Skip to main content
Top
Published in: Skeletal Radiology 5/2019

01-05-2019 | Doxycycline | Scientific Article

Aneurysmal bone cyst treated with percutaneous doxycycline: is a single treatment sufficient?

Authors: Jason T. K. Woon, Damien Hoon, Andrew Graydon, Mike Flint, Anthony J. Doyle

Published in: Skeletal Radiology | Issue 5/2019

Login to get access

Abstract

Objective

The purpose of this case series is to report on the effectiveness of a single percutaneous injection of doxycycline as a primary treatment for aneurysmal bone cyst (ABC).

Materials and methods

A retrospective cohort study was conducted on seven patients diagnosed with ABC at various anatomical sites, with the intention to treat by a single percutaneous injection of doxycycline. Mean patient age was 14 years.

Results

Signs of treatment response were seen in six of seven patients after one injection. Three of the seven received a second treatment, despite signs of response. Another had expansion of the lesion after treatment, requiring excision. In total, three patients had a single injection of doxycycline as their sole treatment and another three showed signs of response after a single injection.

Conclusions

A single percutaneous injection of doxycycline should be considered a viable primary treatment option for ABC.
Literature
1.
go back to reference Fletcher C DM, Bridge JA, Hogendoorn PCW, Mertens F. WHO classification of tumors of soft tissue and bone. 4th ed. Geneva: WHO; 2013. p. 110–111. Fletcher C DM, Bridge JA, Hogendoorn PCW, Mertens F. WHO classification of tumors of soft tissue and bone. 4th ed. Geneva: WHO; 2013. p. 110–111.
2.
go back to reference Jaffe HL, Lichtenstein L. Solitary unicameral bone cyst: with emphasis on the roentgen picture, the pathologic appearance and the pathogenesis. Arch Surg. 1942;44(6):1004–25.CrossRef Jaffe HL, Lichtenstein L. Solitary unicameral bone cyst: with emphasis on the roentgen picture, the pathologic appearance and the pathogenesis. Arch Surg. 1942;44(6):1004–25.CrossRef
3.
go back to reference Lichtenstein L. Aneurysmal bone cyst: observations on fifty cases. JBJS. 1957;39(4):873–82.CrossRef Lichtenstein L. Aneurysmal bone cyst: observations on fifty cases. JBJS. 1957;39(4):873–82.CrossRef
4.
go back to reference Schajowicz F. Histological typing of bone tumours. Berlin: Springer Science & Business Media; 2012. Schajowicz F. Histological typing of bone tumours. Berlin: Springer Science & Business Media; 2012.
5.
go back to reference Park HY, Yang SK, Sheppard WL, Hegde V, Zoller SD, Nelson SD, et al. Current management of aneurysmal bone cysts. Curr Rev Musculoskelet Med. 2016;9(4):435–44.CrossRefPubMedPubMedCentral Park HY, Yang SK, Sheppard WL, Hegde V, Zoller SD, Nelson SD, et al. Current management of aneurysmal bone cysts. Curr Rev Musculoskelet Med. 2016;9(4):435–44.CrossRefPubMedPubMedCentral
6.
go back to reference Biesecker JL, Marcove RC, Huvos AG, Mike V. Aneurysmal bone cysts. A clinicopathologic study of 66 cases. Cancer. 1970;26(3):615–25.CrossRefPubMed Biesecker JL, Marcove RC, Huvos AG, Mike V. Aneurysmal bone cysts. A clinicopathologic study of 66 cases. Cancer. 1970;26(3):615–25.CrossRefPubMed
7.
go back to reference Oliveira AM, Perez-Atayde AR, Inwards CY, Medeiros F, Derr V, Hsi BL, et al. USP6 and CDH11 oncogenes identify the neoplastic cell in primary aneurysmal bone cysts and are absent in so-called secondary aneurysmal bone cysts. Am J Pathol. 2004;165(5):1773–80.CrossRefPubMedPubMedCentral Oliveira AM, Perez-Atayde AR, Inwards CY, Medeiros F, Derr V, Hsi BL, et al. USP6 and CDH11 oncogenes identify the neoplastic cell in primary aneurysmal bone cysts and are absent in so-called secondary aneurysmal bone cysts. Am J Pathol. 2004;165(5):1773–80.CrossRefPubMedPubMedCentral
8.
