Aneurysmal bone cysts treated by superselective embolization

A series of 7 cases of aneurysmal bone cysts (ABC), all but 1 located in the pelvic bones, which were treated by transcatheter embolization is presented. Five embolizations were performed for primary treatment, while in 2 patients they were performed preoperatively. In all patients a definite histological diagnosis was established by open biopsy, and plain radiographs as well as computerized tomography (CT) were applied for evaluation of the results. The embolizing materials were tissue adhesive for permanent, and Gelfoam for preoperative vessel occlusions. Of 5 lesions treated for the purpose of definitive embolization, 3 (all located in the superior pubic ramus) showed complete ossification; in one, partial remineralization and progression occurred. In a further patient with a secondary ABC, partial reconstitution was recorded. Both preoperative embolizations resulted in successful en bloc resection with minimal blood loss. Transcatheter embolization is the treatment of choice for the highly vascular ABC in unfavorable anatomical locations.