Clinicoradiological outcome of percutaneous intralesional polidocanol in Aneurysmal Bone Cysts: A prospective study of 43 patients in a single tertiary care centre

Rai, Abhishek Kumar; Rathod, Tushar; Bansa, Dixit; Hadole, Bhushan Sunil; Rahman, Syed Hifzur; G, Geekesh Kumar K; Prabhu, Rudra Mangesh

doi:10.1016/j.jor.2022.05.010

Cited by 4 publications

(6 citation statements)

References 17 publications

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“…16 Treatment options for ABC include surgical removal of the lesion, curettage with or without bone grafting, optional adjuvant therapy, endovascular treatment using selective arterial embolization, external-beam radiotherapy, and percutaneous directed therapies such as sclerotherapy, ablation, cementoplasty, and percutaneous injections of bisphosphonates or doxycycline. [4][5][6][7][8][9][10][11][12][13][14]17,18 En bloc excision, is associated with the lowest rates of recurrence with 95-100 % localized control but it comes at the cost of high patient morbidity. 4,17 Simple Curettage of the lesion with or without bone grafting has been linked with high and sometime unacceptable recurrence rate of 18 to 59% 18 .…”

Section: Discussionmentioning

confidence: 99%

“…Sclerotherapy is a newer modality that acts by causing damage to the endothelium of vessels and initiating a coagulation cascade that results in thrombosis and healing of the lesion. 11,12 Percutaneous sclerotherapy with polidocanol has been used in a few studies with promising results in terms of lesser recurrence and morbidity but safety and efficacy are still debated. [10][11][12][13][14]…”

Section: Introductionmentioning

confidence: 99%

“…11,12 Percutaneous sclerotherapy with polidocanol has been used in a few studies with promising results in terms of lesser recurrence and morbidity but safety and efficacy are still debated. [10][11][12][13][14]…”

Section: Introductionmentioning

confidence: 99%

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Percutaneous sclerotherapy using polidocanol in the treatment of aneurysmal bone cysts of extremities – a report of 28 consecutive cases

Harshwal,

Kumawat,

Saini

et al. 2023

Eur J Clin Exp Med

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Introduction and aim. Aneurysmal bone cysts (ABC) are aggressive benign lesions with high rates of recurrence rendering its treatment uniquely challenging. We report the outcome in 28 consecutive patients of ABC of extremities treated with percutaneus sclerotherapy using 3% polidocanol over a period of 5 years. Material and methods. In biopsy proven 28 ABC cases, Injection polidocanol 3% was used as sclerosing agent under fluoroscopy guidance. Injections were repeated at 6-week intervals till complete healing of cysts. Radiological and functional results were assessed by Rastogi et al. criteria, VAS score and Enneking scoring method. Results. 25 out of 26 patients (89.28%) displayed good clinical response with an average 2.56 injections per patients. The mean follow-up period was 17.04±7.08 months. Reduction in cyst volume (mean 6.86±1.48 to 0.71±1.48.) and VAS score (mean 6.72±1.51 to 0.56±1.08) and improvement in Enneking score (17.35±3.14 to 28.92±1.35) at last follow up was significant. No recurrence was reported during the study period. Treatment failure, skin sclerosis and infection were reported in one case each. Conclusion. sclerotherapy with polidocanol 3% for primary ABC is safe and effective alternate method with advantage of no surgical morbidity, having better functional score with lesser recurrence and minimal complications.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Percutaneous sclerotherapy using polidocanol in the treatment of aneurysmal bone cysts of extremities – a report of 28 consecutive cases

Harshwal,

Kumawat,

Saini

et al. 2023

Eur J Clin Exp Med

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“…Both studies emphasize the importance of establishing optimal treatment duration, having a gradual discontinuation strategy and long-term monitoring for growth (deformities), serum calcium and mineral homeostasis. Earlier studies suggested the use of bisphosphonates as a preventive strategy [38 ▪ ], and these studies confirm the usefulness [36 ▪ ,37 ▪ ]. However, knowledge regarding consequences for the growing skeleton and strong evidence to the effectiveness of bisphosphonates in ABCs are lacking.…”

Section: Percutaneous Proceduresmentioning

confidence: 91%

“…The use of denosumab in particular has been shown effective as rescue therapy for controlling ABCs [ 2 ▪ ]. However, a growing number of articles were published, like Deodati et al and Del Sindaco et al warning for severe adverse events after discontinuation in children [ 36 ▪ , 37 ▪ ]. Deodati et al report a 10-year-old boy with ABC, who after 10 months of high-dose denosumab treatment developed a hypercalcemia with nephrocalcinosis.…”

Section: Percutaneous Proceduresmentioning

confidence: 99%

The treatment of aneurysmal bone cysts

Geloven

Sande²,

Heijden³

2022

Current Opinion in Pediatrics

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Purpose of reviewAneurysmal bone cysts are rare, locally aggressive bone tumors. Optimal treatment of ABCs is still matter of debate as therapies including sclerotherapy, selective arterial embolization and systemic treatment with denosumab are increasingly utilized, in addition to or instead of traditional curettage. The purpose of this review is to discuss current concepts and difficulties in diagnosing and treating primary ABCs, based on latest available literature.Recent findingsIn diagnostics, multiple new fusion partners of USP-6 have been described on next-generation sequencing specifically for primary ABCs. In a recent systematic review, failure rates of percutaneous injections and surgery were comparable. In a literature review, the use of denosumab seemed effective but resulted in multiple cases of severe hypercalcemia in children.SummaryAccurately diagnosing primary ABC is crucial for treatment decisions. Curettage remains a valid treatment option, especially with adjuvant burring, autogenous bone grafting and phenolization. Percutaneous sclerotherapy represents a solid alternative to surgery, with polidocanol showing good results in larger studies. Systematic therapy with denosumab exhibits favorable results but should be reserved in the pediatric population for unresectable lesions, as it may result in severe hypercalcemia in children. When selecting a treatment option, localization, stability and safety should be considered.

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Management of Aneurysmal Bone cyst with pathological femur fracture: A rare case report and review of literature

Jagiasi¹,

Rai²,

Sharan³

et al. 2023

Journal of Orthopaedic Reports

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Clinicoradiological outcome of percutaneous intralesional polidocanol in Aneurysmal Bone Cysts: A prospective study of 43 patients in a single tertiary care centre

Cited by 4 publications

References 17 publications

Percutaneous sclerotherapy using polidocanol in the treatment of aneurysmal bone cysts of extremities – a report of 28 consecutive cases

Percutaneous sclerotherapy using polidocanol in the treatment of aneurysmal bone cysts of extremities – a report of 28 consecutive cases

The treatment of aneurysmal bone cysts

Management of Aneurysmal Bone cyst with pathological femur fracture: A rare case report and review of literature

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