Aneurysmal bone cysts (ABC) are expansile lytic lesions constituting around 1% of all benign bone
tumors with an annual incidence of 1.4/100000. A variety of treatments are available ranging from
curettage with or without
bone grafting (autologous or allogeneic),
curettage with use of adjuvants [
Polymethylmethacrylate (
PMMA)
bone cement, high speed burr,
phenol, liquid
nitrogen], wide en-block excision with or without reconstruction, selective arterial embolization of the feeding vessels,
radiation therapy, high precision megavoltage
radiotherapy and percutaneous radio-nuclide ablation,
sclerotherapy (
ethibloc,
aetoxisclerol, alcohol gel,
polidocanol). The optimal treatment is debatable due to various indications and
contraindications of different modalities of treatment. Recent data suggest that percutaneous
sclerotherapy with
polidocanol is safe and effective alternative to surgery for treatment of ABCs as it has minimal side effects. We are reporting the first case of life-threatening adverse reaction to intra-lesional
polidocanol in a three-year-old boy with a proximal femoral aneurysmal
bone cyst. The importance of reporting this case is to make people aware regarding the adverse reaction of
polidocanol and to highlight the precautions one should follow while using
polidocanol for
aneurysmal bone cysts.