J. Palussière

Radiofrequency ablation of bone tumours

The indications for radiofrequency bone ablation in the case of benign tumours (osteoid osteoma, osteoblastoma) are curative, whereas for bone metastases, the prime aim is palliative analgesia. The failure rate for osteoid osteomas is low (<15%), and 70 to 90% of patients with metastases experience considerable relief, but if the treatment fails, it can be offered again. In the spine, heating can damage neighboring nerve structures, which means they need to be protected (CO(2) dissection). Radiofrequency ablation may be combined with an injection of cement. The osteonecrosis resulting from heating is painful and justifies performing the procedure under general anesthesia.

Radiologically guided percutaneous cryotherapy for soft tissue tumours: A promising treatment

Studies of percutaneous cryotherapy in the treatment of benign or malignant soft tissue tumours are rare and mainly involve small populations. Nevertheless, results show cryotherapys potential in terms of local control of tumours, analgesic efficacy, reduced intra- and postoperative complications, and reduction in the length of convalescence after the procedure. The objective of this update is to set out the short-term prospects for this technique in the treatment of soft tissue tumours, so that it may be more widely offered in these indications.

Imaging benign inflammatory syndromes

Benign mastitis is a rare disease and its management is difficult. The diagnostic challenge is to distinguish it from carcinomatous mastitis. We make a distinction between acute mastitis secondary to an infection, to inflammation around a benign structure or to superficial thrombophlebitis, and chronic, principally plasma cell and idiopathic granulomatous mastitis. Imaging is often non-specific but we need to know and look for certain ultrasound, mammogram or magnetic resonance imaging (MRI) signs to give a pointer as early as possible towards a benign aetiology. A biopsy should be undertaken systematically where there is the slightest diagnostic doubt, to avoid failing to recognise a carcinomatous mastitis.

Le lymphome malin non-hodgkinien est une cause d'hypodensité péri-portale intra-hépatique au scanner

The authors report two cases of non-Hodgkin lymphoma in non immunodeficient subjects characterized by periportal low attenuation at CT. Both patients showed gallbladder wall thickening. The different causes of periportal abnormalities are presented and discussed.

Mise au pointOligométastases : prise en charge thérapeutique à visée curative ? Radiofréquence pulmonaireOligometastases: To a curative treatment? Lung radiofrequency ablation?

Percutaneous ablation allows to treat tumours with temperature modifications. These non-invasive techniques are useful to treat metastatic lung tumours in patients with a slowly evolving disease, which requires multiple local treatment. Ablation is therefore proposed as a locoregional treatment because it has a minimal impact on the lung. Other advantages are its efficacy and a low morbidity. Limits may be the tumour size and its location.Percutaneous ablation allows to treat tumours with temperature modifications. These non-invasive techniques are useful to treat metastatic lung tumours in patients with a slowly evolving disease, which requires multiple local treatment. Ablation is therefore proposed as a locoregional treatment because it has a minimal impact on the lung. Other advantages are its efficacy and a low morbidity. Limits may be the tumour size and its location.

Oligométastases : prise en charge thérapeutique à visée curative ? Radiofréquence pulmonaire

Percutaneous ablation allows to treat tumours with temperature modifications. These non-invasive techniques are useful to treat metastatic lung tumours in patients with a slowly evolving disease, which requires multiple local treatment. Ablation is therefore proposed as a locoregional treatment because it has a minimal impact on the lung. Other advantages are its efficacy and a low morbidity. Limits may be the tumour size and its location.Percutaneous ablation allows to treat tumours with temperature modifications. These non-invasive techniques are useful to treat metastatic lung tumours in patients with a slowly evolving disease, which requires multiple local treatment. Ablation is therefore proposed as a locoregional treatment because it has a minimal impact on the lung. Other advantages are its efficacy and a low morbidity. Limits may be the tumour size and its location.

Destruction par radiofrequence des tumeurs mammaires, experience de l’institut bergonie et revue de la litterature

Objectifs Savoir quel bilan pre-therapeutique est necessaire avant radiofrequence mammaire. Decrire sa technique de realisation. Connaitre les modifications post-therapeutiques et les resultats therapeutiques. Discuter de sa place dans le traitement des cancers du sein. Messages a retenir Le bilan pre-therapeutique comporte un examen senologique standard et une IRM mammaire pour assurer l’unifocalite et mesurer la taille tumorale. Le geste est simple, fiable, bien tolere, en ambulatoire sous anesthesie loco-regionale. La modification post-therapeutique systematique est la palpation de la zone d’ablation. Le controle tumoral local est satisfaisant. Les indications sont les tumeurs infiltrantes inferieures a 3 centimetres chez des femmes âgees inoperables. Resume Le bilan pre-therapeutique comporte : examen clinique, mammographie, echographie et IRM pour assurer l’unifocalite, la taille inferieure a 3 cm et une distance de securite peri-lesionnelle centimetrique. Le traitement effectue en ambulatoire, sous anesthesie loco-regionale, sous echographie n’entraine pas de complications generales mais de rares complications locales : douleurs, brulures cutanees, ecchymoses. A noter la palpation systematique d’une masse plus dure et plus grande que la lesion initiale. La sous-estimation echographique de l’extension tumorale peut entrainer un traitement insuffisant et exposer au risque de rechute locale. Les indications sont les femmes âgees ayant une contre indication au traitement local chirurgical.