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Diagnosed with aneurysmal bone cyst. Waiting for MRI. Have lesion on femoral neck. Treatment?

Dec 2012
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General & Family Physician
Practicing since : 2012
Answered : 1704 Questions
Hi,my name its XXXXXXX my son awaiting MRI scan,but on the moment been diagnosed as he have an aneurysmal bone cyst.The relatively large size and location of the lesion does however put him at high risk of fracture of the right femoral neck.The expansile lucent focus involving more than 50% of the cortex of the right femoral neck.It has well defined slightly sclerotic margins and relatively thick XXXXXXX bony septae.I am very afraid and really worry about my 20year old son,could You please tell me about the risk and treatment he should have ,please
Posted Fri, 5 Apr 2013 in Bones, Muscles and Joints
Answered by Dr. Nsah Bernard 2 hours later

Thanks for posting on XXXXXXX

I am pleased to be able to help you with more info regarding your son's condition.
Aneurysmal bone cyst (ABC) is an expansile cystic lesion that most often affects individuals during their second decade of life and may occur in any bone in the body (13% affects the femur). Although benign, the ABC can be locally aggressive and can cause extensive weakening of the bony structure and impinge on the surrounding tissues. In the medical community the cause still remain a mystery, but the mainstay of treatment has been intralesional curettage. Recurrence is not uncommon in inactive lesions.
Curettage is performed on some patients, and is sufficient for inactive lesions. The recurrence rate with curettage is significant in active lesions, and marginal resection has been advised. Liquid nitrogen, phenol, methyl methacrylate are considered for use to kill cells at margins of resected cyst.
Other surgical options include "en bloc" resection or wide excision, selective arterial embolization, and curettage with locally applied adjuvants such as liquid nitrogen or phenol.
How ever, specific treatment depends on stage (and that will only be determined after MRI).
Intraoperatively, depending on the size and nature of the lesion, the patient's fluid volume and blood loss may need to be monitored closely (so saying blood loss is more if lesion is big).
Activity modification should be as tolerated to the fitness of the patient, the anatomic location of the surgery, and the extent of the surgery and reconstruction. Mechanical or chemical prophylaxis against XXXXXXX vein thrombosis may also be indicated.
Recurrence usually happens within the first year after surgery, and almost all episodes occur within 2 years (recurrence rate depends on stage of ABC and type of surgery). Patient should be monitored closely within the first 5 years.
Complications may range from recurrence, wound infection, DVT (after surgery), blood loss, osteomyelitis, possible damage to surrounding tissues etc etc.
The prognosis for an ABC is generally excellent, although some patients need repeated treatments because of recurrence, which is the most common problem encountered when treating an ABC, the overall cure rate being 90-95%.

Well further information you will need to discuss with your son's treating doctor as you will understand that outcomes of each diseases maybe case dependent and so your son's doctor is better placed to through more light on this issue.

Hope this helps and wish you the best. If you are satisfied with my answer, please will you accept it.

Thank you
Dr. Bernard
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