Treatment of aneurysmal bone cysts by percutaneous CT-guided injection of calcitonin and steroid.

Abstract

OBJECTIVES:

To determine the efficacy and safety of percutaneous calcitonin and steroid injection in the treatment of aneurysmal bone cysts (ABCs).

MATERIALS AND METHODS:

Our study was IRB-approved and HIPAA-compliant. We reviewed pre- and post-procedural imaging studies and medical records of all CT-guided percutaneous injections of ABCs with calcitonin and steroid performed at our institution between 2003 and 2015.

RESULTS:

Treatment success based on imaging was categorized as substantial (51-100 %), partial (1-50 %), or none (0 %) by comparing radiographs of the lesion before and after treatment. Our study group comprised 9 patients (7 female, 2 male; mean age 19 ± 5 (range 12-25) years). ABCs were located in the pubis (n = 3), femur (n = 2), and humerus/scapula/ilium/sacrum (n = 1 for each). One patient did not have any clinical or imaging follow-up. For the other 8 patients, clinical and imaging follow-up ranged from 1 to 93 months (mean 16 ± 29 months). One patient had two injections, and 1 patient had three injections. Six out of eight patients (75 %) had complete symptomatic relief and 2 patients (25 %) had partial symptomatic relief after initial injection. Imaging follow-up revealed substantial imaging response in 4 out of 8 patients (50 %). There was a partial imaging response in 2 patients (25 %) and no imaging response in 2 out of 8 patients (25 %), and all 4 of these patients had local recurrence. There were no complications.

CONCLUSION:

Percutaneous CT-guided injection of ABCs with calcitonin and steroid is a safe and effective treatment. Lack of imaging response may necessitate more aggressive treatment to minimize local recurrence.

• Authors: Connie Y Chang, Susan V Kattapuram, Ambrose J Huang, F Joseph Simeone, Martin Torriani, Miriam A Bredella
• Journal: Skeletal radiology (Skeletal Radiol) Vol. 46 Issue 1 Pg. 35-40 (Jan 2017) ISSN: 1432-2161 [Electronic] Germany
• PMID: 27743037 (Publication Type: Journal Article)

Chemical References

• Bone Density Conservation Agents
• Steroids
• Calcitonin

Topics

• Adolescent
• Adult
• Bone Cysts, Aneurysmal (diagnostic imaging, drug therapy)
• Bone Density Conservation Agents (administration & dosage)
• Calcitonin (administration & dosage)
• Child
• Female
• Humans
• Injections, Intralesional
• Male
• Radiography, Interventional
• Steroids (administration & dosage)
• Tomography, X-Ray Computed
• Treatment Outcome