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Metastatic Melanoma Epidural Tumour Regression Following Percutaneous Radiofrequency Ablation
Percutaneous radiofrequency ablation of spinal metastases is an emerging treatment for patients with painful metastatic spine disease. It is typically performed for patients who have not responded to conventional treatments or who have contraindications to radiotherapy. Destruction of the posterior...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cureus
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7282353/ https://www.ncbi.nlm.nih.gov/pubmed/32528775 http://dx.doi.org/10.7759/cureus.8039 |
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author | Papanikitas, Joseph Fairhead, Rory Chekroud, Ameen Chung, Siok Li McKean, David |
author_facet | Papanikitas, Joseph Fairhead, Rory Chekroud, Ameen Chung, Siok Li McKean, David |
author_sort | Papanikitas, Joseph |
collection | PubMed |
description | Percutaneous radiofrequency ablation of spinal metastases is an emerging treatment for patients with painful metastatic spine disease. It is typically performed for patients who have not responded to conventional treatments or who have contraindications to radiotherapy. Destruction of the posterior wall of the vertebral body and epidural disease may be considered relative contraindications for radiofrequency ablation. This is due to the difficulty in achieving satisfactory ablation balanced against the risk of neural injury. We describe a case of metastatic melanoma with an expansile lytic metastasis and epidural tumour extension at the L4 vertebral body level resulting in severe central canal stenosis. This was successfully treated with percutaneous radiofrequency ablation and vertebral augmentation. The patient reported significant pain relief post-procedure and follow-up MRI at two months demonstrated local tumour regression, epidural disease resolution and improved spinal canal dimensions. To the best of our knowledge, this is the first report of epidural disease resolution from metastatic melanoma following radiofrequency ablation and emphasises the potential benefits of ablation therapy even in the presence of canal stenosis and epidural metastatic disease. |
format | Online Article Text |
id | pubmed-7282353 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Cureus |
record_format | MEDLINE/PubMed |
spelling | pubmed-72823532020-06-10 Metastatic Melanoma Epidural Tumour Regression Following Percutaneous Radiofrequency Ablation Papanikitas, Joseph Fairhead, Rory Chekroud, Ameen Chung, Siok Li McKean, David Cureus Pain Management Percutaneous radiofrequency ablation of spinal metastases is an emerging treatment for patients with painful metastatic spine disease. It is typically performed for patients who have not responded to conventional treatments or who have contraindications to radiotherapy. Destruction of the posterior wall of the vertebral body and epidural disease may be considered relative contraindications for radiofrequency ablation. This is due to the difficulty in achieving satisfactory ablation balanced against the risk of neural injury. We describe a case of metastatic melanoma with an expansile lytic metastasis and epidural tumour extension at the L4 vertebral body level resulting in severe central canal stenosis. This was successfully treated with percutaneous radiofrequency ablation and vertebral augmentation. The patient reported significant pain relief post-procedure and follow-up MRI at two months demonstrated local tumour regression, epidural disease resolution and improved spinal canal dimensions. To the best of our knowledge, this is the first report of epidural disease resolution from metastatic melanoma following radiofrequency ablation and emphasises the potential benefits of ablation therapy even in the presence of canal stenosis and epidural metastatic disease. Cureus 2020-05-09 /pmc/articles/PMC7282353/ /pubmed/32528775 http://dx.doi.org/10.7759/cureus.8039 Text en Copyright © 2020, Papanikitas et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Pain Management Papanikitas, Joseph Fairhead, Rory Chekroud, Ameen Chung, Siok Li McKean, David Metastatic Melanoma Epidural Tumour Regression Following Percutaneous Radiofrequency Ablation |
title | Metastatic Melanoma Epidural Tumour Regression Following Percutaneous Radiofrequency Ablation |
title_full | Metastatic Melanoma Epidural Tumour Regression Following Percutaneous Radiofrequency Ablation |
title_fullStr | Metastatic Melanoma Epidural Tumour Regression Following Percutaneous Radiofrequency Ablation |
title_full_unstemmed | Metastatic Melanoma Epidural Tumour Regression Following Percutaneous Radiofrequency Ablation |
title_short | Metastatic Melanoma Epidural Tumour Regression Following Percutaneous Radiofrequency Ablation |
title_sort | metastatic melanoma epidural tumour regression following percutaneous radiofrequency ablation |
topic | Pain Management |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7282353/ https://www.ncbi.nlm.nih.gov/pubmed/32528775 http://dx.doi.org/10.7759/cureus.8039 |
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