Rădulescu Radu, Bădilă Adrian, Manolescu Robert, Sajin Maria, Japie Ion
Department of Orthopedic Surgery, Bucharest University Hospital, Romania;
Rom J Morphol Embryol. 2014;55(3):977-81.
To assess the results of surgical treatment in aneurysmal bone cysts.
31 patients with aneurysmal bone cysts underwent surgical treatment in our department. In almost half of cases, the lesion was located in the femur. In 12 cases, a pathological bone fracture was the first clinical sign. The treatment consisted in curettage, abrasion of the cavity inner walls using a motorized burr and filling with morsellized bone grafts (autografts ± allografts) or bone substitutes (four cases). Microscopically, the diagnosis relies on cystic spaces filled with blood, divided by fibrous septae consisting in immature bone trabeculae, hemosiderin filled macrophages and fibroblasts. We performed multiple bioptic probes from different levels of the lesion.
Macroscopically, the osseous lesion appeared as a multi-loculated blood-filled cavity (cavities separated by septa) in 30 (96.77%) cases and as a solid tumor in one (3.23%) case. At 12 months after surgery, grafts osteointegration was present in 24 cases. At an average follow-up time of six years and four months, refilling with bone grafts was necessary in two cases and no local recurrence was observed.
Aneurysmal bone cyst is most frequent in the second decade of age. Its prevalence in female gender is double compared to the male gender. The positive diagnosis relies on the histopathological examination. Because of the strong relationship with a number of precursor lesions (giant cell tumor, fibrous dysplasia, non-ossifying fibroma, chondroblastoma, osteoblastoma) multiple bioptic probings are mandatory, in order to diagnose, if possible, a primary lesion, which may modify the therapeutic attitude. Treatment by curettage, abrasion of the cavity inner walls and filling with morsellized grafts has very good results. The risk of recurrence is very low.
评估骨动脉瘤样囊肿的手术治疗效果。
我科对31例骨动脉瘤样囊肿患者进行了手术治疗。近半数病例病变位于股骨。12例患者首发临床症状为病理性骨折。治疗方法包括刮除、用电动磨钻打磨腔内壁并填充碎骨移植片（自体骨移植±异体骨移植）或骨替代物（4例）。显微镜下，诊断依据为充满血液的囊性间隙，由包含未成熟骨小梁、含铁血黄素巨噬细胞和成纤维细胞的纤维间隔分隔。我们从病变的不同层面进行了多次活检取样。
宏观上，骨病变在30例（96.77%）中表现为多房性充满血液的腔隙（由间隔分隔的腔隙），1例（3.23%）表现为实体瘤。术后12个月，24例移植骨实现骨整合。平均随访6年4个月时，2例需要再次填充骨移植片，未观察到局部复发。
骨动脉瘤样囊肿在第二个十年最为常见。其在女性中的患病率是男性的两倍。阳性诊断依赖于组织病理学检查。由于与多种前驱病变（巨细胞瘤、骨纤维异常增殖症、非骨化性纤维瘤、成软骨细胞瘤、成骨细胞瘤）关系密切，必须进行多次活检取样，以便尽可能诊断出可能改变治疗方案的原发性病变。刮除、打磨腔内壁并填充碎骨移植片的治疗效果非常好。复发风险很低。
