背景:动脉瘤样骨囊肿(ABC)是一种良性的,而是骨的局部侵袭性囊性病变.它通常发生在青少年和年轻人的长骨干phy端,但也可能影响骨盆。
方法:这项单中心研究是对17例原发性骨盆ABCs患者的回顾性研究。与病灶内刮治或边缘切除术相比,它研究了脊髓灰质炎滴注作为骨盆ABC微创治疗选择的重要性。
结果:研究中纳入了17例诊断为骨盆原发性ABC的患者。6名患者为男性(35%),11名患者为女性(65%);平均年龄为18(9-49)岁。随访时间12~136个月,平均50个月。最常见的表现位置是耻骨(6;35%),其次是髂骨(6;35%),骶骨(3;18%)和坐骨(2;12%)。8例患者通过使用佐剂进行病灶内刮治,一名患者通过边缘切除术,七个通过顺序滴注脊髓灰质炎和一名患者通过简单观察。五名患者接受了额外的经动脉栓塞。病灶内刮除后,有4/8例(50%)发现局部复发。经滴注治疗后,6例患者(86%)病情稳定,无复发,只有1例患者(14%)患有持续性疾病,需要额外治疗,因此在随访中转为病灶内刮治,无局部复发.
结论:依次滴注脊髓灰质炎是有希望的,骨盆ABCs的微创治疗方法,可以很好地结合经动脉栓塞。
BACKGROUND: The aneurysmal bone cyst (ABC) is a benign, but locally aggressive cystic lesion of the bone. It usually occurs in the metaphysis of long bones of adolescents and young adults but can also affect the pelvis.
METHODS: This single-center study is a retrospective review of 17 patients with primary ABCs of the pelvis. It examines the importance of polidocanol instillations as minimally invasive treatment option for ABCs of the pelvis compared to intralesional curettage or marginal resection.
RESULTS: Seventeen patients with the diagnosis of a primary ABC of the pelvis were included in the study. Six patients were male (35%) and 11 patients female (65%); the mean age was 18 (9-49) years. The mean follow-up time was 50 months (12-136 months). The most common location of manifestation was the pubis (6; 35%), followed by the ilium (6; 35%), the sacrum (3; 18%) and the ischium (2; 12%). Eight patients were treated by intralesional curettage with the use of adjuvants, one patient by marginal resection, seven by sequential instillation of polidocanol and one patient by simple observation. Five patients received an additional transarterial embolization. After intralesional curettage local recurrence was detected in 4/8 cases (50%). After instillation therapy six patients (86%) had a stable disease without recurrence, only one patient (14%) had a persistent disease with need of additional treatment and was therefore converted to intralesional curettage without local recurrence in the follow-up.
CONCLUSIONS: Sequential instillations of polidocanol are a promising, minimally invasive treatment method for ABCs of the pelvis and can be well combined with transarterial embolization.