Radiofrequency ablation, an effective modality of treatment in tumor-induced osteomalacia: a case series of three patients
| Autor: | Nitin Shetty, Rajeev Kasaliwal, Varsha S. Jagtap, Sweta Budyal, Swati Jadhav, Nalini S. Shah, Anurag R. Lila, Krantikumar Rathod, Shruti Khare, Harshal Kakade, Bhavesh Popat, Amol Bukan, Suyash Kulkarni, Tushar Bandgar |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
Male medicine.medical_specialty Radiofrequency ablation Paraneoplastic Syndromes Endocrinology Diabetes and Metabolism Biopsy Clinical Biochemistry Context (language use) Biochemistry Multimodal Imaging law.invention Lesion Endocrinology Left femur law medicine Humans Femur Tomography Emission-Computed Single-Photon Osteomalacia Neoplasms Connective Tissue medicine.diagnostic_test business.industry Femoral Neoplasms Biochemistry (medical) Complete remission Middle Aged medicine.disease Catheter Ablation Female Radiology medicine.symptom business Tomography X-Ray Computed |
| Zdroj: | The Journal of clinical endocrinology and metabolism. 99(9) |
| ISSN: | 1945-7197 |
| Popis: | Context: Tumor-induced osteomalacia is curable if the tumors can be totally excised. However, when the tumors are present in locations that make surgery disproportionately risky, the need for less invasive strategies like radiofrequency ablation (RFA) is realized. Patients and Methods: We describe three patients with suspected tumor-induced osteomalacia who were treated in our department between 2006 and 2013 with tumors in surgically difficult locations and were subjected to single or multiple sessions of RFA. The response was documented in terms of symptomatic improvement, phosphorus normalization, and follow-up 99mTechnitium-labelled hydrazinonicotinyl-Tyr3-octreotide (99mTc HYNIC TOC) scan. Results: Two of the three individuals, patient A (with a 1.5 × 1.2-cm lesion in the head of the right femur) and patient B (with a 1.3 × 1.2-cm lesion on the endosteal surface of the shaft of the left femur), achieved complete remission with single sessions of RFA. Three months after the procedure, 99mTc HYNIC TOC scans revealed the absence of uptake at the previous sites, corroborating with the clinical improvement and phosphorus normalization. Patient C had a large 5.6 × 6.5-cm complex lesion in the lower end of the left femur with irregular margins, loculations, and bone grafts placed in previous surgery. He failed to achieve remission after multiple sessions of RFA due to the complex nature of the lesion, although the tumor burden was reduced significantly as documented on serial 99mTc HYNIC TOC scans. Conclusions: Although surgery remains the treatment of choice, RFA could be an effective, less invasive, and safe modality of treatment in judiciously selected patients. |
| Databáze: | OpenAIRE |
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