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Treatment of aneurysmal bone cysts by percutaneous CT-guided injection of calcitonin and steroid

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Abstract

Objectives

To determine the efficacy and safety of percutaneous calcitonin and steroid injection in the treatment of aneurysmal bone cysts (ABCs).

Materials and methods

Our study was IRB-approved and HIPAA-compliant. We reviewed pre- and post-procedural imaging studies and medical records of all CT-guided percutaneous injections of ABCs with calcitonin and steroid performed at our institution between 2003 and 2015.

Results

Treatment success based on imaging was categorized as substantial (51–100 %), partial (1–50 %), or none (0 %) by comparing radiographs of the lesion before and after treatment. Our study group comprised 9 patients (7 female, 2 male; mean age 19 ± 5 (range 12–25) years). ABCs were located in the pubis (n = 3), femur (n = 2), and humerus/scapula/ilium/sacrum (n = 1 for each). One patient did not have any clinical or imaging follow-up. For the other 8 patients, clinical and imaging follow-up ranged from 1 to 93 months (mean 16 ± 29 months). One patient had two injections, and 1 patient had three injections. Six out of eight patients (75 %) had complete symptomatic relief and 2 patients (25 %) had partial symptomatic relief after initial injection. Imaging follow-up revealed substantial imaging response in 4 out of 8 patients (50 %). There was a partial imaging response in 2 patients (25 %) and no imaging response in 2 out of 8 patients (25 %), and all 4 of these patients had local recurrence. There were no complications.

Conclusion

Percutaneous CT-guided injection of ABCs with calcitonin and steroid is a safe and effective treatment. Lack of imaging response may necessitate more aggressive treatment to minimize local recurrence.

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Authors and Affiliations

  1. Department of Radiology Division of Musculoskeletal Imaging and Intervention, Massachusetts General Hospital, 55 Fruit Street Yawkey 6E, Boston, MA, 02114, USA

    Connie Y. Chang, Susan V. Kattapuram, Ambrose J. Huang, F. Joseph Simeone, Martin Torriani & Miriam A. Bredella

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  1. Connie Y. Chang
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  2. Susan V. Kattapuram
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  3. Ambrose J. Huang
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  4. F. Joseph Simeone
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  5. Martin Torriani
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  6. Miriam A. Bredella
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Corresponding author

Correspondence to Connie Y. Chang.

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Conflicts of interest

The authors declare that they have no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed consent

Informed consent was waived for individual participants included in the study. The study was approved by the local Institutional Review Board (IRB) and was HIPAA-compliant.

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Chang, C.Y., Kattapuram, S.V., Huang, A.J. et al. Treatment of aneurysmal bone cysts by percutaneous CT-guided injection of calcitonin and steroid. Skeletal Radiol 46, 35–40 (2017). https://doi.org/10.1007/s00256-016-2503-7

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  • DOI: https://doi.org/10.1007/s00256-016-2503-7

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