What Are the Treatments for Cystic Lesion in the Bone?

Cystic lesions in the bone are fluid-filled cavities that compromise the integrity of normal bone tissue. They come in two basic forms: simple cysts---which fill with a clear fluid---and aneurysmal cysts, which fill with blood. Treatment for a cystic lesion varies with its severity and the type of lesion present.

Understanding and Treating Simple Bone Cysts

• According to the American Academy of Orthopaedic Surgeons, simple bone cysts---also known as unicameral cysts---typically occur in children and young adults under the age of 20. They most frequently appear in the upper arm or thighbone, although they are also found in the ankle, heel and pelvis. Simple cysts are divided into two categories. Active cysts occur near the growth plates that allow bones to expand and may lead to serious structural problems. Latent cysts occur away from a bone's growth plate and are generally less disruptive.

  If your child has a simple bone cyst, a number of factors will determine the appropriate treatment. These include your child's age, medical history, overall health and tolerance to medications. Your child's doctor will also consider the current extent of the cyst, its likely future progression and your child's suitability for surgery or other corrective procedures.

  The main goal of treatment is to prevent a bone fracture. If the bone surrounding the cysts is strong, or if your child's activity patterns do not present an increased fracture risk, simple observation of the cyst may be a suitable first treatment option. In cases where more active treatment is needed, several options are available. Curettage and bone grafting are used as a combined technique. First, a surgeon will remove the fluid from inside your child's cyst, then surgically scrape its interior with a specialized instrument called a curette. The remaining bone cavity is then filled with either donated bone tissue or bone chips taken from elsewhere on your child's body. Alternatively, steroid injections may be used to heal a simple cyst by reducing the presence of prostaglandin, a fatty acid that blocks cyst reabsorption. Additionally, bone marrow taken from your child's hip may be injected into a cyst to encourage new bone growth.

Understanding and Treating Aneurysmal Bone Cysts

• Aneurysmal bone cysts typically occur in individuals under the age of 25. These cysts expand and alter the bone surface, and in some cases also affect nearby connective tissue. They most commonly affect the long bones of the body and the spine, and have a tendency to reappear after treatment. Since aneurysmal cysts contain blood, treatment carries a real risk of serious bleeding. As a result, your doctor may temporarily block blood flow to the affected area before proceeding. This may be followed by curettage and grafting. However, if the cyst is located in an area that is not structurally critical, such as the ribs or fibula, your surgeon may also remove a margin of bone around the cyst to reduce chances of recurrence. You or your child may also receive radiation therapy or cryotherapy (surgical freezing) to further reduce recurrence risks. Consult your surgeon for more details.