Aneurysmal Bone Cyst

Percutaneous Doxycycline Treatment of Aneurysmal Bone Cysts With Low Recurrence Rate: A Preliminary Report

“…We found all patients had a reduction in the size of the area of lytic destruction if not complete resolution of lytic foci (in two patients). This consistent response compares favorably with treatments including en bloc resection and amputation [35,42,44]. Furthermore, the lack of need for posttreatment physical rehabilitation (once pathologic fractures heal) offers patients greater mobility and maintenance of normal activities of daily living (recreational and work activity within limits set by the patient's orthopaedic surgeon) during the therapeutic regimen.…”

“…The 5% recurrence rate demonstrated in this series, particularly with juxtaphyseal lesions, provides an acceptable comparative recurrence rate [1,11,16,17,25,28,33,35,36,42,44] with which to pursue further study of this percutaneous treatment option. Furthermore, when recurrence (evidence of residual foci of tumor cells) occurs, patients are able to pursue a minimally invasive option of percutaneous treatment of small recurrent foci.…”

“…In addition, evidence of new bone healing provides key information for the physicians involved that treatment was progressing in the proper direction. Evidence of healing in 100% of patients compares favorably with surgical and nonsurgical care series [1,11,16,17,25,28,33,35,36,42,44].…”

“…Second, our followup ranged from 24 to 63 months. Given the median recurrence rates for this lesion ranging from 18 to 24 months [8,17,34], this followup (mean, 38 months) should capture more than 90% of potential recurrences [8,17,28,34,35]. These patients require and will continue further in 5-year surveillance to determine whether their ABCs will ultimately recur.…”

“…The recurrence rate of ABCs after traditional surgical treatments ranges from 12% to 71% (71% in children \ 10 years) with 90% detected within 2 years of surgical treatment [11,16,17,25,28,35,42,44]. Recurrence is particularly associated with juxtaphyseal locations of ABCs in skeletally immature patients [16].…”