Accuracy of intraoperative consultation for bone tumors: experience in an orthopedic hospital

Abstract

Background

Intraoperative consultation is an integral part of surgical pathology. However, there are few reports concerning intraoperative pathology consultation exclusively for bone tumors.

Method

Our hospital is an orthopedic institution that specializes in the diagnosis and treatment of bone tumors, and we retrospectively reviewed the intraoperative consultations for bone tumors on our service from January 2002 to February 2006. The objectives of this work were to: (1) evaluate the clinical reasons for intraoperative consultation on bone tumors; (2) identify discordant diagnoses between the intraoperative consultation diagnosis and the definitive diagnosis; (3) determine in how many cases it was possible to establish a specific diagnosis; and (4) analyze the accuracy of the intraoperative consultation diagnosis on the bone tumors.

Results

The two most common reasons for an intraoperative consultation were to rule out malignancy and to determine the adequacy of the resection margins. The third most common reason was to establish a diagnosis. In the latter cases, it was possible to establish a specific diagnosis in 86.3% of the cases; and we had only one discordant case.

Conclusions

Intraoperative consultation on bone tumors has problems and limitations. They are due mainly to the characteristics of the material that comprise the specimen from this type of lesion. It is important that similar assays be carried out at medical institutions that specialized in bone tumors to determine the effectiveness rates of intraoperative consultation in this field throughout the world. This is the first series that has analyzed the accuracy of intraoperative consultation on bone tumors with respect to the clinical reasons for the consultation.