Abstract
BackgroundTo review the safety and efficacy of percutaneous cryoablation for the treatment of chondroblastoma and osteoblastoma in the pediatric and adolescent population.Materials and methodsA retrospective review from 2016 to 2020 was performed to evaluate clinical and imaging response to percutaneous cryoablation in 11 symptomatic patients with diagnosis of chondroblastoma and osteoblastoma treated from two pediatric hospitals with at least 12-month follow-up. Technical success (correct needle placement and potential full coverage of the tumor with the planned ablation zone) and clinical success (relief of the symptoms) were evaluated. The primary objective was to alleviate pain related to the lesion(s). Immediate and late complications were recorded. Patients were followed in clinic and with imaging studies such as MRI or CT for a minimum of 6 months.ResultsA total of 11 patients were included (mean 14 years, age range 9–17; male n = 8). Diagnoses were osteoblastoma (n = 4) and chondroblastoma (n = 7). Locations were proximal humerus (n = 1), femur condyle (n = 1), and proximal femur (n = 1) tibia (n = 3), acetabulum (n = 3), thoracic vertebra (n = 1) and lumbar vertebra (n = 1). Cryoablation was technically successful in all patients. Clinical success (cessation of pain) was achieved in all patients. No signs of recurrence were observed on imaging follow-up in any of the patients. One of the patients developed periprocedural right L2–L3 transient radiculopathy as major immediate complication.ConclusionsPercutaneous image-guided cryoablation can be considered potentially safe and effective treatment for chondroblastoma and osteoblastoma in children and adolescents.
Highlights
To review the safety and efficacy of percutaneous cryoablation for the treatment of chondroblastoma and osteoblastoma in the pediatric and adolescent population
Cryoablation is a safe treatment of chondroblastoma and osteoblastoma in children and adolescents
Cryoablation of chondroblastoma and osteoblastoma is effective for pain control in pediatric patients
Summary
To review the safety and efficacy of percutaneous cryoablation for the treatment of chondroblastoma and osteoblastoma in the pediatric and adolescent population. Chondroblastoma and osteoblastoma are rare benign, locally aggressive bone tumors. Despite their low risk of malignant transformation, they can cause local complications such as pain disability and gait disturbances which may significantly impact the patient’s quality of life [1]. Osteoblastoma commonly involves the spine and long bones. Most chondroblastomas occur in the long tubular bones and almost invariably involve the epiphysis; they incite inflammatory changes in the surrounding tissues, resulting in pain and decreased range of motion [2]. Radiofrequency ablation (RFA) is the most commonly used thermal ablation method and has shown positive and long-standing effects for the local control of osteoblastoma and chondroblastoma [5]
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