Skip to main content

Advertisement

SpringerLink
Log in

Intralesional Ethibloc injections in primary aneurysmal bone cysts: an efficient and safe treatment

  • Article
  • Published:
Skeletal Radiology Aims and scope Submit manuscript

Abstract

Objective

Ethibloc is a fibrogenic and thrombogenic agent recently proposed for the treatment of bone cysts. The purpose of this study is to report the results of direct Ethibloc injection in primary aneurysmal bone cyst (ABC) in children.

Design and patients

Seventeen patients, aged from 2 to 18 years (mean 8 years), were treated with either a single injection (14 patients) or supplementary injections (3 patients) of Ethibloc. The histological diagnosis was assessed following surgical biopsy and was retrospectively reviewed. The mean follow-up was 5 years (range 18 months to 11 years).

Results

At 5 year follow-up, 14 of 17 patients demonstrated complete healing manifest by increased cortical and septal thickening. Surgical excision was required in three patients, in two of whom the ABC increased rapidly in size despite the injection, and in one of whom the healing was incomplete. We observed inflammatory reactions in 16 of 17 patients with local pain and fever. Three patients developed a small cutaneous fistula which resolved spontaneously in a few weeks. No major complications such as deep infection, pulmonary embolism, epiphyseal necrosis or malignant degeneration were observed.

Conclusion

Percutaneous direct Ethibloc injection is a safe, efficient and noninvasive treatment for ABC. The authors highlight the frequent local reactions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1A–C.
Fig. 2A–C.
Fig. 3A–C.
Fig. 4A, B.
Fig. 5A, B.

Similar content being viewed by others

References

  1. Adamsbaum C, Kalifa G, Seringe R, Dubousset J. Direct Ethibloc injection in benign bone cysts: preliminary report on four patients. Skeletal Radiol 1993; 22:317–320.

    CAS  PubMed  Google Scholar 

  2. Biesecker JL, Marcove RC, Huvos AG, Mike V. Aneurysmal bone cysts: a clinicopathologic study of 66 cases. Cancer 1970; 26:615–625.

    CAS  PubMed  Google Scholar 

  3. Bonakdarpour A, Levy WM, Aegerter E. Primary and secondary aneurysmal bone cyst: a radiological study of 75 cases. Radiology 1978; 126:75–83.

    CAS  PubMed  Google Scholar 

  4. Campanacci M, Capanna R, Picci P. Unicameral and aneurysmal bone cysts. Clin Orthop 1986; 204:25–36.

    PubMed  Google Scholar 

  5. Capanna R, Betteli G, Biaginia R, et al. Aneurysmal bone cysts of long bones. Ital J Orthop Traumatol 1985; 11:409–417.

    Google Scholar 

  6. Capanna R, Campanacci DA, Manfrini M. Unicameral and aneurysmal bone cysts. Orthop Clin North Am 1996; 27:605–614.

    CAS  PubMed  Google Scholar 

  7. Capanna R, Sudanese A, Baldini N, Campanacci M. Phenol as an adjuvant in the control of local recurrence of benign neoplasms of bone treated by curettage. Ital J Orthop Traumatol 1985; 11:381–388.

    CAS  PubMed  Google Scholar 

  8. Cory DA, Fritsch SA, Cohen MD, Mail JT, Holden RW. Aneurysmal bone cysts. Imaging findings and embolotherapy. AJR Am J Roentgenol 1989; 153:369–373.

    CAS  PubMed  Google Scholar 

  9. Dubois JM, Sebag GH, De Prost Y, et al. Soft tissue venous malformations in children: percutaneous sclerotherapy with Ethibloc. Radiology 1991; 180:195–198.

    CAS  PubMed  Google Scholar 

  10. Falappa P, Fassari FM, Fanelli A, et al. Aneurysmal bone cysts: treatment with direct percutaneous Ethibloc injection. Long-term results. Cardiovasc Intervent Radiol 2002; 24:1–10.

    Google Scholar 

  11. Freiberg AA, Loder RT, Heidelberger KP, Hensinger RN. Aneurysmal bone cysts in young children. J Pediatr Orthop 1994; 14:86–91.

    CAS  PubMed  Google Scholar 

  12. Garg NK, Carty H, Walsh HPJ, Dorgan JC, Bruce CE. Percutaneous Ethibloc injection in aneurysmal bone cysts. Skeletal Radiol 2000; 29:211–216.

