Kuyumcu Gokhan, Sundaram Murali, Schils Jean P, Ilaslan Hakan
Cleveland Clinic Imaging Institute, 9500 Euclid Avenue, Cleveland, OH, 44106, USA.
Skeletal Radiol. 2017 Nov;46(11):1561-1565. doi: 10.1007/s00256-017-2702-x. Epub 2017 Jul 8.
Osteoid osteoma is a common benign tumor that is typically found in young adults and children, usually in the long bones of the lower extremity. Radiofrequency ablation (RFA) under computed tomography guidance is the standard of care for symptomatic osteoid osteomas. However, patients with osteoid osteoma of the hand or foot are often treated with open surgery because of the risk of injury to vascular and neural structures from RFA. This risk is more pronounced in pediatric patients because of the small lesion size and proximity of lesions to important neurovascular structures. Here, we present 2 pediatric patients, one with an osteoid osteoma in the hand and the other with an osteoid osteoma in the foot. In both patients, a 22-gauge, 2.5-mm active tip ablation probe was used. The smaller ablation volume achieved with this probe protected neighboring neurovascular structures while effectively ablating the osteoid osteoma nidus. Based on our success in these cases, we recommend the application of this method for cases in which neurovascular proximity to the osteoid osteoma lesion makes ablation challenging.
骨样骨瘤是一种常见的良性肿瘤，多见于青少年和儿童，通常位于下肢长骨。计算机断层扫描引导下的射频消融（RFA）是有症状骨样骨瘤的标准治疗方法。然而，由于手部或足部骨样骨瘤患者接受RFA治疗时有损伤血管和神经结构的风险，这类患者常采用开放手术治疗。由于病变较小且病变与重要神经血管结构相邻，这种风险在儿科患者中更为明显。在此，我们报告2例儿科患者，1例手部患有骨样骨瘤，另1例足部患有骨样骨瘤。在这2例患者中，均使用了22号、2.5毫米有源尖端消融探针。该探针消融体积较小，在有效消融骨样骨瘤病灶的同时保护了邻近的神经血管结构。基于我们在这些病例中的成功经验，我们建议将该方法应用于神经血管与骨样骨瘤病灶相邻而使消融具有挑战性的病例。
