Aneurysmal bone cyst of the calcaneus

NewsBot · Nov 15, 2014

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Aneurysmal bone cyst of the calcaneus.
Kaplanoğlu V, Ciliz DS, Kaplanoğlu H, Elverici E.
J Clin Imaging Sci. 2014 Oct 31;4:60.

Aneurysmal bone cysts (ABCs) are benign, non-neoplastic, expansile, vascular, locally destructive lesions. The lesion may arise de novo (65%) or secondarily (35%) in pre-existing benign or malignant lesions (giant cell tumor, osteoblastoma, chondroblastoma, angioma, and others). The calcaneus is a rare localization for ABC, comprising only 1.6% of the cases. In this paper, we present a case of a female patient with a 3-month history of heel pain that got worse and was accompanied by swelling and difficulty in walking. The magnetic resonance images of the postero-lateral calcaneus showed a contrast-enhanced cystic lesion located in the medullary cavity; exophytic portion of the tumor extended into the soft tissue causing distinctive cortical thinning. Heterogeneous hyperintense septae formations and blood level components were also detected. After correlation with pathology results, the lesion was diagnosed as an ABC. Since an ABC of the calcaneus is a rarely seen phenomenon, we present the radiologic findings in this case and a review of the literature.
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NewsBot · Jan 29, 2015

Treatment of Unicameral Bone Cysts of the Calcaneus: A Systematic Review
David M. Levy, MD, Christopher E. Gross, MD, David N. Garras, MD
Jnl Foot Ank Surg; January 28, 2015

The calcaneus is the most common tarsal affected by unicameral bone cysts (UBCs); however, the treatment of calcaneal UBCs remains controversial. The purpose of the present systematic review was to evaluate the treatment modalities for calcaneal UBCs. A systematic review was performed using clinical studies of calcaneal UBCs with a minimum of 1 year of follow-up and level I to IV evidence. Ten studies with 171 patients (181 cysts) were selected. Heel pain and radiographic cyst consolidation were the primary outcomes. A series of Z tests were used to compare the outcomes in the nonoperative and operative groups, cannulated screw and bone augmentation groups, and autografting and allografting groups. All patients treated with open curettage and bone augmentation had significant improvements in heel pain (p < .001). Only 1.1% ± 1.0% of the cysts treated conservatively had healed on radiographs compared with 93.0% ± 13.0% of the cysts after surgery (p < .001). A greater percentage of patients treated with bone augmentation had preoperative heel pain and resolution of that pain than did patients treated with cannulated screws (p < .001). Autografting had a significantly greater percentage of radiographic cyst consolidation than did allografting (97.4% ± 11.1% versus 85.1% ± 15.8%, p < .001, Z = 3.5). Objective outcomes data on calcaneal UBCs are relatively sparse. The results of the present review suggest that open curettage with autograft bone augmentation is the most effective procedure. We would encourage future comparative clinical studies to elucidate differences in UBC treatment modalities.
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NewsBot · Mar 15, 2021

Aneurysmal bone cyst of the foot: A series of 10 cases
NilsDeventerGregorToporowskiGeorgGoshegerMariekede VaalTimoLuebbenTymoteuszBudnyNiklasDeventer
Foot and Ankle Surgery; 6 March 2021

Highlights
•ABC is a rare, benign but locally aggressive tumor.
•Histopathological examinations of tissue biopsies are compulsory for the diagnosis.
•Sequential instillations of polidocanol are a minimally invasive treatment option.
•A conversion to intralesional curettage can be necessary.
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Background
Aneurysmal bone cyst (ABC) is a benign, locally aggressive tumor that occurs in childhood and early adulthood. It usually affects the metaphysis of long bones but can also occur in the foot.

Methods
This single-center study is a retrospective review of ten patients with primary ABCs of the foot which underwent an intralesional curettage or a polidocanol instillation.

Results
After intralesional curettage a local recurrence was observed in 3/5 cases. The instillation of polidocanol showed a significant reduction of the initial cyst volume (p = 0.0267). In the instillation subgroup a primary complete healing was achieved in three cases. Due to a persisting disease two cases were converted to intralesional curettage without local recurrence in the follow-up.

Conclusions
Percutaneous instillation of polidocanol is a minimally invasive treatment option for ABCs of the foot and especially for small bones. Nevertheless, several sequential instillations and a conversion to intralesional curettage can be necessary.
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NewsBot · Feb 15, 2022

Aneurysmal bone cyst of the foot: A series of 10 cases
NilsDeventerGregorToporowskiGeorgGoshegerMariekede VaalTimoLuebbenTymoteuszBudnyNiklasDeventer
Foot and Ankle Surgery; Volume 28, Issue 2, February 2022, Pages 276-280

Highlights
•ABC is a rare, benign but locally aggressive tumor.
•Histopathological examinations of tissue biopsies are compulsory for the diagnosis.
•Sequential instillations of polidocanol are a minimally invasive treatment option.
•A conversion to intralesional curettage can be necessary.
Click to expand...

Background
Aneurysmal bone cyst (ABC) is a benign, locally aggressive tumor that occurs in childhood and early adulthood. It usually affects the metaphysis of long bones but can also occur in the foot.

