Treatment of the aneurysmal bone cyst

The aneurysmal bone cyst represents a tumorlike lesion,which does not occur frequently. Every site of the skeleton may be involved. Although it can be observed at any age, it distinctly predominates from 10 to 20 years of age . Distinction of aneurysmatic bone cysts from certain benign or malignant b one tumours requires subtle imaging techniques and an experienced bone tumo ur pathologist. Since the lesion shows a heterogeneous biological behaviour and typically occurs in the growing skeleton, a wide range of surgical pro cedures must be provided concerning tumour resection and defect reconstruct ion. In the current retrospective study results of 41 surgically treated an eurysmal bone cysts, thereof 5 latent, 31 active, and 5 aggressive lesions, were investigated. While morbidity due to the therapeutic measures was comp aratively low even in extended lesions and demanding reconstructions, a rec urrence rate of 19.5% had to be observed in our series. Taking into conside ration the biological activity of the lesion, analysis of the recurrences r evealed inappropriate surgical margins had been chosen at the primary opera tion in all of these patients. Since the risk of a local relapse is linked both to aggressiveness of the primary lesion and to surgical radicality, th erapy of aneurysmal bone cyst requires preoperative staging and stage-depen dent surgical procedures.