Treatment of Aneurysmal Bone Cyst Located in an Expendable Bone (Clavicle, Rib, Proximal Fibula, Pubic Ramus)
When an aneurysmal bone cyst arises in an expendable bone — the clavicle, rib, proximal fibula, or pubic ramus — the site itself opens a distinct and more definitive surgical path.
Clinical Scenario
This protocol is for aneurysmal bone cysts arising in expendable skeletal sites: clavicle, rib, proximal fibula, and pubic ramus. Because these bones are expendable, more definitive resection options are available that would not be appropriate at functionally critical sites.
Treatment Approach
The primary intervention is surgical resection of the lesion. Whether reconstruction is undertaken alongside resection depends on factors detailed in the full protocol.
The complete surgical algorithm — including indications, reconstruction decisions, and evidence grading — is available in the full protocol below.
Clinical Goal
Complete local control with no recurrence.
References
DOI: 10.7759/cureus.53587
- En block excision is the best treatment option for lesions that develop in expandable bones (clavicle, rib, proximal fibula, pubic ramus) or for recurrent lesions and lesions that do not respond to less invasive treatments.
- When the tumor is located in an expandable bone (such as the fibula or rib) resection is recommended, with or without reconstruction.
- En block excision, which is also called "complete resection," has the lowest risk of recurrence.
- After a wide resection, there was no local relapse in the series by Campanacci et al.
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