Korean J Radiol.  2013 Oct;14(5):823-828. 10.3348/kjr.2013.14.5.823.

Image-Guided Percutaneous Lipiodol-Pingyangmycin Suspension Injection Therapy for Sacral Chordoma

• Huang D
• Chen Y
• Zeng Q
• Wu R
• Li Y

• KMID: 1711441
• DOI: http://doi.org/10.3348/kjr.2013.14.5.823

Abstract

A 74-year-old man presented with a progressively worsening pain in sacrum and was diagnosed to have a sacral chordoma by biopsy in May, 2004. Percutaneous intratumoral injection with lipiodol-pingyangmycin suspension (LPS) was carried out under image guidance and repeated when the pain in sacrum recurred and the tumor increased. During a 6-year follow-up period, three sessions of this treatment were executed. CT imaging and Karnofsky Performance Score were used to evaluate the size of tumor and quality of life, respectively. The patient was free of pain after each procedure and had a high quality of life with a Karnofsky Performance Score above 80 points. The tumor lesion in sacral area was effectively controlled. No complications were observed. Percutaneous intratumoral injection with LPS under image guidance may be an effective and safe alternative for the patients with sacral chordoma.

Keyword

Percutaneous intratumoral injection; Lipiodol-pingyangmycin suspension; Sacral chordoma

MeSH Terms

Aged
Antineoplastic Combined Chemotherapy Protocols/*administration & dosage
Biopsy
Bleomycin/administration & dosage/analogs & derivatives
Chordoma/diagnosis/*drug therapy
Ethiodized Oil/administration & dosage
Humans
Injections, Intralesional
Magnetic Resonance Imaging
Male
*Sacrum
Spinal Neoplasms/diagnosis/*drug therapy
Suspensions
Tomography, X-Ray Computed
Bleomycin
Ethiodized Oil
Suspensions

Figure

• 

  Fig. 1 Seventy four-year-old man with sacral chordoma treated by percutaneous LPS injection. A. Contrast-enhanced CT showed 5-cm mass without enhancements in tumor. B. Injection was performed under fluoroscopy, and LPS distributed throughout entire tumor (Black arrow pointing to needle). C. LPS deposited well within sacrum tumor 3 days after first procedure. D. CT scan obtained 2 months after first procedure showed that tumor lesion decreased from 5 cm to 3 cm in diameter and residual LP deposited in tumor. LPS = lipiodol-pingyangmycin suspension. E. Twenty eight months (in Sep, 2006) after first procedure, follow-up CT scan showed that lesion obviously increased in size measuring 8.7 × 5.4 × 8.1 cm and LP thinly retained in tumor. F. 3 days after second procedure (in Oct, 2006), CT scan showed that tumor was fully filled with LPS and some LPS deposited in gluteus. LPS = lipiodol-pingyangmycin suspension

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