go back to reference Lau AW, Pringle LM, Quick L, Riquelme DN, Ye Y, Oliveira AM, et al. TRE17/ubiquitin-specific protease 6 (USP6) oncogene translocated in aneurysmal bone cyst blocks osteoblastic maturation via an autocrine mechanism involving bone morphogenetic protein dysregulation. J Biol Chem. 2010;285(47):37111–20.CrossRefPubMedPubMedCentral Lau AW, Pringle LM, Quick L, Riquelme DN, Ye Y, Oliveira AM, et al. TRE17/ubiquitin-specific protease 6 (USP6) oncogene translocated in aneurysmal bone cyst blocks osteoblastic maturation via an autocrine mechanism involving bone morphogenetic protein dysregulation. J Biol Chem. 2010;285(47):37111–20.CrossRefPubMedPubMedCentral
9.
go back to reference Ye Y, Pringle LM, Lau AW, Riquelme DN, Wang H, Jiang T, et al. TRE17/USP6 oncogene translocated in aneurysmal bone cyst induces matrix metalloproteinase production via activation of NF-kappaB. Oncogene. 2010;29(25):3619–29.CrossRefPubMedPubMedCentral Ye Y, Pringle LM, Lau AW, Riquelme DN, Wang H, Jiang T, et al. TRE17/USP6 oncogene translocated in aneurysmal bone cyst induces matrix metalloproteinase production via activation of NF-kappaB. Oncogene. 2010;29(25):3619–29.CrossRefPubMedPubMedCentral
10.
go back to reference Kumta SM, Huang L, Cheng YY, Chow LT, Lee KM, Zheng MH. Expression of VEGF and MMP-9 in giant cell tumor of bone and other osteolytic lesions. Life Sci. 2003;73(11):1427–36.CrossRefPubMed Kumta SM, Huang L, Cheng YY, Chow LT, Lee KM, Zheng MH. Expression of VEGF and MMP-9 in giant cell tumor of bone and other osteolytic lesions. Life Sci. 2003;73(11):1427–36.CrossRefPubMed
11.
12.
go back to reference Shiels WE 2nd, Mayerson JL. Percutaneous doxycycline treatment of aneurysmal bone cysts with low recurrence rate: a preliminary report. Clin Orthop Relat Res. 2013;471(8):2675–83.CrossRefPubMedPubMedCentral Shiels WE 2nd, Mayerson JL. Percutaneous doxycycline treatment of aneurysmal bone cysts with low recurrence rate: a preliminary report. Clin Orthop Relat Res. 2013;471(8):2675–83.CrossRefPubMedPubMedCentral
13.
go back to reference Tsagozis P, Brosjo O. Current strategies for the treatment of aneurysmal bone cysts. Orthop Rev (Pavia). 2015;7(4):6182.CrossRef Tsagozis P, Brosjo O. Current strategies for the treatment of aneurysmal bone cysts. Orthop Rev (Pavia). 2015;7(4):6182.CrossRef
14.
go back to reference Hauschild O, Ludemann M, Engelhardt M, Baumhoer D, Baumann T, Elger T, et al. Aneurysmal bone cyst (ABC): treatment options and proposal of a follow-up regime. Acta Orthop Belg. 2016;82(3):474–83.PubMed Hauschild O, Ludemann M, Engelhardt M, Baumhoer D, Baumann T, Elger T, et al. Aneurysmal bone cyst (ABC): treatment options and proposal of a follow-up regime. Acta Orthop Belg. 2016;82(3):474–83.PubMed
15.
16.
go back to reference Rastogi S, Varshney MK, Trikha V, Khan SA, Choudhury B, Safaya R. 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. 2006;88(9):1212–6.CrossRefPubMed Rastogi S, Varshney MK, Trikha V, Khan SA, Choudhury B, Safaya R. 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. 2006;88(9):1212–6.CrossRefPubMed
17.
go back to reference Brosjo O, Pechon P, Hesla A, Tsagozis P, Bauer H. Sclerotherapy with polidocanol for treatment of aneurysmal bone cysts. Acta Orthop. 2013;84(5):502–5.CrossRefPubMedPubMedCentral Brosjo O, Pechon P, Hesla A, Tsagozis P, Bauer H. Sclerotherapy with polidocanol for treatment of aneurysmal bone cysts. Acta Orthop. 2013;84(5):502–5.CrossRefPubMedPubMedCentral
18.
go back to reference Varshney MK, Rastogi S, Khan SA, Trikha V. Is sclerotherapy better than intralesional excision for treating aneurysmal bone cysts? Clin Orthop Relat Res. 2010;468(6):1649–59.CrossRefPubMed Varshney MK, Rastogi S, Khan SA, Trikha V. Is sclerotherapy better than intralesional excision for treating aneurysmal bone cysts? Clin Orthop Relat Res. 2010;468(6):1649–59.CrossRefPubMed
19.
go back to reference Docquier PL, Delloye C. Treatment of aneurysmal bone cysts by introduction of demineralized bone and autogenous bone marrow. J Bone Joint Surg Am. 2005;87(10):2253–8.PubMed Docquier PL, Delloye C. Treatment of aneurysmal bone cysts by introduction of demineralized bone and autogenous bone marrow. J Bone Joint Surg Am. 2005;87(10):2253–8.PubMed
20.
