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Stellenwert der sonographisch kontrollierten perkutanen Stanzbiopsie in der Diagnostik von Weichgewebstumoren

Significance of sonographically guided percutaneous needle biopsy in the diagnostics of soft tissue tumors

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Zusammenfassung

Hintergrund

Die Stanzbiopsie zur pathologischen Diagnostik von Weichgewebstumoren wird bzgl. ihrer Spezifität kontrovers diskutiert. Wir haben die Spezifität der Methode bei unseren eigenen Patienten untersucht und den Einfluss einer Spezialisierung des durchführenden Chirurgen überprüft.

Patienten und Methode

Sechsundneunzig Patienten mit Stanzbiopsie und ggf. im Verlauf durchgeführter Resektion wurden eingeschlossen. Evaluiert wurden Spezifität, logistische Anforderungen sowie eventuelle Komplikationen der Methode. Ein besonderes Augenmerk lag auf dem Einfluss der Erfahrung des behandelnden chirurgischen Teams auf die Spezifität.

Ergebnisse

In 69,7 % der Fälle stimmte die Entität, in 75,0 % die Dignität und in 72,0 % das Grading überein. In der Gruppe der durch ein spezialisiertes Team biopsierten Patienten lag die Spezifität bzgl. der Entität bei 84,6 %, der Dignität bei 84,6 % und des Gradings bei 80 %. Bei der Entitätsbestimmung ergab sich hier ein signifikant höherer Wert für die Spezifität (p < 0,05).

Schlussfolgerung

Die perkutane Stanzbiopsie stellt aus unserer Sicht eine logistisch einfache, effiziente und komplikationsarme Methode in der Diagnostik von Weichgewebstumoren dar. Hierzu sollte die Überweisung des Patienten in ein spezialisiertes Zentrum erfolgen.

Abstract

Background

The role of percutaneous needle biopsy in the diagnostics of soft tissue tumors is controversially discussed. The specificity of this method has been examined in this study based on the collective of patients treated in our university hospital. Secondly, the influence of the specialization of the treating surgeon has been evaluated.

Patients and methods

This study included 96 patients who underwent percutaneous needle biopsy and, if necessary, surgical resection. The specificity, logistic requirements and possible complications of percutaneous biopsy were evaluated. Special attention was paid to the influence of specialization of the treating surgical team on the specificity of the method.

Results

The results of the biopsy were able to define the entity of the lesion correctly in 69.7 %, the dignity in 75.0 % and the grading in 72.0 % of the cases. In the group treated by a specialized team, the specificity of the method was 84.6 % concerning the entity of the lesion, 84.6 % concerning the dignity and 80 % concerning the grading. With regard to the entity the specificity was significantly increased (p < 0.05).

Conclusion

The findings show that percutaneous needle biopsy represents a logistically simple and efficient diagnostic method for soft tissue tumors which is rarely associated with complications. Subsequent treatment should be performed in a specialized centre.

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Literatur

  1. Rydholm A, Berg NO (1983) Size, site and clinical incidence of lipoma. Factors in the differential diagnosis of lipoma and sarcoma. Acta Orthop Scand 54:929–934

    Article  PubMed  CAS  Google Scholar 

  2. Hoos A, Lewis JJ, Brennan MF (2000) Soft tissue sarcoma: prognostic factors and multimodal treatment. Chirurg 71:787–794

    Article  PubMed  CAS  Google Scholar 

  3. Taeger G, Ruchholtz S, Schutte J, Nast-Kolb D (2004) Diagnostics and treatment strategies for soft tissue sarcomas. Unfallchirurg 107:601–615

    PubMed  CAS  Google Scholar 

  4. Fletcher CD (2006) The evolving classification of soft tissue tumours: an update based on the new WHO classification. Histopathology 48:3–12

    Article  PubMed  CAS  Google Scholar 

  5. Edmonson JH, Petersen IA, Shives TC et al (2002) Chemotherapy, irradiation, and surgery for function-preserving therapy of primary extremity soft tissue sarcomas: initial treatment with ifosfamide, mitomycin, doxorubicin, and cisplatin plus granulocyte macrophage-colony-stimulating factor. Cancer 94:786–792

    Article  PubMed  CAS  Google Scholar 

  6. Lachenmayer A, Yang Q, Eisenberger CF et al (2009) Superficial soft tissue sarcomas of the extremities and trunk. World J Surg 33:1641–1649

    Article  PubMed  Google Scholar 

  7. Coindre JM (2006) Grading of soft tissue sarcomas: review and update. Arch Pathol Lab Med 130:1448–1453

    PubMed  Google Scholar 

  8. Oliveira AM, Nascimento AG (2001) Grading in soft tissue tumors: principles and problems. Skeletal Radiol 30:543–559

    Article  PubMed  CAS  Google Scholar 

  9. Delaney TF, Spiro IJ, Suit HD et al (2003) Neoadjuvant chemotherapy and radiotherapy for large extremity soft-tissue sarcomas. Int J Radiat Oncol Biol Phys 56:1117–1127

    Article  PubMed  Google Scholar 

  10. Schwartz HS, Spengler DM (1997) Needle tract recurrences after closed biopsy for sarcoma: three cases and review of the literature. Ann Surg Oncol 4:228–236

    Article  PubMed  CAS  Google Scholar 

  11. Scarborough MT (2004) The biopsy. Instr Course Lect 53:639–644

    PubMed  Google Scholar 

  12. Bruns J, Delling G, Henne-Bruns D, Hossfeld DK (2008) Biopsy of tumors of the musculoskeletal system. Dtsch Arztebl Int 105:492–497

