ANEURYSMAL BONE-CYST - MANAGEMENT, OUTCOM E, AND PROGNOSIS IN 71 CASES

A multicenter study identified 71 cases of aneurysmal bone cyst (ABC), including eight in the spine and 63 in the appendicular skeleton, Spi nal forms raised the greatest challenges, in particular because of the common occurrence of neurologic symptoms, Emergency decompression sur gery was followed by full recovery of neurologic function except in th ose patients with severe neurologic loss at presentation. Management o f the tumor consisted in either curettage or excision. In appendicular ABCs, the recovery rates were 77% and 83% after curettage with packin g of the cavity and excision of the tumor, respectively, Ten per cent of patients treated by curettage had a recurrence, versus only one of the patients treated by excision; this last patient had an ABC seconda ry to an osteosarcoma. The highest recurrence/recovery rates were seen after calcitonin injection (1.5), orthopedic treatment (2.5), and sim ple curettage (4), However, two of the six patients treated by calcito nin injections achieved a full recovery. Calcitonin may promote osteoc lastosis and osteoblastosis with reossification of the lesions, and ap pears to be a promising method. Among patients with recurrences, 91% o f those treated by curettage-packing achieved a full recovery. Watchfu l waiting demonstrated the possibility of spontaneous regression, afte r a follow-up of seven years. Time to recurrence was one month to four years. Treated patients should receive close clinical and radiologica l follow-up.