title: Cryoablation of recurrent sacrococcygeal tumors.
abstract: OBJECTIVE
  To review the safety and efficacy of cryoablation of recurrent sacrococcygeal tumors.
  
  
  METHODS
  The radiology departmental ablation database was retrospectively searched for cases of cryoablation performed to treat recurrences of sacrococcygeal tumors between January 1, 2010, and August 1, 2011. Patient demographics, procedure technical parameters, and patient outcomes were reviewed.
  
  
  RESULTS
  Five cases of recurrent chordoma and one recurrent myxopapillary ependymoma were treated with cryoablation in six patients whose ages ranged from 31 to 80 years. The tumors measured 14-39 mm in maximal dimension. Cryoablation was performed with the use of computed tomography guidance (n = 5) or a combination of ultrasound and magnetic resonance imaging guidance (n = 1). Sterile fluid was instilled to displace adjacent bowel and/or vagina in four cases, and electromyography monitoring was performed in two cases with adjacent nerve roots. Two patients with recurrent chordoma were treated for palliation of pain, with complete pain relief in one patient (pain recurred after 6 wk) and immediate reduction in pain from a score of six to a score of two on a 10-point scale in the other (pain recurred after 7 mo). Four tumors were treated for local control, with no evidence of recurrence on follow-up imaging at 3, 6, 12, and 15 months. No serious complication occurred.
  
  
  CONCLUSIONS
  Limited results suggest cryoablation to be a safe and relatively effective means of treating recurrent sacrococcygeal neoplasms for local control or palliation of pain in this small series with short-term follow-up.
authors: Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. kurup.anil@mayo.edu
authors: Anil Nicholas
authors: AN
authors: Kurup
authors: David A
authors: DA
authors: Woodrum
authors: Jonathan M
authors: JM
authors: Morris
authors: Thomas D
authors: TD
authors: Atwell
authors: Grant D
authors: GD
authors: Schmit
authors: Timothy J
authors: TJ
authors: Welch
authors: Michael J
authors: MJ
authors: Yaszemski
authors: Matthew R
authors: MR
authors: Callstrom
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000627:therapeutic use; D001416:Back Pain / Q000209:etiology / Q000628:therapy; D002817:Chordoma / Q000150:complications / Q000473:pathology / Q000601:surgery*; D003050:Coccyx / Q000473:pathology / Q000601:surgery*; D003452:Cryosurgery / Q000009:adverse effects; D004806:Ependymoma / Q000150:complications / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D053783:Magnetic Resonance Imaging, Interventional; D008297:Male; D008910:Minnesota; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery*; D010166:Palliative Care; D015641:Radiography, Interventional / Q000379:methods; D012189:Retrospective Studies; D012447:Sacrum / Q000473:pathology / Q000601:surgery*; D013125:Spinal Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
chemical_list: D000700:Analgesics