Cryoablation of Osteoid Osteoma: Two Case Reports

Liu, David M.; Kee, Stephen T.; Loh, Christopher; McWilliams, J.; Ho, Stephen; Brower, Jayson; Munk, Peter L.

doi:10.1016/j.jvir.2009.12.389

Cited by 22 publications

(14 citation statements)

References 10 publications

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“…41 Treatment of the central nidus is the key to therapeutic success, and RFA achieves a focus of high temperatures around the probe positioned directly within the nidus. While RFA has the longest track record, MWA 42 and cryoablation 43 have also been shown to be safe and effective for treatment of symptomatic osteoid osteomas in preliminary investigations, and either could have been used in this case as well. From a technical standpoint, the percutaneous penetration and ablation of the osteoid osteoma nidus is often extremely painful, and thus the intervention is frequently performed using general anesthesia or utilizing nerve blocks.…”

Section: Case 8: Rfa For Osteoid Osteomamentioning

confidence: 99%

Technical and Practical Considerations for Device Selection in Locoregional Ablative Therapy

Zivin

Gaba

2014

Semin intervent Radiol

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Percutaneous image-guided ablation is increasingly being used as definitive treatment of primary and metastatic focal malignancies, local therapy for tumors in poor operative candidates, and for pain palliation. Advances in tissue ablation technologies with development of new modalities have made device selection an increasingly complex endeavor. As the arsenal of ablation devices continues to evolve, each is slowly finding its optimal niche; however, the clinical benefits and limitations of each tool are still not conclusively delineated, with significant overlap in effective and safe applicability. In many scenarios, the choice of ablation modality is dependent on the available equipment, operator expertise, and institutional preference. However, a firm understanding of the physical, chemical, and biological mechanisms underlying induction of tissue necrosis, the realworld benefits and shortcomings of each technology, and the performance profile for each ablation technique in specific organ systems is critical in choosing the most favorable device for each individual clinical situation. This article aims to provide practical guidance on ablative device selection by briefly reviewing the mechanism of action of currently available thermal and nonthermal ablation technologies, highlighting the clinical and technical advantages or disadvantages of each modality, and utilizing a case-based format to illustrate selection considerations and practical application of ablation equipment in assorted clinical cases. Ablation Modalities and Mechanisms of Action Thermal AblationHyperthermic or heat-based ablation techniques cause cellular death by coagulative necrosis, leading to denaturation of intracellular enzymes and protein complexes, and leading to structural damage and apoptosis. Irreversible cellular injury typically occurs when cells are heated to greater than 60°C, and ensues more rapidly as temperature rises.1 Examples of commonly utilized hyperthermic ablation modalities include radiofrequency ablation (RFA) and microwave ablation (MWA). Other hyperthermic modalities, including high- AbstractPercutaneous ablation therapy is an essential component of contemporary interventional oncologic therapy of primary and secondary malignancies. The growing armamentarium of available ablation technologies calls for thorough understanding of the different ablation modalities to optimize device selection in individual clinical settings.The goal of the current article is to provide direction on ablative device selection by reviewing device mechanisms of action, advantages and disadvantages, and practical considerations in real-life case scenarios.

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Section: Case 8: Rfa For Osteoid Osteomamentioning

confidence: 99%

Technical and Practical Considerations for Device Selection in Locoregional Ablative Therapy

Zivin

Gaba

2014

Semin intervent Radiol

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“…Then, the tumor is allowed to thaw. Cell death is induced by repeated cycles of rapid freezing and thawing with a temperature below -40˚C (82). The success rate of the technique is 95.2% (83).…”

Section: Minimally Invasive Techniquesmentioning

confidence: 99%

Osteoid Osteoma: An Updated Review of Epidemiology, Pathogenesis, Clinical Presentation, Radiological Features, and Treatment Option

TEPELENIS

SKANDALAKIS

PAPATHANAKOS

et al. 2021

In Vivo

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Osteoid osteoma, the third most common benign bone tumor, usually occurs in the cortex of long bones. It consists of a radiolucent nidus surrounded by reactive osteosclerosis. Generally, osteoid osteoma affects young males. Nocturnal pain that eases with salicylates or nonsteroidal anti-inflammatory drugs (NSAID) is the typical clinical presentation. Sometimes, it remains undiagnosed for a long time. Plain radiography and computed tomography are usually sufficient for the diagnosis of osteoid osteoma. Initial treatment includes salicylates and NSAID because the tumor often regresses spontaneously over 2-6 years. Surgical treatment is indicated in case of unresponsive pain to medical therapy, no tolerance of prolonged NSAID therapy due to side effects, and no willingness to activity limitations. Nowadays, minimally invasive techniques have replaced open surgery and are considered the gold standard of surgical treatment. Although cryoablation seems superior in terms of the nerve damage and immunotherapy effect, radiofrequency ablation is the preferred technique.

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“…Cryoablation involving rapidly freezing temperatures within the target tissues, followed by rapid active thawing leading to cellular death through immediate and delayed mechanisms, has also been described. [23][24][25] Arthroscopic excision has also been found to have excellent functional results when used for intraarticular hip lesions.…”

Section: Osteoid Osteomamentioning

confidence: 99%

Benign Pediatric Tumors and Tumor-Like Conditions of the Hip

et al. 2019

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Hip pain in the pediatric population can be a challenging presenting complaint to assess. An extensive differential list, including the possibility of infection, transient conditions, and malignancy, results in numerous questions that can render diagnosis difficult. As clinicians, it is imperative that we have the ability to recognize, properly diagnose, and possibly treat the multitude of potential pediatric hip disorders. Here the authors present the incidence, characteristics, and treatment of various benign tumors and tumor-like conditions of the pediatric hip.

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Cryoablation of Osteoid Osteoma: Two Case Reports

Cited by 22 publications

References 10 publications

Technical and Practical Considerations for Device Selection in Locoregional Ablative Therapy

Technical and Practical Considerations for Device Selection in Locoregional Ablative Therapy

Osteoid Osteoma: An Updated Review of Epidemiology, Pathogenesis, Clinical Presentation, Radiological Features, and Treatment Option

Benign Pediatric Tumors and Tumor-Like Conditions of the Hip

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