Learning objectives
Our aim is to review the technique aspects of CT-guided percutaneous radiofrequency thermoablation of osteoid osteoma. We evaluate the clinical outcome and results of 21 cases performed in our institutions.
Background
Osteoid Osteoma represents 10% of all benign bone tumors. It is composed of a highly vascularized nidus of connective tissue and trabeculae of newly formed osseous tissue surrounded by peripherical dense sclerotic bone ( 1 ) . Periosteal bone reaction is variable and the intensity of it depends on the location either cortical or subperiosteal of the lesion . It presents in ages comprehended between 1 and 63 years of age with a mean age of 17 years and in 85 % of the cases...
Imaging findings OR Procedure details
Patients are chosen to be candidates to the application of percutaneous radiofrequency ablation as treatment of osteoid osteomas ,when presenting typical clinical features and radiological characteristic findings. Twenty-five patients with clinically and radiologically suspected osteoid osteoma were seen over a 18 month period.Twenty-one patients (graphic) were treated by means of CT-guided percutaneous radiofrecuency ablation.Another important condition is that the lesion must be at least one centimetre away from any vascular or neurological structure in risk of being damaged. The technique was performed by CT guide...
Conclusion
The classic treatment of the osteoid osteoma has been the surgery excision in block that, although highly effective, it is not exempt of diverse complications: relapse of the tumor, fractures, use of internal fixers, hospital stay and lingering functional recovery, among other described adverse effects. With percutaneous CT-guided resection complications have also been described: fractures, cutaneous necrosis and burns , intramuscular hematoma, paresis and osteomyelitis. We consider that percutaneous radiofrequency ablation of osteoid osteomas is a sure, effective technique and minimally invasive; and it should...
References
1.- Bloem JL, Kroon HM. Osseous lesions. Radiol Clin North Am 31:261-278, 19932.- Parlier-Cuau C, Champsaur P, Nizard R, Hamze B, Laredo JD. Percutaneous removal of osteoid osteoma. Radiol Clin N Am 36: 559-566, 1998.3.- Witt JD, Hall-Craggs MA, Ripley P, Cobb JP, Bown SG. Interstitial laser photocoagulation for the tretment of osteoid osteoma. J Bone Joint Surg Br. 82:1125-1128, 2000.4.- Kneisl JS, Simon MA. Medical management compared with operative treatment for osteoid osteoma. J Bone Joint Surg Am. 74-A: 179-185, 1992.5.- Campanacci M, Ruggieri...