Aneurysmal bone cyst of the first cervical vertebrae in a child treated with percutaneous intralesional injection of calcitonin and methylprednisolone - A case report

Study Design. First published report of a child with an aneurysmal bone cys t (ABC) of the first cervical vertebrae treated successfully with intralesi onal injection of calcitonin and methylprednisolone. Objective. To describe a safe and effective nonsurgical treatment method fo r an ABC of the first cervical vertebrae. Summary of Background Data. Aneurysmal bone cysts of the spine comprise fro m 3% to 20% of all such lesions. Upper cervical spine involvement is rare a nd these lesions are difficult to treat. Standard treatment with curettage and bone grafting or other alternatives such as radiation therapy or emboli zation may not be possible in this location. Percutaneous injection with a variety of agents has also been described. Methylprednisolone and calcitoni n were selected in this case in an effort to combine the proposed angiostat ic and fibroblastic inhibitory effects of steroid with the proposed osteocl astic inhibitory and promotion of new bony trabeculae formation effects of calcitonin. Method. This case was described, and pertinent literature reviewed. Results. Sclerosis and shrinkage of the lesion with concomitant symptom res olution occurred after two injections with calcitonin and methylprednisolon e via computed tomography (CT) guidance. No complications occurred The lesi on remained quiescent at a 2-year 7-month follow-up. Conclusions. Percutaneous intralesional injection of an ABC of the first ce rvical vertebrae with calcitonin and methylprednisolone in a child via CT g uidance was a safe and effective treatment. This is a promising treatment f or surgically inaccessible aneurysmal bone cysts.