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Aneurysmal bone cyst in 29 children
Andres Rodriguez Ramírez1, Robert P Stanton
1Alfred I. duPont Hospital for Children, Wilmington, Delaware, USA.
Insights
Aneurysmal bone cysts in children often recur, with a 27.5% rate observed in this study. Using a high-speed bur during treatment may help reduce recurrence of these bone lesions.
Area of Science:
- Pediatric Orthopedics
- Skeletal Pathology
- Surgical Oncology
Background:
- Aneurysmal bone cysts (ABCs) are benign, expansile, osteolytic bone lesions.
- Pediatric ABCs present unique challenges in management and treatment due to their location and potential for growth.
- Understanding recurrence patterns is crucial for optimizing treatment strategies in pediatric patients.
Purpose of the Study:
- To longitudinally review clinical features, treatment methods, and recurrence rates of pediatric aneurysmal bone cysts.
- To evaluate the impact of different surgical techniques on recurrence.
- To identify factors influencing the outcomes of ABC treatment in children.
Main Methods:
- Retrospective review of 40 pediatric cases of aneurysmal bone cyst treated at a single institution.
- Inclusion criteria: histologic confirmation and minimum 2-year follow-up for 29 patients.
- Treatment modalities included curettage, curettage with bone grafting, and resection.
Main Results:
- Overall recurrence rate of 27.5% (8/29 patients), with an average time to recurrence of 18.7 months.
- The tibia was the most common site (7 cases).
- Complications occurred in 6 cases, including physeal arrest in 3. Recurrence rates decreased with the use of a high-speed bur.
Conclusions:
- Aneurysmal bone cysts in children have a significant recurrence rate.
- Surgical technique, particularly the use of a high-speed bur, may influence recurrence rates.
- Long-term follow-up is essential for managing pediatric ABCs effectively.
Abstract:
The purpose of this study was to review longitudinally the clinical features, method of treatment, and recurrence rates of 40 cases of aneurysmal bone cyst in children treated at one institution. Twenty-nine patients with histologic confirmation of the diagnosis and minimum follow-up of 2 years were included. Thirteen patients were less than 10 years of age, and 16 were in the second decade of life. The most frequent location of the lesion was the tibia (seven cases). Patients were treated with curettage, curettage and bone grafting, or resection. The overall recurrence rate was 27.5%. Five lesions recurred once, and three recurred twice. The average time before recurrence was 18.7 months. Complications occurred in six cases, three of them with physeal arrest. The lesion occurred more commonly in females in the second decade of life and was not associated with a pre-existing tumor. The recurrence rate dropped after the use of a high-speed bur.