Traditional treatments for pelvic bone metastases include surgery and external beam radiation therapy. If bone destruction is limited, analgesics, radiation therapy, hormonal therapy, chemotherapy, embolization, bisphosphonates and minimally invasive techniques such as radiofrequency ablation, osteoplasty and cryosurgery can be considered. Lesions of the hemipelvis not directly involving the hip joint, pathological fractures sustained through an area of the pelvis other than the acetabulum and avulsion fractures of the anterior superior/inferior iliac spines, iliac crest and pubic rami seldom require surgical stabilization and reconstruction because pelvic stability is maintained. Diffuse involvement of the pelvis, impending or existing pelvic discontinuity and bony destruction of the periacetabular area warrants surgical treatment. There is doubt regarding resection compared with curettage for pelvic bone metastases.
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