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Oncology

ABC CAN EASILY BE TREATED WITH POLYDOCANOL

The European Musculo-Skeletal Oncology Society (EMSOS)



Abstract

Aim

To present our experience and results of percutaneus sclerotherapy of aneurysmal bone cysts (ABC).

Method

All patients from January 2007 to September 2009, where radiology and cytology were consistent with ABC (n=20), were treated with repeated injections of 30 mg/ml polidocanol. The mean age was 16 (5-27) years. There were 13 lesions in the long bones, 2 in the pelvic bones, 2 in the sacrum, 2 in the foot, and 1 in a finger. The sclerotherapy was performed under fluoroscopic or CT guidance and under local or general anesthesia. Each injection consisted of 2 mg polidocanol per kg body weight. Three injections with an interval of 4 weeks were most commonly scheduled. Radiological assessment was performed regularly after the last injection. Injections were continued if the lesion had not healed.

Results

All patients were successfully treated after mean 3.5 (1-11) injections. The patient with an ABC and pathologic fracture in a finger needed 11 injections. No patient was operated. The only side effect was in 2 patients who experienced local inflammatory reaction during 2 weeks after the sclerotherapy.

Conclusion

Our results are in concordance with published data from India, showing that percutaneus sclerotherapy with polidocanol is a safe alternative to surgery for the treatment of ABC. It is especially valuable in the pelvis and sacrum where surgery is associated with considerable morbidity.