Karaca Mustafa Onur, Bozkurt Orhun Eray, Dursun Savran Merve, Özyıldıran Mustafa, Başarır Kerem, Yıldız Hüseyin Yusuf
Ankara University Faculty of Medicine, Orthopedics and Traumatology Department, Ankara, Turkey.
Kulu Region State Hospital, Orthopedics and Traumatology Department, Konya, Turkey.
Int Orthop. 2025 Jul 11. doi: 10.1007/s00264-025-06603-3.
Aneurysmal bone cysts (ABCs) are bone tumours characterised by blood-filled cystic lesions. Management strategies for ABCs vary widely and lack consensus. This study aims to evaluate outcomes in 258 patients and investigate the factors affecting the recurrence rates.
This study is a single-centre retrospective analysis of patients diagnosed with ABC between January 1990 and December 2020. Patients who were histologically diagnosed with ABC, had available pathology, radiology, and surgery records, and were followed up for at least 24 months were included. Secondary ABCs were excluded. Presenting symptoms and location, computerised tomography (CT) and magnetic resonance imaging (MRI), treatment modalities, and recurrence were investigated.
The mean age of the 258 ABC patients was 17.25 ± 12.37 years, 67.44% being under 18 years, and 12.40% under five years. 49.45% were female. The average follow-up duration was 47.80 ± 41.92 months. Pain was the most common presenting symptom, reported by 79.97% of patients. 5.04% were asymptomatic and diagnosed incidentally, whereas 11.63% were diagnosed following a pathological fracture. The median disease-free survival was ten months, with the average time to first recurrence being 24.22 ± 22.14 months. Recurrence was more common in patients under five years of age (34.38% vs. 19.03%, p = 0.046) and in those with pathologic fractures (40.00% vs. 18.42%, p = 0.006). Conversely, recurrence was less common when burr and/or cautery was added to curettage (31.97% vs. 11.03%, p < 0.001). Time to recurrence was significantly shorter in cases with soft tissue oedema (median 5 vs. 12 months, p = 0.010) or fluid-fluid levels (median 6 vs. 12 months, p = 0.038).
The study found that pathological fractures and age under five years are associated with a higher risk of recurrence in aneurysmal bone cysts. Electrocauterization and/or high-speed burring as local adjuvant therapy is associated with low recurrence rates.
骨动脉瘤样囊肿（ABCs）是一种以充满血液的囊性病变为特征的骨肿瘤。ABCs的治疗策略差异很大且缺乏共识。本研究旨在评估258例患者的治疗结果，并调查影响复发率的因素。
本研究是一项对1990年1月至2020年12月期间诊断为ABC的患者进行的单中心回顾性分析。纳入组织学诊断为ABC、有可用的病理、放射学和手术记录且随访至少24个月的患者。排除继发性ABCs。对患者的症状表现及部位、计算机断层扫描（CT）和磁共振成像（MRI）、治疗方式及复发情况进行调查。
258例ABC患者的平均年龄为17.25±12.37岁，67.44%的患者年龄在18岁以下，12.40%的患者年龄在5岁以下。49.45%为女性。平均随访时间为47.80±41.92个月。疼痛是最常见的症状表现，79.97%的患者报告有疼痛。5.04%的患者无症状，为偶然诊断，而11.63%的患者是在病理性骨折后被诊断。无病生存期的中位数为10个月，首次复发的平均时间为24.22±22.14个月。5岁以下患者的复发更为常见（34.38%对19.03%，p=0.046），病理性骨折患者的复发也更常见（40.00%对18.42%，p=0.006）。相反，刮除术加用磨钻和/或烧灼术时复发较少见（31.97%对11.03%，p<0.001）。软组织水肿（中位数5个月对12个月，p=0.010）或液-液平面（中位数6个月对12个月，p=0.038）的病例复发时间明显更短。
该研究发现病理性骨折和5岁以下年龄与骨动脉瘤样囊肿的较高复发风险相关。电烧灼和/或高速磨钻作为局部辅助治疗与低复发率相关。
