Summary
The problems of biopsy procedures and the effect that these had on subsequent surgery were studied in fifty one consecutive patients with musculoskeletal tumours. Difficulties included inadequate tissue for histology in 4 patients, wound infection in 5, haematoma formation in 2, inappropriate biopsy site in 7 and incorrectplacement of drain exit site in 4.
Open biopsy gave a more reliable diagnosis than needle biopsy, but was associated with ahigher incidence of complications. Staging techniques such as magnetic resonance imaging, computed tomography and bone scans were less accurate when performed after the biopsy. Longitudinal incisions, centred over representative tumour tissue with the drain site placed in line with the incision, facilitate the adequate and uncomplicated removal of the entire biopsy scar and tract at the time of the definitive surgical procedure. It is concluded that biopsy for suspected musculoskeletal tumours should not be delegated to junior residents and should be performed in centres that have experience in the management of such tumours.
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References
Jaaffe, N., Watts, H., Fellows, K. E. and Vawter, G. Local ‘en bloc’ resection for limb preservation. Cancer Treatment Report, 1978: 62, 217–223.
Lane, J. M., Hurson, B., Boland, P. J. and Glasser, D. B. Osteogenic sarcoma. Clin. Orthop. Related Res. 1986: 204, 93–110.
Schubiner, J. M., Simon, M. A. Primary bone tumours in chidren. Orthop. Clin. North Am. 1987: 4, 577–595.
Enneking, W. F. The issue of the biopsy. Editorial: J. Bone Joint Surg. 1982: 64, 119–1120.
Mankin, H. J., Lange, T. A., Spanier, S. S. The hazards of biopsy in patients with malignant bone and soft-tissue tumours. J. Bone Joint Surg. 1982: 64, 1121–1127.
Simon, M.D. Limbsalvageforosteosarcoma. Currentconcepts review. J. Bone Joint Surg. 1988: 70, 307–310.
Hudson, H. J., Schakel, M., Dempsey, S. Limitations of computed tomography following excisional biopsy of soft tissue sarcomas. Skeletal Radiol. 1985: 13, 49–54.
Bondorf, K., Reiser, M., Lochner, B., Feaux de Lacroix, W. Magnetic Resonance Imaging of primary tumours and tumourlike lesions of bone. Skeletal Radiol. 1986: 15, 511–517.
Den Heeten, G. J., Oldhoff, J., Oosterhuis, J. W. Biopsy of bone tumours. J. Surg. Oncol. 1985: 28, 247–251.
Moore, T. M., Myers, M. H., Patzakis, M. J. Closed biopsy of musculoskeletal lesions. J. Bone Joint Surg. 1979: 61, 375–380.
Schajowicz, F., Derqui, J. C. Puncture biopsy in lesions of the locomotor system. Review of results in 4050 cases including 941 vertebral puncture. Cancer 1968: 21, 531–548.
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Waldron, B., Moran, R.M. & Hurson, B.J. Biopsy problems in patients with musculoskeletal tumours. I.J.M.S. 159, 246–248 (1990). https://doi.org/10.1007/BF02937380
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DOI: https://doi.org/10.1007/BF02937380