Gelfoam embolization or (125)I seed implantation may be a more effective treatment than surgical treatment for giant benign sacral neurogenic tumors

BACKGROUND: The goal of the present study was to assess the effects of computed tomography (CT)-guided iodine-125 ((125)I) seed implantation or gelatin sponge particle (GSP) embolization on patients with giant benign sacral neurogenic tumors. METHODS: A total of 24 cases with giant sacral neurogenic tumor were performed in a retrospective study between 2000 and 2012. Nineteen cases received surgical resection, and five cases received non-surgical treatment. In surgical group, patients with type III sacral tumor had received a combined anterior-posterior approach and patients with type IV were treated with simple anterior approach. In non-surgical group, CT-guided (125)I seed implantation or GSP embolization was applied to occlude vessels. Besides, CT scanning or magnetic resonance imaging was used to assess the size and development of tumors. RESULTS: Two of the five patients were treated three times with GSP embolization, one had received GSP embolization combined with CT-guided (125)I seed implantation, one case did not receive any treatment, and one patient was lost to follow-up. Patients in non-surgical group were followed up for 2–8 years. CONCLUSIONS: Our study suggested that CT-guided (125)I seed implantation or GSP embolization treatment is very useful to slow down the development of giant benign sacral neurogenic tumors.