Does Treatment Technique, Age, Sex and Lesion Side Effect the Rate of Recurrence? An Epidemiologic Study of Aneurysmal Bone Cysts

Abstract

Objective We aimed to present the outcomes of primer aneurysmal bone (PABC) cysts ( Sakarya Med J, 2018, 8(3):593-602 ).
Materials and
Methods
One hundred patients with PABC were included in this study. We investigated age, sex, location, treatment technique and recurrence rates
Results Forty-fi ve patients were female and 55 patients were male. The mean age was 22 (4-56). %54 (54) of the patients were on the fi rst and second decade. %22 (22) lesions were located in upper extremity, %55 (55) were in lower extremity and 23 (23) were in pelvis and vertebra.
Fifty-seven were treated by curettage with or without bone grafting, 31 with curettage and cementation and 12 with resection. The mean
follow-up period was 64,6 months (25-120). All of the lesions were PABC.
The total recurrence was 16 (%16). Fifteen recurrences were seen in the fi rst two year. Eight of them were in the lower extremity, 5 of them
were upper extremity, 3 recurrences were at the pelvis. One of the recurrence was seen at the fi rst decade, 8 of the recurrences were seen
at the second decade, 6 of the recurrences were seen at the third decade and 1 of the recurrence was seen at the fourth decade. %21.05 of
the patients who were treated by curettage with or without grafting had recurrence. %12.90 of the patients who were treated by curettage
and cementation had recurrence. None of the patients who had treated by resection had recurrence.
Conclusion Aggressive surgery decreases the recurrence rate but curettage with or without grafting or with cementation and adjuvant treatments also
provide good results

Keywords

• Aneurysmal Bone Cyst
• Recurrence
• Curettage
• Pathology

Ameliyat Tekniği, Yaş, Cinsiyet ve Lezyonun Bölgesi Nüks Oranını Etkiler Mi? Anevrizmal Kemik Kistinin (AKK) Epidemiolojik Çalışması

Abstract

Amaç:Anevrizmal kemik kistinde tedavi tekniği,lezyonun anatomik bölgeleri, cinsiyet ve yaşınnüksoranlarıüzerindekietkilerivegörülmesıklığınınnaraştırılması.

Gereç ve Yöntemler:Kliniğimizdeanevrizmal kemik kisti tanısıyla100hasta, geriye dönükolarakçalışmaya alındı.  Çalışmamızdaparametreolarak farklıtedavitekniklerin nüksoranları,cinsiyeteve lezyonun lokalizasyonuna göregörülmesıklığıvenüksoranıelealındı.

Bulgular:Hastaların45’ikadın,55’ierkek idi. Ortalama yaşı22(4-56)idi. Hastaların%54’iyirmi yaşınaltındaydı.22’siüstekstremite,55’ialt ekstremite ve 23’üpelvis ve vertebra’dankaynaklanıyordu.31’iküretajsonrasısementleme, 57’siküretajsonrasıgrefonajve 12’sirezeksiyonile tedavi edilmiş.  Ortalamatakipsüremiz64,6(1-216) aydı.Toplam 16 (%22,53) nüksgörüldü.Buhastalarınbirinde2,birinde3keznüksgörülmüş. Nükslerinbirihariçhepsitedavidensonraki ilk iki sene içindegörülmüş. Bir hastada 9 yıl7aysonra nüksgörülmüş.Nükslerin8’ialt ekstremiteden 5’iüstekstremiteden ve 3’üpelvistenkaynaklanıyormuş. Nükslerin1’ibirincionyıllıkdönemde,8’iikincionyıllıkdönemde,6’sıüçüncüonyıllıkdönemdeve1’i(%6,25)dördüncüonyıllıkdönemdegörülmüş.Küretajsonrasıgrefonaj yapılmışhastaların%21.05’unda nüksgörülmüş. Küretajsonrasısementleme yapılanhastaların%12,90’indenüksgörülmüş.

Sonuç:Agresif tedavi yapılanlardanüksolanıazaldığıgörülmekteancakküretaj-grefonajveyaküretaj-sementlemegibiyöntemlereekolarakadjuvantedavilerlekabul edilebilir sonuçlareldeedilebilir.Agresiftedavininrekonstrüksiyonuçokdahazorolacağıiçinnilktedaviseçeneğiolarakagresifyöntemlerkullanılmamasınıöneriyoruz.Nükslerinçoğuoperasyondansonrakiilkikiseneiçindegörüldüğüiçin,opereedilen lezyonlar en az iki sene takip altındatutulmalıdır.

