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Pediatric Radiology
Published 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

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

Published in: Pediatric Radiology | Issue 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.
Literature
1.
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.
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.
Cottalorda J, Bourelle S (2007) Aneurysmal bone cyst in 2006. Rev Chir Orthop Reparatrice Appar Mot 93:5–16PubMedCrossRef
4.
Bonakdarpour A, Levy WM, Aegerter E (1978) Primary and secondary aneurysmal bone cyst: a radiological study of 75 cases. Radiology 126:75–83PubMed
5.
Kransdorf MJ, Sweet DE (1995) Aneurysmal bone cyst: concept, controversy, clinical presentation, and imaging. AJR 164:573–580PubMed
6.
Cottalorda J, Bourelle S (2007) Modern concepts of primary aneurismal bone cysts. Arch Orthop Trauma Surg 127:105–114PubMedCrossRef
7.
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.
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.
Garg NK, Carty H, Walsh HP et al (2000) Percutaneous Ethibloc injection in aneurysmal bone cysts. Skeletal Radiol 29:211–216PubMedCrossRef
10.
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.
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.
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.
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.
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.
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.
Clayer M (2008) Injectable form of calcium sulphate as treatment of aneurysmal bone cysts. ANZ J Surg 78:366–370PubMedCrossRef
17.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Capanna R, Springfield DS, Biagini R et al (1985) Juxtaepiphyseal aneurysmal bone cyst. Skeletal Radiol 13:21–25PubMedCrossRef
29.
Lichtenstein L (1953) Aneurysmal bone cyst: further observations. Cancer 6:1228–1237
30.
Mirra JM (1989) Bone tumors: clinical, radiologic and pathologic correlations. Lea and Febiger, Philadelphia, pp 1233–1334
31.
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.
Mulliken JB, Glowacki J (1982) Classification of pediatric vascular lesions. Plast Reconstr Surg 70:120–121PubMedCrossRef
33.
Enjolras O, Mulliken JB (1997) Vascular tumors and vascular malformations. Adv Dermatol 13:375–423PubMed
34.
Redondo P (2007) Vascular malformations (I). Concept, classification, pathogenesis and clinical features. Actas Dermosifiliogr 98:141–158PubMedCrossRef
35.
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.
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
Metadata
Title
Primary aneurysmal bone cysts in children: percutaneous sclerotherapy with absolute alcohol and proposal of a vascular classification
Authors
K. Lambot-Juhan
S. Pannier
D. Grévent
Z. Péjin
S. Breton
L. Berteloot
S. Emond-Gonsard
N. Boddaert
C. Glorion
F. Brunelle
Publication date
01-05-2012
Publisher
Springer-Verlag
Published in
Pediatric Radiology / Issue 5/2012
Print ISSN: 0301-0449
Electronic ISSN: 1432-1998
DOI
https://doi.org/10.1007/s00247-011-2312-z

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