Background: This article represents a review of the use of image-guided cryotherapy in
the treatment of musculoskeletal tumor lesions. Cryotherapy is able to induce a lethal effect on cancer
cells through direct and indirect mechanisms. In this manuscript, we combined our experience
with that of other authors who have published on this topic in order to provide indications on when
to use cryotherapy in musculoskeletal oncology.
Discussion: Image-Guided percutaneous cryotherapy is a therapeutic method now widely accepted
in the treatment of patients with musculoskeletal tumors. It can be used both for palliative treatments
of metastatic bone lesions and for the curative treatment of benign bone tumors, such as osteoid
osteoma or osteoblastoma. In the treatment of bone metastases, cryotherapy plays a major
role in alleviating or resolving disease-related pain, but it has also been demonstrated that it can
have a role in local disease control. In recent years, the use of cryotherapy has also expanded for
the treatment of both benign and malignant soft tissue tumors.
Conclusion: Percutaneous cryotherapy can be considered a safe and effective technique in the treatment
of benign and malignant musculoskeletal tumors. Cryotherapy can be considered the first option
in benign tumor lesions, such as osteoid osteoma, and a valid alternative to radiofrequency
ablation. In the treatment of painful bone metastases, it must be considered secondarily to other
standard treatments (radiotherapy, bisphosphonate therapy, and chemotherapy) when they are no
longer effective in controlling the disease or when they cannot be repeated (for example, radiotherapy).