ABSTRACT
PURPOSE: To assess efficacy and safety of imaging-guided radiofrequency ablation (RFA) of Osteoid Osteoma (OO) in both typical and atypical sites. METHODS AND MATERIALS: Between January 2014 and March 2019, 102 consecutive percutaneous RFA were performed and retrospectively reviewed. The procedures were performed using a RFA bipolar ablation system (Covidien, exposed tip of 0.7-1cm), under Computed Tomography (CT) guidance or using a navigation system (Masmec) under CT and Cone Beam CT (CBCT) guidance. Patients were followed up over 24 months. Clinical success and recurrences were considered on the base of established criteria. In patients with clinical failure and/or imaging evidence of relapse, retreatment was considered. RESULTS: Administered power per-procedure was ≤8 W (mean temperature, 90°C). The pre-procedure average value of visual analog scale (VAS) was 8.33+/-0.91. Primary and secondary success rate 96.08% (98/102) and100% (102/102), respectively. No major complication was described. Technical success was proved in every patient by CT scan acquisition after needle positioning. Relapse and tumour location were significantly correlated (p-value = 0.0165). The mean dose-length product was 751.55 mGycm2. Advanced bone healing was noted in 68 lesions after 1y-follow up and in 86 lesions after 2y-follow up. CONCLUSION: Imaging-guided percutaneous RFA is a highly effective technique for OO, both in typical and atypical sites. CT or CBCT guidance, navigation systems and operator experience grant the technical success, which is the most crucial parameter affecting outcome.
Subject(s)
Bone Neoplasms/therapy , Cancer Pain/therapy , Neoplasm Recurrence, Local/epidemiology , Osteoma, Osteoid/therapy , Radiofrequency Ablation/methods , Adolescent , Adult , Bone Neoplasms/complications , Bone Neoplasms/diagnosis , Cancer Pain/diagnosis , Cancer Pain/etiology , Cone-Beam Computed Tomography , Female , Follow-Up Studies , Humans , Male , Middle Aged , Neoplasm Recurrence, Local/prevention & control , Osteoma, Osteoid/complications , Osteoma, Osteoid/diagnosis , Pain Measurement/statistics & numerical data , Radiofrequency Ablation/statistics & numerical data , Retrospective Studies , Treatment Outcome , Young AdultABSTRACT
The novel coronavirus, SARS-CoV-2, causes much more severe disease in adults than in children. Although it is anticipated that immune compromised children and children with cancer may be at higher risk of developing severe or fatal COVID-19, there are no currently published reports of fatal disease in a child with cancer. Because of the discrepancy in disease severity between adult and pediatric patients, we report the case of an adolescent with pulmonary metastatic osteosarcoma who died of COVID-19 early in the course of the pandemic in New York City in the hope that heightening awareness that pulmonary metastatic disease may predispose to a more severe outcome will increase surveillance in this vulnerable population.
Subject(s)
Bone Neoplasms/pathology , COVID-19/complications , Lung Neoplasms/secondary , Osteosarcoma/pathology , Respiratory Insufficiency/pathology , SARS-CoV-2/isolation & purification , Bone Neoplasms/complications , Bone Neoplasms/virology , COVID-19/virology , Child , Humans , Lung Neoplasms/complications , Lung Neoplasms/virology , Male , Osteosarcoma/complications , Osteosarcoma/virology , Respiratory Insufficiency/etiology , Severity of Illness IndexSubject(s)
COVID-19/diagnosis , Stevens-Johnson Syndrome/diagnosis , Adrenal Cortex Hormones/therapeutic use , Androstadienes/therapeutic use , Aromatase Inhibitors/therapeutic use , Body Surface Area , Bone Neoplasms/complications , Bone Neoplasms/drug therapy , Bone Neoplasms/secondary , Brain Neoplasms/complications , Brain Neoplasms/drug therapy , Brain Neoplasms/secondary , Breast Neoplasms/complications , Breast Neoplasms/drug therapy , Breast Neoplasms/pathology , COVID-19/complications , Dexamethasone/therapeutic use , Emollients/therapeutic use , Female , Hospitalization , Humans , Liver Neoplasms/complications , Liver Neoplasms/drug therapy , Liver Neoplasms/secondary , Middle Aged , Palliative Care , SARS-CoV-2 , Stevens-Johnson Syndrome/drug therapy , Stevens-Johnson Syndrome/etiology , Stevens-Johnson Syndrome/pathologyABSTRACT
A 78-year-old man had a medical history of hypertension, atrial fibrillation, chronic kidney disease, and metastatic castration-resistant prostate cancer (CRPC). He had progressed to first-line therapy for CRPC with abiraterone plus androgen-deprivation therapy (ADT) and as second-line therapy he was being treated with docetaxel, with biochemical progression in his last prostate specific antigen measurement. He was admitted to the hospital on April 2020, in the middle of the coronavirus disease 2019 (COVID-19) pandemic, because of painful bone lesions and deterioration of renal function.