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Society for Pediatric Radiology – Poster Archive
Final ID: Poster #: SCI-036
Percutaneous Treatment of Aneurysmal Bone Cysts in the Pediatric and Adolescent Population
Purpose or Case Report: Aneurysmal bone cysts (ABCs) are expansile lytic lesions and can cause significant disability and pain most commonly seen in patients 10-30 years old. This study evaluates the technical feasibility, safety, and efficacy of percutaneous management of ABCs in pediatric and adolescent patients.
Methods & Materials: In this Institutional Review Board approved retrospective study, 11 consecutive ABCs treated with doxycycline sclerotherapy and/or percutaneous ablation from December 2015 to October 2018 were evaluated. Demographics, clinical presentation, procedural details, and safety/efficacy outcomes were assessed.
Results: A total of 11 ABCs in 11 patients (average age = 13.4 yrs; range: 8-17) were treated with 22 total procedures (range: 1-4 treatments/patient). 7/11 (63.6%) ABCs presented with recurrence following surgical resection. ABC location included spine 3/11 (27.3%), pelvis 4/11 (36.4%), lower extremity 2/11 (18.1%), humerus 1/11 (9.1%), and rib 1/11 (9.1%). Doxycycline sclerotherapy alone was used in 10 procedures in 4 (36.4%) patients, cryoablation alone was used in 7 procedures in 4 (36.4%) patients, and a combination of percutaneous ablation and doxycycline was used in 5 procedures in 3 patients (27.3%).
All 22 (100%) procedures were technically successful. Clinically, 10/11 (91%) showed clinical improvement including cessation of pain and improved range of motion. Mean follow-up time= 9 months (range: 1-20 months). On imaging, 9/10 (90%) ABCs decreased in size with increasing sclerosis on follow-up imaging. 1/10 (10%) ABC did not respond to percutaneous treatment and required repeat surgical resection. One patient is awaiting imaging follow-up. 1/11 (9.1%) patient experienced a major complication of left lower-extremity paralysis, bowel incontinence, and fecal incontinence following treatment of an L4 ABC that resolved. 1/11 (9.1%) patient experienced a minor complication of transient numbness of the lateral thigh.
Conclusions: Percutaneous treatment of ABCs is a safe and efficacious treatment option in the pediatric and adolescent population.
Methods & Materials: In this Institutional Review Board approved retrospective study, 11 consecutive ABCs treated with doxycycline sclerotherapy and/or percutaneous ablation from December 2015 to October 2018 were evaluated. Demographics, clinical presentation, procedural details, and safety/efficacy outcomes were assessed.
Results: A total of 11 ABCs in 11 patients (average age = 13.4 yrs; range: 8-17) were treated with 22 total procedures (range: 1-4 treatments/patient). 7/11 (63.6%) ABCs presented with recurrence following surgical resection. ABC location included spine 3/11 (27.3%), pelvis 4/11 (36.4%), lower extremity 2/11 (18.1%), humerus 1/11 (9.1%), and rib 1/11 (9.1%). Doxycycline sclerotherapy alone was used in 10 procedures in 4 (36.4%) patients, cryoablation alone was used in 7 procedures in 4 (36.4%) patients, and a combination of percutaneous ablation and doxycycline was used in 5 procedures in 3 patients (27.3%).
All 22 (100%) procedures were technically successful. Clinically, 10/11 (91%) showed clinical improvement including cessation of pain and improved range of motion. Mean follow-up time= 9 months (range: 1-20 months). On imaging, 9/10 (90%) ABCs decreased in size with increasing sclerosis on follow-up imaging. 1/10 (10%) ABC did not respond to percutaneous treatment and required repeat surgical resection. One patient is awaiting imaging follow-up. 1/11 (9.1%) patient experienced a major complication of left lower-extremity paralysis, bowel incontinence, and fecal incontinence following treatment of an L4 ABC that resolved. 1/11 (9.1%) patient experienced a minor complication of transient numbness of the lateral thigh.
Conclusions: Percutaneous treatment of ABCs is a safe and efficacious treatment option in the pediatric and adolescent population.
More abstracts on this topic:
Imaging and Clinical Findings of Aneurysmal Bone Cysts Post-Percutaneous Cryoablation
Weber Jonathon, Samet Jonathan, Green Jared, Donaldson James, Rajeswaran Shankar
Clinical Applications of Coronary CT Angiography in Preclinical Coronary Abnormalities in ChildrenGould Sharon, Harty M., Ostrowski John, Tsuda Takeshi
Poster____SCI-036.pdf
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