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Aneurysmal bone cyst treated with percutaneous doxycycline: is a single treatment sufficient?

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Abstract

Objective

The purpose of this case series is to report on the effectiveness of a single percutaneous injection of doxycycline as a primary treatment for aneurysmal bone cyst (ABC).

Materials and methods

A retrospective cohort study was conducted on seven patients diagnosed with ABC at various anatomical sites, with the intention to treat by a single percutaneous injection of doxycycline. Mean patient age was 14 years.

Results

Signs of treatment response were seen in six of seven patients after one injection. Three of the seven received a second treatment, despite signs of response. Another had expansion of the lesion after treatment, requiring excision. In total, three patients had a single injection of doxycycline as their sole treatment and another three showed signs of response after a single injection.

Conclusions

A single percutaneous injection of doxycycline should be considered a viable primary treatment option for ABC.

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References

  1. Fletcher C DM, Bridge JA, Hogendoorn PCW, Mertens F. WHO classification of tumors of soft tissue and bone. 4th ed. Geneva: WHO; 2013. p. 110–111.

  2. Jaffe HL, Lichtenstein L. Solitary unicameral bone cyst: with emphasis on the roentgen picture, the pathologic appearance and the pathogenesis. Arch Surg. 1942;44(6):1004–25.

    Article  Google Scholar 

  3. Lichtenstein L. Aneurysmal bone cyst: observations on fifty cases. JBJS. 1957;39(4):873–82.

    Article  Google Scholar 

  4. Schajowicz F. Histological typing of bone tumours. Berlin: Springer Science & Business Media; 2012.

    Google Scholar 

  5. Park HY, Yang SK, Sheppard WL, Hegde V, Zoller SD, Nelson SD, et al. Current management of aneurysmal bone cysts. Curr Rev Musculoskelet Med. 2016;9(4):435–44.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Biesecker JL, Marcove RC, Huvos AG, Mike V. Aneurysmal bone cysts. A clinicopathologic study of 66 cases. Cancer. 1970;26(3):615–25.

    Article  CAS  PubMed  Google Scholar 

  7. Oliveira AM, Perez-Atayde AR, Inwards CY, Medeiros F, Derr V, Hsi BL, et al. USP6 and CDH11 oncogenes identify the neoplastic cell in primary aneurysmal bone cysts and are absent in so-called secondary aneurysmal bone cysts. Am J Pathol. 2004;165(5):1773–80.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Lau AW, Pringle LM, Quick L, Riquelme DN, Ye Y, Oliveira AM, et al. TRE17/ubiquitin-specific protease 6 (USP6) oncogene translocated in aneurysmal bone cyst blocks osteoblastic maturation via an autocrine mechanism involving bone morphogenetic protein dysregulation. J Biol Chem. 2010;285(47):37111–20.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Ye Y, Pringle LM, Lau AW, Riquelme DN, Wang H, Jiang T, et al. TRE17/USP6 oncogene translocated in aneurysmal bone cyst induces matrix metalloproteinase production via activation of NF-kappaB. Oncogene. 2010;29(25):3619–29.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Kumta SM, Huang L, Cheng YY, Chow LT, Lee KM, Zheng MH. Expression of VEGF and MMP-9 in giant cell tumor of bone and other osteolytic lesions. Life Sci. 2003;73(11):1427–36.

    Article  CAS  PubMed  Google Scholar 

  11. Ghajar CM, George SC, Putnam AJ. Matrix metalloproteinase control of capillary morphogenesis. Crit Rev Eukaryot Gene Expr. 2008;18(3):251–78.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Shiels WE 2nd, Mayerson JL. Percutaneous doxycycline treatment of aneurysmal bone cysts with low recurrence rate: a preliminary report. Clin Orthop Relat Res. 2013;471(8):2675–83.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Tsagozis P, Brosjo O. Current strategies for the treatment of aneurysmal bone cysts. Orthop Rev (Pavia). 2015;7(4):6182.

    Article  Google Scholar 

  14. Hauschild O, Ludemann M, Engelhardt M, Baumhoer D, Baumann T, Elger T, et al. Aneurysmal bone cyst (ABC): treatment options and proposal of a follow-up regime. Acta Orthop Belg. 2016;82(3):474–83.

