Treatment of Aneurysmal Bone Cyst When Surgical Resection Is Not Feasible or Would Substantially Increase Morbidity

This protocol applies to aneurysmal bone cysts (ABCs) that are deemed irresectable, or that are located in anatomic areas — such as the spine or pelvis — where surgery would substantially increase morbidity. In these settings, the size or location of the lesion makes conventional resection inappropriate or prohibitively risky.

Radiation therapy is currently reserved for tumours deemed irresectable because of the risk of sarcoma induction. Where surgical intervention would substantially increase morbidity — due to the anatomic location or extent of the lesion — non-surgical strategies become the primary consideration for achieving local control.

In this scenario, management focuses on achieving local control of the lesion through approaches that address its vascularity or apply targeted radiation. The full protocol details the recommended interventions and their specific indications for this clinical situation.