Percutaneous Thermal Ablation For Treatment of Benign Bone Tumors: Principles, Technologies, and Clinical Outcomes

1. To describe the clinical and imaging features of benign bone neoplasms. 2. To review percutaneous ablative technologies, indications, and clinical outcomes in the treatment of bone tumors. 3. Describe representative case examples of ablation treatment of benign bone tumors.





Background:

Benign bone tumors are the most common variety of primary bone neoplasms and primarily affect children and young adults under 25. While they have low or no metastatic potential, benign bone tumors may cause significant pain during activity or at rest and exhibit increased fracture risk due to aberration of healthy bone architecture. Furthermore, many types are locally aggressive and also exhibit a high rate of recurrence after initial surgical treatment, including osteoblastoma, giant cell tumors, and chondromyxoid fibromas. Traditionally, multiple surgeries are required, which poses an increased risk of complications including growth abnormalities and functional deficit, given the predominantly pediatric population. Thermal ablation has emerged in the last two decades as both an adjuvant and primary treatment alternative to surgery due to comparable efficacy combined with a reduced risk profile, with shorter post-operative stays, reduced procedural complications, and lower cost.




Clinical Findings/Procedure Details:

Ablation technologies used in the treatment of benign bone tumors include 1) radiofrequency, 2) microwave, 3) laser, and 4) cryoablation. These technologies differ in utility and must be selected on a case-to-case basis depending on the tumor size, lesion pathology, and adjacent structures.

In this exhibit, we will review the differences in ablation technologies and procedural techniques. We will also review literature-reported outcomes of different ablation technologies on the treatment of benign bone tumors, stratifying by common tumor types, and we will describe use cases of each modality through multiple case reports.

Conclusion and/or Teaching Points:

Ablation is an established treatment for benign bone tumors and includes multiple modalities. Consideration of each type’s characteristics in combination with the clinical context allows for a safe and effective surgical treatment alternative.