Abstract
A 21-year-old female presented with a huge painful aneurysmal bone cyst (ABC) involving the left ilium, acetabulum, and ischium, resulting in a limp and activity limitation. After serial selective arterial embolization, intravenous bisphosphonates, and surgical curettage with bone grafting and cementing, she could achieve painless, nearly full range of motion at 2-year and 3-month follow-up with no recurrence. Her quality of life using the RAND 36-item Health Survey (version 1.0), the Musculoskeletal Tumor Society Scoring System (MSTS), and the Toronto Extremity Salvage Score indicated a good outcome. The aim of reporting this case was to show that it is safe to surgically approach a large pelvic ABC after devascularization with scleroembolic procedures augmented with intravenous bisphosphonates.