Aneurysmal bone cyst (ABC) treatment

An aneurysmal bone cyst (ABC) is an aggressive benign bone tumor that expands and replaces normal bone. It is very vascular and is filled with bubbly blood containing spaces.

Treatment of ABC

Sclerotherapy

• "Washing" the ABC with medicine that causes it to fill in with bone. This is done by placing needles in the ABC under imaging guidance.
• Serial treatments are performed.

Embolization

• Blocking the arterial blood supply using tiny particles or glue.
• This is often done in preparation for surgical resection/removal.

The procedure typically requires 30 - 60 minutes to complete.

Typically, sedation or anesthesia will be used to help facilitate the successful completion of the procedure. This helps to minimize anxiety for the child and decrease risk of complications as a result of movement during the procedure.

• The child will be positioned on the imaging table.
• The imaging technique used is a mobile X ray tube (fluoroscopy) that can also make a CT image used for needle guidance.
• The skin surface will be cleaned to allow for a sterile skin puncture site.
• Local anesthetic will be introduced to help with comfort at the expected skin puncture site prior to a small skin nick being made to permit insertion of the needle into the ABC.
• Contast is injected to fill the ABC and determine volume and blood flow to the ABC.
• Medicine is introduced to scar the inside of the ABC which initiates the healing process.

Typically patients go home the same day of the procedure with pain medicine. Your child may have some soreness at the site of treatment. Typically, this can be well controlled with ibuprofen or acetaminophen (Tylenol®) or stronger medications.

Benefits and risks of treatment

Benefits

• Potentially avoid surgical resection.
• Allow the body to heal the ABC to preserve the bone involved.

Risks

• Any procedure where the skin is penetrated carries a potential risk of infection. The chance of developing an infection that requires added antibiotic treatment appears to be less than one in 1,000.
• Rarely significant bleeding may occur.
• Potential injury of nearby tissue from medicine used to treat the ABC.

Resuming normal activities

Your child can resume bathing the same day.

Your child can resume activities as tolerated following recovery from sedation and/or anesthesia.