Aneurysmal Bone Cyst (ABC) Specialist Surgeon Singapore 

Management of Locally Aggressive Vascular Bone Lesions.

We manage aneurysmal bone cysts (ABC) as complex, blood-filled lesions that demand a balance between radical clearance and structural preservation. Under the clinical direction of Dr. Saminathan Suresh Nathan, our practice focuses on neutralizing the aggressive expansile nature of these cysts which can otherwise lead to rapid bone destruction. Utilizing thirty years of surgical discernment, we employ advanced curettage and stabilization techniques to restore the integrity of the affected limb. The aneurysmal bone cyst is a unique tumor that happens typically in children below the age of sixteen. The bone is expanded by these lesions and the walls of the lesion are line by blood vessel cells (endothelium). They themselves contain blood and hence are like aneurysms or dilated vessels. These lesions may exist in the secondary form where they are part of another lesion in as high as 20% of cases. These other forms are not believed to be primary tumors. They are aggressive tumors causing invasion of bone. They usually need to be removed and filled with bone graft as they risk the bone to fracture and dissemination. In addition, in the spine especially the can cause compression of vital structures like the spinal cord.

Surgical Considerations

• Adjuvant Sterilization: Utilization of high-speed burring, argon beam coagulation, or cryotherapy to destroy residual cystic lining and minimize high recurrence rates.

• Vascular Control: Strategic use of preoperative embolization in hypervascular lesions to ensure a controlled and clear surgical field.

• Structural Void Management: Precision use of allografts or synthetic bone substitutes to fill large cavitary defects and prevent pathological fracture.

Figure. This lady had a giant cell tumor of the distal femur presenting at the age of 30 years. Further evaluation showed there was an aneurysmal bone cyst residing in the giant cell tumor. A currettage and cryotherapy with liquid nitrogen was done saving her near-destroyed knee.