Megavoltage therapy in patients with aneurysmal bone cysts

Area of Science:

• Orthopedic Oncology
• Radiation Oncology
• Pediatric Bone Tumors

Background:

• Aneurysmal bone cysts (ABCs) are benign but locally destructive bone tumors.
• Pelvic ABCs can be challenging to treat due to their location and unresectable nature.
• Adolescent patients present unique considerations for bone tumor management.

Observation:

• Three adolescent patients presented with destructive pelvic lesions.
• These lesions were diagnosed as unresectable aneurysmal bone cysts.
• Patients received megavoltage irradiation therapy.

Findings:

• Successful and permanent control of aneurysmal bone cysts was achieved in all three patients.
• Good functional outcomes were observed 2 to 7 years post-treatment.
• Radiographs confirmed bone reconstitution and calcification with no late complications.
• A dose of 4,000 rads was used, with potential for a slightly lower effective dose.

Implications:

• Megavoltage irradiation is a viable treatment for unresectable pelvic aneurysmal bone cysts in adolescents.
• This therapeutic approach offers durable disease control and functional preservation.
• Further research may optimize radiation dosage for similar cases.