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Intralesional Ethibloc injections in primary aneurysmal bone cysts: an efficient and safe treatment
C Adamsbaum1, E Mascard, J M Guinebretière
1Department of Radiology, St. Vincent de Paul Hospital, 82 avenue Denfert Rochereau, 75674 Paris Cedex 14, France. c.adamsbaum@svp.ap-hop-paris.fr
Insights
Direct Ethibloc injection effectively treated aneurysmal bone cysts (ABC) in children, with most patients showing complete healing. Frequent local reactions like pain and fever were noted but resolved without major complications.
Area of Science:
- Orthopedic Surgery
- Pediatric Oncology
- Interventional Radiology
Background:
- Aneurysmal bone cysts (ABC) are benign, expansile bone lesions.
- Ethibloc, a fibrogenic and thrombogenic agent, is a novel therapeutic option for ABC.
- Minimally invasive treatments are sought for pediatric bone lesions.
Purpose of the Study:
- To evaluate the efficacy and safety of direct Ethibloc injection for treating primary aneurysmal bone cysts in children.
- To assess long-term outcomes following Ethibloc treatment for pediatric ABC.
Main Methods:
- Seventeen pediatric patients (2-18 years) with primary ABC received direct Ethibloc injection.
- Treatment involved single or supplementary injections.
- Histological diagnosis was confirmed, and patients were followed for a mean of 5 years.
Main Results:
- Complete healing, indicated by cortical and septal thickening, was observed in 14 of 17 patients at 5-year follow-up.
- Three patients required surgical excision due to rapid ABC enlargement or incomplete healing.
- Common local reactions included pain and fever in 16 patients; three developed transient cutaneous fistulas. No major complications occurred.
Conclusions:
- Percutaneous Ethibloc injection is a safe and effective noninvasive treatment for pediatric aneurysmal bone cysts.
- Frequent local inflammatory reactions are expected but manageable.
- Ethibloc offers a promising alternative to surgical intervention for ABC.
Objective:
Ethibloc is a fibrogenic and thrombogenic agent recently proposed for the treatment of bone cysts. The purpose of this study is to report the results of direct Ethibloc injection in primary aneurysmal bone cyst (ABC) in children.
Design And Patients:
Seventeen patients, aged from 2 to 18 years (mean 8 years), were treated with either a single injection (14 patients) or supplementary injections (3 patients) of Ethibloc. The histological diagnosis was assessed following surgical biopsy and was retrospectively reviewed. The mean follow-up was 5 years (range 18 months to 11 years).
Results:
At 5 year follow-up, 14 of 17 patients demonstrated complete healing manifest by increased cortical and septal thickening. Surgical excision was required in three patients, in two of whom the ABC increased rapidly in size despite the injection, and in one of whom the healing was incomplete. We observed inflammatory reactions in 16 of 17 patients with local pain and fever. Three patients developed a small cutaneous fistula which resolved spontaneously in a few weeks. No major complications such as deep infection, pulmonary embolism, epiphyseal necrosis or malignant degeneration were observed.
Conclusion:
Percutaneous direct Ethibloc injection is a safe, efficient and noninvasive treatment for ABC. The authors highlight the frequent local reactions.