    CAS  PubMed  Google Scholar 

  15. Reddy KI, Sinnaeve F, Gaston CL, Grimer RJ, Carter SR. Aneurysmal bone cysts: do simple treatments work? Clin Orthop Relat Res. 2014;472(6):1901–10.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Rastogi S, Varshney MK, Trikha V, Khan SA, Choudhury B, Safaya R. Treatment of aneurysmal bone cysts with percutaneous sclerotherapy using polidocanol. A review of 72 cases with long-term follow-up. J Bone Joint Surg Br. 2006;88(9):1212–6.

    Article  CAS  PubMed  Google Scholar 

  17. Brosjo O, Pechon P, Hesla A, Tsagozis P, Bauer H. Sclerotherapy with polidocanol for treatment of aneurysmal bone cysts. Acta Orthop. 2013;84(5):502–5.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Varshney MK, Rastogi S, Khan SA, Trikha V. Is sclerotherapy better than intralesional excision for treating aneurysmal bone cysts? Clin Orthop Relat Res. 2010;468(6):1649–59.

    Article  PubMed  Google Scholar 

  19. Docquier PL, Delloye C. Treatment of aneurysmal bone cysts by introduction of demineralized bone and autogenous bone marrow. J Bone Joint Surg Am. 2005;87(10):2253–8.

    PubMed  Google Scholar 

  20. Doyle A, Field A, Graydon A. Recurrent aneurysmal bone cyst of the cervical spine in childhood treated with doxycycline injection. Skelet Radiol. 2015;44(4):609–12.

    Article  Google Scholar 

  21. Oliveira AM, Chou MM. USP6-induced neoplasms: the biologic spectrum of aneurysmal bone cyst and nodular fasciitis. Hum Pathol. 2014;45(1):1–11.

    Article  CAS  PubMed  Google Scholar 

  22. Daley E, Kurdziel MD, Koueiter D, Moore DD. Characterization of doxycycline-loaded calcium phosphate cement: implications for treatment of aneurysmal bone cysts. J Mater Sci Mater Med. 2018;29(7):109.

    Article  CAS  PubMed  Google Scholar 

  23. Capanna R, Springfield DS, Biagini R, Ruggieri P, Giunti A. Juxtaepiphyseal aneurysmal bone cyst. Skelet Radiol. 1985;13(1):21–5.

    Article  CAS  Google Scholar 

  24. Shiels WE 2nd, Beebe AC, Mayerson JL. Percutaneous doxycycline treatment of juxtaphyseal aneurysmal bone cysts. J Pediatr Orthop. 2016;36(2):205–12.

    Article  PubMed  Google Scholar 

  25. Malghem J, Maldague B, Esselinckx W, Noel H, De Nayer P, Vincent A. Spontaneous healing of aneurysmal bone cysts. A report of three cases. J Bone Joint Surg Br. 1989;71(4):645–50.

    Article  CAS  PubMed  Google Scholar 

  26. McQueen MM, Chalmers J, Smith GD. Spontaneous healing of aneurysmal bone cysts. A report of two cases. J Bone Joint Surg Br. 1985;67(2):310–2.

    Article  CAS  PubMed  Google Scholar 

  27. Ibrahim T, Howard AW, Murnaghan ML, Hopyan S. Percutaneous curettage and suction for pediatric extremity aneurysmal bone cysts: is it adequate? J Pediatr Orthop. 2012;32(8):842–7.

    Article  PubMed  Google Scholar 

  28. Louahem D, Kouyoumdjian P, Ghanem I, Mazeau P, Perrochia H, L'Kaissi M, et al. Active aneurysmal bone cysts in children: possible evolution after biopsy. J Child Orthop. 2012;6(4):333–8.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Dabska M, Buraczewski J. Aneurysmal bone cyst. Pathology, clinical course and radiologic appearances. Cancer. 1969;23(2):371–89.

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Anthony J. Doyle.

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Woon, J.T.K., Hoon, D., Graydon, A. et al. Aneurysmal bone cyst treated with percutaneous doxycycline: is a single treatment sufficient?. Skeletal Radiol 48, 765–771 (2019). https://doi.org/10.1007/s00256-019-03188-y

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  • DOI: https://doi.org/10.1007/s00256-019-03188-y

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