Courtney L Kaiser1, Caleb M Yeung1, Kevin A Raskin1, Santiago A Lozano-Calderon2. 1. Musculoskeletal Oncology Service, Department of Orthopaedic Surgery, Massachusetts General Hospital-Harvard Medical School, Boston, MA, USA. 2. Musculoskeletal Oncology Service, Department of Orthopaedic Surgery, Massachusetts General Hospital-Harvard Medical School, Boston, MA, USA. Electronic address: slozanocalderon@mgh.harvard.edu.
Abstract
BACKGROUND: Aneurysmal bone cyst (ABC) is a benign but locally aggressive bone tumor occurring most commonly in the first 2 decades of life. The clavicle is a rare location for tumors, and ABCs of the clavicle have been sparsely described in the literature. We present the largest known series of ABCs of the clavicle to describe this rare condition. METHODS: Patients were identified retrospectively from an orthopedic oncology database to obtain demographic, diagnostic, and treatment information. A literature search was performed to identify all English language reports of ABC of the clavicle. RESULTS: We identified 13 patients with ABC of the clavicle, 77% of which were in the acromial end. Most patients (77%) presented with pain or swelling or both. The initial treatment in 11 patients was by curettage, with or without allograft bone packing, and 1 underwent resection/reconstruction of the lateral clavicle. Seven patients (58%) had 1 or more recurrences at an average of 6 months, for which 2 were treated with partial resection of the clavicle. CONCLUSIONS: ABC of the clavicle is a rare condition that we found to occur most frequently in the acromial end of the bone. Most patients were initially treated with curettage and showed a higher rate of recurrence than in other locations. The unique anatomy of the clavicle makes resection a feasible and very functional option, especially if the coracoclavicular ligaments can be preserved. However, the potential resulting deformity may cause patients to opt for a less aggressive and, consequently, less effective treatment method.
BACKGROUND:Aneurysmal bone cyst (ABC) is a benign but locally aggressive bone tumor occurring most commonly in the first 2 decades of life. The clavicle is a rare location for tumors, and ABCs of the clavicle have been sparsely described in the literature. We present the largest known series of ABCs of the clavicle to describe this rare condition. METHODS:Patients were identified retrospectively from an orthopedic oncology database to obtain demographic, diagnostic, and treatment information. A literature search was performed to identify all English language reports of ABC of the clavicle. RESULTS: We identified 13 patients with ABC of the clavicle, 77% of which were in the acromial end. Most patients (77%) presented with pain or swelling or both. The initial treatment in 11 patients was by curettage, with or without allograft bone packing, and 1 underwent resection/reconstruction of the lateral clavicle. Seven patients (58%) had 1 or more recurrences at an average of 6 months, for which 2 were treated with partial resection of the clavicle. CONCLUSIONS: ABC of the clavicle is a rare condition that we found to occur most frequently in the acromial end of the bone. Most patients were initially treated with curettage and showed a higher rate of recurrence than in other locations. The unique anatomy of the clavicle makes resection a feasible and very functional option, especially if the coracoclavicular ligaments can be preserved. However, the potential resulting deformity may cause patients to opt for a less aggressive and, consequently, less effective treatment method.
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