Minimally Invasive Treatment of a Cervical Aneurysmal Bone Cyst Through Percutaneous Doxycycline-Albumin Foam Injection

We report the case of a 28-year-old male with no medical history presenting with cervical pain over a month. Initial MRI and CT findings showed a lobulated and cystic lesion of the fourth cervical vertebra with thin cortical walls, around 2,2 × 3,5 × 4,2 cm, with blood-fluid levels consistent with an aneurysmal bone cyst (ABC) (Fig. 1). The vertebra lacked substantial bone tissue and was considered fracture prone. Multi-centric evaluation revealed a high-risk operation since the right vertebral artery was encased in the lesion and would have to be sacrificed. Transarterial embolization was considered too risky due to the situation of the anterior spinal artery (Fig. 2) and surgical stabilization would be a risky and only palliative option. Percutaneous doxycycline therapy was then considered the best curative option in this case.

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