJ, Sweet DE (1995) Aneurysmal bone cyst: concept, controversy, clinical presentation, and imaging. AJR 164:573–580PubMed Kransdorf MJ, Sweet DE (1995) Aneurysmal bone cyst: concept, controversy, clinical presentation, and imaging. AJR 164:573–580PubMed
6.
Zurück zum Zitat Cottalorda J, Bourelle S (2007) Modern concepts of primary aneurismal bone cysts. Arch Orthop Trauma Surg 127:105–114PubMedCrossRef Cottalorda J, Bourelle S (2007) Modern concepts of primary aneurismal bone cysts. Arch Orthop Trauma Surg 127:105–114PubMedCrossRef
7.
Zurück zum Zitat Guibaud L, Herbreteau D, Dubois J et al (1998) Aneurysmal bone cysts: percutaneous embolization with an alcoholic solution of zein—series of 18 cases. Radiology 208:369–373PubMed Guibaud L, Herbreteau D, Dubois J et al (1998) Aneurysmal bone cysts: percutaneous embolization with an alcoholic solution of zein—series of 18 cases. Radiology 208:369–373PubMed
8.
Zurück zum Zitat Falappa P, Fassari FM, Fanelli A et al (2002) Aneurysmal bone cysts: treatment with direct percutaneous Ethibloc injection: long-term results. Cardiovasc Intervent Radiol 25:282–290PubMedCrossRef Falappa P, Fassari FM, Fanelli A et al (2002) Aneurysmal bone cysts: treatment with direct percutaneous Ethibloc injection: long-term results. Cardiovasc Intervent Radiol 25:282–290PubMedCrossRef
9.
Zurück zum Zitat Garg NK, Carty H, Walsh HP et al (2000) Percutaneous Ethibloc injection in aneurysmal bone cysts. Skeletal Radiol 29:211–216PubMedCrossRef Garg NK, Carty H, Walsh HP et al (2000) Percutaneous Ethibloc injection in aneurysmal bone cysts. Skeletal Radiol 29:211–216PubMedCrossRef
10.
Zurück zum Zitat Dubois J, Chigot V, Grimard G et al (2003) Sclerotherapy in aneurismal bone cysts in children: a review of 17 cases. Pediatr Radiol 33:365–372PubMed Dubois J, Chigot V, Grimard G et al (2003) Sclerotherapy in aneurismal bone cysts in children: a review of 17 cases. Pediatr Radiol 33:365–372PubMed
11.
Zurück zum Zitat Adamsbaum C, Mascard E, Guinebretière JM et al (2003) Intralesional Ethibloc injections in primary aneurysmal bone cysts: an efficient and safe treatment. Skeletal Radiol 32:559–566PubMedCrossRef Adamsbaum C, Mascard E, Guinebretière JM et al (2003) Intralesional Ethibloc injections in primary aneurysmal bone cysts: an efficient and safe treatment. Skeletal Radiol 32:559–566PubMedCrossRef
12.
Zurück zum Zitat Ernemann U, Kramer U, Miller S et al (2010) Current concepts in the classification, diagnosis and treatment of vascular anomalies. Eur J Radiol 75:2–11PubMedCrossRef Ernemann U, Kramer U, Miller S et al (2010) Current concepts in the classification, diagnosis and treatment of vascular anomalies. Eur J Radiol 75:2–11PubMedCrossRef
13.
Zurück zum Zitat Puig S, Aref H, Brunelle F (2003) Double needle sclerotherapy of lymphangiomas and venous angiomas in children: a simple technique to prevent complications. AJR 180:1399–1401PubMed Puig S, Aref H, Brunelle F (2003) Double needle sclerotherapy of lymphangiomas and venous angiomas in children: a simple technique to prevent complications. AJR 180:1399–1401PubMed
14.
Zurück zum Zitat Mason KP, Michna E, Zurakowski D et al (2000) Serum ethanol levels in children and adults after ethanol embolization or sclerotherapy for vascular anomalies. Radiology 217:127–132PubMed Mason KP, Michna E, Zurakowski D et al (2000) Serum ethanol levels in children and adults after ethanol embolization or sclerotherapy for vascular anomalies. Radiology 217:127–132PubMed
15.
Zurück zum Zitat Bisdorff A, Mazighi M, Saint-Maurice JP et al (2010) Ethanol threshold doses for systemic complications during sclerotherapy of superficial venous malformations: a retrospective study. Neuroradiology 53(11):891–914 Bisdorff A, Mazighi M, Saint-Maurice JP et al (2010) Ethanol threshold doses for systemic complications during sclerotherapy of superficial venous malformations: a retrospective study. Neuroradiology 53(11):891–914
16.
