title: Active aneurysmal bone cysts in children: possible evolution after biopsy.
abstract: OBJECTIVE
  The active or aggressive character in certain localisations of aneurysmal bone cysts in children requires either curettage with a considerable recurrence rate or a radical segmental excision, raising complex reconstructive challenges. Cyst maturation with subsequent ossification may be observed either spontaneously or after incisional biopsy.
  
  
  METHODS
  Five new cases of active aneurysmal bone cysts (ABCs) with healing of the cyst after biopsy alone are reported. All patients had no treatment of the cyst after the biopsy.
  
  
  RESULTS
  In two cases, the lesion initially increases in size immediately after the biopsy, and it is only secondarily that the lesion decreases in size. Four out of five cases of the spontaneous healing occurred in pelvic bone. The cysts healed after, respectively, 36, 24, 12, 32 and 12 months.
  
  
  CONCLUSIONS
  The emergence of these new cases of spontaneous healing encourages promoting clinical and radiological supervision after biopsy in selected cases. Unfortunately, it is impossible to predict a possible aggressive behaviour in ABCs. Then, if the lesion is quickly aggressive with clinically and radiologically increasing size after biopsy, it would be illogical and dangerous to let this ABC evolve. It would be necessary to treat it without delay. On the other hand, if the lesion moderately increased after the biopsy, it is possible to wait and observe the patient during a period of 5 months for a possible healing, if the ABC localisation is not dangerous. Of course, if the lesion does not increase in size after biopsy, there is no delay to treat it.
authors.affiliation: Orthopaedic Pediatric Surgery Department, Service d'Orthopédie Infantile, Hôpital Lapeyronie, 34295 Montpellier Cedex 5, France.
authors.forename: Djamel
authors.initials: D
authors.lastname: Louahem
authors.forename: Pascal
authors.initials: P
authors.lastname: Kouyoumdjian
authors.forename: Ismat
authors.initials: I
authors.lastname: Ghanem
authors.forename: Philippe
authors.initials: P
authors.lastname: Mazeau
authors.forename: Hélène
authors.initials: H
authors.lastname: Perrochia
authors.forename: Mohamed
authors.initials: M
authors.lastname: L'kaissi
authors.forename: Jérôme
authors.initials: J
authors.lastname: Cottalorda
keywords: Adolescent; Aneurysmal bone cyst; Benign bone tumour; Spontaneous healing
references.citation: Rev Chir Orthop Reparatrice Appar Mot. 1987;73(5):337-48
references.pmid: 3659452
references.citation: Ital J Orthop Traumatol. 1985 Dec;11(4):409-17
references.pmid: 3830963
references.citation: J Pediatr Orthop B. 2004 Nov;13(6):389-94
references.pmid: 15599231
references.citation: J Pediatr Orthop B. 2006 May;15(3):155-67
references.pmid: 16601582
references.citation: Mayo Clin Proc. 1968 Jul;43(7):478-95
references.pmid: 5710584
references.citation: J Bone Joint Surg Am. 1957 Jul;39-A(4):873-82
references.pmid: 13438943
references.citation: Cancer. 1992 Jun 15;69(12):2921-31
references.pmid: 1591685
references.citation: Radiology. 1978 Jan;126(1):75-83
references.pmid: 619438
references.citation: J Pediatr Orthop. 1990 May-Jun;10(3):362-4
references.pmid: 2355080
references.citation: Acta Orthop Belg. 1995;61(3):199-204
references.pmid: 8525816
references.citation: Clin Orthop Relat Res. 1973 Nov-Dec;(97):52-63
references.pmid: 4590226
references.citation: Clin Orthop Relat Res. 1999 Jun;(363):176-9
references.pmid: 10379320
references.citation: J Bone Joint Surg Br. 1985 Mar;67(2):310-2
references.pmid: 3980546
references.citation: J Pediatr Orthop. 2005 Jul-Aug;25(4):471-5
references.pmid: 15958897
references.citation: Arch Orthop Trauma Surg. 1986;105(5):279-84
references.pmid: 3535735
references.citation: Arch Orthop Trauma Surg. 2007 Feb;127(2):105-14
references.pmid: 16937137
references.citation: Cancer. 1970 Sep;26(3):615-25
references.pmid: 5458269
references.citation: J Pediatr Orthop. 1986 May-Jun;6(3):326-9
references.pmid: 3519676
references.citation: J Pediatr Orthop B. 1998 Oct;7(4):286-92
references.pmid: 9810527
references.citation: J Bone Joint Surg Br. 1989 Aug;71(4):645-50
references.pmid: 2768314
references.citation: Cancer. 1969 Feb;23(2):371-89
references.pmid: 5764977