Clinical diagnosis and treatment strategy for recurrent aneurysmal bone cysts of the extremities: a report of 29 cases
10.3969/j.issn.1000-8179.2018.24.055
- VernacularTitle:29例复发性动脉瘤样骨囊肿的临床诊治经验*
- Author:
Haijun TANG
1
;
Yun LIU
;
Zengming XIAO
;
Yinjuan LAI
;
Jianghong LIU
;
Changwu WEI
Author Information
1. 广西医科大学第一附属医院脊柱骨病外科(南宁市530021)
- Keywords:
aneurysmal bone cyst;
recurrence;
therapy
- From:
Chinese Journal of Clinical Oncology
2018;45(24):1254-1257
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To explore the clinical characteristics, imaging feature, surgical outcomes, and prognosis of recurrent aneurysmal bone cysts (RABC) of the extremities. Methods: Between January 2008 and January 2016, 29 patients histopathologically diagnosed with RABC were treated at our hospital. These patients included 15 males and 14 females. The mean age at the time of diagnosis was 17.4 years(range 4-42 years). The most common site of the RABC was the proximal tibia (12 cases), followed by the distal femur (11 cases), and 3 cases each with involvement of the proximal humerus and the proximal femur. Recurrence was most commonly ob-served within 24 months following the initial treatment. Intralesional re-curettage was performed in 24 patients and en bloc resection of the tumor and reconstruction in 5 patients. The medial tibial stress syndrome (MTSS) score was used to evaluate postoperative func-tion of the affected limb, and the comprehensive clinical efficacy was evaluated on the basis of the Mankin criteria. Results: The mean follow-up duration was 64 months (range 24-90 months). Re-recurrence occurred in 1 patient with a total re-recurrence rate of 3.4%. The postoperative MTSS score was 26-30 points (mean 29.1 points) in the intralesional re-curettage group and 21-27 points (mean 23.0 points) in the tumor resection group. Based on the Mankin criteria, excellent and good clinical outcomes were observed in 95.8% of patients in the intralesional and 60% of the patients in the tumor resection and reconstruction groups. Conclusions: Regular follow-up is essential for the early diagnosis of RABC. The re-recurrence rate following intralesional re-curettage was within an acceptable range, and postoperative limb function was satisfactory; therefore, intralesional re-curettage is the treatment of choice for RABC in-volving the extremities. Tumor resection can be performed in patients with severe articular surface destruction and repeated recur-rence, although long-term complications may occur.
