Aneurysmal Bone Cyst : New Treatments

Aneurysmal Bone Cyst (ABC) is a cystic and expanding vascular bone lesion composed of blood-filled spaces separated by connective tissue septa containing fibroblasts, osteoclast-type giant cells and reactive woven bone. ABC can exist either as a primary bone lesion (in about 70% of the cases) when it arises de novo or as a secondary lesion when a pre-existing osseous benign or malignant lesion can be identified (in about 30% of the cases). So, accurate histologic evaluation is imperative for definitive diagnosis. The usual methods of treatment are embolization, curettage, and resection. Ethibloc® sclerosis is currently not use because this product is not any more marketed. Several new therapeutic methods were described these last years. Percutaneous sclerotherapy can be done with absolute alcohol or polidocanol. Demineralized bone and autogenous bone marrow can be used as an inducer of the healing phase. Percutaneous doxycycline injection and injectable form of calcium sulphate has been described. Bisphosphonate therapy and Denosumab are a potential innovative treatment option for ABC. The authors make a critical analysis of the various publications, trying to specify advantages, inconveniences and their respective indications.