Keywords

• Anevrizmal kemik kisti
• Nüks
• Küretaj
• Patoloji

References

1. 1) Szendröi M, Konya A, Renyi-Vamos A. Aneurysmal Bone cysts. A review of 52 primer and 16 seconder aneurysmal bone cysts. Arch Orthop Trauma Surg. 111-318 -322, 1992
2. 2) Campanacci M. Aneurysmal bone cyst. In: Campanacci M ( editor): bone and soft tissue tumors. 2nd ed. New-York: springer- verlag; 1999, pp 813-840
3. 3) Campanacci M, Capanna R, Picci. Unicameral and aneurysmal bone cysts. Clin Orthop 1986; 204:25-36
4. 4) Lichtentein, Louis. Aneurysmal Bone cysts. Further Observation. Cancer, &:1228-1237, 1953.
5. 5) Kransdorf MJ, Sweet DE. Aneuryzmal bone cyst: consetp, controversy, clinical presentation, and imaging. AJR 1995; 164:573-80.
6. 6) Leithner A, Windhager R, Lang S, Hass OA, Kainberger F, kotz R, Anevrizmal bone cyst. A papulation based epidemiologic study and literature review . Clin orthop 1999;363:176-179
7. 7) Ramirez AR, Stanton RP . Aneuryzmal bone cyst in 29 childern. J Pediatr Orthop B 2002 22:533-539
8. 8) Arlet V, Rigault P. Paovani JP, et al. Le Kyste anuvryzmal de sos chez l'enfant. Etude de 28 cas ( aneurysmal bone cysts in children. A study of 28 cases). Rev Chir Orthop; 73:337-348.