Methods
This single-center study is a retrospective review of ten patients with primary ABCs of the foot which underwent an intralesional curettage or a polidocanol instillation.

Results
After intralesional curettage a local recurrence was observed in 3/5 cases. The instillation of polidocanol showed a significant reduction of the initial cyst volume (p = 0.0267). In the instillation subgroup a primary complete healing was achieved in three cases. Due to a persisting disease two cases were converted to intralesional curettage without local recurrence in the follow-up.

Conclusions
Percutaneous instillation of polidocanol is a minimally invasive treatment option for ABCs of the foot and especially for small bones. Nevertheless, several sequential instillations and a conversion to intralesional curettage can be necessary.
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NewsBot · May 1, 2022

Endoscopic curettage and allografting of simple bone cysts of the calcaneus in young soccer players: Report of three cases
Ioannis Terzidis et al
Foot (Edinb). 2021 Sep 25

Open curettage with bone graft has been the traditionally suggested surgical treatment for the symptomatic simple (or unicameral as they used to be called) calcaneal bone cyst. Less invasive endoscopically assisted treatment with curettage and bone grafting with allograft have recently provided less postoperative morbidity. The aim of the present study is to present our experience with this method in young soccer athletes. Between April 2014 and May 2016 three consecutive young soccer players with symptomatic calcaneal bone cysts underwent endoscopic curettage, and percutaneous injection of demineralized bone matrix allograft. The mean age was 17.3 (16, 17 and 19 years old), and the mean follow-up was 32.1 (range 24-47) months. Both radiographic and functional follow-up, using the AOFAS score, showed good to excellent results. All lesions were radiographically healed. Preoperative AOFAS score (max. 100 pts) was 78.6 ± 4.7, improving to 98.0 ± 4.1. The patients returned to their initial level of sports activities within 18.3 (range 17-19) weeks after surgery. Evidence suggests an earlier return to sports using bone substitutes. However, the present study showed that endoscopic curettage and percutaneous injection of bone allograft is also an excellent treatment option for young athletes with a symptomatic calcaneal bone cyst.
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NewsBot · May 16, 2022

Imaging Findings of Calcaneal Cyst and Lipoma: Can Intraosseous Cyst Changes Into Lipoma With Advancing Age?
Masaya Kawaguchi et al
J Comput Assist Tomogr. 2022 May-Jun 01;46(3):434-439

Objective: Recent studies have indicated that intraosseous lipomas originate from simple bone cysts of the calcaneus. This study evaluates computed tomography (CT) and magnetic resonance imaging (MRI) findings of calcaneal cysts and lipomas in pediatric and adult populations.

Methods: Forty-six patients with bone lesions located in the anterior portion of the calcaneus beneath the talocalcaneal joint, who underwent CT and/or MRI, were enrolled in this study. The imaging characteristics were retrospectively reviewed and compared between the pediatric (aged 18 years or younger; n = 29) and adult (aged 19 years or older; n = 17) groups.

Results: On CT images, water/soft tissue attenuation alone was more frequent in the pediatric group than in the adult group (84% vs 13%, respectively; P < 0.01), whereas the combined water/soft tissue and fat attenuation (11% vs 47%, respectively; P < 0.05) and fat attenuation alone (5% vs 40%, respectively; P < 0.05) were less frequent in the pediatric group than in the adult group. On MRI, cystic components alone were more frequent in the pediatric group than in the adult group (88% vs 13%, respectively; P < 0.01), whereas the combined cystic and fat components (8% vs 38%, respectively; P < 0.05) and fat components alone (4% vs 50%, respectively; P < 0.01) were less frequent in the pediatric group than in the adult group.

Conclusions: Calcaneal cysts were more frequent in the pediatric group, whereas calcaneal lipomas were more frequent in the adult group. These results could be additional evidence that intraosseous lipomas originate from simple bone cysts of the calcaneus.
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NewsBot · Mar 15, 2023

Management of Calcaneal Cysts in the Pediatric Population: A Review
Caleb Gottlich, John C Fisher, Dominic Campano, Michel Diab
J Am Acad Orthop Surg Glob Res Rev. 2023 Mar 10;7(3):e22.00248

Cysts of the bone are a common pathology that, although benign, are frequently treated because of their tendency to compromise the integrity of affected bone. Two common entities are unicameral bone cysts and aneurysmal bone cysts. Although these are two distinct pathologies, they are treated similarly and thus will be discussed in tandem. The optimal treatment of calcaneal bone cysts in pediatric patients has long been debated among orthopaedic surgeons because of the relatively small number of cases and varied results within the literature. Currently, there are three lines of thought regarding treatment: observation, injection, and surgical intervention. When considering which course of treatment is best for an individual patient, the surgeon must consider the fracture risk without treatment, the risk of complications with treatment, and the recurrence rate with each treatment approach. There are limited data on pediatric calcaneal cysts specifically. Still, there are much data concerning simple bone cysts of long bones in the pediatric population and calcaneal cysts in the adult population. Because of the lack of literature on the subject, there is a need for a review of the available literature and a consensus on the approach to treating calcaneal cysts in the pediatric population.
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