Zurück zum Zitat Clayer M (2008) Injectable form of calcium sulphate as treatment of aneurysmal bone cysts. ANZ J Surg 78:366–370PubMedCrossRef Clayer M (2008) Injectable form of calcium sulphate as treatment of aneurysmal bone cysts. ANZ J Surg 78:366–370PubMedCrossRef
17.
Zurück zum Zitat Rastogi S, Varshney MK, Trikha V et al (2006) Treatment of aneurysmal bone cysts with percutaneous sclerotherapy using polidocanol. A review of 72 cases with long-term follow-up. J Bone Joint Surg Br 88:1212–1216PubMedCrossRef Rastogi S, Varshney MK, Trikha V et al (2006) Treatment of aneurysmal bone cysts with percutaneous sclerotherapy using polidocanol. A review of 72 cases with long-term follow-up. J Bone Joint Surg Br 88:1212–1216PubMedCrossRef
18.
Zurück zum Zitat Varshney MK, Rastogi S, Khan SA et al (2010) Is sclerotherapy better than intralesional excision for treating aneurysmal bone cysts? Clin Orthop Relat Res 468:1649–1659PubMedCrossRef Varshney MK, Rastogi S, Khan SA et al (2010) Is sclerotherapy better than intralesional excision for treating aneurysmal bone cysts? Clin Orthop Relat Res 468:1649–1659PubMedCrossRef
19.
Zurück zum Zitat Rossi G, Rimondi E, Bartalena T et al (2010) Selective arterial embolization of 36 aneurysmal bone cysts of the skeleton with N-2-butyl cyanoacrylate. Skeletal Radiol 39:161–167PubMedCrossRef Rossi G, Rimondi E, Bartalena T et al (2010) Selective arterial embolization of 36 aneurysmal bone cysts of the skeleton with N-2-butyl cyanoacrylate. Skeletal Radiol 39:161–167PubMedCrossRef
20.
Zurück zum Zitat Peraud A, Drake JM, Armstrong D et al (2004) Fatal Ethibloc embolization of vertebrobasilar system following percutaneous injection into aneurysmal bone cyst of the second cervical vertebra. AJNR 25:1116–1120PubMed Peraud A, Drake JM, Armstrong D et al (2004) Fatal Ethibloc embolization of vertebrobasilar system following percutaneous injection into aneurysmal bone cyst of the second cervical vertebra. AJNR 25:1116–1120PubMed
21.
Zurück zum Zitat Turowski B, Schellhammer F, Herdmann J et al (2005) Fatal Ethibloc embolization of vertebrobasilar system following percutaneous injection into aneurysmal bone cyst of the second cervical vertebra. AJNR 26:1883–1884PubMed Turowski B, Schellhammer F, Herdmann J et al (2005) Fatal Ethibloc embolization of vertebrobasilar system following percutaneous injection into aneurysmal bone cyst of the second cervical vertebra. AJNR 26:1883–1884PubMed
22.
Zurück zum Zitat George HL, Unnikrishnan PN, Garg NK et al (2009) Long-term follow-up of Ethibloc injection in aneurysmal bone cysts. J Pediatr Orthop B 18:375–380 George HL, Unnikrishnan PN, Garg NK et al (2009) Long-term follow-up of Ethibloc injection in aneurysmal bone cysts. J Pediatr Orthop B 18:375–380
23.
Zurück zum Zitat Tonomura ET, Ramos P, Hemais PM et al (2008) Aneurysmal bone cyst at C2: imaging evaluation after intralesional injection of calcitonin and methylprednisolone. Arq Neuropsiquiatr 66:711–715PubMedCrossRef Tonomura ET, Ramos P, Hemais PM et al (2008) Aneurysmal bone cyst at C2: imaging evaluation after intralesional injection of calcitonin and methylprednisolone. Arq Neuropsiquiatr 66:711–715PubMedCrossRef
24.
Zurück zum Zitat Ohashi M, Ito T, Hirano T et al (2008) Percutaneous intralesional injection of calcitonin and methylprednisolone for treatment of an aneurysmal bone cyst at C-2. J Neurosurg Pediatr 2:365–369PubMedCrossRef Ohashi M, Ito T, Hirano T et al (2008) Percutaneous intralesional injection of calcitonin and methylprednisolone for treatment of an aneurysmal bone cyst at C-2. J Neurosurg Pediatr 2:365–369PubMedCrossRef
25.
Zurück zum Zitat Perlmutter DH, Campbell S, Rubery PT et al (2009) Aneurysmal bone cyst: surgical management in the pediatric cervical spine. Spine (Phila Pa 1976) 34:E50–E53 CrossRef Perlmutter DH, Campbell S, Rubery PT et al (2009) Aneurysmal bone cyst: surgical management in the pediatric cervical spine. Spine (Phila Pa 1976) 34:E50–E53 CrossRef
26.
