Resection of a solitary bone metastasis using preoperative computed tomography (CT)-guided hook wire localization: a case report

Abstract

Secondary bone metastasis are a common evolution of many types of cancer. In some instance, it is needed to remove those metastases to improve the prognosis of the patient. Bone metastasis that are invisible and non-palpable during the intervention are difficult to remove while being sure to respect safe resection margins. We present the case of a woman suffering from breast cancer. Despite the treatment of the primitive lesion, she presented a solitary bone metastasis on her iliac crest. The lesion was removed surgically but could not be seen or touched during the procedure due to its location. To be certain to remove this lesion during surgery, while respecting safe resection margins, we performed a pre-operative computed tomography (CT)-guided hook wire localization. Using this method, the anatomopathological examination confirmed the tumoral nature of the lesion and that the resection margins were in a safe zone. This technique frequently used to target soft lesion in cases of breast or lung cancers could therefore be used the same way with solid bone lesion.