Interest of preoperative embolization of aneurysmal bone cyst (ABC): A case report

Abstract

Aneurysmal bone cyst (ABC) is a rare lesion that primarily affects young adults and children. The optimal treatment approach for ABC remains controversial and varies depending on the preferences of the medical team. While some advocate for surgery as the treatment of choice, others recommend a less invasive first-line option such as selective embolization. In this case report, we present the case of a 41-year-old female patient with an ABC in the right iliac bone who underwent surgical treatment following preoperative selective embolization. Additionally, we provide a literature review on the topic.

Keywords: ABC; Embolization; MRI; Surgery.

Fig. 1

Front (A) and profile (B) radiographs of the right hip: Lytic, eccentric lesion of the right iliac wing with incomplete peripheral sclerosis and cortical rupture externally.

Fig. 2

MRI of the pelvis with T2-weighted sagittal (A) and axial (B); coronal T1 (C) and T1 FAT SAT sequences with gadolinium injection (D): Expansive lesion of the right iliac wing with solid, hemorrhagic and liquid portions of variable signal with a liquid-liquid level.

Fig. 3

Angiography Selective microcatheterization of the medial circumflex artery showing sheet-like bleeding (arrows) (A). After embolization with microparticles, bleeding disappeared (B). Selective microcatheterization of the superficial epigastric artery showing sheet-like bleeding (arrow) (C). After embolization with microparticles, bleeding disappeared (D). Selective microcatheterization of the superior gluteal artery showing sheet-like bleeding (arrows) (E). After embolization with microparticles and resorbable gelatin, bleeding disappeared (F).

Fig. 4

Frontal radiograph of the pelvis postoperatively (A) showing complete excision of the lesion with the surgical specimen (B).