Aneurysmal bone cysts: treatment with direct percutaneous Ethibloc injection: long-term results.
OBJECTIVE
To assess the efficacy and long-term results of Ethibloc treatment in aneurysmal bone cysts (ABC).


METHODS
Thirteen patients with ABC were treated with direct percutaneous Ethibloc injection. Four patients had only one injection and the other nine patients from two to four injections. No severe complications were observed; in two patients a local leakage of Ethibloc from the cyst into the soft tissues occurred but it was temporary and the consequent inflammation self-healed without residua and sequelae. Imaging follow-up lasted from 6 to 67 months and included conventional radiology (CR) and magnetic resonance imaging (MRI), both used in the presurgical phase.


CONCLUSIONS
All images demonstrated a remarkable shrinkage of the cystic lesion and bone cortex thickening. In all patients, circumscribed areas of lucency persisted at radiography, corresponding to residual cystic areas without fluid-fluid levels at MRI. Pain, which was present in all the patients before treatment, was relieved within a month. According to our experience, direct percutaneous Ethibloc injection is effective in the treatment of ABC and can be recommended as the first-choice treatment. Due to its higher sensitivity MRI must be included either in the pretreatment phase to study the multilocular structure or in the imaging follow-up to evaluate the efficacy of Ethibloc in persistently non-responsive areas.
Falappa
Piergiorgio
P
Department of Radiology, Hospital IDI IRCCS, Via Monti di Creta, 104, I-00167 Rome, Italy. piergiorgio@falappa.net
Fassari
Fausto M
FM
Fanelli
Arturo
A
Genovese
Elisabetta
E
Ascani
Elio
E
Crostelli
Marco
M
Salsano
Vittorio
V
Montanaro
Antonello
A
Di Lazzaro
Antonio
A
Serra
Fabrizio
F
D000279:Administration, Cutaneous; D000293:Adolescent; D000328:Adult; D017824:Bone Cysts, Aneurysmal / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D003973:Diatrizoate / Q000008:administration & dosage* / Q000627:therapeutic use*; D004338:Drug Combinations; D005227:Fatty Acids / Q000008:administration & dosage* / Q000627:therapeutic use*; D005260:Female; D005529:Foot Bones / Q000000981:diagnostic imaging* / Q000473:pathology*; D006801:Humans; D006811:Humerus / Q000000981:diagnostic imaging* / Q000473:pathology*; D007267:Injections; D007866:Leg / Q000000981:diagnostic imaging* / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D010384:Pelvic Bones / Q000000981:diagnostic imaging* / Q000473:pathology*; D011409:Propylene Glycols / Q000008:administration & dosage* / Q000627:therapeutic use*; D011859:Radiography; D013995:Time; D015028:Zein / Q000008:administration & dosage* / Q000627:therapeutic use*
D004338:Drug Combinations; D005227:Fatty Acids; D011409:Propylene Glycols; D003973:Diatrizoate; D015028:Zein; C020481:alcoholic prolamine solution