We reviewed seven young children (less-than-or-equal-to 10 years) with
aneurysmal bone cysts. There were four girls and three boys. Six had
involvement of the long bones and one had involvement of the clavicle.
The average age was 5.5 years (range 2.9-10.6 years). Initial treatme
nt was curettage and bone grafting. There were recurrences in five of
the seven children (71%). This represented 100% of children with radio
graphically aggressive or active lesions. The recurrences appeared rap
idly, at an average of 8 months from the first procedure. The mitotic
index of the initial lesion did not correlate with that of the recurre
nt lesion. Surgical management of the recurrences must be handled indi
vidually, but repeat curettage and grafting is only recommended when s
urgical resection is not possible. This high rate of recurrence in rad
iographically aggressive or active aneurysmal bone cysts in young chil
dren should be considered when planning treatment, and in the preopera
tive counseling of parents.