Radiofrequency ablation of chondroblastoma: long-term clinical and imaging outcomes

Eur Radiol. 2015 Apr;25(4):1127-34. doi: 10.1007/s00330-014-3506-1. Epub 2014 Nov 30.

Abstract

Objectives: To investigate the long-term clinical and imaging outcomes of patients with chondroblastoma treated by radiofrequency ablation (RFA).

Methods: Retrospective analysis of 25 consecutive patients treated with RFA from September 2006 to December 2013. Patients were reviewed within one month of the procedure, then every 3-6 months, and yearly for up to three years. Serial magnetic resonance imaging (MRI) was performed at follow-up to monitor recovery. Functional outcome was assessed using the Musculoskeletal Tumour Society Score (MSTS).

Results: Pre-procedure MRI confirmed osteolytic lesions (size range 1.0-3.3 cm; mean 2.0 cm). Patients reported continued symptomatic improvement at four months review. Serial MRI confirmed progressive resolution of inflammation with fatty consolidation of cavity. 88 % of patients became asymptomatic during the follow up period. Three patients' (12 %) symptoms returned at 16, 22 and 24 months respectively after RFA. MRI and biopsy confirmed recurrence in these patients. Functional assessment using MSTS score had an average score of 97.5 %. Mean follow up for the study group was 49 months.

Conclusion: RFA is an effective alternative to surgery in the management of chondroblastoma. We recommend a multi-disciplinary approach and RFA should be considered as a first-line treatment. Long-term follow-up is required for timely detection of recurrences.

Key points: • RFA is a safe and effective technique in the treatment of chondroblastoma. • Positive outcomes in 88 % patients at mean follow-up period of 49 months. • Local recurrences occurred in 12 % cases. • Long-term follow-up is required for timely detection of recurrences. • RFA should be considered as a first-line treatment for chondroblastoma.

MeSH terms

  • Adolescent
  • Bone Neoplasms / diagnosis*
  • Bone Neoplasms / pathology
  • Bone Neoplasms / surgery*
  • Catheter Ablation / methods*
  • Child
  • Chondroblastoma / diagnosis*
  • Chondroblastoma / pathology
  • Chondroblastoma / surgery*
  • Female
  • Follow-Up Studies
  • Humans
  • Magnetic Resonance Imaging*
  • Male
  • Neoplasm Recurrence, Local / pathology
  • Retrospective Studies
  • Treatment Outcome