    PubMed  Google Scholar 

  13. Bannasch H, Eisenhardt SU, Grosu AL et al (2011) The diagnosis and treatment of soft tissue sarcomas of the limbs. Dtsch Arztebl Int 108:32–38

    PubMed  Google Scholar 

  14. Katenkamp K, Katenkamp D (2009) Soft tissue tumors: new perspectives on classification and diagnosis. Dtsch Arztebl Int 106:632–636

    PubMed  Google Scholar 

  15. Puri A, Shingade VU, Agarwal MG et al (2006) CT-guided percutaneous core needle biopsy in deep seated musculoskeletal lesions: a prospective study of 128 cases. Skeletal Radiol 35:138–143

    Article  PubMed  CAS  Google Scholar 

  16. Tomozawa Y, Inaba Y, Yamaura H et al (2011) Clinical value of CT-guided needle biopsy for retroperitoneal lesions. Korean J Radiol 12:351–357

    Article  PubMed  Google Scholar 

  17. Steinfort DP, Vincent J, Heinze S et al (2011) Comparative effectiveness of radial probe endobronchial ultrasound versus CT-guided needle biopsy for evaluation of peripheral pulmonary lesions: a randomized pragmatic trial. Respir Med 105:1704–1711

    Article  PubMed  Google Scholar 

  18. Schmidt AJ, Kee ST, Sze DY et al (1999) Diagnostic yield of MR-guided liver biopsies compared with CT- and US-guided liver biopsies. J Vasc Interv Radiol 10:1323–1329

    Article  PubMed  CAS  Google Scholar 

  19. Mankin HJ, Mankin CJ, Simon MA (1996) The hazards of the biopsy, revisited. Members of the Musculoskeletal Tumor Society. J Bone Joint Surg [Am] 78:656–663

    Google Scholar 

  20. Ball AB, Fisher C, Pittam M et al (1990) Diagnosis of soft tissue tumours by Tru-Cut biopsy. Br J Surg 77:756–758

    Article  PubMed  CAS  Google Scholar 

  21. Pitcher ME, Fish S, Thomas JM (1994) Management of soft tissue sarcoma. Br J Surg 81:1136–1139

    Article  PubMed  CAS  Google Scholar 

  22. Hoeber I, Spillane AJ, Fisher C, Thomas JM (2001) Accuracy of biopsy techniques for limb and limb girdle soft tissue tumors. Ann Surg Oncol 8:80–87

    Article  PubMed  CAS  Google Scholar 

  23. Skrzynski MC, Biermann JS, Montag A, Simon MA (1996) Diagnostic accuracy and charge-savings of outpatient core needle biopsy compared with open biopsy of musculoskeletal tumors. J Bone Joint Surg [Am] 78:644–649

    Google Scholar 

  24. Welker JA, Henshaw RM, Jelinek J et al (2000) The percutaneous needle biopsy is safe and recommended in the diagnosis of musculoskeletal masses. Cancer 89:2677–2686

    Article  PubMed  CAS  Google Scholar 

  25. Ray-Coquard I, Ranchere-Vince D, Thiesse P et al (2003) Evaluation of core needle biopsy as a substitute to open biopsy in the diagnosis of soft-tissue masses. Eur J Cancer 39:2021–2025

    Article  PubMed  CAS  Google Scholar 

  26. Yao L, Nelson SD, Seeger LL et al (1999) Primary musculoskeletal neoplasms: effectiveness of core-needle biopsy. Radiology 212:682–686

    Article  PubMed  CAS  Google Scholar 

  27. Barth RJ Jr, Merino MJ, Solomon D et al (1992) A prospective study of the value of core needle biopsy and fine needle aspiration in the diagnosis of soft tissue masses. Surgery 112:536–543

    PubMed  Google Scholar 

  28. Peer S, Freuis T, Loizides A, Gruber H (2011) Ultrasound guided core needle biopsy of soft tissue tumors; a fool proof technique? Med Ultrason 13:187–194

    PubMed  Google Scholar 

  29. Narvani AA, Tsiridis E, Saifuddin A et al (2009) Does image guidance improve accuracy of core needle biopsy in diagnosis of soft tissue tumours? Acta Orthop Belg 75:239–244

    PubMed  Google Scholar 

  30. Yeow KM, Tan CF, Chen JS, Hsueh C (2000) Diagnostic sensitivity of ultrasound-guided needle biopsy in soft tissue masses about superficial bone lesions. J Ultrasound Med 19:849–855

    PubMed  CAS  Google Scholar 

  31. Choyke PL, Dwyer AJ, Knopp MV (2003) Functional tumor imaging with dynamic contrast-enhanced magnetic resonance imaging. J Magn Reson Imaging 17(5):509–520

    Article  PubMed  Google Scholar 

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Einhaltung ethischer Richtlinien

Interessenkonflikt. A.K. Gillenberg, F. Länger, U. Brunnemer, V. Grünwald, C. Krettek, T. Gösling geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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  1. Unfallchirurgische Klinik, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland

    A.K. Gillenberg, F. Länger, U. Brunnemer, V. Grünwald, C. Krettek & T. Gösling

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  1. A.K. Gillenberg
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  2. F. Länger
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  3. U. Brunnemer
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Correspondence to A.K. Gillenberg.

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Gillenberg, A., Länger, F., Brunnemer, U. et al. Stellenwert der sonographisch kontrollierten perkutanen Stanzbiopsie in der Diagnostik von Weichgewebstumoren. Orthopäde 42, 941–947 (2013). https://doi.org/10.1007/s00132-013-2135-8

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