Palliative management of painful pelvic bone metastasis using percutaneous thermal ablation and cement-augmented osteoplasty: A case report

TL;DR

A 46-year-old woman with painful pelvic bone metastasis from breast cancer experienced significant pain relief and improved function after a minimally invasive treatment combining thermal ablation and bone cement.

Contribution

This case report demonstrates the effectiveness of combining percutaneous thermal ablation and cement-augmented osteoplasty for managing painful pelvic bone metastasis.

Findings

The patient experienced significant pain reduction from NAS 7–8 to 3–4 after the procedure.

The treatment provided rapid recovery with minimal complications and reduced analgesic use.

The combination of RFA and cementoplasty improved bone stability and quality of life.

Abstract

Bone metastases are common in advanced malignancies, particularly from breast and prostate cancers, leading to significant morbidity due to pain, functional impairment, and skeletal-related events. This case report discusses a multidisciplinary approach using minimally invasive techniques for managing a challenging supracetabular metastatic lesion.

A 46-year-old female with metastatic bone disease in the right supracetabular pelvic region secondary to primary breast cancer presented with severe pain (Numeric Analog Scale [NAS] 7–8) and functional impairment. Systemic bisphosphonate therapy with zoledronic acid was initiated. The patient underwent a combination of percutaneous radiofrequency ablation (RFA), osteoplasty, and cementoplasty under C-arm guidance. Medium-viscosity acrylic cement was injected to stabilize the lesion post-ablation.

The procedure was successful, with significant pain relief (NAS reduced to 3–4) and improved functional stability. The patient experienced rapid recovery with minimal complications and reduced analgesic requirement. This case highlights the efficacy of combining RFA and cementoplasty for localized management of osteolytic metastatic lesions. RFA provided cytotoxic tumor ablation, while cementoplasty reinforced bone structure and contributed to additional pain relief. The outcomes align with existing literature demonstrating the benefits of these techniques in reducing pain and improving quality of life.

Minimally invasive interventions such as RFA and cementoplasty are effective in managing symptomatic bone metastases, offering a viable alternative to traditional surgical methods. This approach underscores the importance of integrating systemic and localized therapies in advanced cancer care.

•Bone metastases are common, leading to significant modbidity due to pain, functional impairment, and skeletal-related events•Percutaneous thermal ablation is a technique to induce tumor necrosis•Cement-augmented osteoplasty is a procedure to stabilize bone and restore mechanical strength•Multidisciplinary approach in managing metastatic bone disease with bisphosphonates, percutaneus thermal ablation, and cement-augmented osteoplasty provides comprehensive strategy with promising outcome

Bone metastases are common, leading to significant modbidity due to pain, functional impairment, and skeletal-related events

Percutaneous thermal ablation is a technique to induce tumor necrosis

Cement-augmented osteoplasty is a procedure to stabilize bone and restore mechanical strength

Multidisciplinary approach in managing metastatic bone disease with bisphosphonates, percutaneus thermal ablation, and cement-augmented osteoplasty provides comprehensive strategy with promising outcome

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