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Skeletal Radiology

, Volume 39, Issue 2, pp 161–167 | Cite as

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

  • Giuseppe Rossi
  • Eugenio RimondiEmail author
  • Tommaso Bartalena
  • Antonio Gerardi
  • Marco Alberghini
  • Eric Lodwijk Staals
  • Costantino Errani
  • Giuseppe Bianchi
  • Angelo Toscano
  • Mario Mercuri
  • Daniel Vanel
Scientific Article

Abstract

Background

Aneurysmal bone cyst (ABC) is a lytic benign bone lesion representing about 1% of all primary bone tumors. The lesion causes pain and swelling, which are generally present for less than 3 months.

Methods

From April 2003 to April 2008 36 patients affected by aneurysmal bone cysts were treated by selective arterial embolization with N-2-butyl cyanoacrylate. The study population comprised 20 male and 16 female patients with an age range of 3.3–60.8 years. Nine lesions were localized in the appendicular skeleton (1 in the upper and 8 in the lower limb), 4 in the thoracic cage (1 rib lesion and 3 scapular lesions), 17 in the pelvis and 6 in the spine (1 thoracic and 5 sacral localizations).

Results

A total of 55 embolizations were performed: in 22 cases (61%) only one embolization was needed, whilst two embolizations were necessary in 9 cases (25%) and 3 in the remaining 5 patients (14%). The treatment was effective in 32 patients (94% ): follow-up was 0.9–5 years. In one patient, previously surgically treated, only the cyanoacrylate embolization turned out to be useful for healing the lesion. Another 7 patients underwent surgery during the study period. In the 55 procedures we performed we had 3 complications (5%): 2 cases of skin necrosis and 1 of transient paresis.

Conclusions

Arterial embolization with cyanoacrylate may be the treatment of choice for aneurysmal bone cysts. Embolization is a less invasive, lower cost, simpler procedure than surgery and is easily repeatable.

Keywords

Aneurysmal bone cyst (ABC) Tumor-like lesion Digital subtraction angiography (DSA) Selective arterial embolization (SAE) N-2-butyl cyanoacrylate 

