Summary
Over a period of 3 years in Southern Sweden 35 patients were seen with deep-seated limb sarcomas without metastases, 30 of whom were referred before any operation had been carried out. Thirty seven patients with deep-seated benign lesions were referred during the same period because of suspected malignancy. A preoperative diagnosis considered sufficient for a definitive operation was made from the clinical findings, aspiration cytology and radiographic examination, but without open biopsy, in 59 of these 67 cases. The differentiation between a benign and a malignant tumour was correct in all but one. The extent of excision necessary to achieve adequate margins for a soft-tissue sarcoma can often be reduced if open biopsy is avoided, with preservation of function. We conclude that treatment without open biopsy is possible in the great majority of patients with soft-tissue sarcoma.
Résumé
En l'espace de trois ans, en Suède méridonale, on a rassemblé 35 malades porteurs de sarcomes profonds des membres, sans métastases. Trente d'entre eux ont été adressées avant toute intervention. Pendant la même période 37 patients présentant des tumeurs bénignes profondément situées ont été adressés pour suspicion de malignité. Dans 59 de ces 67 cas, un diagnostic pré-opératoire, suffisant pour déterminer le type d'intervention à réaliser, a été obtenu grâce à l'examen clinique, à l'examen radiologique et à la cytologie par ponction biopsie, mais sans biopsie opératoire. La distinction entre tumeur bénigne et maligne s'est révélée exacte dans tous les cas sauf un. L'étendue de l'excision nécessaire pour délimiter correctement un sarcome des parties molles peut souvent être réduite si la biopsie pré-opératoire a été évitée, permettant la conservation de la fonction. Les auteurs concluent que le traitement des malades porteurs de sarcomes des parties molles est possible dans la grande majorité des cas sans qu'il faille recourir à la biopsie chirurgicale.
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Rydholm, A., Alvegård, T., Berg, N.O. et al. Preoperative diagnosis of soft tissue tumours. International Orthopaedics 12, 109–114 (1988). https://doi.org/10.1007/BF00266974
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DOI: https://doi.org/10.1007/BF00266974