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Changes in histological diagnosis in soft tissue tumours from biopsy to final surgery specimen: causes and consequences

Änderung der histologischen Diagnose von der Biopsie zum definitiven Operationspräparat bei Weichteiltumoren: Ursachen und Konsequenzen

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Zusammenfassung

HINTERGRUND: Aus verschiedenen Gründen sind primär histologische Fehldiagnosen für Weichteiltumoren. Aus diesem Grund haben wir eine Tumordatenbankanalyse durchgeführt, um die Anzahl der histologischen Diagnoseänderungen zu filtern und potentielle Ursachen für die primäre Fehldiagnose zu diskutieren. METHODIK: Wir haben alle 663 Patienten mit der Diagnose einer Weichteiltumorentität aus unserer Tumordatenbank über einen Zeitraum von zehn Jahren (01.12.1998 bis 20.11.2008) herausgefiltert und alle Fälle mit einer Diagnoseänderung von der Biopsie zum Definitivpräparat selektiert. ERGEBNISSE: Innerhalb der Patienten, die primär an einem Nichttumorzentrum behandelt wurden, musste die Primärdiagnose in 20,3 % (28/138) geändert werden. Daraus resultierte eine therapeutische Konsequenz in 8,0 % (11/138) der Fälle. An unserem Tumorzentrum musste die primär gestellte histologische Diagnose im Vergleich dazu nur in 5,5 % (29/525) revidiert werden. Eine therapeutische Konsequenz resultierte daraus in 3,0 % (16/525). In 4,2 % (15/358) war für die nicht korrekte histologische Diagnose ein sampling error verantwortlich. SCHLUSSFOLGERUNGEN: Die Ergebnisse dieser Studie unterstreichen die Bedeutung eines spezialisierten interdisziplinären Teams in der Behandlung von Weichteiltumoren, um eine korrekte primäre Diagnose und damit optimale Therapieplanung zu erreichen.

Summary

BACKGROUND: Owing to several causes, incorrect primary histological diagnoses in soft tissue tumours still occur. Therefore we analysed our database for soft tissue tumours to determine the number of histological diagnoses which had to be revised and looked for potential causes leading to revisions of initial diagnosis. METHODS: We selected all 663 patients with a soft tissue tumour listed in our database over a period of ten years (01.12.1998 to 20.11.2008). Subsequently we identified all cases, where the final histological diagnosis differed from initial diagnosis. RESULTS: Among patients from referring institutions the final diagnosis had to be corrected in 20.3% (28/138 cases) with therapeutic relevance in 8.0% (11/138 cases). At our tumour centre the initial biopsy diagnosis had to be corrected in 5.5% (29/525 cases), with therapeutic relevance in 3.0% (16/525 cases). Overall in 4.2% (15/358) failure in diagnoses was due to sampling errors. CONCLUSIONS: The results of this study underline the importance of an interdisciplinary team specialised in soft tissue tumours to achieve high rates of primary correct diagnosis at the beginning of the treatment of these tumours.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Medical University of Graz, Graz, Austria

    W. Maurer-Ertl, A. Leithner, S. Tauber, E. V. Fröhlich, G. Kuerzl, M. Glehr, M. Zacherl & R. Windhager

  2. Institute of Pathology, Medical University of Graz, Graz, Austria

    B. Liegl

Authors
  1. W. Maurer-Ertl
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  2. A. Leithner
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  3. S. Tauber
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  4. E. V. Fröhlich
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  5. G. Kuerzl
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  6. M. Glehr
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  7. M. Zacherl
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  8. B. Liegl
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  9. R. Windhager
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Correspondence to W. Maurer-Ertl.

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Maurer-Ertl, W., Leithner, A., Tauber, S. et al. Changes in histological diagnosis in soft tissue tumours from biopsy to final surgery specimen: causes and consequences. Eur Surg 41, 150–154 (2009). https://doi.org/10.1007/s10353-009-0475-8

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  • DOI: https://doi.org/10.1007/s10353-009-0475-8

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