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The treatment of aneurysmal bone cysts
Thomas P G van Geloven1, Michiel A J van de Sande, Lizz van der Heijden
1Department of Orthopaedics, Leiden University Medical Center, Leiden, The Netherlands.
Current Opinion in Pediatrics
|November 21, 2022
Summary
Aneurysmal bone cysts (ABCs) are rare bone tumors. Current treatments include surgery, sclerotherapy, and denosumab, with varying success and risks, especially in children.
Area of Science:
- Orthopedic Oncology
- Skeletal Radiology
- Pediatric Oncology
Background:
- Aneurysmal bone cysts (ABCs) are uncommon, locally aggressive bone neoplasms.
- Treatment strategies for ABCs are evolving, incorporating sclerotherapy, embolization, and denosumab alongside traditional curettage.
- Optimal management remains debated due to the diverse therapeutic landscape.
Approach:
- This review discusses current diagnostic and therapeutic concepts for primary ABCs.
- Literature review of recent advancements in diagnostics and treatment.
- Analysis of novel fusion partners identified via next-generation sequencing.
Key Points:
- Diagnostic advancements include identifying USP-6 fusion partners using next-generation sequencing.
- Percutaneous sclerotherapy with polidocanol shows promise as a surgical alternative.
- Denosumab is effective but carries risks of severe hypercalcemia in children.
Conclusions:
- Accurate diagnosis is paramount for effective ABC treatment.
- Curettage with adjuvant techniques remains a viable option.
- Sclerotherapy is a strong alternative; denosumab should be used cautiously in children.
- Treatment selection requires careful consideration of lesion characteristics and patient safety.
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