PDF(Pubmed)
Abstract：
The purpose of this review is to increase awareness about the evolution and development of current trends in the diagnosis and treatment of aneurysmal bone cysts (ABCs). ABCs are benign, but locally aggressive bone tumors that mainly affect children. ABCs comprise 1% of all primary bone tumors and occur most frequently during the first two decades of life. The diagnosis is made using a variety of imaging modalities and has the characteristic features of an expansile, radiolucent lesion that is often seen in the metaphyseal region of the bone and has fluid-fluid levels that are apparent on MRI. In the pediatric population, telangiectatic osteosarcoma and unicameral bone cyst (UBC) are the main differential diagnoses of an ABC. Giant cell tumors (GCTs) also include in differential diagnosis, which often manifest in patients older than 15 and do not penetrate the open physis although they develop after the physeal closure. Imaging alone cannot rule out telangiectatic osteosarcoma; therefore, a biopsy is recommended. A variety of treatment options have been described; traditionally, most patients are treated with curettage and bone grafting. Curettage alone, however, usually results in tumor recurrence following excision. A variety of adjuvants have been utilized with varying degrees of effectiveness to reduce the risk of local recurrence. When a cyst is in the pelvis, its location and size are such that surgery is a very risky option. Selective arterial embolization has significantly contributed to the development of effective treatments for these situations. Embolization or radiation, as well as denosumab therapy, are widely used as therapies for ABCs in anatomic locations where surgery would significantly increase morbidity.
摘要：
这篇综述的目的是提高对动脉瘤性骨囊肿（ABC）的诊断和治疗的当前趋势的演变和发展的认识。ABC是良性的，但主要影响儿童的局部侵袭性骨肿瘤。ABCs占所有原发性骨肿瘤的1％，在生命的头二十年中最常见。诊断是使用多种成像方式进行的，并且具有膨胀性的特征，放射状病变，常见于骨的干phy端区域，并且在MRI上具有明显的流体水平。在儿科人群中，毛细血管扩张骨肉瘤和单房骨囊肿（UBC）是ABC的主要鉴别诊断。巨细胞瘤（GCT）也包括在鉴别诊断中，这通常表现在15岁以上的患者中，尽管它们在physeal闭合后发展，但不会穿透开放性physis。单靠影像学不能排除毛细血管扩张骨肉瘤；因此，建议进行活检。已经描述了多种治疗方案；传统上，大多数患者接受刮宫和植骨治疗。独自刮宫，然而,切除后通常会导致肿瘤复发。已使用各种佐剂以不同程度的有效性来降低局部复发的风险。当囊肿在骨盆时，它的位置和大小使得手术是一个非常危险的选择。选择性动脉栓塞术极大地促进了针对这些情况的有效治疗方法的发展。栓塞或辐射，以及denosumab疗法，在手术会显着增加发病率的解剖位置，广泛用作ABC的疗法。
