Sclerotherapy in aneurysmal bone cysts in children: a review of 17 cases

Objective: To determine the efficacy of percutaneous sclerotherapy in the treatment of aneurysmal bone cysts. Materials and methods: Seventeen patients (7 girls, 10 boys) with aneurysmal bone cysts were treated by the percutaneous approach with Ethibloc (n = 14) and histoacryl glue (n = 3) in our institution between January 1994 and June 2000. The cysts were located in the extremities (n = 6), pelvis (n = 2), spine (n = 2), mandible (n = 5), rib (n = 1) and sphenoid bone (n = 1). Percutaneous sclerotherapy was performed with fluoroscopic and/or computed tomographic guidance under general anesthesia. Clinical and imaging follow-up lasted from 24 months to 9 years and 6 months (mean: 57.3 months). The results were quantified as: excellent (residual cyst less than 20% of the initial involvement), satisfactory (residual cyst 30-50%), unsatisfactory (residual cyst more than 50%). Results: The age of the patients ranged from 4 years and 6 months to 15 years and 8 months (mean: 11 years and 2 months). In nine patients, the therapeutic procedure was repeated 2-5 times. Excellent regression was observed in 16 (94%), satisfactory results in 1 (6%). There was no failure (unsatisfactory result or no response to treatment) in this reported series. The complications were minor and included: local inflammatory reaction (n = 2), small blister (n = 1), and leakage (n = 1). Relief of symptoms was achieved in all patients. No recurrence was noted during follow-up. Conclusion: Percutaneous sclerotherapy of aneurysmal bone cysts with Ethibloc is safe and effective. It is an important alternative to surgery, especially when surgery is technically impossible or not recommended in high-risk patients.