Powell Daniel K, Ardestani Allen
Oncologic Radiologist, West Cancer Center and Research Institute, University of Tennessee Health Science Center, 7945 Wolf River Blvd, Germantown, TN 38138, USA.
Radiol Case Rep. 2019 Jul 12;14(9):1093-1099. doi: 10.1016/j.radcr.2019.06.009. eCollection 2019 Sep.
We present 2 cases of palliative percutaneous screw fixation for refractory pain from periacetabular residual cavities, after clinical remission, from osteolytic iliac masses involving the cortices of the sacroiliac joint (SIJ). Two patients-1 with a treated 8 cm breast metastasis and another with a treated 14 cm plasmacytoma-were selected for osseous stabilization based on imaging criteria and physical signs of iliac deformability and SIJ dysfunction. Neither lesion exhibited active malignancy following systemic therapy or discrete fracture. Following computed tomography-guided screw fixation across the mass and SIJ, with surrounding cement osteoplasty, to reduce mechanical stress on abnormal bone, both patients reported pain resolution beyond 1-year. This technique may be a suitable palliation even for large treated pelvic metastastic cavities and in the absence of fracture.
我们报告2例姑息性经皮螺钉固定术，用于治疗溶骨性髂骨肿块累及骶髂关节（SIJ）皮质后髋臼周围残余腔引起的难治性疼痛，且临床已缓解。根据影像学标准以及髂骨变形和SIJ功能障碍的体征，选择了2例患者——1例为已治疗的8 cm乳腺转移瘤患者，另1例为已治疗的14 cm浆细胞瘤患者——进行骨质稳定治疗。全身治疗后，两个病灶均未显示有活动性恶性肿瘤，也未出现明显骨折。在计算机断层扫描引导下，通过肿块和SIJ置入螺钉，并进行周围骨水泥成形术，以减轻异常骨上的机械应力，两名患者均报告疼痛在1年以上得到缓解。即使对于已治疗的大型盆腔转移腔且无骨折的情况，该技术也可能是一种合适的姑息治疗方法。
