Cool-tipラジオ波凝固システムを用いて治療した類骨骨腫の1例

CT-guided Cool-tip Radiofrequency Ablation for Osteoid Osteoma : Case Report

　抄録：近年，類骨骨腫に対する治療としてCTガイド下経皮的切除術が一般化しつつあり，さらなる低侵襲手術を期待したCTガイド下ラジオ波焼灼術（RFA）の報告例も散見される．今回われわれは，夜間痛，X線，CTなどから右けい骨類骨骨腫と診断した10歳の女児に対し，CTガイド下に内部冷却機構を備えたCool-tipラジオ波凝固システムを用いて手術を行った．術翌日より症状は消失し，術後2年の時点で症状の再発はない．CTガイド下RFAによる小侵襲手術は早期より日常生活への復帰が可能であり，今後，症例によってはさらに用いられるべき治療法であると思われる．

　A variety of methods, including CT-guided percutaneous radiofrequency thermal ablation, have been developed in recent years to lessen the invasiveness of surgical treatment of osteoid osteoma. We report a case of osteoid osteoma of the right tibia in a 10-year-old girl with right popliteal pain that we treated by CT-guided radiofrequency ablation with a Cool-tip electrode. The Cool-tip system allows control of the temperature around the electrode, which makes it possible to decrease both coagulation diameter and heat injury to normal tissue around the lesions. Rapid, reliable lasting pain relief was achieved in our patients, and she quickly returned to her premorbid functional state. As of 2 years after the procedure, the patient has remained pain-free with no evidence of recurrence. CT-guided radiofrequency ablation with Cool-tip electrodes is an effective and safe method of treatment of osteoid osteoma.