Percutaneous intralesional injection of calcitonin and methylprednisolone for treatment of an aneurysmal bone cyst at C-2.

An aneurysmal bone cyst (ABC) is a rare skeletal tumor that accounts for approximately 1% of all bone tumors. A spinal location for an ABC is very rare. Methods for treatment of an ABC include resection, curettage, embolization, and intralesional injection of a variety of agents. The patient in this case was a 9-year-old girl presenting with neck pain who was diagnosed with an ABC involving the C-2 spinal level. Percutaneous intralesional injections of calcitonin and methylprednisolone were performed. Two years and 7 months after the initial injection, a CT scan showed massive bone formation and cortical thickening without a change in the size of the lesion. To the authors' knowledge, this is the third reported case of intralesional injection of calcitonin and methylprednisolone for treatment of an ABC. This method is safe and effective, and is an important alternative to surgery, especially when a surgical procedure is technically difficult or unsafe in high-risk patients.