CHARACTERISTICS OF PHENOL - INSTILLATION IN INTRALESIONAL TUMOR-EXCISION OF CHONDROBLASTOMA, OSTEOCLASTOMA AND ENCHONDROMA

Because of the typical metaphyseal-epiphyseal growth of giant cell tum ors and chondroblastomas, the optimal result of an en bloc resection c an usually only be achieved by a loss of joint function. For this reas on, intralesional excision has prevailed, though it leads to a high ra te of relapses. Adjuvant therapy involving irrigation of the remaining bone cavity with phenol can distinctly decrease the rate of relapse. Little is known about the amount of phenol applied that is absorbed. T his study investigated the urinary excretion of phenol following the i nstillation of 102 mi of a 5% phenol solution. The method consisted of urine collection from 11 patients treated by phenol instillation preo peratively, and at 1, 3, 6, 12 and 24 h postoperatively. The urine spe cimens were analysed for phenol by mass spectrometry. Preoperatively, the value was 5.1 mg/l on average. The maximum concentration of 62 mg/ l was found 1 h after instillation, with an average value of 41.5 mg/l , and after 3 h of 18.9 mg/l. A further rapid decrease in the excretio n rate was recorded, with normal values being reached after 12 h. This means a maximum of 9% and an average of 2% of the instilled amount of phenol were excreted in the urine within 24 h postoperatively. By com paring these urinary concentrations to published standards, we conclud e that the instillation of a 5% phenol solution into bony lesions is a ssociated with a relatively low risk of systemic toxicity.