PMC10159330_01
Preoperative sagittal magnetic resonance images (MRI) enhanced in T2 (a), T1 (b) and short-tau inversion recovery (STIR) (c); axial image displayed in T2 (d); and axial tomography image with a bone window image (e), where an infiltrative lesion is visualized in the S1 and S2 vertebrae as an expansive lytic bone lesion that is hypointense on T1 and T2 and hyperintense on STIR; the MRI presents an extraosseous soft-tissue component projected in the spinal canal and presacral space, encompassing and noticeably affecting the left L5 and S1 roots (d); note the characteristic absence of periosteal reaction in the tomography images (e).
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F1
There appeared to be no metastases [Figure 1].
Sequential T2-weighted sagittal and axial magnetic resonance images; (a) Before treatment, (b) At 48 h postmicrowave ablation and (c) 4 months post-ablation. In the initial image before treatment, (a) the lesion is hypointense on images at 48 h and (b) the tumor with a slight increase in its size and a total change in its potency when it became hyperintense; in its control at 4 months, disappearance of the lytic lesion and the soft tissue component can be observed, with a noticeable decrease in the height of the S1 vertebra and formation of sclerotic areas in the bone.
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F2
However, due significant intraoperative bleeding, only a 10% partial resection/decompression was achieved [Figure 2].
(a) Ablation antenna used in the patient's surgical procedure; 14.5 gauge; Med Waves. (b) Image of the surgical procedure where the introduction of the antenna toward the sacral region can be seen. (c) Image obtained by fluoroscopy at the moment of the introduction of the antenna in one of the 5 vectors directed toward the sacral lesion.
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F3
This required 10 min of total ablation time of (i.e., temperature of 95-100 C, and ablation mode of 28 Watts) [Figure 3].