Abstract
Biopsy is a key step in the diagnosis of bone and soft tissue tumours. An inadequately performed biopsy may fail to allow proper diagnosis. An improperly planned biopsy may jeopardise plans for limb salvage surgery.
Aims: To analyse the effectiveness of core-needle biopsy for evaluation of suspected primary musculoskeletal neoplasms.
Methods: Core-needle biopsy was performed at our institution in 130 consecutive patients suspected of having a mesenchymal neoplasm. Details of the biopsy and any additional procedures were recorded including size of sample, method of localisation and any complications. Clinical and histological features of the neoplasm and previous radiological or histological diagnosis were compared. Core-needle biopsy results were correlated with results from specimens subsequently obtained at definitive surgery.
Results: 130 consecutive core biopsies were performed for evaluation of suspected primary musculoskeletal neoplasms. All patients tolerated the procedure well and there were no significant complications. A definitive diagnosis was obtained from a single core biopsy in 107 (82%) patients; an additional biopsy was necessary in 24 (18%) following equivocal histology. Twenty-three (96%) of these repeat biopsies were an open procedure. In 98% of patients, core-needle biopsy results were concordant with results from specimens subsequently obtained at surgery with respect to tumour histological features and grade. The accuracy and rate of performance of open biopsy for soft tissue lesions were not significantly different from those for bone lesions.
Conclusions: Obtaining tissue safely, for diagnosis of bone and soft tissue tumours is the goal of all biopsies The biopsy, however, must be well planned so as to avoid creating inadvertent tumour spread, and take into consideration any subsequent approaches for limb-sparing surgery.
The abstracts were prepared by Mr Ray Moran. Correspondence should be addressed to him at Irish Orthopaedic Associaton, Secretariat, c/o Cappagh National Orthopaedic Hospital, Finglas, Dublin 11.
