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

Shiels, William E.; Mayerson, Joel L.

doi:10.1007/s11999-013-3043-2

Cited by 115 publications

(111 citation statements)

References 44 publications

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“…Doxycycline (10 mg/mL) was used as the chemical ablation agent and delivered as a protein foam (mixture of doxycycline and 25% albumin and agitated with air to create a stable protein foam delivery system). 39 Doxycycline foam was injected into the cystic locules and, when possible, into the solid elements of the ABC. Postprocedural pain was managed with either oral NSAIDs or oral narcotic analgesics.…”

Section: Methodsmentioning

confidence: 99%

“…38 The authors previously have reported pathologic specimens from 3 ABC patients treated with doxycycline injection 1 to 2 weeks before surgical resection with histologic evidence of tumor necrosis. 39 Seventy-one patients have been treated for ABC in the authors' institution. The purpose of this study is to answer 5 questions regarding percutaneous treatment of juxtaphyseal ABC with doxycycline: (1) Is there reduction of lytic bony destruction and evidence of new bone healing?…”

mentioning

confidence: 99%

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Percutaneous Doxycycline Treatment of Juxtaphyseal Aneurysmal Bone Cysts

Shiels

Beebe

Mayerson

2016

Journal of Pediatric Orthopaedics

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Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

Percutaneous Doxycycline Treatment of Juxtaphyseal Aneurysmal Bone Cysts

Shiels

Beebe

Mayerson

2016

Journal of Pediatric Orthopaedics

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“…Isolated intracystic injection of demineralized bone powder, bone marrow, calcitonin, bone substitute or doxycycline have given contradictory results and sometimes require a large number of procedures [10,22,26,27].…”

Section: Treatmentmentioning

confidence: 99%

Bone cysts: Unicameral and aneurysmal bone cyst

Mascard

Gomez‐Brouchet

Lambot

2015

Orthopaedics & Traumatology: Surgery & Research

242

280

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Simple and aneurysmal bone cysts are benign lytic bone lesions, usually encountered in children and adolescents. Simple bone cyst is a cystic, fluid-filled lesion, which may be unicameral (UBC) or partially separated. UBC can involve all bones, but usually the long bone metaphysis and otherwise primarily the proximal humerus and proximal femur. The classic aneurysmal bone cyst (ABC) is an expansive and hemorrhagic tumor, usually showing characteristic translocation. About 30% of ABCs are secondary, without translocation; they occur in reaction to another, usually benign, bone lesion. ABCs are metaphyseal, excentric, bulging, fluid-filled and multicameral, and may develop in all bones of the skeleton. On MRI, the fluid level is evocative. It is mandatory to distinguish ABC from UBC, as prognosis and treatment are different. UBCs resolve spontaneously between adolescence and adulthood; the main concern is the risk of pathologic fracture. Treatment in non-threatening forms consists in intracystic injection of methylprednisolone. When there is a risk of fracture, especially of the femoral neck, surgery with curettage, filling with bone substitute or graft and osteosynthesis may be required. ABCs are potentially more aggressive, with a risk of bone destruction. Diagnosis must systematically be confirmed by biopsy, identifying soft-tissue parts, as telangiectatic sarcoma can mimic ABC. Intra-lesional sclerotherapy with alcohol is an effective treatment. In spinal ABC and in aggressive lesions with a risk of fracture, surgical treatment should be preferred, possibly after preoperative embolization. The risk of malignant transformation is very low, except in case of radiation therapy.

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“…53 It has been reported that occasionally these lesions heal spontaneously or after a pathological fracture or biopsy alone. 54 The recurrence rate of ABCs, particularly associated with juxtaphyseal locations in skeletally immature patients, 55 and the potential of disturbance of growth when the lesion is near a physeal plate after traditional surgical treatments is high and ranges from 30.8% to 50% according to Marcove et al, 56 Cole 57 and Schreuder et al 58 This suggests mini invasive management of ABCs such as embolization or sclerotherapy. Embolization of the feeding vessels was initially a pre-operative procedure performed to reduce intraoperative bleeding.…”

Section: Osteoid Osteomamentioning

confidence: 99%

“…Beyond simple cytotoxicity, doxycycline is antiangiogenic, a potent inhibitor of matrix metallo proteinase (MMP), an inhibitor of osteoclastic activity, induces apoptosis in osteoclasts and promotes osteoblastic activity. 54,[72][73][74][75] The authors reported a lesion volume reduction in all patients treated with one minor complication (skin necrosis) and 5% recurrence. Percutaneous sclerotherapy is well-described and is now the primary treatment of ABC in many centres; since surgical treatment may be difficult at certain sites, has higher risk of complications and a 10-44% local recurrence rate.…”

Section: Osteoid Osteomamentioning

confidence: 99%

Paediatric musculoskeletal interventional radiology

Natali¹,

Paolantonio²,

Fruhwirth³

et al. 2016

BJR

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Interventional radiology technique is now well established and widely used in the adult population. Through minimally invasive procedures, it increasingly replaces surgical interventions that involve higher percentages of invasiveness and, consequently, of morbidity and mortality. For these advantageous reasons, interventional radiology in recent years has spread to the paediatric age as well. The aim of this study was to review the literature on the development, use and perspectives of these procedures in the paediatric musculoskeletal field. Several topics are covered: osteomuscle neoplastic malignant and benign pathologies treated with invasive diagnostic and/or therapeutic procedures such as radiofrequency ablation in the osteoid osteoma; invasive and non-invasive procedures in vascular malformations; treatment of aneurysmal bone cysts; and role of interventional radiology in paediatric inflammatory and rheumatic inflammations. The positive results that have been generated with interventional radiology procedures in the paediatric field highly encourage both the development of new ad hoc materials, obviously adapted to young patients, as well as the improvement of such techniques, in consideration of the fact that childrens' pathologies do not always correspond to those of adults. In conclusion, as these interventional procedures have proven to be less invasive, with lower morbidity and mortality rates as well, they are becoming a viable and valid alternative to surgery in the paediatric population. MUSCULOSKELETAL MALIGNANT TUMOURSOsteosarcoma, Ewing sarcoma and rhabdomyosarcoma are the most common musculoskeletal tumours of childhood and adolescence.

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

Cited by 115 publications

References 44 publications

Percutaneous Doxycycline Treatment of Juxtaphyseal Aneurysmal Bone Cysts

Percutaneous Doxycycline Treatment of Juxtaphyseal Aneurysmal Bone Cysts

Bone cysts: Unicameral and aneurysmal bone cyst

Paediatric musculoskeletal interventional radiology

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