Selective arterial embolization with n-butyl cyanoacrylate in the treatment of aneursymal bone cyst of the thoracic vertebra: a case report.

Abstract

A case report of aneurysmal bone cyst of the mobile spine. To present a pediatric case of aneurysmal bone cyst (ABC) of the mobile spine treated successfully by selective arterial embolization (SAE) with n-butyl cyanoacrylate (NBCA). The endovascular treatment is an important treatment option for the ABC of the mobile spine. However, there are few reported case treated by SAE with NBCA. A 12-year-old healthy boy was introduced with a complaint of back pain. Computed tomography showed an osteolytic expanding mass in the pedicle, lamina, and spinous process on the level of T10. Magnetic resonance imaging revealed a multicystic mass with fluid-fluid levels that extended into the spinal canal and compressed the spinal cord from the dorsal side. Digital subtraction angiography showed an abnormal blood supply from the posterior spinal branch of the left T9 artery. An abnormal mass was diagnosed as an ABC based on these neuroradiologic examinations. The patient underwent SAE with NBCA (Histoacryl, B. Braun, Melsungen, Germany) diluted with Lipiodol (Laboratorie Guerbet, France) in a rate of 1:4. Computed tomography performed 1 month after treatment revealed partial ossification of the bone cortex. MR imaging showed shrinkage of the cyst and decompression of the spinal cord. Back pain of the patient disappeared and the shrunken cyst was stable without recurrence during the 3-year follow-up period. SAE in a pediatric case with ABC of the mobile spine was effective in improving of clinical symptom and shrinking of the cyst.