go back to reference Doyle A, Field A, Graydon A. Recurrent aneurysmal bone cyst of the cervical spine in childhood treated with doxycycline injection. Skelet Radiol. 2015;44(4):609–12.CrossRef Doyle A, Field A, Graydon A. Recurrent aneurysmal bone cyst of the cervical spine in childhood treated with doxycycline injection. Skelet Radiol. 2015;44(4):609–12.CrossRef
21.
go back to reference Oliveira AM, Chou MM. USP6-induced neoplasms: the biologic spectrum of aneurysmal bone cyst and nodular fasciitis. Hum Pathol. 2014;45(1):1–11.CrossRefPubMed Oliveira AM, Chou MM. USP6-induced neoplasms: the biologic spectrum of aneurysmal bone cyst and nodular fasciitis. Hum Pathol. 2014;45(1):1–11.CrossRefPubMed
22.
go back to reference Daley E, Kurdziel MD, Koueiter D, Moore DD. Characterization of doxycycline-loaded calcium phosphate cement: implications for treatment of aneurysmal bone cysts. J Mater Sci Mater Med. 2018;29(7):109.CrossRefPubMed Daley E, Kurdziel MD, Koueiter D, Moore DD. Characterization of doxycycline-loaded calcium phosphate cement: implications for treatment of aneurysmal bone cysts. J Mater Sci Mater Med. 2018;29(7):109.CrossRefPubMed
23.
go back to reference Capanna R, Springfield DS, Biagini R, Ruggieri P, Giunti A. Juxtaepiphyseal aneurysmal bone cyst. Skelet Radiol. 1985;13(1):21–5.CrossRef Capanna R, Springfield DS, Biagini R, Ruggieri P, Giunti A. Juxtaepiphyseal aneurysmal bone cyst. Skelet Radiol. 1985;13(1):21–5.CrossRef
24.
go back to reference Shiels WE 2nd, Beebe AC, Mayerson JL. Percutaneous doxycycline treatment of juxtaphyseal aneurysmal bone cysts. J Pediatr Orthop. 2016;36(2):205–12.CrossRefPubMed Shiels WE 2nd, Beebe AC, Mayerson JL. Percutaneous doxycycline treatment of juxtaphyseal aneurysmal bone cysts. J Pediatr Orthop. 2016;36(2):205–12.CrossRefPubMed
25.
go back to reference Malghem J, Maldague B, Esselinckx W, Noel H, De Nayer P, Vincent A. Spontaneous healing of aneurysmal bone cysts. A report of three cases. J Bone Joint Surg Br. 1989;71(4):645–50.CrossRefPubMed Malghem J, Maldague B, Esselinckx W, Noel H, De Nayer P, Vincent A. Spontaneous healing of aneurysmal bone cysts. A report of three cases. J Bone Joint Surg Br. 1989;71(4):645–50.CrossRefPubMed
26.
go back to reference McQueen MM, Chalmers J, Smith GD. Spontaneous healing of aneurysmal bone cysts. A report of two cases. J Bone Joint Surg Br. 1985;67(2):310–2.CrossRefPubMed McQueen MM, Chalmers J, Smith GD. Spontaneous healing of aneurysmal bone cysts. A report of two cases. J Bone Joint Surg Br. 1985;67(2):310–2.CrossRefPubMed
27.
go back to reference Ibrahim T, Howard AW, Murnaghan ML, Hopyan S. Percutaneous curettage and suction for pediatric extremity aneurysmal bone cysts: is it adequate? J Pediatr Orthop. 2012;32(8):842–7.CrossRefPubMed Ibrahim T, Howard AW, Murnaghan ML, Hopyan S. Percutaneous curettage and suction for pediatric extremity aneurysmal bone cysts: is it adequate? J Pediatr Orthop. 2012;32(8):842–7.CrossRefPubMed
28.
go back to reference Louahem D, Kouyoumdjian P, Ghanem I, Mazeau P, Perrochia H, L'Kaissi M, et al. Active aneurysmal bone cysts in children: possible evolution after biopsy. J Child Orthop. 2012;6(4):333–8.CrossRefPubMedPubMedCentral Louahem D, Kouyoumdjian P, Ghanem I, Mazeau P, Perrochia H, L'Kaissi M, et al. Active aneurysmal bone cysts in children: possible evolution after biopsy. J Child Orthop. 2012;6(4):333–8.CrossRefPubMedPubMedCentral
29.
go back to reference Dabska M, Buraczewski J. Aneurysmal bone cyst. Pathology, clinical course and radiologic appearances. Cancer. 1969;23(2):371–89.CrossRefPubMed Dabska M, Buraczewski J. Aneurysmal bone cyst. Pathology, clinical course and radiologic appearances. Cancer. 1969;23(2):371–89.CrossRefPubMed
Metadata
Title
Aneurysmal bone cyst treated with percutaneous doxycycline: is a single treatment sufficient?
Authors
Jason T. K. Woon
Damien Hoon
Andrew Graydon
Mike Flint
Anthony J. Doyle
Publication date
01-05-2019
Publisher
Springer Berlin Heidelberg
Published in
Skeletal Radiology / Issue 5/2019
Print ISSN: 0364-2348
Electronic ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-019-03188-y

Other articles of this Issue 5/2019

Skeletal Radiology 5/2019 Go to the issue

Test Yourself: Answer

Painful right elbow mass