TRANSCUTANEOUS TREATMENT OF OSTEOID OSTEO MAS

Osteoid osteomas are tumors with intense clinical symptoms and extensi ve reactive bone changes far exceeding the volume of the lesion itself . Because of their small size they can be approached by minimally inva sive surgical procedures. We treated ten symptomatic patients with ost eoid osteomas (n 6 hip point, n 1 iliac bone, n 1 femoral diaphysis, n 2 tibial diaphysis) by excision of the nidus with a 3-mm Harlow-Wood needle using a percutaneous CT-guided approach. Seven patients with re sidual tumor were treated with either thermocautery (n 2) or sclerosis with 1 ml of 96% ethanol (n 5). Six patients had instant and constant relief (3 years' observation) of their pain. In two patients a second transcutaneous intervention was successful. Only two patients needed open resection. Compared with the invasive open resection of the tumor s, sometimes even putting the stability of the femoral neck at risk,tr anscutaneous CT-guided enucleation of the nidus of the osteoid osteoma with additional sclerotherapy is a good alternative method, especiall y in the region of the femoral neck.