Bone lymphangiomatosis: treatment with percutaneous cementoplasty.
METHODS
Case report, minimally invasive technique.


OBJECTIVE
Disseminated lymphangiomatosis is a rare disorder that can produce clinical manifestation secondary to soft tissue, visceral and bone involvement. The overall prognosis of this disorder is usually poor, and the current treatment options for its sequelae are limited and only palliative. In this report, we present the use of cementoplasty in the percutaneous treatment of a sacral lymphangiomatous bone lesion producing severe pain.


BACKGROUND
Disseminated lymphangiomatosis is a rare disorder that can produce clinical manifestation secondary to soft tissue, visceral, and bone involvement. Major morbidity related to skeletal involvement requiring surgical intervention is less common than that related to visceral involvement, but it has been reported in a few case reports to palliate neurologic sequelae secondary to vertebral involvement. We present case of osteoplasty used to treat a painful osteolytic sacral lesion in a patient with diffuse lymphangiomatosis. Computed tomography guided osteoplasty injecting acrylic bone cement into the lesion resulted in almost immediate reduction in pain.


METHODS
The technique and results of minimally invasive percutaneous computed tomography-guided cementoplasty of a painful osteolytic sacral lesion resulting from chylous reflux in a patient with lymphangiomatosis is presented.


RESULTS
Computed tomography was used to accurately position a 13-gauge needle into a dominant sacral osteolytic lesion. The injection of bone cement into the sacral lesion was then monitored by intermittent CT imaging. The patient reported substantial pain relief within several hours of the procedure.


CONCLUSIONS
The case presented demonstrates the feasibility and efficacy of computed tomography-guided cementoplasty used to palliate unusual causes of benign osteolytic bone lesions. These procedures can be performed as outpatients with minimal recovery.
Wallace
Michael J
MJ
Departments of Diagnostic Radiology, University of Texas M. D. Anderson Cancer Center, Houston, TX 77030-4009, USA. mwallace@mdanderson.org
Ross
Merrick
M
D000328:Adult; D001843:Bone Cements / Q000627:therapeutic use*; D006801:Humans; D008202:Lymphangioma / Q000473:pathology / Q000628:therapy*; D008297:Male; D019060:Minimally Invasive Surgical Procedures; D009364:Neoplasm Recurrence, Local; D019637:Orthopedic Procedures / Q000379:methods*; D010014:Osteolysis / Q000469:parasitology / Q000601:surgery; D012447:Sacrum / Q000473:pathology*; D013125:Spinal Neoplasms / Q000473:pathology / Q000628:therapy*; D014057:Tomography, X-Ray Computed
D001843:Bone Cements