References

  1. 1.
    Campanacci M, Cervellati C, Donati D, et al. Aneurysmal bone cyst: a study of 127 cases. Ital J Orthop Traumatol. 1976;2:341–3.PubMedGoogle Scholar
  2. 2.
    Campanacci M, Capanna R, Picci P. Unicameral and aneurysmal bone cysts. Clin Orthop. 1986;204:25–36.Google Scholar
  3. 3.
    Mirra JM. Aneurysmal bone cyst. In: Mirra JM, Picci P, Gold RH, editors. Bone tumors. Clinical, radiologic, and pathologic correlations, 2nd edn. Philadelphia: Lea and Febiger; 1989. p. 1267–311.Google Scholar
  4. 4.
    Cigala F, Sadile F, Iaccarino V. Embolizzazione arteriosa selettiva della cisti aneurismatica dello stelo. Napoli: Idelson-Gnocchi; 2004. p. 9–10.Google Scholar
  5. 5.
    Jaffe HL. Aneurysmal bone cyst. Bull Hosp Joint Dis. 1950;11:3–13.PubMedGoogle Scholar
  6. 6.
    Jaffe HL. Tumors and tumorous conditions of the bones and joints. Philadelphia: Lea and Febiger; 1958. p. 54–62.Google Scholar
  7. 7.
    Biesecker JL, Marcove RC, Huvos AG, et al. Aneurysmal bone cyst. Cancer 1970;26:615–25.CrossRefGoogle Scholar
  8. 8.
    Mankin HJ, Hornicek FJ, Ortiz-Cruz E, et al. Aneurysmal bone cyst: a review of 150 patients. J Clin Oncol. 2005;23(27):6756–62.CrossRefGoogle Scholar
  9. 9.
    McQueen MM, Chalmers J, Smith GD. Spontaneous healing of aneurysmal bone cyst. A report of two cases. J Bone Joint Surg (Br). 1985;67(b):310–2.CrossRefGoogle Scholar
  10. 10.
    Scott I, Connell DG, Duncan CP. Regression of aneurysmal bone cyst following open biopsy. Can Assoc Radiol J. 1986;37:198–200.PubMedGoogle Scholar
  11. 11.
    Dorfman HD, Czerniak B. Cystic lesions in bone tumors. St. Louis: Mosby; 1998. p. 855–79.Google Scholar
  12. 12.
    Conway WF, Curtis WH. Miscellaneous lesions of bone. In: Moser RP, editor. Radiologic Clinics of North America. Imaging of bone and soft tissue tumors. Philadelphia: Saunders Company; 1993. p. 339–58.Google Scholar
  13. 13.
    Tillman BP, Dahlin DC, Lipscomb PR, et al. Aneurysmal bone cyst: an analysis of 95 cases. Mayo Clin Proc. 1968;43:478–95.PubMedGoogle Scholar
  14. 14.
    Falappa P, Fassari FM, Fanelli A, et al. Aneurysmal bone cyst: treatment with direct percutaneous ethibloc injection: long term results. Cardiovasc Intervent Radiol. 2002;25:282–90.CrossRefGoogle Scholar
  15. 15.
    Adamsbaum C, Mascard E, Guinebretiere JM, et al. Intralesional ethibloc injection in primary aneurysmal bone cysts: an efficient and safe treatment. Skeletal Radiol. 2003;32:559–66.CrossRefGoogle Scholar
  16. 16.
    Topouchian V, Mazda K, Hamze B, et al. Aneurysmal bone cyst in children: complications of fibrosing agent injection. Radiology 2004;232:522–6.CrossRefGoogle Scholar
  17. 17.
    Meyer S, Reinhard H, Graf N, et al. Arterial embolization of a secondary aneurysmatic bone cyst of the thoracic spine prior surgical excision in a 15-year-old girl. Eur J Radiol. 2002;43:79–81.CrossRefGoogle Scholar
  18. 18.
    Pogoda P, Linhart W, Priemel M, et al. Aneurysmal bone cyst of the sacrum. Clinical report and review of the literature. Arch Orthop Trauma Surg. 2003;123:247–51.CrossRefGoogle Scholar
  19. 19.
    Koci TM, Mehringer CM, Yamagata N, et al. Aneurysmal bone cyst of the thoracic spine: evolution after particulate embolization. AJNR Am J Neuroradiol. 1995;16:857–60.PubMedGoogle Scholar
  20. 20.
    Marushima A, Matsumaru Y, Kensuke S, et al. Selective arterial embolization with n-butil cianoacrylatein the treatment of aneurysmal bone cyst of the thoracic vertebra. A case report. Spine 2009;34(6):230–34.CrossRefGoogle Scholar
  21. 21.
    Papagelopoullos PJ, Choudhury SN, Frassica FJ, et al. Treatment of aneurysmal bone cysts of the pelvis and sacrum. J Bone Jt Surg Am. 2001;83-A(11):1674–81.CrossRefGoogle Scholar
  22. 22.
    De Cristofaro R, Biagini R, Boriani S, et al. Selective arterial embolization in the treatment of aneurysmal bone cyst and angioma of bone. Skeletal Radiol. 1992;21:523–7.CrossRefGoogle Scholar
  23. 23.
    Cottalorda J, Bourelle S. Modern concepts of primary aneurysmal bone cyst. Arch Orthop Trauma Surg. 2007;127:105–14.CrossRefGoogle Scholar

Copyright information

© ISS 2009

Authors and Affiliations

  • Giuseppe Rossi
    • 1
  • Eugenio Rimondi
    • 2
    Email author
  • Tommaso Bartalena
    • 3
  • Antonio Gerardi
    • 4
  • Marco Alberghini
    • 5
  • Eric Lodwijk Staals
    • 6
  • Costantino Errani
    • 6
  • Giuseppe Bianchi
    • 6
  • Angelo Toscano
    • 6
  • Mario Mercuri
    • 6
  • Daniel Vanel
    • 2
  1. 1.Department of Interventional Angiographic RadiologyRizzoli Orthopaedic InstituteBolognaItaly
  2. 2.Department of RadiologyRizzoli Orthopaedic InstituteBolognaItaly
  3. 3.University of BolognaBolognaItaly
  4. 4.Department of Anatomical Human Science and Physiopathology of the Musculoskeletal SystemRizzoli Orthopaedic InstituteBolognaItaly
  5. 5.Department of Pathological AnatomyRizzoli Orthopaedic InstituteBolognaItaly
  6. 6.V Division of Musculoskeletal TumorsRizzoli Orthopaedic InstituteBolognaItaly

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