9. 9) Bollini G, Jouve JL, Cottalorda J et al. Aneurysmal bone cysts in children: analysis of twenty-seven patients. J Pediatr Orthop B 1998;7:274-285
10. 10) Dormans JP, Hanna BG, Johnston DR, et al. Surgical Treatment and Recurrens Rate of Aneurysmal Bone Cysts in children. Clin Orthop 2004 421:205-211
11. 11) Carlson DH, Wilkinson RH Bhakkaviziam A. Aneurysmal bone cysts in Children. Am J Roentgenol 1972;116:644-650.
12. 12) Moreau CA. Aneurysmal bone cyst [in Franch]. Ann Orthop Quest 1981; 13:47-53
13. 13) Epeldegui Torre T. Aneurysmal bone cyst. In: Bone tumors in children and adolescents. Mapfre Medicina 1997;8(suppl I):160-165.
14. 14) Clough JR, Price HG. Aneurysmal bone cyst: pathogenesis and long term results of treatment. Clin Orthop 1973; 97:52-63
15. 15) Slowick FA Campbell CJ Kettelkamp DB. Aneurysmal bone cyst: an analisi of thirteen cases. J Bone Joint Surg Am 1968; 50A:1142-1151
16. 16) Daudet M. Marion J, Faysse R, Vauzelle JL, Baulieu J, Rebouillat J, Lapras C. Aneurysmal bone cyst in children [in Franch]. Ann Chir Infant 1971; 12:7-34
17. 17) Van Loon CJM, Veth RPH, Pruszczynski M, Lemmens JAM, Van Hom JR. Aenurysmal bone Cysts. Long-term results and functional evaluation. Acta Orthop Belg 1995;6:199-204
18. 18) Lapyrie M, Picard JJ, Pous JG. Aneruysmal bone cyst: about 7 cases [in Franch]. Rev Chir Orthop 1965 ;51:545-556
19. 19) Dabska M, Buraczewski J. Aneurysmal bone cyst. Pathology, clinical course and radiologic Appearances. Cancer 1969;23:371-389.
20. 20) William F. Donaldson JR. Aneurysmal Bone Cysts. J Bone Joint Surg Am. 1962;44:25-40
21. 21) Barnes R. Aneurysmal bone cyst. J Bone Joint Surg Br 1956; 38B: 301-311
22. 22) Taylor FW. Aneurysmal bone cyst. Report of three cases. J Bone Joint Surg Br 1956; 38B:293-300
23. 23) Cottalorda J. Epidemiology of aneurysmal bone cyst in childern a multicenter study and literature review. J Pediatr Orthop B. 2004 Nov;13(6):389-94. Review
24. 24) Dios V. D. AM, Bond JR, Shives TC , Mc leod RA, Unni KK. Aneuryzmal bone cyst. A clinicopathologic study of 238 cases . Canser 1992 ; 69:2921-2931.
25. 25) Ruiter DJ, Van Rijssel TG, Vander Velde EA. Aneurysmal bone cysts: A clinicopatholgy of 105 cases. Cancer 1977, 39:2231-2239
26. 26) Server Perez F, Gomez bensfills X, Mateo Montanes X, Garcia Garcia C, Casamitjana J, Vidal Homs E. Aneurysmal bone cysts: review of 20 cases [infrench]. Acta Ortop Belg 1980; 46:272-288
27. 27) Biesecker JL, Marcove RC. Huvos AG. Mike V. Aneurysmal bone cysts. A clinicopathologic study of 66 cases. Cancer 26(3):615-625
28. 28) Cottalorda J, Kohler R Chotel F, et al. Recurrence of aneurysmal bone cysts in young children : a multicenter study. J Pediatr Orthop B 2005 ; 14: 212-218
29. 29) Tilmann's BP, Dahlin DC, Lipscomb PR, Steewaart JR. Aneurysmal bone cysts, analisis of 95 cases. Mayo Clin Proc 1968; 43:478-495
30. 30) Cole WG. Treatment of aneurysmal bone cysts in childhood. J Pediatr Orthop 1986; 6:326-329
31. 31) Mankin HJ, Hornicek FJ, Ortiz-Cruz E, et al. Aneurysmal Bone Cysts: A review of 150 patients. J Clin Oncol 2005;23:6756-6762
32. 32) Marcove RC, Sheth DS, Tekemoto S, et al. The treatment of aneurysmal bone cyst. Clin Orthop 1995;311:157-163
33. 33) Ozaki T, Hillmann A, Lindner N, et al. Cementation of primer aneurysmal bone cysts. Clin Orthop 1997;337:240-248
34. 34) Nobler MP, Higinbotham NL, Philips RF. The cue os anuerysmal bone cyst: İrradation superior to surgery in an analysis of 33 cases. Radiology 1968;90:1185-1192
35. 35) Clough JR, Price HG. Aneurysmal bone cyst: pathogenesis and long term results of treatment. Clin Orthop 1973; 97:52-63
36. 36) Koskinen EVS, Visuri TI, Holmström T, et al. Aneurysmal bone cyst. Evaluation of resection and curettage in 20 cases. Clin Orthop 1976; 118:136-146
37. 37) Farsetti P, Tudisco C,Rosa M, et al. Aneurysmal bone . Long term follow up of 20 cases. Arch Orthop Trauma Surg 1990;109:221-223
38. 38) Ozaki, Hillmann A, Lindner N, et al. Aneurysmal bone cysts in children. J Cancer Res Clin Oncol 1996; 122:767-769.
39. 39) Freiberg AA, Loder RT, Heidelberger KP, et al . Aneurysmal bone cysts in young children. J pediatr Orthop 1994; 14:86-91
40. 40) Gibbs CP, Helefe MC peabody TD, et al. Aneurysmal bone cysts of the extremities: factors related to local recurrence after curettage with a high-speed burr. J Bone Joint Surg [Am] 1999;81:1671-1678
41. 41) Capanna R, Sudanese A, Baldini N, Campanacci M. Phenol as an adjuvant in the control of local recurrence of benign neoplasms of bone treated by curettage. Ital J Orthop Traumatol 1985 ;11:381-8
42. 42) Schreuder HWB, Veth RPH, Pruszczynski M, et al. Aneurysmal bone cysts treated by curretage, Cryotherapy and grafting. J Bone Joint Surg [Br] 1997;79:20-25
43. 43) Green JA, Bellemore MC Marsden FW. Embolization in treatment of aneurysmal bone cysts. J Pediatr Orthop 1997 ; 17:440-443
44. 44) Cristofaro R, Biagini R, Boriani S, et al. Selective artrial embolization in the treatment of aneurysmal bone cysts and angioma. Skeletal Radiol 1992; 2:523-527
45. 45) Dick HM, Bigliani LU, Michelsen WJ, et al. Adjuvant arterial embolization in the treatment of benign primer bone tumors in children. Clin Orthop 1979 139:133-141
46. 46) Cisneros AJ, Gomez CH Benedicto FC, et al. Aneurysmal bone cyst of the ischium. Int Orthop 1985; 9:49-54
47. 47) Boraini S, De Lure F, Campanacci L, et al. Aneurysmal bone cyst of the mobile spine. Report of 41 cases. Spine 2001; 26:27-35
48. 48) Jerome C, Sophie B. Current treatment of Primer Anevrizmal bone Cysts. J Pediatr Orthop B 2006, 15:155-167