E2435. Radiofrequency Ablation in Osteoid Osteoma: From a Tertiary Cancer Centre in India
Pinnamaneni Siddhartha Institute of Medical Sciences
Osteoid osteoma is a benign but painful lesion. Percutaneous CT guided radiofrequency ablation (RFA) is the primary treatment option for osteoid osteomas as it is minimally invasive with lesser complications, rapid recovery and short hospital stay compared to surgical treatment.
Educational Goals / Teaching Points
This exhibit provides an overview on patient selection criteria, technical aspects and possible complications of RFA in osteoid osteomas. To ensure safe tumor ablation,the plane of approach is chosen based on the anatomy of adjacent neurovascular bundles and critical structures to avoid their injury during ablation. Techniques to access the lesion in difficult locations through adjacent sclerosed bone , with accurate placement of the RF probe into nidus of the lesion is crucial for successful ablation. Management also includes prevention and treatment of complications along with prophylaxis for secondary infections. We present our experience of RFA of osteoid osteomas in 160 patients in a tertiary care oncology centre.
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Atypical presentations included atypical sites like clavicle, talus, acetabulum, humerus, cervical vertebra and atypical age (infancy).Technical success was achieved in all patients with intranidal localization of the needle. Successful pain relief was achieved in all patients within 1 day to 1 week. Immediate complications included minor thermal skin burn and pain in the distal limb farther to the site of ablation. During follow up, 5 patients developed recurrence after 5 months which was treated with repeat ablation.
Radiofrequency ablation is a relatively safe, minimally invasive, and effective method for the management of osteoid osteomas with few complications.