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Radiat Med (2008) 26:603608 DOI 10.1007/s11604-008-0277-0
CASE REPORT
Percutaneous osteoplasty for hypervascular bone metastasis
Makoto Shinoto Kanehiro Hasuo Hitoshi Aibe Yoshitaka Shida Maya Kinjo Yuko Kubo Kotaro Terashima
Received: January 16, 2008 / Accepted: August 27, 2008 Japan Radiological Society 2008
Abstract We report three cases of percutaneous osteoplasty for the treatment of hypervascular bone metastasis. Four hypervascular bone metastases were treated in three consecutive patients by percutaneous osteoplasty under uoroscopic or computed tomographic guidance. Primary malignant tumors included pheochromocytoma and renal cell carcinoma. Pain relief after osteoplasty was achieved in all three patients. There was no major complication. Projectile bleeding and subcutaneous hematoma were noted during or after osteoplasty but were easily controlled conservatively. Percutaneous osteoplasty for hypervascular bone metastases is not only a highly effective but also a minimally invasive technique that provides immediate pain relief without major complication.
Key words Hypervascular bone metastasis Percutaneous osteoplasty Vertebroplasty
Introduction
Metastatic bone disease from malignant neoplasms occurs not infrequently. It causes intolerable pain and reduces the quality of life when pathological fracture occurs. Since percutaneous vertebroplasty was rst described in 1987,1 it has been widely applied for painful compression fracture due to osteoporosis and neoplasms including myeloma, multiple metastatic bone tumors,
and hemangioma.24 It has been proposed to be a highly effective therapy for painful bone lesions. The technique can be used for neoplastic lesions in pelvic bone as well as vertebral bodies; it is called percutaneous osteoplasty or pelvic osteoplasty.2,5,6
Metastatic bone disease from a hypervascular tumor is usually rich in vascularity, similar to primary lesions.79
In these cases, a hemorrhagic complication might be of concern during osteoplasty. To our knowledge, although there have been some reports about percutaneous osteoplasty for hypervascular tumors,4,1012 there has been only one report describing a hemorrhagic complication.10
Here we describe our experience with osteoplasty in patients with metastatic hypervascular tumors.
Case report
Three patients with four metastatic hypervascular bone lesions were treated in our hospital (Table 1). All patients had undergone previous irradiation for the painful meta-stases, but it did not relieve the pain, which was also refractory to medication. Performance status (Eastern Cooperative Oncology Group) of these patients was 2 or 3, and they were expected to be alive at least 1 year or more. Percutaneous osteoplasty...