Cirugía radioguiada de tumores mesenquimales con semilla de 125I

Introduction

Radioguided surgery uses radioactive substances to identify and remove hard-to-locate lesions. Mesenchymal tumors constitute a heterogeneous group of neoplasms derived from the mesoderm, including benign lesions and malignant sarcomas. The aim of this study was to evaluate the ability of the ¹²⁵I radioactive seed to guide intraoperative localization of mesenchymal tumors, analyzing its complication rates and evaluating the margins of the surgical specimens retrieved.

Methods

Retrospective observational study of all consecutive patients undergoing radioguided surgery of a mesenchymal tumor with a ¹²⁵I radioactive seed from January 2012 to January 2020 at a tertiary referral center in Spain. The seed was inserted percutaneously guided by ultrasound or computed tomography on an outpatient setting.

Results

Fifteen lesions were removed in 11 surgeries on 11 patients, recovering all marked lesions (100%) with a ¹²⁵I seed. The lesions included areas of benign fibrosis (26.7%), cellular angiofibroma (6.7%), desmoid tumor (20%), solitary fibrous tumor (13.3%), chondrosarcoma (6.7%), and pleomorphic sarcoma (26.7%), with a high rate of recurrent tumors (60%). There was only one complication (6.7%) due to the seed falling within the surgical bed. According to the UICC classification of residual tumor, 80% of the lesions resulted in an R0 resection, 6.7% were an R1 resection, and 13.3% were an R2 resection.

Conclusion

Radioguided surgery was a precise technique for the removal of hard-to-locate mesenchymal tumors.