Cottalorda Jérôme, Kohler Rémi, Chotel Franck, de Gauzy Jérôme Sales, Lefort Gérard, Louahem Djamel, Bourelle Sophie, Diméglio Alain
Department of Orthopaedic Paediatric Surgery, University of Medicine, Saint-Etienne, France.
J Pediatr Orthop B. 2005 May;14(3):212-8. doi: 10.1097/01202412-200505000-00014.
Some authors have reported that the clinical and pathologic behaviour of aneurysmal bone cysts (ABCs) is more aggressive in younger patients and that younger patients have more tumour recurrence. The authors carried out a retrospective, multicentred paediatric population-based analysis of 21 patients (14 boys and seven girls), 5 years of age or younger, with primary ABCs. Only patients with a minimum follow-up of 2 years were included. The most common operation was curettage (14 cases). Methylprednisolone acetate injection was used in two cases (failure in the initial diagnosis before biopsy) with negative results. An Ethibloc (Ethnor Laboratories/Ethicon, Norderstedt, Germany) injection was employed in four cases. There were five recurrences. Three lesions recurred once, one lesion recurred three times and one recurred six times. These recurrences occurred in two cases after methylprednisolone acetate injection, after Ethibloc (Ethnor Laboratories/Ethicon) injection (one case) and, after curettage (two cases). ABCs in children, 5 years of age or younger, do not seem to be more aggressive than in older children. Curettage is a surgical procedure that can be used even in young children. Of course, recurrence is always possible but the recurrence rate is not unacceptable. More aggressive operative intervention does not appear to be indicated.
一些作者报告称，动脉瘤样骨囊肿（ABCs）在年轻患者中的临床和病理行为更具侵袭性，且年轻患者的肿瘤复发率更高。作者对21例5岁及以下患有原发性ABCs的儿科患者（14名男孩和7名女孩）进行了一项基于人群的回顾性多中心分析。仅纳入了随访至少2年的患者。最常见的手术是刮除术（14例）。2例（活检前初诊失败）使用醋酸甲泼尼龙注射，结果为阴性。4例采用Ethibloc（Ethnor Laboratories/Ethicon，德国诺德施泰特）注射。有5例复发。3个病灶复发1次，1个病灶复发3次，1个复发6次。这些复发分别发生在2例醋酸甲泼尼龙注射后、Ethibloc（Ethnor Laboratories/Ethicon）注射后（1例）以及刮除术后（2例）。5岁及以下儿童的ABCs似乎并不比大龄儿童更具侵袭性。刮除术是一种即使在幼儿中也可使用的外科手术。当然，复发总是有可能的，但复发率并非不可接受。似乎不需要更积极的手术干预。
