Pathology Findings With Acrylic Implants

Bone. 1999 Aug;25(2 Suppl):85S-90S. doi: 10.1016/s8756-3282(99)00140-4.

Abstract

We report the pathological findings in cases of acrylic implants obtained by direct intratumoral injection of polymethyl-methacrylate (PMMA) and N-butyl-cyano-acrylate (NBCA). Direct intratumoral injection of acrylic implants was performed for a variety of primary and secondary bone lesions. These types of treatments have been used at our institution in the last 4 years for 40 vertebroplasty (PMMA) procedures and for nine bone lesions of other locations (PMMA, NBCA). Postmortem histology became available for 1 case of PMMA and for 5 cases with NBCA intratumoral acrylic implants. The pathological findings associated with PMMA and NBCA were evaluated and compared. PMMA exhibited a macroscopic and microscopic rim of tumor necrosis, 6 months after implantation. NBCA exhibited compressive effects on the nearby tumor tissue, however, without signs of significant necrosis outside the acrylic tumor cast. Tumor captured inside the acrylic cast showed extensive to near complete necrosis. Acrylic implants may lead to necrosis when injected directly in tumors. The necrotizing effect may extend beyond the limits of an implant in the case of PMMA. Such an extended effect of PMMA, when compared with NBCA, may be due to the variable toxicity of acrylic implants, including the different degrees of the exothermic reaction during polymerization.

Publication types

  • Case Reports
  • Comparative Study

MeSH terms

  • Adenocarcinoma / pathology*
  • Adenocarcinoma / secondary
  • Adenocarcinoma / therapy
  • Aged
  • Bronchial Neoplasms / pathology
  • Enbucrilate*
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Osteonecrosis / pathology*
  • Paraganglioma / pathology*
  • Paraganglioma / secondary
  • Paraganglioma / therapy
  • Pelvic Neoplasms / pathology
  • Polymethyl Methacrylate*
  • Prostheses and Implants*
  • Spinal Neoplasms / pathology*
  • Spinal Neoplasms / secondary
  • Spinal Neoplasms / therapy
  • Thoracic Vertebrae / diagnostic imaging
  • Thoracic Vertebrae / pathology
  • Tomography, X-Ray

Substances

  • Polymethyl Methacrylate
  • Enbucrilate