Radiology physicians at Nationwide Children’s Hospital were the first to discover and pioneer the minimally-invasive treatment of aneurysmal bone cyst using doxycycline foam injections. Our team pioneered the precise use of ultrasound as a highly specific imaging tool for identification of solid tumor nodules in the aneurysmal bone cysts, which allows for precise, minimally-invasive treatment of all parts of the tumor.
If you, or your child, have been diagnosed with aneurysmal bone cyst and want to pursue minimally invasive treatment, call our Interventional Coordinator at (614) 722-2375 to set up a consultation with an Interventional Radiologist. You may also request an appointment using our online form.
Dr. Shiels dedicated his life to advancing the field of radiology in order to provide the best care to children in our community, across the country and around the world. As we remember and celebrate his work, we will remain ever-grateful for his passionate mentorship of our radiology team and staff – some of whom have worked side by side with Dr. Shiels for more than a decade. Everything Dr. Shiels learned over his career, he taught to and instilled in his staff including his revolutionary advancements in interventional radiology and ultrasound; treating lymphatic malformations; bone tumor ablation, aneurysmal bone cyst and salivary gland ablation. His passion inspires the entire team to continue delivering the best possible care to children everywhere and his legacy will live in the advancements we continue to make here at Nationwide Children’s.
Aneurysmal bone cyst (ABC) is a highly destructive benign bone tumor, representing 1 to 6 percent of all solid bone tumors. The term "aneurysmal" refers to the explosive, expansile nature of the bone containing the aneurysmal bone cyst, similar to dilation and expansion seen with heart aneurysms. The majority of aneurysmal bone cysts are a large network of blood-filled cystic spaces. However, 3 to 7.5 percent of aneurysmal bone cysts are predominantly solid tumors with small vascular spaces.
Approximately 70 percent of aneurysmal bone cysts are primary lesions meaning they are directly related to the diagnosis of the cyst and not another medical reason. The remaining 30 percent occur coincidentally with other bone lesions, such as giant cell tumor, osteoblastoma, chondroblastoma, hemangioma, fibrous dysplasia and telangiectatic osteosarcoma. These tumors most often appear in the first two decades of life, with the most common locations including the humerus, tibia, fibula, skull, femur and spine. Approximately 8 to 30 percent are in the spine, most often involving the posterior aspects of the spine.
Previously considered to be an idiopathic (uncertain cause) bone cyst consisting of multiple honeycomb blood-filled spaces, aneurysmal bone cyst is now known to be a benign neoplasm (tumor) of bone. Most often, it is the result of translocations (criss-crossing) of the #16 and #17 chromosomes, resulting in the formation of highly destructive tumor tissue. The science of the aneurysmal bone cyst is explained by the chromosomal translocation that develops what is known as an "oncogene". Scientifically, the oncogene triggers the development of destructive solid tissue, giant cell-like osteoclasts (other cells that destroy bone) and vascular spaces. In addition, the oncogene triggers expression of an enzyme called "matrix metalloproteinase" that attacks and destroys the underlying structural matrix of bone. Furthermore, the translocation oncogene triggers the expression of "Vascular Endothelial Growth Factor" (VEGF) that recruits blood supply for this destructive tumor.
Personally trained by Dr. Shiels, James Murakami, MD, MS, will be carrying on the care of Dr. Shiels' patients. A faculty member at Nationwide Children's for more than 15 years, Dr. Murakami has interventional radiology interests focusing on sclerotherapy of vascular malformations and benign cysts of the head and neck, orbits, and bones.