Published online Sep 18, 2023. doi: 10.5312/wjo.v14.i9.698
Peer-review started: July 3, 2023
First decision: August 4, 2023
Revised: August 17, 2023
Accepted: August 23, 2023
Article in press: August 23, 2023
Published online: September 18, 2023
As an alternative to the traditional treatment of aneurysmal bone cysts (ABC), which consists of curettage with bone grafting, alternative treatment methods with promising results have been described. At our department, we have been using percutaneous sclerotherapy with polidocanol for primary and recurrent ABC. To our knowledge, this is the first larger series reporting on polidocanol as a salvage procedure.
The main challenge with aneurysmal bone cysts is their locally aggressive nature and a high risk of recurrence. Therefore, there is a need to find evidence for the best available treatment, which optimally shows high efficacy and at the same time low morbidity and low rates of recurrence.
The main objective was to identify the efficacy and safety of sclerotherapy with polidocanol in primary and recurrent ABC. The outcomes of this study, especially regarding recurrent ABC, propose sclerotherapy as a relevant treatment method to be considered.
This is a single-center retrospective study, where all patients treated for ABC with percutaneous sclerotherapy from 2016-2021 were included. The data was collected through review of the electronic medical records.
In our series, sclerotherapy with polidocanol showed the ability to achieve healing or stable disease in 96% of cases (100% in primary ABC and 92% in recurrent ABC). These results support the positive experience with sclerotherapy for primary ABC in the recent literature and open the debate about sclerotherapy as a possible salvage treatment. The median length of radiographic follow-up was 19.5 mo. Further studies with longer follow-up are needed to decide if this provides a long-lasting effect.
Based on the present study, sclerotherapy with polidocanol may also be considered as a salvage procedure for failed surgery or multiple recurrences. This can be a valuable alternative to other salvage treatment methods, which may have higher morbidity.
Given the variety of possible treatment methods, future research should focus on randomized clinical trials to identify the gold standard treatment for primary and recurrent ABC.