Percutaneous Sclerotherapy for the Treatment of Aneurysmal Bone Cyst, What are the Outcomes?
Journal Title: GUJARAT CANCER SOCIETY RESEARCH JOURNAL - Year 2018, Vol 20, Issue 1
Abstract
Aneurysmal bone cyst (ABC) shows onset in the first decades of life with incidence of 1.4/100,000 constituting about 1% of benign bone tumours. Management includes combinations of embolization, curettage with or without bone grafting, cementing of the cavity, reconstructive surgery but shows recurrence rates of 10 to 30%. Sclerotherapy is an interesting alternative to surgery with less recurrence. We report our experience using 3% polidocanol as sclerosant and describe the clinical and radiological results. We retrospectively reviewed 15 patients who underwent percutaneous sclerotherapy for the treatment of Aneurysmal bone cyst with polidocanol from 2015 to 2017. Repeated percutaneous injection of 30 mg/mL 3% polidocanol under fluoroscopic or CT guidance and general anaesthesia was the mainstay of treatment. Three injections were given at the interval of six weeks and maximum of four injections had been given if previous three failed to heal the lesion. Radiological assessments of the tumour combined with clinical assessment of the patient’s symptoms were performed on an outpatient basis, usually 6–8 weeks after completion of a session of injections. The median number of injections per patient was 2 (1-4). 4 patients were cured by a single injection of polidocanol, whereas 1 patient required 4 injections. The efficacy of the method was 93.33%. Pain resolved (VAS = 0) in 14 patients (93.33%) by 3 months after injections and had convincing radiological sclerosis. One patient had persistent pain even after fourth injection and progression of disease, hence opted for scapulectomy. There were no cases of local recurrence, anaphylaxis, major adverse reactions or local necrosis at the injection site. Minor local inflammatory reactions were observed in 2 patients and resolved spontaneously. Sequential percutaneous administration of polidocanol is the standard treatment for Aneurysmal bone cyst at our institution as we have found it to be a safe, simple procedure with an excellent cure rate.
Authors and Affiliations
Rahul Parmar, Jaymin Shah, Abhijeet Salunke, Ashokkumar Singh, Jyotindra Pandit, Shashank Pandya
Keywords
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