Sclerotherapy with polidocanol for treatment of aneurysmal bone cysts

Brosjö, Otte; Pechon, Pierre; Hesla, Asle Charles; Tsagozis, Panagiotis; Bauer, Henrik

doi:10.3109/17453674.2013.850013

Cited by 78 publications

(74 citation statements)

References 17 publications

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“…Recent publications on minimally-invasive techniques (e. g. injection of fibrosing agents or CT-guided injection of demineralized bone and bone marrow) demonstrate that extensive operations can be avoided [2, 16, 27 -29]. Likewise, percutaneous injection of polidocanol for sclerotherapy of the cyst is an effective procedure; however, in the case of larger cysts, multiple applications using anesthesia are required [13]. Sequential injection therapy in the sacral region can be usefully employed, especially if angiography rules out a hypervascularized tumor bed, and embolization does not appear to be medically sensible.…”

Section: Clinical Post-treatment Examinationmentioning

confidence: 99%

Selective arterial Embolisation of Aneurysmal Bone Cysts of the Sacrum: a promising Alternative to Surgery

Henrichs

Beck

Gosheger

et al. 2015

Fortschr Röntgenstr

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Purpose: The sacrum is a rare but unfavourable location for Aneurysmal Bone Cysts (ABCs), surgical procedures aiming to achieve local tumour control can be mutilating. Aim of this study was to evaluate whether selective arterial embolisation (AE) of ABC of the sacrum is an effective treatment and might be an alternative to surgical treatment options. Materials and Methods: Between 2007 and 2011 six patients (mean age 13.7 years, range 8???18 years) with an ABC of the sacrum were treated by AE. Follow-up was performed by MRI-scans as well as clinical examination (mean 36.5 months, range 14???56 months). Results: No treatment related complications have been observed. AE resulted in devascularisation of ABC and led to local tumour control in all patients. A partial consolidation was noticed in three patients. Pain relief was achieved in five of six patients, neurological deficits dissolved. In two patients more than one embolization was necessary. In one of these patients due to exacerbation of pain a surgical decompression was performed. Conclusion: AE of sacral ABCs can serve as an effective and safe treatment option. Thus it might be an alternative to potentially harmful surgical procedures. In case of ongoing tumour growth or pain recurrence AE can be repeated. In case of treatment failure surgical interventions are still possible. Key Points: ??transarterial embolisation enables local tumour control in sacral ABCs ??transarterial embolisation of sacral ABCs is a safe procedure ??in case of tumour progression repetitive embolisations are possible and effective Citation Format: ??Henrichs MP, Beck L, Gosheger G et?al. Selective arterial Embolisation of Aneurysmal Bone Cysts of the Sacrum: a promising Alternative to Surgery. Fortschr R?ntgenstr 2016; 188: 53???59

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Section: Clinical Post-treatment Examinationmentioning

confidence: 99%

Selective arterial Embolisation of Aneurysmal Bone Cysts of the Sacrum: a promising Alternative to Surgery

Henrichs

Beck

Gosheger

et al. 2015

Fortschr Röntgenstr

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“…Eine weitere minimal-invasive Modalität für die Behandlung von AKZ, welche in den letzten Jahren an Bedeutung zugenommen hat, ist die perkutane Instillation von Polidocanol, einer sklerosierenden Substanz, die zur Therapie oberflächlicher Varizen eingesetzt wird [4,19,24]. Ziel der Behandlung ist die Denaturierung der Zys tenwand, die zur ossären Konsolidierung führt (.…”

Section: Polidocanolinstillationunclassified

“…1, [19]). Auch dieses Verfahren wird nur bei primären AKZ nach histologischer Sicherung angewendet [4,19,24]. Da im Moment der Polidocanolinstillation kurzzeitig starke lokale Schmerzen auftreten können, findet die Intervention in Allgemeinnarkose oder Analgosedierung statt [4,19].…”

Section: Polidocanolinstillationunclassified

Neue Operationsverfahren bei Knochentumoren

et al. 2014

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Primary bone neoplasms can be classified into benign, locally/aggressive and rarely metastasizing and malignant tumors. Patients with benign tumors usually undergo surgical treatment in cases of local symptoms, mainly consisting of pain or functional deficits due to compression of important anatomical structures, such as nerves or blood vessels. Locally/aggressive and rarely metastasizing tumors exhibit an infiltrative growth pattern, so that surgical treatment is necessary to prevent further destruction of bone leading to local instability. Finally, the surgical treatment of malignant tumors is, with few exceptions, considered to be a prerequisite for long-term survival, either alone or in combination with systemic chemotherapy. Whereas the main objective of surgery in the treatment of benign tumors is relief of local symptoms with a minimum amount of damage to healthy tissue and minimizing the risk of local recurrence while ensuring bone stability in locally aggressive and rarely metastasizing tumors, the primary goal in the operative treatment of bone sarcomas is the resection of the tumor with clear surgical margins followed by defect reconstruction and the preservation of function. This review examines the current developments in the surgical treatment of primary bone neoplasms with respect to the management of the tumors and novel reconstructive options.

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“…Adjuvant radiation has been associated with malignant transformation and is therefore not recommended; however, cases have progressed to malignancy without prior radiation [50] . Sclerotherapy is an alternative with relative success for aneurysmal bone cysts not amenable to surgical treatment, although we cannot find a case of sclerotherapy for an orbital lesion [51,52] . Recently, Pelle et al [53] have demonstrated strong RANK ligand expression in stromal cells in vivo and tumor shrinkage in a 5-year-old boy with a large sacral aneurysmal bone cyst treated with denosumab [54] .…”

Section: Benign Reactive Bone Lesions Of the Orbitmentioning

confidence: 99%

Treatment Challenges with Benign Bone Tumors of the Orbit

Merritt

Yin²,

Pfeiffer

et al. 2015

Ocul Oncol Pathol

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Benign mesenchymal tumors of the craniofacial complex present unique challenges for orbital surgeons because of their potential for orbital compartment syndrome, ocular morbidity, and facial disfigurement and because definitive surgical management may be associated with significant morbidity. While the precise classification of such lesions depends on radiologic as well as histologic evaluations and remains controversial, benign tumors involving the bony walls of the orbit share features of bony expansion, facial deformity, and the potential to cause significant orbital and ophthalmic morbidity. We herein present 2 cases of benign mesenchymal tumors with bony involvement in the orbitofacial region (1 juvenile ossifying fibroma and 1 central giant cell granuloma) and review the current management of similar benign fibro-osseous and reactive bone lesions of the orbit. These rare entities presented share common orbital and ophthalmic manifestations and remain without any effective definitive treatment options.

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Sclerotherapy with polidocanol for treatment of aneurysmal bone cysts

Cited by 78 publications

References 17 publications

Selective arterial Embolisation of Aneurysmal Bone Cysts of the Sacrum: a promising Alternative to Surgery

Selective arterial Embolisation of Aneurysmal Bone Cysts of the Sacrum: a promising Alternative to Surgery

Neue Operationsverfahren bei Knochentumoren

Treatment Challenges with Benign Bone Tumors of the Orbit

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