    Article  CAS  PubMed  Google Scholar 

  13. Guibaud L, Herbreteau D, Dubois J, Stempfle N, Bérard J. Aneurysmal bone cysts: percutaneous embolization with an alcoholic solution of zein. Series of 18 cases. Radiology 1998; 208:369–373.

    CAS  PubMed  Google Scholar 

  14. Kransdorf MJ, Sweet DE: Aneurysmal bone cyst. Concept, controversy, clinical presentation and imaging. AJR Am J Roentgenol 1995; 164:573–580.

    CAS  PubMed  Google Scholar 

  15. Kuhne D, Helmke K. Embolization with Ethibloc of vascular tumors and arterio-venous malformations in the head and neck. Neuroradiology 1982; 23:253–258.

    PubMed  Google Scholar 

  16. Leclet H, Pasquier G. Percutaneously injectable bone substitutes: Rev Rhum [Engl Ed] 1993; 60:261.

    Google Scholar 

  17. Leclet HL, Pasquier GJ, Adamsbaum CS, Hardouin PA. Bone properties of Ethibloc: experimental data. Radiology 1993; 189(P):386.

    Google Scholar 

  18. Marcove RC, Shelth DS, Takemoto S, Healey JH. The treatment of aneurysmal bone cyst. Clin Orthop 1995; 311:157–163.

    PubMed  Google Scholar 

  19. Martinez V, Sissons HA. Aneurysmal bone cyst. A review of 123 cases including primary lesions and those secondary to other bone pathology. Cancer 1988; 61:2291–2304.

    CAS  PubMed  Google Scholar 

  20. Matsuno T, Okada K, Knuutila S. Telangiectatic osteosarcoma. In: Fletcher C, Unni K, Mertens F (eds) Pathology and genetics. Tumours of soft tissue and bone. Lyon: IARC Press, 2002:271–272.

  21. Ozaki T, Hillman A, Lindener N, Winkelmann W. Cementation of primary aneurysmal bone cysts. Clin Orthop 1997; 337:240–248.

    PubMed  Google Scholar 

  22. Riche MC, Hadjean E, Tran Ba Huy P, Merland JJ. The treatment of capillary venous malformation using a new fibrosing agent. Plast Reconstr Surg 1983; 71:607–614.

    CAS  PubMed  Google Scholar 

  23. Ruiter DJ, Van-Rijssel TG, Van-Der-Velde EA. Aneurysmal bone cysts: a clinicopathological study of 105 cases. Cancer 1977; 39:2231–2239.

    Google Scholar 

  24. Unni K. Dahlin's bone tumors. General aspects and data on 11,087 cases. Philadelphia New York: Lippincott-Raven, 1996:385–386

  25. Vergel de Dios AM, Bond JR, Shives TC, McLeod RA, Unni KK. Aneurysmal bone cyst: a clinicopathologic study of 238 cases. Cancer 1992; 69:2921–2931.

    PubMed  Google Scholar 

Download references

Acknowledgements

We thanks Dr. Ebrard (Paediatric Surgery, CHU of Guadeloupe), Dr. Catone (Orthopedic Surgery, CHU of Fort de France), Dr. Couanet (Radiology, Institut Gustave Roussy, Villejuif) for providing radiographs, D. Brisset (Centre René Huguenin, Saint Cloud) for the histological photographs and P. Zerbini for the manuscript.

Author information

Authors and Affiliations

  1. Department of Radiology, St. Vincent de Paul Hospital, 82 avenue Denfert Rochereau, 75674, Paris Cedex 14, France

    C. Adamsbaum, G. Kalifa & J. Dubousset

  2. Service de Radiologie, Hôpital St. Vincent de Paul, 82 avenue Denfert Rochereau, 75674, Paris Cedex 14, France

    C. Adamsbaum

  3. Department of Surgery, St. Vincent de Paul Hospital, 82 avenue Denfert Rochereau, 75674, Paris Cedex 14, France

    E. Mascard & J. Dubousset

  4. Department of Histopathology C, Institut Gustave Roussy, 94805, Villejuif Cedex, France

    J. M. Guinebretière

Authors
  1. C. Adamsbaum
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. E. Mascard
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. J. M. Guinebretière
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. G. Kalifa
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. J. Dubousset
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to C. Adamsbaum.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Adamsbaum, C., Mascard, E., Guinebretière, J.M. et al. Intralesional Ethibloc injections in primary aneurysmal bone cysts: an efficient and safe treatment. Skeletal Radiol 32, 559–566 (2003). https://doi.org/10.1007/s00256-003-0653-x

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00256-003-0653-x

Keywords

Search

Navigation