Aneurysmal Bone Cyst (ABC) Treatment in Delhi, India

An aneurysmal bone cyst (ABC) is a benign, blood-filled lesion that can develop within bones. Despite its name, it is not a true cyst but rather a bone tumour that can cause bone expansion and thinning. ABCs are most commonly found in the long bones, such as the tibia and the spine, though they can occur in any bone, including the jaw. These cysts are often discovered in individuals under the age of 20, but they can also be present in adults.

Symptoms of an Aneurysmal Bone Cyst

Symptoms of an aneurysmal bone cyst depend on the location and size of the cyst:

• Pain: The most common symptom, often worsening with activity.
• Swelling: A noticeable lump may form over the affected bone.
• Limited mobility: ABCs in the spine or joints can restrict movement.
• Fractures: Weakened bones may lead to fractures, especially with larger cysts.

In some cases, an aneurysmal bone cyst in the spine can cause neurological symptoms due to compression of the spinal cord.

Causes of Aneurysmal Bone Cysts

The exact cause of aneurysmal bone cysts remains unknown. However, several factors may contribute to their development:

• Genetic mutations: Some cases of ABCs have been linked to genetic mutations that lead to abnormal blood vessel formation within the bone.
• Trauma: Although not a direct cause, trauma to a bone may trigger the development of an ABC in susceptible individuals.

How is an Aneurysmal Bone Cyst Diagnosed?

Diagnosis typically involves imaging studies and sometimes a biopsy:

• X-ray: A common first step, x-rays can reveal the characteristic "soap bubble" appearance of ABCs.
• MRI and CT scan: These advanced imaging techniques provide detailed views of the cyst's size, location, and impact on surrounding tissues.
• Biopsy: In certain cases, a biopsy may be required to confirm the diagnosis and rule out malignancy.

What Surgery Treats Aneurysmal Bone Cysts?

Surgery is often the treatment of choice for aneurysmal bone cysts, especially in symptomatic cases. The surgical approach depends on the cyst's size, location, and potential complications:

• Curettage: This is the most common procedure where the surgeon scrapes out the cyst from the bone. Often, the cavity is filled with bone grafts or bone cement to stabilise the area.
• Resection: In cases where the cyst is large or located in a critical area, complete resection of the affected bone segment may be necessary.
• Embolization: For ABCs in complex locations, like the spine, pre-surgical embolization (blocking blood flow to the cyst) may reduce bleeding during surgery.

What Happens During Curettage for Aneurysmal Bone Cysts?

During curettage, the surgeon:

• Makes an incision to access the bone.
• Scrapes out the cystic tissue from the bone cavity.
• Fills the cavity with bone grafts, bone cement, or other materials to promote healing and bone strength.
• Closes the incision, allowing the bone to heal over time.

Outlook

The prognosis for individuals with aneurysmal bone cysts is generally favourable, especially with prompt treatment. The recurrence rate after surgery varies, with curettage alone having a higher recurrence rate than when combined with other treatments like bone grafting. In rare cases, untreated or recurrent ABCs can lead to significant complications, including bone deformities or fractures.

Frequently Asked Questions

What age is aneurysmal bone cyst common? 

Aneurysmal bone cysts are most common in individuals under 20, but they can occur at any age.

How long does it take to recover from an aneurysmal bone cyst? 

Recovery time varies depending on the treatment method. Most patients can expect to recover within a few months to a year.

How do you treat aneurysmal bone cysts without surgery?

Sclerotherapy is a minimally invasive method for treating aneurysmal bone cysts. Rather than opting for surgical removal, doctors administer specific chemicals directly into the cyst to stimulate the formation of scar tissue. Over time, this scar tissue matures and solidifies into bone, effectively resolving the cyst without the necessity of open surgery.

What are the complications of an aneurysmal bone cyst? 

Complications may include bone fractures, deformities, and, in rare cases, neurological symptoms if the cyst compresses nearby nerves or the spinal cord.

Do aneurysmal bone cysts grow? 

Yes, if left untreated, aneurysmal bone cysts can grow and expand, leading to further bone weakening and potential complications.

How Can I Prevent an Aneurysmal Bone Cyst?

There is no known method to prevent aneurysmal bone cysts, as their exact cause remains uncertain. However, early detection and treatment can prevent complications like fractures and severe pain.

Review 

Reviewed By  Dr L Tomar - Principal Director and Unit Head department of Orthopaedic and Joint Replacement on 03 Sept 2024.