Zurück zum Zitat Cottalorda J, Chotel F, Kohler R et al (2005) Aneurysmal bone cysts of the pelvis in children: a multicenter study and literature review. J Pediatr Orthop 25:471–475PubMedCrossRef Cottalorda J, Chotel F, Kohler R et al (2005) Aneurysmal bone cysts of the pelvis in children: a multicenter study and literature review. J Pediatr Orthop 25:471–475PubMedCrossRef
27.
Zurück zum Zitat Agarwal A, Goel P, Khan SA et al (2010) Large aneurysmal bone cyst of iliac bone in a female child: a case report. J Orthop Surg Res 5:24PubMedCrossRef Agarwal A, Goel P, Khan SA et al (2010) Large aneurysmal bone cyst of iliac bone in a female child: a case report. J Orthop Surg Res 5:24PubMedCrossRef
28.
Zurück zum Zitat Capanna R, Springfield DS, Biagini R et al (1985) Juxtaepiphyseal aneurysmal bone cyst. Skeletal Radiol 13:21–25PubMedCrossRef Capanna R, Springfield DS, Biagini R et al (1985) Juxtaepiphyseal aneurysmal bone cyst. Skeletal Radiol 13:21–25PubMedCrossRef
29.
Zurück zum Zitat Lichtenstein L (1953) Aneurysmal bone cyst: further observations. Cancer 6:1228–1237 Lichtenstein L (1953) Aneurysmal bone cyst: further observations. Cancer 6:1228–1237
30.
Zurück zum Zitat Mirra JM (1989) Bone tumors: clinical, radiologic and pathologic correlations. Lea and Febiger, Philadelphia, pp 1233–1334 Mirra JM (1989) Bone tumors: clinical, radiologic and pathologic correlations. Lea and Febiger, Philadelphia, pp 1233–1334
31.
Zurück zum Zitat Mulliken JB (1988) Vascular malformations of the head and neck. In: Mulliken JB, Young AE (eds) Vascular birthmarks: hemangiomas and vascular malformations. WB Saunders, Philadelphia Mulliken JB (1988) Vascular malformations of the head and neck. In: Mulliken JB, Young AE (eds) Vascular birthmarks: hemangiomas and vascular malformations. WB Saunders, Philadelphia
32.
Zurück zum Zitat Mulliken JB, Glowacki J (1982) Classification of pediatric vascular lesions. Plast Reconstr Surg 70:120–121PubMedCrossRef Mulliken JB, Glowacki J (1982) Classification of pediatric vascular lesions. Plast Reconstr Surg 70:120–121PubMedCrossRef
33.
Zurück zum Zitat Enjolras O, Mulliken JB (1997) Vascular tumors and vascular malformations. Adv Dermatol 13:375–423PubMed Enjolras O, Mulliken JB (1997) Vascular tumors and vascular malformations. Adv Dermatol 13:375–423PubMed
34.
Zurück zum Zitat Redondo P (2007) Vascular malformations (I). Concept, classification, pathogenesis and clinical features. Actas Dermosifiliogr 98:141–158PubMedCrossRef Redondo P (2007) Vascular malformations (I). Concept, classification, pathogenesis and clinical features. Actas Dermosifiliogr 98:141–158PubMedCrossRef
35.
Zurück zum Zitat Sales De Gauzy JS, Abid A, Accadbled F et al (2005) Percutaneous Ethibloc injection in the treatment of primary aneurysmal bone cysts. J Pediatr Orthop B 14:367–370CrossRef Sales De Gauzy JS, Abid A, Accadbled F et al (2005) Percutaneous Ethibloc injection in the treatment of primary aneurysmal bone cysts. J Pediatr Orthop B 14:367–370CrossRef
36.
Zurück zum Zitat Bruder E, Perez-Atayde AR, Jundt G et al (2009) Vascular lesions of bone in children, adolescents, and young adults. A clinicopathologic reappraisal and application of the ISSVA classification. Virchows Arch 454:161–179PubMedCrossRef Bruder E, Perez-Atayde AR, Jundt G et al (2009) Vascular lesions of bone in children, adolescents, and young adults. A clinicopathologic reappraisal and application of the ISSVA classification. Virchows Arch 454:161–179PubMedCrossRef
Metadaten
Titel
Primary aneurysmal bone cysts in children: percutaneous sclerotherapy with absolute alcohol and proposal of a vascular classification
verfasst von
K. Lambot-Juhan
S. Pannier
D. Grévent
Z. Péjin
S. Breton
L. Berteloot
S. Emond-Gonsard
N. Boddaert
C. Glorion
F. Brunelle
Publikationsdatum
01.05.2012
Verlag
Springer-Verlag
Erschienen in
Pediatric Radiology / Ausgabe 5/2012
Print ISSN: 0301-0449
Elektronische ISSN: 1432-1998
DOI
https://doi.org/10.1007/s00247-011-2312-z

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