Abstract:
(1) Background: An aneurysmal bone cyst (ABC) is a benign, locally aggressive tumor. Different treatment modalities are described in the literature i.e., en bloc resection, intralesional curettage and percutaneous sclerotherapy. (2) Methods: This single-center study is a review of 74 patients with primary ABCs who underwent a surgical treatment or polidocanol instillation. Cyst volume measurements using MRI and conventional radiographs are compared. (3) Results: The mean pre-interventional MRI-based cyst volume was 44.07 cm3 and the mean radiographic volume was 27.27 cm3. The recurrence rate after intralesional curettage with the need for further treatment was 38.2% (13/34). The instillation of polidocanol showed a significant reduction of the initial cyst volume (p < 0.001) but a persistent disease occurred in 29/32 cases (90.6%). In 10 of these 29 cases (34.5%) further treatment was necessary. After en bloc resection (eight cases) a local recurrence occurred in two cases (25%), in one case with the need for further treatment. (4) Conclusions: MRI scans are superior to biplanar radiographs in the examination of ABCs. Sequential percutaneous instillations of polidocanol are equally effective in the therapy of primary ABCs compared to intralesional curettage. However, several instillations have to be expected. In a considerable number of cases, a conversion to intralesional curettage or en bloc resection may be necessary.
摘要:
(1)背景:动脉瘤样骨囊肿(ABC)是一种良性,局部侵袭性肿瘤。文献中描述了不同的治疗方式,即整块切除,病灶内刮治和经皮硬化治疗。(2)方法:这项单中心研究是对74例接受手术治疗或脊髓灰质炎滴注的原发性ABC患者的回顾。比较了使用MRI和常规X射线照片进行的囊肿体积测量。(3)结果:基于MRI的囊肿介入前平均体积为44.07cm3,X线平均体积为27.27cm3。需要进一步治疗的病灶内刮治后的复发率为38.2%(13/34)。滴注policanol显示初始囊肿体积显着减少(p<0.001),但29/32例(90.6%)发生了持续性疾病。在这29例病例中,有10例(34.5%)需要进一步治疗。整块切除(8例)后,2例(25%)发生局部复发,在一种情况下需要进一步治疗。(4)结论:在ABCs的检查中,MRI扫描优于双平面X线片。与病灶内刮治相比,顺序经皮滴注脊髓灰质炎醇在原发性ABC的治疗中同样有效。然而,预计会有几次灌输。在相当多的案例中,可能需要转换为病灶内刮治或整块切除。